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The "Big 8" Trouble Foods
Peanuts, soybeans, fish, crustacea, milk, eggs, tree nuts, and wheat are considered the most common allergenic foods on a worldwide basis.
These 8 food groups account for approximately 90% of all IgE-mediated food allergies (sometimes referred to as the “Big Eight”). The Big Eight actually involves many more than 8 foods because several food groups are included.
- Fish refers to all species of finfish, although some species of fish such as cod and salmon are more commonly allergenic than others. Shrimp, prawns, crab, lobster, and crayfish are included in the category of crustacea; most individuals with crustacean allergy are sensitive to all species of crustacea.
- Egg-allergic individuals are allergic to the eggs of all avian species. Furthermore, both egg white and egg yolk contain allergens, although egg white is considered to be the more potent sensitizing fraction.
- Milk-allergic individuals are primarily sensitized to cows’ milk, but typically are also reactive to the milk of other species including goat and sheep.
- Almonds, walnuts, pecans, cashews, Brazil nuts, macadamias, pistachios, hazelnuts (filberts), hickory nuts, chestnuts, and pine nuts (pinyon nuts) are the commonly allergenic tree nuts. While sometimes included in the tree nut category, coconuts, kola nuts, and shea nuts are rarely, if ever, allergenic.
While the 8 most commonly allergenic foods and food groups account for more than 90% of all IgE-mediated food allergies on a global basis, over 160 other foods have been documented in the medical literature on one or more occasions to elicit food allergies.
Any food that contains protein has the potential to elicit allergic sensitization on a more infrequent basis. Generally, foods that are major sources of protein and that are frequently consumed in the diet are most likely to cause allergic reactions. However, certain foods that are considered to be good sources of protein, such as beef, pork, chicken, and turkey, are rarely allergenic.
Additional information on the Big 8 allergens, unexpected foods that may contain these allergens, and helpful tips for avoiding these allergens can be found at the Food Allergy and Anaphylaxis Network.