Food and Ingredients to Avoid with Fish Allergy

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Trout roe. Maximillian Stock Ltd./Getty Images

Fish allergy is one of the most common food allergies. Fish have fins, as opposed to shellfish (mollusks and crustaceans), which do not. A person can be allergic to both fish and shellfish while others may be allergic to one or the other. It is also possible to be allergic to some species of fish but not to other species.

Fish are often processed in the same facility, and this increases the risk of cross-contamination.

Your allergist can help you determine what types of seafood are safe for you to eat if any.

As one of the more common food allergies, the Food Allergen Labeling and Consumer Protection Act (FALCPA) requires all manufacturers to clearly list fish and fish ingredients on product labels.

The following statements indicate that food may be cross-contaminated with fish.

  • "may contain fish"
  • “produced on shared equipment with fish"
  • “produced in a facility that also processes fish"

These warnings, which are generally voluntary, may not be included, even if there is fish present in their facility. When in doubt, check with the manufacturer.

Types of Fish

Some of the types of fish that are commonly sold for food are:

  • Anchovies
  • Bass
  • Catfish
  • Cod
  • Flounder
  • Grouper
  • Haddock
  • Hake
  • Herring
  • Mahi-mahi
  • Monkfish
  • Orange roughy
  • Perch
  • Pike
  • Pollock
  • Salmon
  • Sardines
  • Scrod
  • Sole
  • Snapper
  • Smelt
  • Swordfish
  • Tilapia
  • Trout
  • Tuna
  • Whitefish

Fish Ingredients

The following foods are commonly made from fish, or may contain fish ingredients.

  • Asian fish sauces such as Nam pla
  • Barbecue sauce
  • Bonito broth (Japanese broth made from dried fish flakes)
  • Bouillabaisse (fish stew)
  • Caesar salad dressing (contains anchovies)
  • Caviar (fish eggs)
  • Ceviche (fish or shellfish in an acidic citrus marinade)
  • Cioppino (fish stew)
  • Fumet (fish stock)
  • Gelatin (kosher gelatin is made from fish bones)
  • Imitation fish or shellfish
  • Omega-3 supplements or foods that advertise Omega-3 fats
  • Pissaladière (French onion tart with anchovies)
  • Steak sauce
  • Sushi
  • Surimi (imitation crab made from fish)
  • Worcestershire sauce

Restaurants to Avoid

Fish is one of the most common causes of allergic reactions in restaurants. Some people may have reactions to airborne particles of fish from cooking or steaming. Fish may be included in fish stock, in soups, or in dressings. You should avoid eating in the following types of restaurants, because of their widespread use of fish ingredients and the danger of cross-contamination:

  • Chinese
  • Indonesian
  • Thai
  • Vietnamese
  • Japanese
  • Seafood

Also, avoid eating anything deep-fried in a restaurant that serves fish, unless the fish is fried in a separate fryer. Use your best judgment and be aware of the dining out guidelines with food allergies.

Non-Food Sources of Fish

  • Fish food
  • Pet food and treats
  • Fertilizer
  • Carrageen (a thickener derived from seaweed)
  • GMO corn or other GMO foods with fish genes have been allergy tested and found to be safe for people with fish allergies.
  • Iodine in food or medical settings is safe. Iodine allergy is not related to fish or shellfish allergies.
  • Vegetarian or Vegan Omega-3 supplements are made from seaweed or flax seed oil.
  • Wine that has been processed with fish ingredients has been tested and found to be safe for people with fish allergies.

Foods that should be safe for people with fish allergies:

  • Carrageen is a thickener derived from seaweed.
  • GMO corn or other GMO foods with fish genes have been allergy tested and found to be safe for people with fish allergies.
  • Iodine in food or medical settings is safe. Iodine allergy is not related to fish or shellfish allergies.
  • Vegetarian or Vegan Omega-3 supplements are made from seaweed or flax seed oil.
  • Wine that has been processed with fish ingredients has been tested and found to be safe for people with fish allergies.

Resources:

Food Allergy Resource and Education: www.foodallergy.org

Joneja JV. The Health Professionals Guide to Food Allergies and Intolerances.

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