Allergy diet - milk, egg, soy, wheat, seafood, peanut and tree nut free
This document is part of the ACI Diet Specifications for Paediatric Inpatients. It is not to be used for patient education.
Aim
To provide a diet suitable for patients with allergy to milk/dairy, egg, soy, wheat, seafood, peanut and tree nuts.
Characteristics
Foods free of milk/dairy, egg, soy, wheat, seafood, peanut, tree nuts and any food items containing them. Nutritious snacks are important to achieve energy needs, as well as specialised dietary products and supplements.
Indications
Multiple food allergy, Eosinophilic Oesophagitis.
Nutritional adequacy
Nutritionally adequate. Assessment and menu planning supervision by an on-site clinical dietitian is required. Nutrition supplements may be required to meet patients’ energy and/or nutrient needs.
Precautions
Should be initiated by a physician. An on-site clinical dietitian should be involved in the assessment and implementation of the diet. For children who do not need this level of food exclusion, the appropriate individual allergy diet(s) should be selected from the Therapeutic diet specifications for adult inpatients to maximise nutritional value and variety.
Note: Gluten is one of the proteins found in wheat, barley, oats and rye. If a product is gluten free it will be wheat free. In this diet only wheat protein is avoided. Oats, barley and rye are suitable. Glucose from wheat is suitable.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | All meats: lamb, beef, pork, chicken, duck, turkey, bacon, ham (wheat-free), gluten-free, egg-free sausages Vegetarian main dishes containing fresh, dried, canned and frozen vegetables Chickpeas, legumes Gluten-free baked beans | Meat marinated in sauce Hamburgers containing egg and/or wheat Sausages, rissoles, meatloaf containing wheat, soy, egg Fish, shellfish Egg white, yolk, dried, powdered, solids Tofu, soy cheese or soy drink Meats crumbed or battered in wheat flour/bread crumbs Meat/casseroles thickened with wheat flour Canned vegetables/legumes thickened with wheat Pizza base Pastry Main meals containing cream, cheese or milk |
| Sauces, gravies | Gravies thickened with gluten-free flours including cornflour, arrowroot, rice flour, potato flour, chickpea flour, tapioca flour, polenta Gluten-free tomato sauce | Gravies thickened with wheat flour, semolina Cheese sauce, white sauce Soy sauce, miso, tamari Sauces made with egg, milk/dairy, wheat, fish, cream, cheese, sour cream Gluten containing tomato sauce |
| Starchy vegetables/pasta/rice | Plain potatoes, sweet potato, rice, including rice noodles, rice paper rolls Gluten-free pasta, including pasta made from corn, amaranth, quinoa, millet, buckwheat, vegetables | Coatings/batters containing wheat/egg/dairy Potato chips dusted in wheat flour, soy or dairy All pasta containing wheat, gluten, milk and egg Couscous, semolina |
| Vegetables | All fresh, dried, canned and frozen vegetables | Canned vegetables and legumes thickened with wheat Canned vegetables in cream (e.g. mushrooms in butter sauce) Wheat flour coated or dusted potato wedges and potato chips Vegetables battered/crumbed in wheat flour/ breadcrumbs |
| Soups | Soups made from allowed ingredients, including meat, vegetables, lentils, legumes (except soy and peanuts), rice and gluten-free pasta | Soups containing wheat, milk/dairy, egg, soy, nuts, cream |
| Sandwiches | Meat, chicken, salad vegetables, gluten-free ham and bacon All made on gluten-free bread/rolls made from the following: rice flour, oats, rye, barley, millet, buckwheat, polenta, corn, quinoa, tapioca, potato flour, sago, amaranth, sorghum, arrowroot, chickpea (besan), lupin, lentil, pea, psyllium husk, polenta, xanthan gum, guar gum Milk-free margarine | Egg, cheese, fish, seafood, tofu, sausage meats, salami Breads, rolls, muffins, bagels, crumpets containing wheat, milk/dairy, egg, soy, peanut and tree nuts Butter and most margarines |
| Salads, dressings | Vegetables Potato Full bean mix White vinegar, oil, lemon juice Gluten-free tomato sauce Herbs and spices | Canned vegetables, vegetables thickened with wheat Milk, cream, cheese Soy Egg, mayonnaise Peanut or satay sauce |
| Breads, cereals | Rice cereal, puffed rice, rolled rice Infant rice cereal (gluten-free) Gluten-free cereals made from grains (e.g. corn, oats, rye, barley, millet, buckwheat, arrowroot, tapioca and other allowed cereals) Polenta Breads/cereals made from gluten-free grain/ flour (e.g. rice flour, oat flour, rye flour, barley flour, millet flour, buckwheat flour, polenta (corn meal), corn (maize) flour, quinoa, tapioca flour, potato flour, sago flour, amaranth grain, sorghum flour, arrowroot flour, chickpea (besan) flour, lupin flour, lentil flour, pea flour, psyllium husk, polenta, xanthum gum, guar gum Gluten-free bake mixes, etc. Taco shells, white corn tortillas Gluten-free baking powder Dextrose (wheat) Pappadams | Breakfast cereals made from wheat, soy, milk/ dairy, peanut and tree nuts Couscous All breads, rolls, muffins, bagels, crumpets containing wheat, rye, barley, oats, milk, egg, soy, peanut and tree nuts Wheat – and its varieties: plain flour, self raising flour, wheat germ, wheat meal, wheat bran, wheat starch Grains – and its varieties: spelt, kamat, durum, semolina/farina, bulgar (burghul), triticale, bread crumbs, baking powder, thickener numbers 1400-1450 (if derived from wheat), dextrin (wheat), modified starch (wheat) |
| Spreads | Milk-free margarine Honey, jam, golden syrup, maple syrup Vegemite™ | Butter, margarine containing milk, egg, soy, wheat, peanuts or tree nuts All spreads containing milk, egg, soy, wheat, peanuts and tree nuts Peanut butter, nut spreads |
| Hot breakfast choices | Bacon (wheat-free), gluten-free, soy-free and egg-free sausages Tomato, mushrooms Gluten-free baked beans Gluten-free spaghetti (no cheese) Gluten-free hash browns Gluten-free creamed corn | Eggs Baked beans/creamed corn thickened with wheat flour Hash browns containing wheat flour |
| Fruit | All fresh, canned, dried and frozen fruit | Fruits with pastry, cake, batter or sauces thickened with wheat flour |
| Yoghurt | None | All |
| Desserts | Jelly Ice blocks Sweetened toppings (gluten-free) Gluten-, soy-, milk-free cake mix Custard made on rice drink thickened with cornflour Milk and egg free sorbet and gelato Milk, soy, nut and egg free chocolate Cocoa | Ice-cream, milk puddings, custard Pastries Cakes containing wheat Desserts containing egg such as meringue, pavlova Chocolate containing milk, egg, soy and nuts All nuts |
| Milk and cheese | Rice drink (fortified with calcium) Soy lecithin | Milk, soy beverage Custard and dairy desserts Butter, cheese Cream, sour cream, ice-cream |
| Beverages | Water Fruit juice, vegetable juice Rice drink Lemonade, cordial Black tea and herbal tea Coffee Caramel colour (wheat – no detectable gluten) Sweetened gluten-free toppings Cocoa and carob | Milk-based drinks, such as milkshakes, malted milk, flavoured milk Milo®, drinking chocolate Soy beverage Drinks containing maltodextrin (wheat) |
| Biscuits | Rice crackers and cakes, corn crackers, corn thins Gluten, egg, milk, soy, and nut free biscuits and crackers | Biscuits and crackers containing gluten, egg, wheat, soy, milk, peanuts, tree nuts |
| Miscellaneous | Salt, pepper, herbs Gluten, soy, egg, and dairy-free stocks/stock powder Selected confectionery (made with wheat or corn glucose) Glucose polymer Plain potato chips, corn chips, popcorn, taco shells | Muesli bars All snack food containing wheat rye, barley, oats, soy, egg, milk, peanuts and tree nuts All nuts including almonds, brazil nuts, cashews, pistachios, peanuts, chestnuts, macadamia nuts, walnuts, pine nuts Stocks, seasoning with added wheat, soy, nuts, dairy Chocolate Nuts (all) Any nut oil |
References
- Spergel J, M and Shuker M. Nutritional Management of Eosinophilic Esophagitis Gastrointest Endoscopy Clinics N Am 18 (2008), 179-194.