But using the epinephrine auto-injector is an emergency situation only, it’s not a treatment.
This is why “avoidance” is the operative word for managing a soy or legume allergy. However, this isn’t as simple or easy as that one word suggests.

Soy is found in many packaged food products. You may see it listed in the ingredients as “soy”, “soy lecithin”, “soyabean oil” or even “hydrolyzed plant protein” (which is often from soy). Soy is a cheap and easy binder, filler and preservative in packaged food products, so it’s very common to find it in crackers, breads, cookies and other foods that have already been prepared.

However, since soy is one of the most common allergens in Canada and the United States, some companies are catching on and are starting to avoid using soy products. However, caution must still be used while shopping because it is unlikely you will find a “soy-free” logo like you might for “peanut-free” on some packaged foods.

Other legumes like beans, peas, chickpeas and lentils are little bit easier to manage. However, they do present their own challenges. Chickpeas are the main component of hummus and hummus can be used not only as a dip on its own but in sauces as well.

If you have a soy allergy, Asian restaurants are off-limits because it is a staple in their cuisine. However, don’t let this discourage you from re-creating traditional Asian dishes minus the legumes. For example, you can create an equally good stir-fry with broccoli, chicken and rice instead of bean sprouts and peas.

Hand-Washing: When your child (or you) has a soybean or another plant from the legume familly, soap and water are your best friends. Hands should be washed thoroughly before and after eating. If you have a school-aged child, ensure he (or she) is able to wash his hands before snacks and lunch. With younger children, schools usually adopt an allergy protocol of washing hands among all children after eating. 

Cross-Contamination: It’s important to make sure soy or legumes and any products that contain them don’t come in contact with the food you are eating. That means thoroughly cleaning utensils and kitchen equipment after use. For example, if someone uses a spoon to take out some hummus in a bowl, make sure you do not use the same spoon for your own food.

When there is a child or adult with a soy or legume allergy in the household, many families choose to eliminate the allergens from the house. This is a personal preference and will depend in part on your family’s ability to be vigilant about keeping the allergic person safe.

Label reading: Whenever you eat a packaged food, you need to read the label in its entirety to check for any mention of peanut. Sometimes, soy (more so than other legumes) can have different names or can be hidden as an ingredient within a manufactured food. You also have to look for precautionary statements on package labels, such as “May Contain Soy.”

The better news is that food labeling in both Canada and the United States has improved considerably in the past few years, especially for the Top Ten food triggers. For more information on what you need to know when reading product labels, please view Label Aware.

One thing to be cautious of with soy allergy: imported foods. Not all countries have the stringent labeling requirements of Canada, the United States and the European Union. Don’t take chances if you suspect soy could be an ingredient of an import.

Speak Up About Food: With food allergies, you have to ask questions and get over shyness when someone else wants to serve food to you or your child with this allergy.

We teach kids to respect adults and authority, but with an allergic child, it’s important to teach them not to eat foods that others offer – unless mom or dad has pre-approved or (when they’re older) unless they’re sure of the ingredients. For adults, get over embarrassment; be certain to ask about ingredients, and learn to do this an efficient, confident manner.
See: Caution: Relatives Ahead

At School: For a parent of a child with soy or legume allergies, sending them off to school can be a time of anxiousness. While soy is on the top 10 list of allergens, it’s unlikely you will find schools restricting soy or soy milk in a class – nor asking other parents to please not send kids to school with hummus.

It’s important to communicate clearly and calmly with your child’s teacher and the principal, and to create an anaphylaxis emergency plan (also called a food allergy action plan) to protect your child. Also ensure that the teacher (and other staff e.g. a coach) is receiving at least annual training on using an epinephrine auto-injector and that he or she knows where your child’s “pen” is kept.

Become familiar with the anaphylaxis policy or law in your province or state and use it to develop a plan tailored to your child. Be sure your allergic child knows not to share food with peers and not to take food from anyone, including the teacher, unless you’ve said it’s OK.

At a restaurant: Dining out with a soy or legume allergy may seem daunting at first, but it is possible to do so safely and enjoyably. First, find a restaurant you trust. Call ahead to ask the manager or chef about menu items and how they handle pans and utensils in the kitchen to avoid cross-contamination. If he or she is unable to answer your questions, don’t eat there.
When you arrive at the restaurant, tell your server directly of your serious soy or legume allergy and discuss menu items that will be safe to eat. If you don’t feel he or she is able to answer your questions properly, ask to speak to the chef or the manager. Be mindful of particularly risky foods: sauces, pre-packaged baked products, breads, salad dressing and items that may be cooked in soyabean oil. And remember: when in doubt, don’t eat it.

Be prepared: Make it a rule – no epinephrine auto-injector means no food. While you’ll do everything to make sure you’re not eating soy or legumes, accidents happen. Make sure you always have your auto-injector on you when you eat, in case of an emergency. If your child is allergic, make sure this rule is one he or she takes seriously. 

Educating Others: In order to successfully manage a soy or legume allergy, those around you/your child need to be aware of the allergy and the serious consequences that could result from eating them.
Plan what you’ll say to others to explain this condition. Be calm, clear about the information and keep the conversation based on facts. Politely request that they help you keep yourself or your child safe. You’ll often find that once a person understands about food allergies and anaphylaxis, they’ll be more than willing to help out. Be mindful that there is a learning curve, and don’t expect people who don’t live with peanut allergy to absorb it all as quickly as you have.

The tiny legumes – which are related to clover, peas and alfalfa – are incredibly versatile as a food, but they are also used in thousands of products such as soaps, cosmetics,plastics, clothing, inks, glues, lubricants, pesticides, coatings and insulation.

They are even used to make biofuel, and Ford Motor Company recently announced that it had developed a new type of soy-based rubber that they intend to use in cup holders and floor mats.

In foods, they are especially desirable, because they are high in protein but low in calories, carbohydrates and fats; they supply all nine essential amino acids; they’re high in vitamins and nutrients; they contain no cholesterol; and they are easy to digest.

Their consistency allows them to be transformed into oils and flours, as well as dairy and meat substitutes. Importantly, isolated soy proteins are used to emulsify fat and bind water, which keeps many products’ moistness without affecting other ingredients. For example, soy lecithin is often used in chocolate, margarine and cheeses to keep their ingredients from separating and clumping.

The isolates can also be used to give an elastic gel texture, which can make drinks such as soy lattes seem more creamy or full-bodied.

Besides a remarkable flexibility, soybeans are also one of the most inexpensive crops to grow, and they can thrive in a wide variety of climates. This explains why they are so desirable for a range of industries. Although the plant originated in Asia, the vast majority of the world’s supply is now grown in the United States and South America.

In recent years there has been an increasing amount of controversy about soybeans, with some scientists raising alarms about their effects on hormone production. Others are concerned that many soy crops have been genetically modified, and it’s unclear how those modifications will affect animals, humans and non-GM crops in the long run.

With the increased prevalence of soy in the North American diet, allergists have also noticed a corresponding rise in allergies to soy and soy products. Fortunately, many people with an allergy to soy can tolerate soy lecithin, which is found in thousands of foods – but it’s important that they discuss their allergy with their physician before eating any products that contain soy or soy products.

Dr. Pistiner: Although oral ingestion is the most common and concerning form of exposure to an allergen, such as soy, skin contact is also of concern. Some studies have shown that short-term exposure to an allergen on the skin does not cause severe allergic reactions. However, these studies (the allergen looked at was peanut) did show that 40 per cent of allergic subjects had localized skin reactions.

Allergens contained in skin products and cosmetics have been reported to cause allergic reactions. Most commonly these reactions are limited to the skin but systemic reactions have been reported, especially in those with a compromised skin barrier (i.e. eczema).

I would advise that avoiding products with soy is your safest option but please discuss your specific case with your healthcare provider prior to changing food allergy management strategies.

Dr. Michael Pistiner is an allergist in Massachusetts and clinical instructor at Children’s Hospital Boston, Harvard Medical School. His 7-year old son is allergic to tree nuts.

Does your child refuse to eat a certain food, or complain that it makes his “tongue hurt”? These could be signs of a food allergy, and should be taken seriously.

It is common for the symptoms of food allergy to vary by individual – and from reaction to reaction in the same person. Not everyone will get all the symptoms, which range greatly in severity from mild to severe (and even fatal): your throat may feel tight on one exposure to your allergen or you may get itchy hives on your skin and vomiting with the next.

The Range of Symptoms

-Tingling in the mouth
-Swelling of the tongue and throat / feeling of throat tightness
-Itchy skin, hives or skin redness
-Abdominal cramps
-Vomiting or diarrhea
-Breathing difficulty, wheezing
-Faintness due to a sudden drop in blood pressure

Anaphylaxis

Anaphylaxis is the severe form of allergic reaction. It involves one or more of the body’s symptoms; for example, the gastrointestinal tract, the respiratory tract, the skin and the cardiovascular system. A person experiencing anaphylaxis often has difficulty breathing, and the person could lose consciousness. Anaphylaxis puts a person at risk of death.

Anaphylactic reactions can come on quickly, and it’s impossible to know when a reaction will become severe. It’s important that people with food allergies are prepared for a reaction by always carrying an epinephrine auto-injector (either EpiPen or Twinject).

Experts recommend using epinephrine early if a person known to be at risk of anaphylaxis begins to show signs of allergy symptoms – don’t wait until the symptoms worsen, as it may become to difficult put a halt to the reaction once it’s in progress.

Symptoms reviewed by Dr. Susan Waserman

Reading labels is a way of life when you or a member of your family has a peanut allergy. Before eating anything in a package, be sure to read the label carefully. Look for hidden sources of soy or legumes and alternate names for them.

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 soy” and “Manufactured in a facility that also processes soy.”

(FYI, while soy and peanuts are legumes that are priority allergens in Canada and the U.S., other legumes don’t have that same designation. Soy and peanut will be included in so-called “May contain” statements, legumes such as lentils or chickpeas won’t be.)

Allergists generally advise people with soy allergies to avoid all products that contain precautionary statements about their allergen.

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 alternate names (ie: kinako, for soybean flour). Ingredients of ingredients that are priority allergens would also have to be listed. For example, manufacturers couldn’t simply list “vegetable protein” if the source of the protein is a priority allergen, such as a legume.

More on Canada’s New 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.

Peanuts are the most common legume that people will react to, and about 5 per cent of peanut allergic people will react to other legumes, such as beans, peas chickpeas and lentil.

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.

Milk and egg allergy are both common in children. In the United States, 2.5 per cent of children under the age of 3 have a milk allergy. Egg allergy affects 1.5 to 3.2 per cent of children.

The good news is many children outgrow their allergies to milk and egg.

Source: AAAAI