Christmas

Under European law, the ingredient lists of pre-packed foods must declare any of the 14 major allergens whenever they appear. Extra care should be taken with catered food where there is usually no ingredient list (see ‘Celebrations’ for more on eating out and allergen labelling).

Christmas foods include many traditional family favourites, with new trends and foods emerging every year. Products to be aware of from an allergy perspective include:

Stuffing: This can be made with all sorts of different ingredients with recent offerings including gingerbread, chestnut, cranberry, pomegranate and all different kinds of nuts.

Brussels sprouts: They’re not everyone’s favourite, but a Christmas classic nonetheless. When ordering in a restaurant, double check for garnishes such as flaked almonds or walnuts which may not always be indicated on the menu.

Christmas cake, Christmas pudding, panettone and mince pies: These Christmas classics tend to be made with a whole host of ingredients that are unsuitable for a range of different allergies, including gluten, eggs, milk, tree nuts and sulphur dioxide/sulphites used as a preservative. To help you find a recipe that is safe to eat, use a reliable app such as Food Maestro to source products that are free from your known allergen.

Stollen: This traditional German treat, which has now become popular in the UK, usually contains nuts, spices, dried fruits and marzipan (see below) though ingredients can vary, so check labels carefully.

Marzipan and praline: These are common ingredients in crafted figures on top of cakes or gooey centres in sweet treats at Christmas. Both products can contain various types of nuts and therefore should be avoided by those allergic to nuts.

Cranberry sauce: If you like a dollop of cranberry sauce on your Christmas dinner, be aware that some recipes include ingredients other than cranberries including slivered almonds or different types of fruit. This may also be the case for other popular festive sauces, such as bread sauce and special gravies, so our advice would be to always check the label!

Unlabelled chocolate products: If you have a food allergy, we’d recommend looking for boxes where chocolate treats are individually wrapped. However, bear in mind that as selection packs, Christmas tree chocolates and treats for children get passed around from person to person, they often get separated from the packaging containing key allergy information; something to be aware of when visiting friends and relatives. To be on the safe side from cross-contamination, you could look for a free-from alternative to take with you or offer to guests.

Advent calendars: Most free-from brands now produce alternative chocolate advent calendars suitable for those with certain allergies, so children don’t have to miss out on the fun in the countdown to Christmas!

Dark chocolate: If you’re allergic to milk, be aware that some brands of plain (dark) chocolate pose a risk even though there is no milk deliberately added. Many plain chocolate products share production lines with milk chocolate and therefore cross-contamination is a real possibility. There have been a number of product withdrawals where milk was detected in plain chocolate.

Special care is also needed with chocolate made on the Continent. Even if there is no nut warning, there may be a risk of nut cross-contamination.

As well as foods, alcoholic drinks can also contain allergens. If any of the 14 major allergens are present in an alcoholic drink this has to be declared in a warning on the label.

However, an exception to this rule are when nuts are used for making alcoholic distillates including ethyl alcohol of agricultural origin as they do not need to be labelled.

Some alcoholic drinks, for example Bombay Sapphire Gin, are infused through a mix of ingredients including almond oil. Some alcoholic drinks containing nuts include Frangelico, Nocello and Crème de Noix. The only way to know if nuts were used in the process for each drink would be to call the manufacturers. It is important to note that if it is used in the process, for example when making gin or vodka, it does not mean that the end product contains the nut. However, we would advise that it would be best to avoid.

Other allergens to watch out for in alcoholic drinks are milk in cream liquors, cereals containing gluten used to make beers and spirits, and sulphites in wines. Sometimes wines are produced using special clearing agents (finings) made from eggs, milk or fish – check the label as it must be noted if the amount still present in the finished wine exceeds the permitted thresholds.

Examine drink labels carefully, looking for any mention of allergens, and when out and about stick to ‘safe’ options. We also tend to drink a bit more during the festive season, be aware that drinking alcohol may reduce your vigilance and could also make any allergic reaction more severe.

The Christmas tree: Evergreen spores from Christmas conifers can cause runny eyes, skin rashes, sneezing and wheezing. For families living with general mould allergies, an artificial tree is a good option. If a live tree is a must for you, let the tree dry in a garage or enclosed porch for a week and give it a good shake before bringing it inside. This advice comes from the American Academy of Allergy, Asthma and Immunology. However, the tree should be removed altogether if there are any signs of allergic symptoms.

Balloons: Latex allergens may become airborne and inhaled which can mean party balloons can be a real concern for people living with Natural Rubber Latex (NRL) allergy. If you’re having an office party, having a quick chat with your employer about decorations may help provide some reassurance.

Poinsettias: These popular festive plants produce a milky ‘latex’ if their stems are broken that contains some allergen proteins in common with Natural Rubber Latex. Whilst unlikely to cause any problems for latex allergy sufferers just by being in the room, it may be best to avoid physical contact with the plant if you have a known allergy to latex.

Food: The greatest risk is from catered food where there is usually no ingredient list, so you need to ask direct questions at parties, in restaurants, at buffets and at other social events. Under European law, catering businesses are required to provide information on the presence of allergenic ingredients. This information can be provided in writing and/or orally. If information is provided orally, the food business must display some sort of clearly visible written signage to show customers that allergen information is available from a member of staff

Kissing under the mistletoe: With mistletoe popping up all over the place, it’s important to remember that allergens can remain in saliva for several hours, with expert estimates ranging from 2-24 hours. To avoid a reaction, make sure before you kiss that the other person is aware of your allergy and can ensure they have not consumed your allergen.

We know Christmas is a busy time but make sure you don’t enter the holidays with adrenaline auto-injectors that are out of date. If you have been prescribed treatments for your allergy, such as adrenaline auto-injectors, make sure you carry two with you wherever you go. This also applies to asthma inhalers. Good daily control of asthma is the single most important factor for lowering the risk from allergy.

Supermarkets often display nuts piled high on their shelves at Christmas, something we know can cause concern to many of our members as nuts can be displayed loose and within easy reach of children.

Our leading medical advisors provide reassurance that though handling nuts when they have been removed from their shells could cause a reaction, such as a skin rash, the risk from touching nuts while they are still inside their shells is minimal. If you notice any breakages or spillages that may cause a risk in the shops, report this to the staff.