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Allergens can be hidden in foods and beverages

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160830HiddenFoodAllergies-325Going out to eat when you have a food allergy can be a little like "Where's Waldo?"—your food allergen could be hiding in anything. Here are a few things to consider.

Be aware of hidden ingredients

While it's common knowledge that foods—especially prepared foods—may contain allergens, it's important to know that beverages can also contain hidden allergens, whether it's a mixed drink, beer or wine, and that the laws governing alcoholic beverages differ from food laws that require a declaration of ingredients.

Labeling laws require that pre-packaged foods be clearly labeled and state whether the product contains one of eight "major food allergens" that account for 90 percent of food allergies, meaning you need to be a vigilant reader to ensure that your allergen is not on the list.

What many people don't know is that ingredients can go by alternative names, essentially hiding them from your watchful eye. Milk products, for instance, can be listed on the label as casein.

Don't be afraid to ask questions

Whether it's a restaurant, fast-food place or a supermarket deli, be sure to ask questions about allergy training for staff, food preparation for special diets, potential cross contamination with utensils and cutting boards, and always ask to review the ingredients. If someone can't tell you or seems unsure of the ingredients, avoid it.

Also be aware that sipping from a friend's beverage can trigger a reaction if he or she consumed your allergen and left invisible remnants on the glass.

Be prepared, learn more

Have your epinephrine auto-injector (Epipen) with you, especially when dining out. The rapid use of epinephrine after accidental consumption of a food allergen is the fastest way to stop an allergic reaction.

For those with food allergies, eating out can be a challenge. However, with a little pre-planning, dining out is possible and can still be fun and enjoyable. There are many restaurants that will allow you to discuss dietary needs with the chef and even plan an allergen-free meal and beverage, so consider calling ahead for the best dining experience.

Ask your allergist about emerging therapies in food allergies that are on the horizon, and find more information at Food Allergy Research and Education (FARE).

Melanie Chala Wayne, MSN, FNP-BC is a nurse practitioner for Oak Street Medical and Oregon Allergy Associates.