I love eating shrimp. At the risk of reenacting a scene straight out of Forrest Gump: fried butterfly shrimp, coconut shrimp, sweet and sour shrimp, or grilled shrimp–it’s all good! Much to my chagrin, there are many people out there who have never experienced the blissful act of popping a popcorn shrimp into their mouth after it’s been kissed by cocktail sauce. Some people, on the other hand, have done just that and found themselves fighting for their lives after an allergic reaction closes down their throat and causes them to wheeze and gasp for air. In some ways, those who survive the shrimp attack are the lucky ones.
The not-so-lucky ones attend a barbecue or an all-you-can-eat buffet and load up on tons of different foods they don’t normally eat and experience the same reaction. The difference here is that they have no idea as to what the culprit might have been. They often live in fear of their food. Others with that same reaction chalk it up to a fluke occurrence and don’t try to avoid anything. Perhaps if either of those types of people had a little more insight into what types of food are most likely to have caused their allergic reaction, they would be able to eat more intelligently and be able to avoid an ambulance ride to the emergency room.
Let’s say you go to your favorite burger joint, and after about 10 minutes of eating your meal, you start to feel sick at your stomach, bloated, and eventually throw up. Later that week you had a similar reaction at the local seafood restaurant. What are the most common causes of food allergy? If you said beef, lettuce, tomato, or potato, think again. When researchers looked over hundreds of cases of food allergy reactions and carefully pinpointed the cause (with a meticulous combination of interviews, allergy tests, and oral food challenges), the most likely causes are consistently the following:
Milk
Egg
Wheat
Peanut
Tree Nut
Shellfish
Fish
Soy
These eight foods (“the big 8”) make up the vast majority of all food allergy reactions. Even though there are over 170 different types of foods thought to cause an allergic reaction, if it isn’t one of the big 8 foods, you may want to carefully reevaluate the cause of the symptoms.
In addition to knowing exactly what you had eaten, it may also be helpful to know what potential food allergens are served at the restaurant that you DIDN’T order. For example, let’s say you are at the seafood restaurant and order a really popular salad, but because you had an allergy test that was reactive to shrimp, you ask the waiter to hold the shrimp. In the kitchen, they have an entire table that has rows of their popular salad already pre-made and ready to be served (shrimp and all). The cook sees the order for the salad without the shrimp, and they remove the shrimp from your salad. Problem solved, right? Nope! There may still be enough shrimp allergen on the salad to cause an allergic reaction. This is known as cross-contact and can be a real problem for people with food allergy. The same thing can happen if one of the utensils that was used to stir one dish is then used to stir another dish. Just because you didn’t order the shrimp, doesn’t mean you didn’t eat the shrimp, Forrest. Sometimes restaurants are like a box of chocolates….
References:
1. Food Allergy: A Practice Parameter Update-2014. J Allergy Clin Immunology 2014;134:1016-25.
2. Critical Issues in Food Allergy: A National Academies Consensus Report. Pediatrics 2017;140(2):e20170194
3. Food Allergy Research & Education website. www.foodallergy.org