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Can Food Additives Cause Allergic Reactions?

Allergic reactions and intolerances to food additives are uncommon, but reactions can and do occur.

A woman reads the nutritional information and ingredients on a loaf of bread checking for allergens and additives that can cause an allergic reaction.

Updated on March 11, 2024

Food allergies are an abnormal response by the immune system where ingestion or exposure to certain foods causes an immune response. When exposed to a trigger food, a person with food allergies may experience a range of symptoms that affect the skin, the respiratory system, and gastrointestinal tract. While food allergies can develop at any age, most cases begin in early childhood.

Most children with food allergies will outgrow the allergy as they get older. While living with a food allergy, parents and children will need to work closely with a healthcare provider to manage the condition.

Managing food allergies

There is no cure for food allergies, and treatment focuses on managing the condition. The primary—and most effective—method of managing a food allergy is avoiding the food or foods that trigger the allergy. While a person can be allergic to nearly any food, most food allergies involve a few foods:

  • Eggs
  • Wheat
  • Dairy
  • Peanuts
  • Nuts
  • Shellfish
  • Fish
  • Soy

A person can be allergic to one food, or they may be allergic to multiple foods.

Adverse reactions to food additives

Some people also have allergic or adverse reactions to food additives. These reactions can include similar symptoms to food allergies—hives, itching, skin rash, GI upset (like vomiting, diarrhea, and bloating), and difficulty breathing.

Though it’s not common, adverse reactions to food additives can include anaphylaxis, a severe allergic reaction that causes the body to go into shock and requires immediate emergency medical treatment. Children at risk for anaphylaxis—as well as parents, educators, school nurses, coaches, and caretakers—will need to have access to self-injecting epinephrine, which is required to treat anaphylaxis.

What are food additives?

Additives are substances that are added to foods. This includes substances that were added directly, as well as substances that were added indirectly. Additives are also found in other products, including cosmetics and medicines. Additives are common and considered safe unless a person experiences a reaction to a particular additive.

Direct food additives

Direct food additives are intentionally placed in a food for a specific reason during production. They may be added to improve texture, nutrient value, to prevent foods from going bad, or to add flavor. Preservatives, coloring, and sweeteners are all examples of direct food additives.

Indirect food additives

A person can also have a reaction if a food or product contains a food they are allergic to. Indirect additives are not an ingredient or component of a food, but are added incidentally during production, packaging, storing, or preparation. For example:

  • Indirect additives are the reason you will find snacks like candy bars with statements like “may contain peanuts” or “may contain eggs” printed on the label. Peanuts are not an ingredient in the candy bar, but small amounts may have been added during production if the same equipment was used to produce candy bars that contain peanuts and candy bars that do not contain peanuts.
  • If a fried food—like chicken fingers—was cooked using oil or equipment that was also used to fry fish or shellfish. For a person with an allergy to fish or shellfish, this can cause an allergic reaction.

Carefully reading nutritional information and warnings on food labels is an important step in avoiding allergens. People with food allergies and parents of children with food allergies should also disclose this information to restaurant staff any time they are dining out.

Working with a healthcare provider

Reactions to food additives can be difficult to identify because they are much less common than the food allergies mentioned above, and there are a great number of potential culprits. Reactions to seemingly unrelated foods or processed foods may be a sign that a person has an allergy or sensitivity to a food additive.

If a child in your care experiences symptoms of an allergic reaction—to food or another possible trigger—see a healthcare provider. In addition to working to identify the cause of the reaction, a healthcare provider can provide instructions on avoiding allergens, alleviating symptoms, and how to recognize and respond to a severe allergic reaction like anaphylaxis.

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Ozge Nur Aktas, Christopher Warren, et al. Prevalence and Characteristics of Multifood Allergy Among US Children with Food Allergy. The Journal of Allergy and Clinical Immunology, 2019. Vol. 145, Issue 2 Supplement.
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