Caregiver Tips for Managing Food Allergies in Elders

By Beth Scholer CC, CDM, CFP

Food allergies are often thought to primarily effect infants and children. Research suggests that 5-10% of the elderly population is affected. It is likely that many cases are undiagnosed, making the number of food allergy cases much higher. A number of factors, from slower digestion to poor nutrient bioavailability, contribute to the increase. Undiagnosed food allergies (including celiac disease) in older adults can contribute to depression, inflammation and a general feeling of weakness and discomfort.

Preventing Allergen Reactions

Caregivers have to be very vigilant when preparing food for a client with food allergies. Below are some tips for preventing an allergen reaction.

  • Wash hands between allergen and non-allergen foods.
  • Change apron or wear clean clothes when preparing food for someone with an allergy.
  • Wash (with hot soapy water) and rinse all utensils and surfaces before and after each use (knives, cutting boards and counter tops)
  • Keep menus simple; don’t use ingredients that may be hidden sources of allergens.
  • Read food labels; the eight common foods must be labeled.
  • If eating out, check the menu before arriving for safe options. Inform the server of the allergy and choose a dish where there is little chance for cross-contact.

Treating Food Allergies

The only proven treatment of a food allergy is to avoid the trigger food. Antihistamines and skin creams may relieve minor reactions. Anyone diagnosed with a food allergy should carry injectable epinephrine at all times. Seek medical attention immediately if a reaction occurs. Reactions can start out mild but become more severe with time.

Common Food Allergies

In the United States, eight foods are commonly known to cause food allergy reactions.

Milk, eggs, wheat, soy, fish, shellfish, tree nuts and peanuts cause about 90% of reactions.

Many other foods have been known to cause a reaction but it is important to understand the difference between a true food allergen and a food intolerance, which may cause uncomfortable, but not life-threatening symptoms.

Avoiding Cross Contact

Even a tiny amount of food can cause a reaction in someone with food allergies. It’s very important to prevent cross contact-inadvertently incorporating an allergen food into another food. Practicing good personal hygiene and cleaning tools and equipment are effective ways to prevent a reaction.

Symptoms of Food Allergy Reactions

A food allergy in an adverse reaction to a protein in a food. The reaction affects the immune system and symptoms can range from mild irritation to life threatening. Elders don’t typically experience anaphylaxis, which can make diagnosis more difficult. Symptoms of a food allergy reaction can involve the skin, eyes, mouth, respiratory or cardiovascular system or gastrointestinal tract and are often mistaken as side effects from medication autoimmune disorders, gastrointestinal problems or caused by aging in general.

Self-Diagnosed Allergies

Research indicates that 25-30% of adults self-diagnose food allergies. While this may seem harmless, it can lead to malnutrition of certain nutrients such as Vitamin D or iron which can in turn lower the function of the immune system. If an elder believes they have a food allergy, diagnosis can be made from a blood test and diet history. If the allergy is confirmed, avoidance of the food is the best treatment.

Why Are Elders at Risk?

A food allergy reaction occurs when the immune system makes a specific immunoglobulin E (IgE) to the allergen. The allergen binds to the IgE antibodies and signals the cells to release large amounts of histamine, causing a reaction. Aging causes decreased of stomach acid (decreasing the digestion of the allergen protein) and reductions in IgE. Deficiencies of key nutrients, such as iron, zinc and Vit. D. which play a critical role in immune function are often deficient in the elderly.

Chef Beth Scholer is certified by the American Culinary Federation and Association of Nutrition and Foodservice Professionals. She is a food scientist, culinary instructor, author and founder of Caregivers Kitchen. She can be reached at


Brophy, L.T. Late-Onset Food Allergies. Today’s Geriatric Medicine, 8 (3). Web. 7 Dec. 2015.

Scholer, B. (2015) Culinary Skills for Caregivers. Lakewood, CA. Avid Readers Publishing Group.

U.S. Dept. of Health and Human Services & National Institutes of Health. What is an Allergic Reaction to Food? NIAID. 6 Dec. 2010. Web. 7 Dec. 2015.