Coconut cream is also surprisingly easy to locate; you’ll find it in the Asian foods section of most grocery stores under the guise of canned coconut milk. Coconut cream is simply the rich part of full-fat coconut milk. As the coconut milk rests, the cream rises to the top to form a very thick layer that can be scooped out like soft ice cream.

In fact, the sign of a good canned coconut milk is one that separates into a watery base with up to three-quarters of a cup of “stand a fork in it” cream on top. In warmer months, chill the coconut milk in the refrigerator for a few hours to assist in the separation.

Allergen

Where It Hides

Alternate Names

• baked goods, e.g. cookies, cakes
• challah and gluten-free bread
• crackers
• fat replacers (e.g. Simplesse)
• meat products with fillers like meatballs or meatloaf
• nougats, marzipan candy
• pasta (fresh but also some dried pasta “may contain” eggs)
• quiche, soufflé
• salad dressing, creamy dressings
• sauces, for example, Béarnaise, hollandaise, Newburg, tartar
• eggnog, whiskey sour
• fish mixtures (surimi) used inimitation crab and lobster meat
• foam and milk toppings on coffee
• anasthetic, for example Diprivan (propofol)
• some vaccines (e.g. flu vaccine; speak to allergist re safety)
• craft materials
• hair-care products
• medications

• albumin/albumen-conalbumin-globulin
• livetin
• lysozyme
• ovo (means egg), for example, ovalbumin, ovomucin, ovotransferrin
• silico-albuminate
• vitellin

Sources:
-ImmunoCAP
-Canadian Food Inspection Agency

Allergen

Where It Hides

Alternate Names

• artificial butter, butter flavor, butter oil
• baked goods, e.g. cakes, cookies
• battered or fried foods
• broths and bouillons
• caramel coloring or flavoring
• chocolate, candies
• crackers
• coffee whiteners
• custards, puddings
• deli meats, hot dogs
• dips and salad dressings
• egg and fat substitutes (Opta, Simplesse)
• high-protein flour
• lactose-free products (don’t confuse wth ‘dairy-free’; many contain milk protein)
• malt drink mixes
• margarine (look for dairy-free brands)
• pâtés and sausages
• soy or rice cheese
• soups and soup mixes
• potatoes (instant, mashed and scalloped potatoes)
• ghee (clarified butter) and butter fat
• kefir
• Kumiss (fermented milk drink)
• medications
• tuna fish (some canned brands)

• beta-lactoglobulin
• casein, rennet casein-caseinate (ammonium caseinate, magnesium caseinate, sodium caseinate, calcium caseinate, potassium caseinate)
• delactosed or demineralized whey
• whey and whey protein concentrate
• dry milk, milk solids
• hydrolyzed casein, hydrolyzed milk protein
• lactalbumin and lactalbumin phosphate
• lactose
• lactoferrin, lactoglobulin
• milk derivative, fat and protein
• modiefied milk ingredients

Sources:
-ImmunoCAP
-Canadian Food Inspection Agency

Most companies had stopped shipping chocolate bars during the hot summer months as heat affected the quality of the product, but September’s here and so is production!

Enjoy Life makes both dark and milk (rice milk) chocolate bars to satisfy all taste buds!  They also offer chocolate chips for the baking. All products are dairy- nut-, soy- and gluten-free.

Guardian Angel Foods sell the cutest chocolates from hearts, to zoo animals or dinosaurs!  If you want fondue or baking chocolate, they offer that as well.  They boast, “All of our delicious products are made without peanuts, nuts, eggs, sesame, bovine protein and dairy.”

Nonuttin’s Double Chocolate Chunk Granola bar is a granola bar that thinks it’s a chocolate bar (or is it the other way around?)  Either way it’s sure to satisfy both your hunger and your sweet tooth!  Again, this company offers 70 per cent dark chocolate chunks. All products are free of dairy, egg, peanut, fish, sesame, mustard, wheat, sulfite and gluten (certified by GFCO).

South of the border and shipping to Canada are:

Amanda’s Own offers dairy free, nut free and egg free chocolate in bars, shapes (from fancy foil wrapped to cars and puppies) as well as chips for baking.

Divvies offers both Devvine Chocolate and Chocolate Benjamint (with organic peppermint crunched up candies).  Both are made in the company’s-own dedicated facility where no peanuts, tree nuts, milk or eggs enter the doors.

Premium Chocolatiers create the finest truffles and gourmet chocolates to indulge chocolate lovers including those with milk, nut, egg, and gluten sensitivities.

The Canadian Food Inspection Agency has been warning for some time now that imported chocolates are not always safe.

Manufacturers:

http://www.amandasown.com/

http://www.alimentsangegardien.com/guardianangelfoods/food-allergies/productscategories.php?categorie=4

http://www.enjoylifefoods.com/our_foods/chocolate_bars.html

http://www.divvies.com/store/commerce.cgi?search=action&category=CDNY

http://www.nonutthttp://www.premiumchocolatiers.com/in.ca/products-for-Canada-International/

http://www.gfco.org/

The vegan inventors of Daiya Foods Mozzarella Style Shreds and Cheddar Style Shreds knew they had an inspired food invention when they showed up at the Natural Foods Products Expo in Anaheim, California in March 2009. But they weren’t prepared for what would follow: the reaction was sizzling.

“We were surprised by the lineups at our booth and people going crazy for our product,” says Greg Blake, Daiya’s CEO. They won, in short order, VegNews’ 2009 product of the year award and PETA’s Libby award for best vegan cheese.

Success continued to snowball for the Vancouver-based shred makers. Blake and his partner Andre Kroecher, Daiya’s vice president of innovation, began sending out samples of their products made with tapioca or arrowroot flours, pea protein and coconut oil to vegan food manufacturers and restaurants. The pair were hoping for feedback. Instead, they were inundated with requests to order.

The partners sprang into action, building a dedicated plant free of all top allergens and gluten, and hiring. Today they employ about 40 people. While delighted with the success, “it has been intense,” Blake says with a chuckle.

In the United States, Daiya’s shreds (which are also low-fat) are available in Whole Foods, Ralphs and growing number of natural food stores, used in restaurant meals and as ingredients in packaged foods, such as Amy’s Kitchen’s new gluten-free Rice Macaroni with Non-Dairy Cheeze. This fall, Daiya will also launch its shreds in Canada’s bigger natural foods chains.

The idea to create a good vegan cheese substitute was Kroecher’s – and he was simply trying to please his own palate. However, when his original recipe proved a hit with even cheese-eating friends, he and Blake decided that, eureka, this might be a business.

Many recipe trials, tinkering and some destroyed kitchen equipment later, they had two excellent shred products. These melt, stretch and maintain texture, even under the searing heat of commercial ovens. A convenience factor is that Daiya shreds can be substituted in the exact same quantity as cheese in recipes.

But what about branching out beyond shreds? Blake says: “We’re constantly working toward new products. We can’t tell you what they are yet, but we’re definitely interested.” So stay tuned: cow-free cheddar may only be the start.

* U.S.: Daiya Cheddar Style Shreds and Mozzarella Style Shreds: $4.99/8 oz;
* Canada: Coming this fall; same retail price.

“I kind of freaked out,” she admits, since her son had previously had an anaphylactic reaction to cottage cheese. Theo didn’t react to the crackers, but avoidance remained the family watchword.

The boy, however, turns out to be among the 75 per cent of kids allergic to dairy whom researchers now believe can actually tolerate milk – provided it has been extensively heated through baking. The same holds true for egg.

While under supervision at Johns Hopkins University School of Medicine in Baltimore, Theo on separate occasions was able to eat one-twelfth of an egg and a quarter cup of milk, both of which were baked into a cake. Emergency treatment was at the ready, but he didn’t react. By May, the boy had started a new diet at home that includes muffins, breads, even croissants; foods thoroughly baked at 350 degrees for at least 30 minutes. There has been a sanctioned bite of lasagna and, in the next phase, Theo will be testing out pizza, which isn’t cooked as long.

Allergists have long heard stories of allergic children who have accidentally eaten milk or egg – perhaps grandma fed the child an off-limits cupcake, or a daycare provider didn’t realize that cookies contained egg – without reactions.

But researchers are getting closer to understanding why kids like Theo can tolerate milk or egg that has been baked, while others still will react immediately. They’re also finding that introducing the baked food into the diet may actually help the child outgrow the allergy.

At Johns Hopkins, some dairy-allergic kids, including those who have had significant reactions to milk in the past, have even moved on to unheated foods such as yogurt and chocolate milk.

The best news: this is research that doesn’t have to wait for clinical trials and government approvals. As long as you begin at the office of your allergist, and he or she has the resources to perform food challenges safely, introducing baked milk or egg into your child’s diet is “something that can be done right now,” Dr. Wesley Burks, head of pediatric allergy and immunology at Duke University Medical Center, told the American Academy of Allergy, Asthma & Immunology conference in New Orleans earlier this year. He called this new way of treating milk and egg allergy a “paradigm change.”

Added Dr. Hugh Sampson, chief of allergy and immunology at New York’s Mount Sinai School of Medicine and leader of the research: “What it means is that as opposed to going to birthday parties and not being able to eat cake, or going to school and worrying about somebody eating a cookie that has milk or – they can suddenly do all this.”

***

THE CONCEPT of feeding allergic kids baked milk or egg goes against longstanding food allergy management practice and what parents like the Glaubers have been doing to protect their children. That is, they do everything in their power to ensure that not a morsel of the allergenic food crosses their child’s lips. A shift in thinking began a few years ago with a study performed by Sampson and his colleagues at Mount Sinai.

They gave each of 100 milk-allergic kids a muffin to eat that contained 1.3 grams of milk protein, in the form of dry milk powder. If a child was able to eat the muffin, baked for 30 minutes, without a reaction, two hours later he or she was served a waffle, which was only cooked for three minutes.

Sampson and his team found that 75 of the 100 children tolerated milk that had been extensively heated, and they were told to keep it in their diet.

While in the past it had been believed that kids were more likely to outgrow a milk allergy if they successfully avoided it, this study suggested otherwise. In follow-up appointments three months later, those children who had continued to eat baked milk products showed a significantly smaller

Reading labels is a way of life when you have milk or egg allergies. Before eating anything in a package, be sure to read the label carefully. Look for hidden sources of dairy or egg and other names for dairy, milk or egg.

Also be on the lookout for precautionary statements. These are statements that indicate an allergen may be in the food, due to cross contamination during processing. Examples of precautionary statements include: “May contain milk” and “Manufactured in a facility that also processes eggs.”

Allergists generally advise people with these allergies to avoid all products that include precautionary statements about dairy or egg.

If you are ever uncertain about whether a food product is safe for you, call the manufacturer to confirm. When in doubt, don’t eat it.

In Canada, new regulations have been proposed that would require food manufacturers list priority allergens in plain language on packaging, rather than using little known alternate names (i.e.: albumin instead of egg). The ingredients within listed ingredients that are priority allergens would also have to be shown. For example, manufacturers couldn’t simply list “flavouring” if the flavouring included a priority allergen, such as butter.

More on Canada’s Food Allergen Regulations.

In the United States, the Food Allergen Labeling and Consumer Protection Act went into effect in 2006. FALCPA requires manufacturers to use plain language when listing priority allergens, and to declare all allergens either in the ingredient list, or in a “Contains:” statement at the end of the list.

The allergens included in this regulation are milk, eggs, fish, shellfish, tree nuts, wheat peanuts and soybeans. These regulations do not include sesame and mustard, unlike the proposed Canadian regulations.

Separate legislation requires companies to declare sulphites if they are present at more than 10 parts per million, or if they had a technical or functional effect in the food.

Both Canada and the United States are studying ways to regulate the precautionary statements used on packaged food labels.

It used to be common for children to outgrow milk and egg allergies before elementary school, two large studies from the Johns Hopkins University show that these allergies are now more persistent and more severe. The studies, published in the November and December 2007 issues of the Journal of Allergy and Clinical Immunology, tracked 800 children with milk allergy and 900 with egg allergy over 13 years.

While previous research indicated most milk-allergic toddlers outgrew milk allergy by the time they were 3 years old, the Johns Hopkins team found that only one-fifth of children outgrew this allergy by age 4, and only 42 per cent outgrew it by age 8. The better news is that a majority was free of dairy allergy by age 16.

With the egg allergy, the trend was similar in the Johns Hopkins’ research. Only 4 per cent outgrew their allergy by 4 years old, and 68 per cent were free of the allergy by age 16.

“The bad news is that the prognosis for a child with a milk or egg allergy appears to be worse than it was 20 years ago,” Dr. Robert Wood, the studies’ lead investigator, told The JHU Gazette in 2008. “Not only do more kids have allergies, but fewer of them outgrow their allergies, and those who do, do so later than before,” said Wood, who is the head of the division of allergy and immunology at Johns Hopkins Children’s Center.

Overall Food Allergy Statistics

In general, food allergy is on the rise in North America and other developed countries. In Canada, an estimated 7.5 per cent of people have food allergies, representing more than 2.5 million people. In the United States it’s estimated that 12 million Americans (or just under 4 per cent of the population) have food allergies.

A major study in the United States recently found that cases of peanut allergy in children more than tripled in a decade, and that more than 3 million Americans now have a peanut or nut allergy.

Here are the rates of some of the major allergens in Canada and the U.S.

CANADA

Source: Surveying Canadians to Assess the Prevalence of Common Food Allergies and Attitudes towards Food Labelling and Risk (SCAAALAR) study. Published in the Journal of Allergy and Clinical Immunology, June 2010.

UNITED STATES

Peanut, Tree Nut or both:
Children -  2.1 %
Adults – 1.3 %

Source: US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. Published in the Journal of Allergy and Clinical Immunology, June 2010.

When someone with a milk allergy ingests milk even a trace amount, that person is at risk of a severe allergic reaction, called anaphylaxis. Egg allergies are often associated with skin symptoms such as hives, but anaphylaxis can also occur.

Prevalence

Milk allergy is the most common food allergy in young children, affecting 2.5 per cent of kids under 3 years old. Egg allergy is the second most common, and is estimated to affect between 1.5 to 3.2 per cent of children.

Although it is common for children to outgrow a milk or egg allergy, this is happening at a much later age than in past, with both of these allergies persisting into high school. The only way to safely determine if you have outgrown an allergy is to get tested by your allergist, including an oral challenge under supervision.

See: Milk/Egg Statistics

Anaphylaxis to Milk or Egg

An anaphylactic reaction includes more than one of the body’s systems, such as the respiratory tract, gastrointestinal tract, the skin and cardiovascular symptom. Symptoms of an allergic reaction include tingling in the mouth, swelling of the tongue and throat, itchy skin or hives, difficulty breathing, abdominal cramping and vomiting. In a severe anaphylactic reaction, a person may experience a drop of blood pressure, loss of consciousness and even cardiac arrest and death.

One of the issues in managing milk or egg allergy is that symptoms can vary greatly. A person may have had minor symptoms, only to suffer anaphylaxis on a subsequent exposure.

Because milk or egg allergy reactions can be severe, it is important that a person with this allergy carry an epinephrine auto-injector (EpiPen or Twinject) with them at all times.

Non-Allergic Reactions

Milk allergy involves the immune system and IgE (allergic) antibodies, but milk can cause non-allergic symptoms, too. Milk allergy is often confused with lactose intolerance, which is a digestive condition and not an allergy. Infants can also develop food-protein-induced enterocolitis syndrome (FPIES for short), a condition involves vomiting and diarrhea (and therefore resembles allergy), but it doesn’t cause hives to develop and allergy tests will not be positive.

Is there a Cure?

Currently, there is no cure for milk or egg allergy. However, scientists are working on ways to “desensitize” patients with these allergies. This is done in a very controlled setting, with emergency treatment at hand, and must never be tried at home.

The most researched and talked about form of desensitization at this point is called oral immunotherapy (OIT).

In this treatment, an allergic child consumes gradually increasing amounts of his or her allergen in an effort to retrain the immune system. Researchers are also studying whether this process may make people “tolerant”, or in other words, cured of their allergy.

See Also:

• Dairy Desensitization

For example, almost 6 per cent of the products from smaller companies that didn’t have an advisory label for milk did, in fact, contain milk. “The bottom line is that it might be wise to exercise more caution with smaller companies,” says Dr. Lara Ford, a fellow at Mount Sinai. (Precautions include checking directly with a food maker.)

What they found for those with peanut allergies was more encouraging: out of all the products tested that did not have a warning for peanuts, none contained the allergen. However, for milk and egg, the two other allergens looked at in this study, there were a few products without these ingredients on the labels that in fact contained the allergen.

Are “May Contain”
Statements Overused?

When it came to advisory labels, or “may contain” statements, there were products in each category of allergen that did in fact include that ingredient when tested. Although the numbers were small (for example, 12 out of 228 products with the may contain advisory), Ford stresses this does not mean warning labels should be ignored.

“The issue is that the most likely way for contamination to occur, especially for a solid food like peanut, would be for a chunk of it to end up in one packet of the food. It’s not evenly distributed through every packet of the food at a low level,” she explains.

Still, Ford says more research needs to be done to determine what level of contamination would be harmful, for various allergens. “Based on the amount of knowledge that we do have, a lot of food that we recorded to have contamination would likely not have triggered symptoms in most patients.”

Related Reading

Food Labeling: FAQ on New Regulations