Food allergens can be disguised by alternate names and hidden in the long words of an ingredient list. Unless you know what words to look for, it’s easy to overlook an allergen. As parents of children with food allergies, you all know how serious such an oversight can be. This month, we are doing a blog series on hidden food allergens to help you recognize hidden ingredients so that this doesn’t happen to you and your little one.

Hidden Sources of Soy:

Last week, Nita discussed hidden names and sources of dairy. Today, we’ll focus on soy. Soy is especially tricky to avoid because it is often found in unexpected places such as in baked goods, cereals, crackers, infant formula, canned tuna, prepared meats (like sausage and lunch meats), sauces and soups. In fact, soy is found in an estimated 60% of processed foods! Therefore, if your child is allergic to soy, it’s incredibly important to always read and decipher food labels. Kids with Food Allergies (KFA) provides a great list of “Ingredients to Avoid”. It may be helpful to print this out, laminate it, and take it along to the grocery store as a guide. They also have a travel card that you can take along on trips, when dining out, etc.

Soy Oil:

Refined soy oil is usually safe for patients with soy allergies. The FDA exempts refined soybean oil from being labeled as an allergen. Talk with your child’s health care provider to determine what’s appropriate for your child. It’s important to note that not all soy oil is refined so unless it is specified as such, you should not assume it is safe.  For example, the ingredient list for Neocate Infant specifies that it contains refined soy oil because our purification process removes all soy proteins to make it safe for patients with soy allergies.  Soy oil described as “cold pressed”, “expeller pressed”, or “extruded” is not safe for those with soy allergies.

Managing a Soy Allergy:

Deciphering labels can be time-consuming and avoiding soy may seem to limit your child’s diet drastically. However, there are still many soy-free food options and plenty of soy substitutions for recipes. The main food limitations are with processed foods, which we could all probably use less of in our diets anyways! Plus, research shows that half of kids grow out of their soy allergy by the age of 7[1].

I must say, I was most shocked by the fact that soy is in canned tuna! Have you come across any other surprising hidden food allergens?

-Mallory

Grocery shopping is always a hard task, but it is even harder when you are shopping for someone with food allergies!  Worse, the ingredients your little ones may be allergic to can be hidden within the food label.  With our latest series, we will aim to uncover some of the sources of hidden allergens.

New food labeling laws require the top eight food allergens to be listed on food labels.  This is really helpful for those reading food labels; however, sometimes allergens can be hidden in the long words in the ingredient list.

Dairy is one of the ingredients which tends to be hidden in foods that you may have otherwise thought were safe. I wanted to share with you a list of some ingredients to watch out for. Some of these definitely contain diary, while others only possibly contain diary.

When viewing the list below, it’s important to always err on the side of caution.  If you think there may be traces of dairy in something, call the manufacturer of the product you would like to purchase and inquire.  If they cannot guarantee that the product is free of dairy, avoid it!

Foods with dairy ingredients:

• Milk and milk products(including condensed, derivative, dry, evaporated, goat’s milk and milk from other animals, low-fat, malted, milkfat, milk protein hydrolysate, nonfat, powder, protein, skimmed, solids, whole)
• Butter, butter fat, butter oil, butter acid, butter ester(s), buttermilk
• Casein, casein hydrolysate, caseinates (in all forms)
• Cheese
• Cream
• Diacetyl
• Ghee
• Lactalbumin, lactalbumin phosphate, lactoferrin, lactulose
• Pudding
• Recaldent®
• Rennet casein
• Sour cream, sour cream solids, sour milk solids
• Tagatose
• Whey (in all forms), whey protein hydrolysate
• Yogurt

Foods with potential dairy ingredients:

• Artificial or natural flavorings (anything which is derived from butter, cream and egg flavors)
• Chewing gum
• Deli meats
• Fat replacers
• Many types of chocolate (although dark chocolate is often free of dairy)
• Margarine
• Prebiotics (galactooligosaccharides, also known as GOS, are derived from dairy sources. Don’t worry, Neocate Junior with Prebiotics only contains prebiotics in the form of fructooligosaccharides, also known as FOS, which are derived from vegetables.)
• Salad dressings

For a more complete list of foods to avoid when accommodating for a dairy allergy, visit the Food Allergies and Anaphylaxis Network website or check out Alisa Marie Flemming’s book Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living and website for more resources.

Can you share any foods you have found that have surprising hidden dairy ingredients?

- Nita

Last week for our Ingredient Series, Christine wrote about the fats in Neocate. In this post, I’ll expand on that and explain DHA and ARA in more detail.

As you may know, the Neocate Infant formula is available in the original formulation and the updated formulation, which contains DHA and ARA.

Docosahexaenoic acid and arachidonic acid, better known as DHA and ARA, are types of fats (lipids) called long-chain polyunsaturated fatty acids (often abbreviated as “PUFAs”). DHA is an omega-3 fatty acid and ARA is an omega-6 fatty acid.

These fatty acids are found naturally in human breast milk and several other foods. Fish, especially cold water fish, have very high amounts of DHA. Eggs are also a natural source of DHA, but to a lesser degree than fish. ARA is found mostly in animal products, such as eggs, meat and fish.

It has been known for many years that long-chain polyunsaturated fatty acids (DHA and ARA in particular) accumulate in the brain and eye of the fetus during gestation, especially during the last trimester of pregnancy.[1] More recent studies show that DHA and ARA may play an important role for brain and eye development during infancy as well.[2] Breast-fed infants receive DHA and ARA from their moms and studies show that breast-fed infants typically have higher blood levels of DHA and ARA in comparison to infants fed formulas without DHA and ARA. For this reason, and because of the important role DHA and ARA are thought to play with brain and eye development, many infant formulas are now fortified with DHA and ARA to more closely resemble the intake of breast-fed infants.

The DHA and ARA found in Neocate Infant with DHA and ARA are vegetarian and non-GMO (meaning they are not derived from genetically-modified sources). The source of DHA is C. Cohnii Oil and the source of ARA is M. Alpina Oil.

So now when you see the “DHA and ARA” banner on your can of Neocate (if you use the Neocate Infant with DHA and ARA), you’ll know exactly what it means!

We hope you found our Ingredient Series helpful. If you are curious about anything else in Neocate please ask us in the comments!

-Mallory

[2] Alan S. Ryan, James D. Astwood, Sheila Gautier, Connye N. Kuratko, Edward B. Nelson, Norman Salem . Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelopment in childhood: A review of human studies. Prostaglandins, Leukotrienes and Essential Fatty Acids - 26 February 2010 (10.1016/j.plefa.2010.02.007

Back in our vitamin series we often referenced the ingredient list on formula & food labels and helped identify some of those long words as vitamins.  This sparked us to think about ingredients in general and the importance of understanding ingredients when dealing with food allergies.

There is so much more to ingredients then what’s listed on the label.  So, of course, we decided to blog about it!  Understanding fats, carbohydrates and proteins will be the topic of our next series.   Within the next few months we hope to cover some common inquiries such as types of fat, healthy vs. unhealthy fats, types of carbohydrate including corn, identify sugars, and hidden allergens such as dairy, and explain the building blocks of protein.

A few things to keep in mind while reading those labels and looking at ingredient lists: 

• The FDA requires all manufacturers to list all ingredients in the food on the label.
• Based on the Food Allergen Labeling and Consumer Protection Act of 2004, manufacturers are required to list the top eight foods which account for the most food allergies in commonly used terms.  This does not include allergens accidently introduced during manufacturing or packaging through cross-contamination. 
• Ingredients are listed in order of predominance.  The ingredient used in the greatest amount is listed first, followed by those in smaller amounts listed next, in descending order.
• There are several different types of ingredients such as:
  • Preservatives (ascorbic acid, citric acid) to prevent food from spoiling
  • Emulsifiers (soy lecithin, mono-and diglycderides) which allow smooth mixing and prevent separation
  • Sweeteners (saccharin, aspartame, acesulfame potassium) to add sweetness with or without the extra calories
  • Color Additives (citrus red no. 2, beta-carotene) which offsets color loss due to exposure to light, air, temperature extremes or moisture

Don’t forget to check back with us next week as we kick-off our ingredient series with the topic of fats.  Do you have any questions on what’s listed in the ingredients on food labels?

- Sarah