Entertaining guests who have food allergies or intolerances can strike fear into the heart of any host, but there are some simple ways to keep your guests happy and healthy

Food allergies

What is a food allergy?

‘Food allergies are related to the immune system,’ explains Holly Shaw, nurse advisor at Allergy UK. ‘It’s where the body identifies a normally harmless food protein and mounts an allergic response to that food.’

‘When the immune system of an individual who is allergic to something recognises that food or substance, it sends out IgE antibodies, which are specific to that particular protein and link to it. This then stimulates the release of an allergic reaction and the production of histamine, which goes on to cause the allergic symptoms.’

Allergic reactions can be mild, moderate or severe, and symptoms could include swelling of the lips and tongue, hives and vomiting. The most severe reaction is anaphylaxis, which can result in collapse and unconsciousness.

How is food intolerance different?

There are many different types of food intolerances, the signs and symptoms of which are specifically related to the gut.

Symptoms may include bloating, nausea, diarrhoea and constipation. However, some people with an intolerance can still eat small amounts of trigger foods without suffering.

Also, unlike a food allergy, where symptoms usually show immediately or within two hours of eating the allergen, an intolerance may have a delayed reaction. Holly explains, ‘The symptoms of food intolerance might be quite delayed and could show up three or four days later.’

Milk

While the majority of people grow out of a milk allergy in childhood, an intolerance to lactose – the sugar in milk – is common among adults.

‘If you have a milk allergy you would need to avoid cow’s milk and products that contain it, such as cheese, ice cream and fromage frais,’ says Holly.

‘For those with lactose intolerance, the symptoms are gut-related and people may feel unwell in different ways or have an upset tummy, but while it may make them feel very unwell, they would not have a severe allergic reaction,’ she adds.

If guests can’t have milk products, try this for a dessert: ‘Coconut milk yogurt makes a delicious, creamy alternative to dairy,’ says nutritionist Kim Pearson (kim-pearson.co.uk). ‘Layer with strawberries and broken meringue to make an Eton mess.’

Fish

If you are planning to serve fish over the Christmas period you may find that your baked salmon could get you into hot water with guests with a fish allergy.

It’s a common food allergy among adults and while some people have to avoid all fish, others’ allergies are specific, which means they can eat one type but not another.

‘Those with a fish allergy should avoid fish completely unless they have had testing or food challenges that result in them being safe to eat specific types of fish, as guided by their allergy doctor,’ Holly says.

Kim recommends a tasty fish alternative as a table centrepiece this Christmas.

‘A fillet of beef is a good source of protein and B vitamins,’ she says. ‘However, it’s important to opt for grass-fed and ideally organic beef if you can, to really maximise the health benefits.’

Gluten

Gluten intolerance – or coeliac disease – is an autoimmune disease related to the protein gluten that is found in cereals such as wheat and barley. It’s found in many festive foods, including stuffing with breadcrumbs and gravy that is thickened with cornflour.

‘An autoimmune disorder occurs when the body’s immune system attacks and destroys healthy body tissue by mistake,’ says Holly. ‘So in individuals with coeliac disease who eat gluten, this autoimmune response results in damage to the lining of the small intestine.

‘It also causes gut-related symptoms, such as nausea, wind, and a range of other symptoms including tiredness and not being able to concentrate,’ she adds.

Kim says there are alternative foods you can eat to keep gluten off the dinner table. ‘Quinoa can be used as an alternative to breadcrumbs in a stuffing mixture. It’s naturally gluten-free and is a good source of fibre, protein and essential minerals,’ she says.

Shellfish

Many people choose to serve shellfish such as lobster and crab over the Christmas period for an indulgent treat.

And while some hosts may offer someone with a shellfish allergy – which encompasses prawns and scallops – an alternative dish, that won’t always avoid a reaction.

‘When you cook shellfish the vapours may become airborne, and in some highly sensitive individuals this may cause allergic symptoms,’ says Holly.

‘Everyone with an allergy reacts differently. And some may be allergic to just one type of shellfish, while others are allergic to all types.’

Kim suggests serving gravlax as an alternative. ‘Salmon is rich in B vitamins, which are essential for converting food into usable energy,’ she says. ‘They are also important for brain health and protecting the
brain as we age.’

Nuts

It may seem hard to avoid nuts at Christmas – they are often set out in bowls as a snack or contained in the boxes of chocolates we enjoy.

But as an allergy to peanuts or tree-nuts – which are grown on trees and include almonds, cashews and pistachios – can lead to severe reactions, it’s essential to prepare for guests with allergies.

Some people can be allergic to just one type of nut, while others may be allergic to all nuts.

‘With nut allergies, the proteins can be transferred through touch, and individual tolerances and sensitivity will be different – some may be able to tolerate eating something that was made in a factory alongside foods containing nuts, whereas for someone with asthma, simply having peanuts in the environment might cause them to feel short of breath,’ says Holly.

Give guests olives to snack on instead, says Kim.

‘They are a source of vitamin E, a powerful antioxidant, and iron, for healthy blood.’

Essential advice

✤ Communication is key – ask guests what their food allergy or intolerance is and use that information to help plan your menu.
✤ Avoid cross-contamination – if you are using a chopping board for a food you know someone is allergic to, make sure it’s only used for that food. Washing with hot soapy water or in a dishwasher will remove the proteins.
✤ Read labels – many sauces and condiments contain fish, such as Worcestershire Sauce. Always check.
✤ Remember, alcohol can cause problems, too – the alcohol itself can be a trigger, as it has various ingredients that some people can’t tolerate.

For gluten-intolerant guests, gluten-free beers are available online (glutenfreebeers.com). Wine may contain suphites, which can cause a problem with people with asthma or sensitivity to sulphites.