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Main dietary allergies list
For download
Government Allergy Leaflet. Pdf format (190Kb)
Coeliac disease is also called gluten intolerance or gluten sensitivity. It’s an auto-immune disease, which means the body’s immune system attacks itself. The type of reaction it causes is different to a food allergy – it doesn’t cause anaphylaxis. Many people with coeliac disease don’t realize they have it.
When people with coeliac disease eat foods continuing gluten, it damages the lining of the small intestine, which stops the body from absorbing nutrients. This can lead to diarrhea, weight loss and eventually malnutrition.
Foods to avoid
Gluten is a protein found in wheat and also in a number of other cereals including rye and barley. So, if you have coeliac disease you need to avoid foods made from these cereals, including most types of bread, pasta, pizza, pastry and cakes.
Wheat ingredients are used in many foods, such as some sausages and burgers, and many sauces. Foods in batter or breadcrumbs aren’t suitable for people with coeliac disease either. If you have coeliac disease, always check the ingredients on the foods you buy. You will also need to avoid some alcoholic drinks made from barley, such as beer and lager.
Rice, potatoes and corn don’t contain gluten, so these are OK to eat. You can also buy special products that are suitable for people with coeliac disease, such as gluten-free pasta and bread.
Oats contain a protein that is similar to gluten, but not exactly the same. It's also possible for small amounts of other cereals, such as wheat, to get into oat products when the crop is growing, or being harvested or transported. Research has shown that some people with coeliac disease can’t tolerate oats or oat products. At the moment, medical experts don’t have enough evidence to decide whether all people with coeliac disease should avoid oats.
If you have coeliac disease you will probably be advised to avoid oats, as well as wheat, rye and barley, especially when you are first diagnosed. You should discuss whether to start eating oats again with your health professional because oats may not be suitable for some people with coeliac disease.
It’s important to understand that products labeled ‘wheat free’ aren’t the same as those labeled ‘gluten free’.
Wheat-free products may contain other cereals, such as rye or barley, so these might not be suitable for someone with coeliac disease (unless they are also labeled ‘gluten free’).
Gluten-free products won’t contain gluten, but they may still contain other proteins found in wheat (albumins, globulins and starch granule proteins). So these might not be suitable for people who are intolerant or allergic to wheat.
Coeliac UK, a charity to support people with gluten intolerance, works with manufacturers to produce a regularly updated list of foods that don’t contain gluten.
Causes of coeliac disease
We don’t fully understand why some people have this condition, but it does often seem to run in families. Coeliac disease is often diagnosed after weaning, when cereals are introduced into the diet, but it can also be diagnosed at a later age.
Research suggests that waiting until a baby is about six months old before starting to give those foods containing wheat, such as bread, wheat flour, breakfast cereals and rusks, makes it less likely that they will develop coeliac disease. (Current advice is not to give your baby any solid foods until six months, unless your GP or health visitor advises you to.)
People with certain medical conditions might be more likely to develop coeliac disease, for example those who have Type 1 diabetes, thyroid problems, ulcerative colitis and certain neurological disorders, such as epilepsy.
There are blood tests that can help find out if someone has coeliac disease, but the only way to be certain is to do a biopsy, where a little piece of the small intestine is removed and examined under a microscope.
Until recently, coeliac disease was thought to affect about one in 1,500 people in the UK. However, evidence published in February 2004 suggests that about 1 in 100 have the condition. This figure is based on blood tests in children and hasn’t been confirmed by biopsies. So coeliac disease might not be as common as the research suggests, but there are probably many people who have the condition and haven’t been diagnosed.
There is no cure for coeliac disease. The only way to avoid the symptoms is not to eat foods and drinks containing gluten. If people with coeliac disease don’t control their condition, it can lead to anemia, bone disease and, on rare occasions, certain forms of cancer. It can also cause growth problems in children.
Peanuts are also known as groundnuts and monkey nuts. When someone is allergic to peanuts this usually lasts all their life. Research suggests that, in a very few cases, young children diagnosed with peanut allergy may grow out of it.
Peanuts are one of the most common causes of food allergy and can cause severe reactions, including anaphylaxis. They contain a number of allergens that are not destroyed by cooking or roasting. In fact, roasting peanuts makes them more allergenic (more likely to cause an allergic reaction) than raw peanuts.
Very tiny amounts of peanut can cause a reaction in people who are sensitive. For example, if they eat food served using the same knife as a food containing peanuts, then traces of peanuts that have got into the food from the knife could cause a reaction. Even being close to someone else eating peanuts can be enough to make some people react.
Most health professionals agree that refined peanut oil is probably safe for people with peanut allergy, because the proteins that cause allergic reactions are likely to be removed during the manufacturing process. However, cold-pressed, or unrefined/unprocessed (crude) peanut oil can contain small amounts of peanut proteins, which can cause a reaction in people who are sensitive. Remember that peanut oil is often called ‘groundnut oil’.
Some people with peanut allergy might also react to other legumes such as Soya, green beans, kidney beans, green peas and lupines, because these foods contain similar allergens to peanuts. Even though, strictly speaking, peanuts aren’t nuts, people with peanut allergy are sometimes allergic to nuts such as almonds, walnuts, pecans, hazelnuts, Brazil nuts and cashew nuts.
When someone has a nut allergy, this usually lasts all their life. The nuts that are most likely to cause allergic reactions are walnuts, hazelnuts, almonds, pecans, Brazil nuts, macadamia nuts and cashew nuts. On rare occasions, all these nuts can cause anaphylaxis in people who are sensitive.
Sometimes people with an allergy to one type of nut will also react to other nuts. If you have a nut allergy, you need to be very careful to avoid nuts and unrefined (crude) nut oil. Talk to your GP oranother health professional for advice.
Strictly speaking, peanuts are legumes, not nuts, and they grow underground, whereas nuts grow on trees. See the section on peanut allergy.
Babies and young children can experience two types of reaction to milk: an allergy or an intolerance.
Allergy to cows’ milk is the most common food allergy in childhood and affects 2 to 7% of babies under one year old. It’s more common in babies with atopic dermatitis (a skin rash caused by an allergic reaction). When a baby has cows’ milk allergy he or she can react to small amounts of milk protein, either passed to the baby through the mother’s breast milk from dairy products she has eaten, or from cows’ milk, or formula based on cows’ milk, given to the baby.
Remember that cows’ milk (and milk from sheep and goats) isn't suitable as a drink for babies under one year old. This is because it doesn't contain enough iron and other nutrients to meet babies’ needs.
Children usually grow out of milk allergy by the age of three, but about a fifth of children who have an allergy to cows’ milk will still be allergic to it as adults. The symptoms of milk allergy are often mild and can affect any part of the body. They can include rashes, diarrhoea, vomiting, stomach cramps and difficulty in breathing. In a very few cases, milk allergy can cause anaphylaxis.
Cows’ milk allergy is caused by a reaction to a number of proteins in cows’ milk and people can react to whole milk, or to casein or whey. Casein is the curd that forms when milk sours, and whey is the watery part that is left when the curd is removed.
People can be allergic to either whey or casein, or both, and can react to very small amounts of these. Heat treatment, such as pasteurisation, changes whey, so people who are sensitive to whey might not react to pasteurised milk. But heat treatment doesn’t affect casein, so someone who is allergic to casein will probably react to all types of milk and milk products.
Milk from other mammals (such as goats and sheep) has previously been used as a substitute for babies who are at risk of developing cows’ milk allergy. But the allergens in milk from goats and sheep are very similar to those in cows’ milk. This means that someone with a cows’ milk allergy might also react to these other types of milk.
Some highly hydrolysed milk formulas are suitable for babies with cows’ milk allergy, but other types of formula, such as partially hydrolysed milk and soya formulas, aren’t recommended as the first choice, because many babies with cows’ milk allergy might react to them as well.
If your baby has a cows’ milk allergy, talk to your GP or health visitor before choosing a formula, or changing to a different type. Many baby foods that you can buy contain protein from milk, so if your baby reacts to cows’ milk check the label carefully.
Milk intolerance, also known as cows’ milk protein intolerance, is common in babies and children. It is different to milk allergy and lactose intolerance. Children who have milk intolerance can have symptoms from the first time they have cows’ milk. Symptoms of milk intolerance can include eczema, vomiting, diarrhoea, and stomach cramps, but not hives or breathing problems (symptoms of milk allergy). Children who have milk intolerance often grow out of it by the time they go to school.
Don't cut milk and dairy products out of your diet, or your child's diet, without talking to your GP or a dietitian. Otherwise you or your child might not get enough of important nutrients such as calcium.
Like most food allergies, egg allergy is more common in childhood and about half the children who have it will grow out of it by the age of three. In a few cases, egg allergy can cause anaphylaxis.
The main causes of egg allergy are three proteins in the white of eggs, ovomucoid, ovalbumin and conalbumin. Cooking can destroy some of these allergens, but not all, which means that some people might react to raw eggs but not cooked eggs.
Occasionally someone might react to egg because they have an allergy to chicken, quail or turkey meat, or to bird feathers. This is called bird-egg syndrome.
Sesame allergy is increasing in the UK, which might be because sesame is being used more.
Sesame seeds, sesame oil and other sesame products, such as tahini and houmous, are used in cooking, for example in Turkish or oriental dishes, and in food products such as bread, biscuits, salads and sauces. Sesame allergy can cause severe reactions including anaphylaxis. People with sesame allergy might also react to poppy seeds, kiwi fruit, hazelnuts and rye.
People who are allergic to sesame should avoid sesame oil. This is because it’s made by cold-pressing sesame seeds and isn’t refined, so it can contain small amounts of proteins, which can cause a reaction in people who are sensitive.
Fish allergy can often cause severe reactions, including anaphylaxis. Adults are more likely to have an allergic reaction to fish and shellfish than children, which is probably because adults will have eaten these foods more often.
People who are allergic to one type of fish, such as cod, often react to other types of fish such as hake, haddock, mackerel and whiting as well. This is because the allergens in these fish are quite similar. Cooking doesn’t destroy fish allergens. In fact, some people with fish allergy can be allergic to cooked fish but not raw fish.
The chemical that is produced by the body as part of an allergic reaction is called histamine. Some fish, if they are not processed properly or stored at a cold enough temperature, may contain histamine. (It is formed by bacteria acting on the flesh of the fish.) This could cause a reaction that is like an allergic reaction, but histamine fish poisoning can affect anyone, not just those with allergies.
Allergy to shellfish is quite common and people who are sensitive can react to a number of different types of shellfish, such as shrimps, prawns, lobsters, crabs, crayfish, oysters, scallops, mussels and clams.
People who are allergic to one type of shellfish often react to other types. Shellfish allergy can often cause severe reactions, and some people can react to the vapours from cooking shellfish.
Lactose is a sugar found naturally in milk. It is important to distinguish between lactose intolerance and milk allergy, because milk allergy can cause severe reactions. (See the section on milk allergy.)
Lactose intolerance is caused by a shortage of the enzyme lactase, which is needed to break down lactose so it can be absorbed into the bloodstream. When someone doesn’t have enough of this enzyme, lactose isn’t absorbed properly from the gut, which can cause symptoms such as bloating and diarrhoea. This condition normally appears in adults because people’s levels of lactase begin to decrease after childhood. Some children are born with lactose intolerance, but this is rare.
Lactose intolerance is more common in certain countries and ethnic groups than in others. In communities where milk is not traditionally part of the typical adult diet, a much bigger proportion of people are affected. For example, in South America, Africa and Asia, more than 50% of the population are intolerant to lactose, rising to nearly 100% in some parts of Asia. In the UK, Ireland, Northern Europe and America, we think, on average, that about 5% of the adult population have this condition.
Digestive diseases or injuries to the small intestine can sometimes cause lactose intolerance, because damage to the lining of the small intestine may reduce the amount of lactase produced. In extremely rare cases, the condition can be inherited.
Milk from mammals including cows, goats, sheep and humans all contain lactose. This means that goats’ milk and sheep’s milk aren’t suitable alternatives to cows’ milk for people who are intolerant to lactose. There is no medical treatment for lactose intolerance, but symptoms can be avoided by controlling the amount of lactose in the diet. Adults with lactose intolerance can often have a small amount of milk without reacting.
People with lactose intolerance often find that they can eat cheese and yoghurt without any problems. Cheese contains much less lactose than milk. Yoghurt contains a similar amount of lactose to milk, but it still seems to be easier to digest for people with lactose intolerance. This might be something to do with the bacteria used to make it.
Pine nuts (or pine kernels) are actually seeds, rather than nuts. But some people are allergic to pine nuts, particularly people who are allergic to more than one type of nut. Peanuts are sometimes used as a substitute for pine nuts in food products such as pesto, so people who are allergic to peanuts should be very careful about eating foods traditionally made with pine nuts.
If you are allergic to nuts, it’s a good idea to avoid pine nuts and other seeds, to be on the safe side, unless you already know you are not allergic to them.
People who are allergic to pine nuts might also react to peanuts and nuts such as almonds.
Wheat allergy is common in the UK, particularly among babies. One of the main allergens in wheat is a protein called gliadin, which is found in gluten. Because of this, people with a wheat allergy are sometimes recommended to eat a gluten-free diet.
However, it is important to note that wheat allergy and coeliac disease are different conditions, and foods that are labelled as being ‘gluten free’ may not be suitable for people with a wheat allergy. See the section on coeliac disease for more information about gluten.
As with all food allergies, if you think you’re allergic to wheat you should talk to your GP or other health professional before changing your diet.
A number of different types of cereal can cause reactions in people who are sensitive. Intolerance or allergy to wheat is more common in the UK than allergy to other cereals such as rye, barley, oats, maize/corn and rice.
Allergy to rice is common in Japan and other parts of the world where rice makes up a major part of the diet. For more information on this, see the section on rice allergy.
For people who are sensitive to maize (also known as corn), avoiding it can be very difficult, because ingredients made from maize are commonly used in a wide variety of food products such as biscuits, cereal products, cake mixes, ice cream cones and some batters. If you are allergic to maize, ask a health professional for advice.
Coeliac disease is an intolerance to gluten, a protein found in wheat and a number of other cereals including rye and barley. See the section on coeliac disease for more information. Coeliac disease is different to wheat allergy. See the section on wheat allergy for more information.
Sometimes people can react to more than one type of cereal.
Celery is one of the most common foods to cause oral allergy syndrome in adults in European countries such as Switzerland, France and Germany. (See the section on fruit and vegetable allergy for more on oral allergy syndrome.)
Allergy to celeriac (the celery root) is more common than to celery (the stalks of the plant), but both can sometimes cause severe reactions. Symptoms vary from mild ones, such as oral allergy syndrome, to anaphylactic shock. Some reports suggest that celery spice is as likely to cause a reaction in sensitive people as raw celery.
Coconut allergy is rare in the UK, but it can cause reactions (including anaphylaxis) in people who are sensitive.
A small number of people who are allergic to nuts also react to coconut. Some people who are allergic to latex may react to coconut too.
A small number of people who are allergic to nuts have reacted to coconut. It might also cause reactions in people who are allergic to latex.
Kiwi fruit was first introduced to the UK in the 1970s. Since then it has become a popular fruit in the UK diet.
A number of people have reported allergic reactions to kiwi fruit. Some of these reactions have been severe, especially in children, and the number of people reacting to kiwi fruit appears to be increasing. This may be linked to a general increase in allergic diseases, as well as kiwi fruit becoming more popular.
In adults, allergy to kiwi normally appears in people who are allergic to latex or birch pollen, because these contain similar allergens to kiwi fruit. See the section on latex-food syndrome
In adults, the symptoms of kiwi allergy are normally quite mild, but in children the condition can be more serious and can occasionally cause anaphylaxis. Experts don’t understand fully why adults and children seem to react differently to kiwi. It could be connected with the age at which they first began to eat kiwi, or it’s possible that adults and children react to different allergens in the fruit
People who are allergic to kiwi should avoid the fruit (as raw fruit, purées or juice). Most people who have been eating kiwi on a regular basis are unlikely to react.
