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Expert Q&A: Eating With Food Allergies

An interview with Stanley Cohen, MD.

What precautions should you take if you suspect you are gluten-intolerant?

Gluten is a combination of starch and protein found primarily in wheat, barley, rye, and spelt. It is used extensively in our food supply as a thickening agent and filler, and can be found in minute amounts in foods ranging from ketchup to ice cream. 

A growing number of people feel they have difficulty digesting gluten, or blame gluten for other conditions.  Grains that are well-tolerated for gluten-sensitive individuals are corn, rice, potatoes, buckwheat, amaranth, quinoa, and sorghum. Legumes are a high-fiber, high-protein option that can be used as a grain substitute.

If you feel you are not tolerating gluten, read labels carefully to avoid products made from wheat, barley, bulgur, matzo, rye, spelt, graham flour, semolina, farina, triticale, durum, gluten, gliadin, and couscous and everything that is made from these products.

Any suggestions for eating out with allergies?

Eating out is a challenge when you have allergies, because you don't know exactly what is in the food you order. Ask lots of questions of the server to better understand the contents of your favorite dishes, and frequent those restaurants where you find foods that are prepared without offending foods.

In general, ordering simply prepared foods is your best bet. Go for grilled or roasted meats, and fish or chicken without flour coatings. Steamed vegetables, baked potatoes, plain rice, and fruit are other dishes that should be well-tolerated. 

Can you develop an allergy to a food that you once tolerated?

Yes, but perhaps more commonly, you may have been allergic but because of a limited exposure to the food you may have not recognized the food reaction symptoms. For example you may not have linked a skin rash to your diet, but it could be a symptom of an allergy. Or, if you typically don't eat much shellfish, you might not know you have an allergy until you eat a large portion.

If you are eliminate certain foods or food groups due to allergies or intolerances, should you be concerned about missing nutrients?

Absolutely. All of my patients work with a registered dietitian to ensure the missing nutrients from the eliminated food is supplied by other foods or dietary supplements. This is especially important when there are multiple allergies or when dairy is limited or eliminated, because it is the best source of calcium in the diet.

Reviewed on June 30, 2009

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