Food Allergies Reference Guide

Food Allergies Reference Guide

While over 170 foods have been reported to cause allergic reactions, the vast majority (about 90%) of food allergies in the U.S. are attributed to just nine major allergens, often referred to as the "Big Nine." This guide provides information on common food allergens, foods to avoid, and key details about each.

The Big Nine Major Food Allergens

These account for 90% of allergic reactions in the U.S. and are required by law (FALCPA and FASTER Act) to be labeled on packaged foods.

1. Milk

• Foods to Avoid: Cow's milk, cheese, butter, yogurt, ice cream, cream, whey, casein, lactose-containing products (e.g., some processed meats, candies)
• Details: Most common in children (2-3% under age 3); 80% outgrow by 16. Distinct from lactose intolerance (digestive issue, not immune-mediated). Can cause anaphylaxis.

2. Eggs

• Foods to Avoid: Eggs (white and yolk), mayonnaise, baked goods (cakes, cookies), egg-based dressings, some vaccines (e.g., flu shots with egg protein)
• Details: Affects 2.5% of kids; 68% outgrow by 16. Reactions often to egg white proteins (e.g., ovalbumin). Baked eggs may be tolerated by some.

3. Peanuts

• Foods to Avoid: Peanuts, peanut butter, peanut oil, peanut flour, some candies, sauces (e.g., satay)
• Details: Common in kids and adults; 20% outgrow. High anaphylaxis risk. A legume, not a tree nut, but cross-contamination with nuts is common.

4. Tree Nuts

• Foods to Avoid: Almonds, walnuts, cashews, hazelnuts, pecans, pistachios, Brazil nuts, macadamia nuts, nut butters, marzipan, some baked goods
• Details: Lifelong for most; 50% of those allergic to one nut react to others. Severe reactions common. Avoid all tree nuts if diagnosed.

5. Fish (Finned)

• Foods to Avoid: Salmon, tuna, cod, haddock, tilapia, fish gelatin, Worcestershire sauce (contains anchovies), imitation crab
• Details: Often lifelong; affects 1% of adults. Reactions to parvalbumin protein. Some tolerate one species but not others—consult an allergist.

6. Crustacean Shellfish

• Foods to Avoid: Shrimp, crab, lobster, prawns, crawfish, some seafood broths
• Details: Most common adult allergy (2% of Americans); usually lifelong. Severe reactions frequent. Distinct from mollusks.

7. Wheat

• Foods to Avoid: Bread, pasta, cereals, couscous, flour, soy sauce, beer, some processed meats, non-food items (e.g., Play-Doh)
• Details: Affects 1% of kids; 66% outgrow by 12. IgE-mediated (not celiac disease). Avoid wheat derivatives like spelt, triticale.

8. Soy

• Foods to Avoid: Soy milk, tofu, edamame, soy sauce, miso, tempeh, many processed foods (e.g., snacks, meat alternatives)
• Details: Common in infants; most outgrow. Found in unexpected places (e.g., candy, tuna). Reactions range from mild to severe.

9. Sesame

• Foods to Avoid: Sesame seeds, tahini, hummus, sesame oil, bagels, sushi, some spice blends
• Details: Added as 9th major allergen in 2021 (FASTER Act); labeling mandatory since 2023. Rising globally; can cause anaphylaxis.

Additional Notable Food Allergens

Beyond the Big Nine, these are less common but documented allergens, often cited in allergy research, clinical reports, or public health data.

10. Molluscan Shellfish

• Foods to Avoid: Clams, oysters, mussels, scallops, squid, octopus
• Details: Distinct from crustaceans; less common but can be severe. Often lifelong.

11. Corn

• Foods to Avoid: Corn, cornmeal, polenta, corn syrup, cornstarch, some sweeteners, processed foods
• Details: Rare but documented; often confused with intolerance. Found in many products (e.g., sodas, snacks).

12. Mustard

• Foods to Avoid: Mustard seeds, mustard powder, prepared mustard, some sauces, dressings
• Details: More common in Europe (priority allergen in Canada); reactions range from mild to severe.

13. Celery

• Foods to Avoid: Raw celery, celery root (celeriac), celery salt, soups, stews
• Details: Priority allergen in Europe; linked to pollen allergies (oral allergy syndrome). Cooking may reduce reactions.

14. Lupin

• Foods to Avoid: Lupin flour, lupin seeds, some gluten-free products, baked goods
• Details: Legume related to peanuts; rising in use (e.g., flour substitutes). Common in Europe; can cross-react with peanut allergy.

15. Garlic

• Foods to Avoid: Garlic, garlic powder, garlic salt, many seasonings, sauces
• Details: Rare; often linked to oral allergy syndrome or contact dermatitis. Cooking may not eliminate allergenicity.

16. Onion

• Foods to Avoid: Onions (raw or cooked), onion powder, many dishes (e.g., soups, stir-fries)
• Details: Uncommon; similar to garlic, often pollen-related. Symptoms typically mild.

17. Beef

• Foods to Avoid: Beef, beef broth, gelatin (from beef), some processed meats
• Details: Rare; can be linked to alpha-gal syndrome (tick-bite induced red meat allergy). Anaphylaxis possible.

18. Pork

• Foods to Avoid: Pork, bacon, ham, sausage, pork gelatin
• Details: Uncommon; may relate to alpha-gal syndrome or direct protein sensitivity.

19. Chicken

• Foods to Avoid: Chicken meat, broth, some processed foods
• Details: Very rare; sometimes linked to egg allergy cross-reactivity.

20. Lamb

• Foods to Avoid: Lamb, lamb broth
• Details: Rare; possible alpha-gal connection. Mild to moderate reactions.

21. Turkey

• Foods to Avoid: Turkey meat, turkey broth
• Details: Extremely rare; similar to other poultry allergies.

22. Rice

• Foods to Avoid: Rice, rice flour, rice milk, some cereals
• Details: Rare globally but noted in Asia; mild symptoms common.

23. Oats

• Foods to Avoid: Oats, oatmeal, oat flour, some baked goods
• Details: Rare; often confused with gluten sensitivity (cross-contamination with wheat).

24. Barley

• Foods to Avoid: Barley, malt, beer, some soups
• Details: Uncommon; distinct from wheat allergy but may overlap with gluten issues.

25. Rye

• Foods to Avoid: Rye, rye bread, some whiskeys
• Details: Rare; similar to other cereal allergies.

26. Buckwheat

• Foods to Avoid: Buckwheat flour, soba noodles, some pancakes
• Details: Not a true cereal; can cause severe reactions despite gluten-free status.

27. Kiwi

• Foods to Avoid: Kiwi fruit, kiwi-flavored products
• Details: Common in oral allergy syndrome; linked to latex-fruit syndrome.

28. Banana

• Foods to Avoid: Bananas, banana-flavored items
• Details: Rare; tied to latex-fruit syndrome or pollen cross-reactivity.

29. Apple

• Foods to Avoid: Raw apples, apple juice, cider (cooking may help)
• Details: Frequent in oral allergy syndrome (birch pollen); mild symptoms.

30. Peach

• Foods to Avoid: Peaches, peach juice, some jams
• Details: Common in oral allergy syndrome; skin often the allergen source.

31. Cherry

• Foods to Avoid: Cherries, cherry-flavored products
• Details: Pollen-related; mild reactions typical.

32. Mango

• Foods to Avoid: Mango, mango juice, chutneys
• Details: Rare; linked to poison ivy sensitivity (urushiol compound).

33. Pineapple

• Foods to Avoid: Pineapple, pineapple juice
• Details: Uncommon; may cause oral irritation or true allergy.

34. Strawberry

• Foods to Avoid: Strawberries, strawberry-flavored items
• Details: Rare; often confused with intolerance or histamine reaction.

35. Blueberry

• Foods to Avoid: Blueberries, blueberry products
• Details: Very rare; mild symptoms reported.

36. Tomato

• Foods to Avoid: Tomatoes, tomato sauce, ketchup
• Details: Uncommon; often oral allergy syndrome or nightshade sensitivity.

37. Potato

• Foods to Avoid: Raw potatoes, potato flour (cooked may be tolerated)
• Details: Rare; raw potato linked to oral allergy syndrome.

38. Carrot

• Foods to Avoid: Raw carrots, carrot juice
• Details: Pollen-related; cooking often reduces reactions.

39. Bell Pepper

• Foods to Avoid: Bell peppers (raw or cooked), some spice blends
• Details: Rare; nightshade family member.

40. Eggplant

• Foods to Avoid: Eggplant, some prepared dishes
• Details: Uncommon; nightshade-related.

41. Avocado

• Foods to Avoid: Avocado, guacamole
• Details: Linked to latex-fruit syndrome; rare but can be severe.

42. Coconut

• Foods to Avoid: Coconut, coconut milk, coconut oil
• Details: Very rare; not a tree nut (botanically a drupe).

43. Sunflower Seeds

• Foods to Avoid: Sunflower seeds, sunflower oil, some snacks
• Details: Uncommon; distinct from sesame allergy.

44. Pumpkin Seeds

• Foods to Avoid: Pumpkin seeds, pepitas
• Details: Rare; mild reactions reported.

45. Poppy Seeds

• Foods to Avoid: Poppy seeds, some baked goods
• Details: Very rare; potential for severe reactions.

46. Flaxseed

• Foods to Avoid: Flaxseed, flax oil, some health foods
• Details: Uncommon; emerging allergen in supplements.

47. Chia Seeds

• Foods to Avoid: Chia seeds, chia puddings
• Details: Rare; linked to seed allergy trends.

48. Lentils

• Foods to Avoid: Lentils, lentil soup
• Details: Uncommon; legume family (possible peanut cross-reactivity).

49. Chickpeas

• Foods to Avoid: Chickpeas, hummus (if no sesame allergy), falafel
• Details: Rare; legume-related.

50. Peas

• Foods to Avoid: Peas, pea protein, some soups
• Details: Uncommon; legume family.

51. Green Beans

• Foods to Avoid: Green beans, some casseroles
• Details: Very rare; legume-related.

52. Gelatin

• Foods to Avoid: Gelatin (from beef/pork), marshmallows, gummy candies, some medications
• Details: Rare; can be tied to alpha-gal syndrome.

53. Chocolate

• Foods to Avoid: Chocolate, cocoa-containing products (check for milk/nut cross-contamination)
• Details: Rare true allergy; often due to additives (milk, nuts).

54. Coffee

• Foods to Avoid: Coffee, coffee-flavored items
• Details: Extremely rare; usually intolerance mistaken for allergy.

55. Tea

• Foods to Avoid: Tea (black, green, herbal)
• Details: Rare; herbal teas may contain allergenic plants.

56. Cinnamon

• Foods to Avoid: Cinnamon, cinnamon-flavored products
• Details: Uncommon; contact dermatitis more common than ingestion allergy.

57. Paprika

• Foods to Avoid: Paprika, some spice blends
• Details: Rare; nightshade family.

58. Black Pepper

• Foods to Avoid: Black pepper, pepper-containing dishes
• Details: Very rare; mild reactions.

59. Honey

• Foods to Avoid: Honey, honey-flavored products
• Details: Rare; may relate to pollen or bee protein residues.

60. Yeast

• Foods to Avoid: Baker's yeast, brewer's yeast, fermented foods (e.g., bread, beer)
• Details: Uncommon; distinct from yeast intolerance.