Safe Food Substitutions for Top 9 Food Allergens

Various foods are displayed, including peanuts, milk, soybeans, hazelnuts, salmon, shrimp, and eggs, arranged on a wooden surface. These items are commonly associated with food allergies.

If you or a loved one lives with food allergies, you may have to adapt your diet to prevent an accidental exposure. But do you have to give up your favorite meals? In most cases, the answer is no. That is because, for many meals and recipes, you may be able to swap out the food allergens with safe substitutions. You can find these substitutions in most grocery stores.

When planning a meal or considering a recipe, always check the food labels or look at the ingredients to identify any potential food allergens. Many are used as food additives.

Then consider alternatives to help manage food allergies. For example, people with a cow’s milk allergy can find almond, cashew, coconut, macadamia, oat, and rice milk in most supermarkets. If you have an egg allergy, applesauce is a possible substitution for a recipe. If you have a peanut allergy and cannot eat peanut butter, consider sunflower or oat butter. And most grocery stores have a gluten-free section for people with wheat allergy.

Remember: people who eat one of their allergens are at risk for food allergy symptoms – and possibly a severe allergic reaction (life-threatening anaphylaxis). It’s important to prevent food allergies with substitutions or not eat the meal at all.

Infographic titled "Top 9 Food Allergens," listing peanuts, tree nuts, dairy, wheat, soy, fish, eggs, shellfish, and sesame. Each allergen is illustrated with images and examples. Allergy & Asthma Network logo on top left.

The top 9 most common food allergens in the United States are:

  • peanuts
  • tree nuts
  • cow’s milk
  • eggs
  • fish
  • crustacean shellfish
  • soy
  • wheat
  • sesame

These nine foods are in many packaged foods and on restaurant menus. They are nutritious and provide protein and other important vitamins and minerals. Safe substitutions are available for each of these common food allergies.

When considering food substitutions, it is important to use foods that have similar nutrients, vitamins and minerals. It may be helpful to replace food allergens with substitutions that function in the same way, even if they are not as nutritious. For example, wheat flour can be replaced with other types of non-wheat flour when making bread. But the substituted flour may not be nutritionally the same as wheat flour. In these cases, it’s important to get any missing nutrients from other foods in your diet.

A diet that is diverse and includes nutritious foods can be balanced even if you have food allergies!

Food Allergen Substitution Chart

Below is a chart with substitutions for the top 9 food allergens. These recommendations are for informational purposes. Any changes to a diet or meals should be addressed with your healthcare provider and possibly a nutritionist. Some people may need to rely on trial and error with certain substitutions (especially baked goods) to ensure the food is nutritious and safe.

Allergen

The top 9 most common food allergens in the United States

Potential Substitutions

Recommendations are for informational purposes.

Peanuts

Peanuts are botanically a legume, like soybeans, but from a cooking perspective they are classified as a nut. They are eaten like other nuts, usually roasted as a snack or ground into a spreadable paste (peanut butter). Peanuts provide protein, magnesium, potassium, zinc, folate and other micronutrients.

Because of the refining process, highly refined peanut oil is not considered allergenic, but should be discussed with your healthcare provider. Unrefined peanut oil is allergenic and can cause reactions.
Tree nuts (if not allergic)

Seeds such as sesame (if not allergic), sunflower, and pumpkin (or pepitas)

Peanut-free butters as a replacement for peanut butter

Peanut oil can be replaced by other safe oils

Tree Nuts

Tree nuts include almonds, beech nut, Brazil nut, butternut, California walnut, cashew, chestnut, chinquapin, coconut, cola/Kola nut, Filbert/hazelnut, Gingko nut, Heartnut or Japanese walnut, hickory nut, macadamia nut, palm nut, pecan, pine nut, pili nut, pistachio, shea nut, and walnut (English, Persian).

Tree nuts are generally high in healthy fats and protein, vitamin E and K, magnesium potassium and B vitamins, which vary by the type of nut.

In most cases, people with a food allergy to one tree nut are not allergic to all tree nuts. However, there can be cross-contact. This occurs when protein from one allergen transfers to a different food.

Tree nuts are eaten as snacks, butters, as ingredients in foods and recipes, and as oils. Most tree nut oils are not highly refined and can cause allergic reactions. Discuss with your healthcare provider whether you need to avoid all tree nuts or can include tree nuts to which you are not allergic.
Tree nuts may be eaten interchangeably, so you may be able to replace them with other tree nuts even if you are allergic to one or more. Check with your healthcare provider first, though.

Seeds such as sesame (if not allergic), sunflower, and pumpkin (or pepitas)

Roasted chickpeas for salads

Peanut and peanut butter (if not allergic)

Cow’s Milk

Cow’s milk products are a common food and ingredient. It is consumed as a beverage, cheese, ice cream, or yogurt. It may be found as an ingredient in everything from flavored snack chips to hot dogs. It is important to carefully read the ingredient label every time a food is eaten to avoid cow’s milk. People who are allergic to cow’s milk may react to other types of animal milk, including goat’s milk or sheep’s milk.

Before consuming cow’s milk, talk with your healthcare provider. Raw cow’s milk is not safe for people with cow’s milk allergy and it may cause foodborne illness even in those who are not allergic. “Nondairy” and “lactose-free” do not mean that a food is free of any cow’s milk ingredients.

Cow’s milk is a source of protein, calcium, vitamins A and D. Evidence has shown that children with cow’s milk allergy may grow shorter than their non-allergic peers. This indicates a potential nutrient shortfall in protein or calcium and other vitamins and minerals. Ensuring that a substitute is nutritionally similar can be helpful in meeting the needs of growing children with most food allergies including cow’s milk allergy.

Soy and pea milks are the most nutritionally similar beverage substitute for cow’s milk.

Available milk substitutes also include almond, cashew, coconut, macadamia, oat, and rice milk. Choose options that are fortified with vitamin D and calcium. For children, encourage unflavored and unsweetened versions. These beverages should not be given to children under 12 months of age; they should be given breastmilk or infant formula instead.

Substitutions for ice cream, yogurt and cheese include products made from almond, cashew, coconut, oat and rice milk. These products are available in most markets across the country.

Eggs

Egg products are a good source of protein and important micronutrients. They also play a functional role in baking and cooking. Eggs are found in packaged foods and on restaurant menus in everything from chicken to bread to all types of candies and pastries.

Choosing a substitute for eggs depends on the purpose the egg plays in the recipe or dish. Some “egg substitute” products still contain eggs, so make sure to carefully read the ingredient labels.

In place of scrambled eggs, try scrambled and seasoned tofu.

In baking, one egg can be replaced by ¼ cup applesauce, ½ of a mashed banana, 1 chia “egg” (one teaspoon chia seeds and 1 tablespoon water) or 1 flaxseed egg (1 teaspoon ground flax and 1 tablespoon water).

Products made to mimic eggs are available, including one popular brand made from mung beans.

Fish

Fish is a source of protein, health fats including omega-3 fatty acids, B vitamins, and magnesium. Nutrition varies by type of fish, such as trout, cod, salmon, mackerel, and tuna for example.

The type of fish must be indicated on the label. Some people with fish allergy can eat some types of fish and not others. Fish can be found as fish filets or whole fish, and as an ingredient in foods like anchovies and in fish sauce.

Animal  protein (chicken, beef, pork, crustacean shellfish if not allergic)

Plant-based proteins like soy products and beans

Omega-3 fatty acids can be found in chia seeds, hemp seeds, walnuts, and flaxseeds

Fish sauce, a common Asian condiment, can be replaced by soy sauce or coconut aminos.

Crustacean Shellfish

Crustacean shellfish includes crab, lobster and shrimp. Molluscan shellfish such as oysters, clams, mussels and scallops are not considered a major allergen in the U.S. and are not included in the labeling laws for shellfish.

Crustacean shellfish are a source of protein and omega-3 fatty acid, iron, B vitamins, zinc and copper. Nutrition varies by type of crustacean shellfish.

Animal protein (chicken, beef, pork, fish if not allergic)

Plant-based proteins like soy products and beans

Omega-3 fatty acids can be found in chia seeds, hemp seeds, walnuts, and flaxseeds.

Soy

Soy foods and ingredients are very common in the U.S. diet. Soy may be eaten green (edamame) or processed into tofu, tempeh, soy milk, miso paste, soybean oil or a host of other vegan alternative foods.

Soybeans, tofu, tempeh, soy milk and products made from them are nutritious. Soy provides protein, fiber, iron, magnesium, calcium, and B vitamins. Soy is also used as an ingredient for many recipes, such as soy sauce for flavoring and as soy lecithin.

Animal protein (chicken, beef, pork, fish if not allergic)

Plant-based proteins that do not contain soy and beans

In place of soy sauce, coconut aminos, tamari, or Worcestershire sauce may be used.

Soy lecithin and highly refined soy oil are not considered allergenic due to the processing that removes the protein.

Soy oil can be replaced by other cooking oils such as canola or olive oil.

Wheat

Wheat is a grain that is eaten all over the world and can be found in many foods. Types of wheat include einkorn, emmer, semolina, durum, spelt, and triticale. These should be avoided if you have a wheat allergy (often referred to as gluten allergy).

Wheat is often used in baked goods and as a main or minor ingredient in a host of foods including granola bars, cereals, crackers, sauces, starch, and as a natural flavoring.

Whole wheat is a good source of fiber. Whole and enriched wheat provides protein, B vitamins, and folic acid.

Corn, rye, oat, potato, rice and tapioca flours can be substituted for wheat flour, depending on the function of the flour in the food item.

Non-wheat (gluten-free) flour blends

Non-wheat (gluten-free) whole grains and pseudo-grains include quinoa and amaranth.

Gluten-free pasta – most of these brands have semolina.

Sesame

Sesame is common as an ingredient in baked goods including breads, rolls and pastries, hummus. It is also used in certain foods as a natural flavoring/seasoning. Sesame oil is a common ingredient in Asian dishes and is allergenic.

Sesame is a source of protein and fats, fiber, magnesium, iron, calcium, and B vitamins.

Sunflower, chia, and hemp seeds.

Sesame oil can be replaced with other oils. Safflower oil offers a very similar flavor to sesame oil and can be cooked at high heat.

Tahini, a sesame paste, can be replaced by other nut or seed butters including peanut butter (if not allergic).

When substituting a food, be mindful of oral allergy syndrome. This occurs when people with pollen allergies to certain trees, grasses and weeds develop symptoms after eating foods that are botanically related to fruits, nuts and vegetables. For example, certain tree nuts such as almond, hazelnut and pumpkin are related to birch trees. Bananas and sunflower seeds are related to ragweed. Most oral allergy syndrome cases are mild, but more severe symptoms may emerge during pollen season.


Content written by Sherry Coleman Collins, MS, RDN, LD, an award-winning registered dietitian and nutritionist. Visit her website at SouthernFriedNutrition.com.


Sources: U.S. Department of Agriculture (USDA); U.S. Department of Health and Human Services (HHS); Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration (FDA); U.S. Centers for Disease Control and Prevention (CDC)


Reviewed by:
Purvi Parikh, MD, FACAAI, is an adult and pediatric allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.