Should You Be on An Egg-Free Diet?

If you or your children develop symptoms after eating eggs, it may be an allergy

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How to Be Healthy and Egg-Free. Influx Productions/The Image Bank/Getty Images

Eggs are a nutrient-rich, protein-packed breakfast food that can start your morning off right—unless they give you rashes or send you running for the nearest bathroom. Egg allergies affect up to 1.7% of the U.S. population, causing symptoms ranging from skin reactions such as hives or rashes; nausea, diarrhea, stomach pain, and vomiting; throat, lips, tongue, or facial swelling; to wheezing, coughing, or a runny nose.

Very rarely, severe reactions such as  anaphylaxis may occur. 

Egg allergies disproportionately affect children; experts estimate that up to 2 percent of kids are allergic to eggs. It is one of the most common food allergies in children, coming in second to milk allergy, and is typically diagnosed before age two. Odds are that 80% of children with an egg allergy will see this it resolve by age five, although more recent studies indicate about half of children will still have an egg allergy at age 10. By the teen years, most kids will have outgrown their egg allergy—but until then, avoiding them is absolutely crucial for your child's health. 

Among adults, many more people are avoiding eggs due to a sensitivity to them, or in order to determine whether they do better digestively without them. Egg sensitivities are generally less severe than allergies. The autoimmune paleo diet is an example of an elimination diet that removes eggs and other potential food sensitivities for a period of time and then reintroduces them one at a time, in order to determine which foods may be causing symptoms.

And of course, others have chosen to follow a vegan diet, which excludes all animal products including eggs. 

How Do I Know If I'm Allergic to Eggs? 

Well, the first step is to listen to your body. Do you or your children experience symptoms within a short time after eating eggs? If you do, a visit to an allergist is in order.

He or she can diagnose an egg allergy through a skin-prick test or a blood test. If those results aren't conclusive, an oral food challenge may be ordered, where you eat a small amount of egg under medical supervision to see what reactions develop. Lastly, a food elimination diet may be used. 

What Do I Need to Know If I'm Allergic to Eggs? 

If you or your child has an egg allergy, your life becomes a bit more complicated, as eggs are hidden in many food products including canned soups, salad dressings, crackers, cereals, baked goods, ice cream and many meat-based dishes, such as meatballs and meatloaf. Even some commercial egg substitutes contain egg protein. However, with some extra diligence and creativity, you can live a perfectly normal life and still enjoy a delicious, nutritious diet, sans eggs. 

Avoid both the white and the yolk. An important thing to know is that the egg white contains the allergenic proteins, but because the egg yolk and egg whites are housed together, individuals with true allergies should avoid the whole egg.

Read food labels. Reading food labels and asking about the ingredients of foods prepared by others will be vital to your success on an egg-free diet.

 If eggs are included in a product regulated by the Food and Drug Administration (FDA), the manufacturer is required to list “egg” on the product label. The Food Allergy Labeling and Consumer Protection Act (FALCPA) is the legislation that requires manufacturers to list egg as a potential allergen ingredient for the consumer. Not only will you find this information in the ingredient list, but it will also be on the package.

Avoid cross-contamination. Products may also contain advisory labeling with statements such as “may contain egg” or “this product has been made in a facility that also produces egg.” While this labeling is not regulated, you should still avoid products with these statements.

If you are unsure about the contents of a product, there are two things you can do: call the manufacturer and inquire about the specific ingredients contained in the product, and/or skip eating the product.

If your newborn is allergic, don't eat eggs. For egg allergic babies who are breastfeeding, moms should avoid egg in their diet, as the egg proteins pass through breastmilk to the baby and may trigger symptoms.

Work with your allergist to determine how strict you have to be. Approximately 70% of people with egg allergy can tolerate small amounts of egg in baked products like cake or cookies. This is due to the process of baking, when heat alters the egg protein so that it is less allergenic. Simply baking an egg isn’t the same; in baked foods the amount of egg exposure is diluted among other ingredients. Still, it's hard to know whether you or your child will be among this 70%. Working with your allergist to determine what foods are safe is your best bet. 

What Do I Eat Instead?

Avoiding egg for an egg allergy means eliminating an important food from your diet. Whenever you have to do this, you must make an effort to replace the important nutrients offered by the eliminated food (in young children, multiple food allergies can be associated with problems with weight gain and growth due to the restricted diet they require). 

Egg is a good source of protein, vitamin D, vitamin B-12, pantothenic acid, selenium, folacin, riboflavin, biotin, and iron. These nutrients can be easily supplied by meat, fish, and poultry foods; whole grains; and vegetables.

As for what to eat for breakfast that packs an equal protein punch, you might try some of these filling ideas to keep you satiated:

  • Chicken or turkey breakfast sausages with a hash of Brussels sprouts and shredded sweet potato
  • A bowl of steel cut oatmeal topped with nuts (barring a nut allergy) and fresh fruit
  • A berry and spinach smoothie with protein powder 
  • Chia seed pudding made with coconut or almond milk and topped with fruit 

Baking without eggs can prove to be a bit challenging, but due in part to the rise of vegan diets, there are many egg-replacement recipes available through a quick Google search. The most common go-tos are flax seed (1 tablespoon of ground flax mixed with 3 tablespoons of water to replace one egg); baking soda and vinegar (1 tablespoon of baking soda mixed with 1 tablespoon of white vinegar to replace one egg); and mashed banana (1/2 to 1 banana to replace one egg). 

Quick Note About Vaccines

There are several types of vaccines that contain egg protein, with the most common ones being vaccines cultured in egg protein. MMR (measles, mumps, and rubella vaccine) is one such vaccine. Based on studies done in children with egg allergy who safely received the MMR vaccine, the American Academy of Pediatrics (AAP) states that the MMR vaccine can be safely administered to those individuals with egg allergy. This includes children with severe egg allergy.

The influenza vaccine also contains a small amount of egg protein, usually. According to the American Academy of Allergy, Asthma & Immunology (AAAAI): "Studies show that flu vaccines can be safely administered to egg allergic individuals, wither in the primary care provider's office or allergist's office depending on the severity of the allergic reaction to eating eggs." Translated: a child or adult may receive this vaccination under the supervision of a medical professional, and where emergency treatment is readily available—not your local pharmacy or grocery store. According to the Centers for Disease Control and Prevention (CDC), no one with an egg allergy should receive the nasal spray version of the flu vaccine.

The yellow fever vaccine also contains egg protein. Both the World Health Organization (WHO) and CDC state that a severe egg allergy is a contraindication for that vaccine. 

Sources

Food Allergy Research and Education (FARE) website (http://www.foodallergy.org/allergens/egg-allergy)

Boyce JA et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report from the NIAID-sponsored Expert Panel. J Allergy Clin Immunology. 2010.

World Health Organization (WHO)

Centers for Disease Control 

American Academy of Allergy, Asthma, and Immunology

Sicherer, S. Food Allergies: A Complete Guide for Eating When Your Life Depends on It

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

The Kitchn. 5 Vegan Substitutes for Eggs in Baking. 

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