If you’re checking an ingredient list with the intensity of a bomb defusal scene, you may have a food allergy. These days, allergies are as common as the common cold, and it’s not unusual to see nut-free tables in school cafeterias, EpiPens in purses and coworkers who can spot “may contain” warnings faster than you can spot an item on the shelf. It’s a whole new food world, and dietitians can help make it safe, healthy and still full of flavor.

May is Food Allergy Action Month, and Food Allergy Awareness Week is May 11-17, so it’s a vital time to raise awareness, advocate for safe food environments and empower clients navigating food allergies.

With the growing variety of allergens, evolving labeling laws and cultural diversity in diets, dietitians must stay up-to-date to provide accurate guidance on allergen avoidance, cross-contact prevention and appropriate substitutions. Food allergies also affect social inclusion, mental health and quality of life, especially in children, so dietitians play a critical role, not just in managing diets, but in supporting clients holistically. Being knowledgeable allows dietitians to educate communities and remain trusted leaders in both clinical and everyday settings.

Background

Food Allergy Awareness Month is a national awareness campaign, led by organizations like FAACT (Food Allergy & Anaphylaxis Connection Team) and FARE (Food Allergy Research & Education) and shines a light on the reality of food allergies — which affect millions of Americans. Approximately 33 million people in the U.S. have at least one food allergy, including over 27 million adults (nearly 11%) and 5.6 million children (about 8% or 1 in 13 kids). The most common allergens include shellfish (8.4 million), milk (6.2 million), peanuts (6.2 million) and tree nuts (3.9 million). Around 40% of children with food allergies are allergic to multiple foods, according to FARE. The goal of the monthlong initiative is to educate the public, promote inclusion and advocate for safety, recognizing that food allergies can affect anyone, regardless of background or age. The theme #FoodAllergiesDontDiscriminate emphasizes that food allergies cross all boundaries — cultural, economic and generational — and require community-wide awareness and compassion.

Food Allergy Awareness Week is a focused, high-impact week within the month where clients, schools, communities, businesses and media join forces to amplify the message. It’s a time for collective advocacy, storytelling and education about the seriousness of food allergies, including life-threatening reactions like anaphylaxis. When more people understand the risks and how to respond, lives can be saved.

As a refresher, for clients with food allergies, exposure to certain foods can trigger a serious immune response. This may result in severe illness or even death. The only way to prevent an allergic reaction is to strictly avoid consuming foods that contain allergens. However, this can be difficult due to the complexity of modern diets and the frequency with which Americans eat foods prepared by others. That’s why having clients read labels and clearly communicate about food allergies are critical steps in reducing risk.

Evolving allergen trends

Although the “Big 9” allergens — milk, eggs, peanuts, tree nuts, soy, wheat, fish, shellfish and sesame — remain the most well-known, the allergy landscape is shifting. Sesame was added in 2023 to the FDA’s list of major allergens, and as of 2024 we’re also seeing an increase in legume allergies beyond peanuts, particularly to lentils, chickpeas and lupin, ingredients often featured in plant-forward diets. Additionally, food allergies among children doubled from 2000 to 2018, according to Northwell Health. Researchers are examining factors like underexposure to allergens in early life, changes in gut microbiota due to processed foods and even the eradication of certain parasites that may have once helped regulate immune responses. Past recommendations, like delaying peanut exposure in infants, may have unintentionally increased allergy risk, leading to revised guidelines that now promote early exposure.

Climate change is worsening seasonal allergies as warmer temperatures and shifting environmental conditions cause plants, especially ragweed, to bloom earlier and more often, release more pollen and extend allergy seasons by up to three weeks, according to the Association of American Medical Colleges. This leads to more severe and longer-lasting symptoms for over 80 million Americans (as of 2021) and contributes to serious health and economic consequences, including increased asthma attacks, emergency room visits, reduced workplace productivity and even DNA damage in the respiratory system. These impacts highlight the growing link between climate change and human health.

Alpha-gal syndrome, a lesser-known allergy triggered by tick bites and associated with red meat consumption, is becoming more common, especially in the southeastern U.S. Additionally, oral allergy syndrome (OAS), remains underdiagnosed, even though it affects up to 50-75% of adults with seasonal allergies like hay fever. It occurs when the immune system mistakes proteins in certain raw fruits and vegetables, such as apples or celery, for pollen proteins, leading to itching in the mouth or throat after consumption. This is especially common in people allergic to birch pollen.

Treatments

Allergy treatments typically involve a combination of avoidance strategies, medications and immunotherapy. Avoiding known triggers is often the most effective first step and is guided by a healthcare professional. Medications such as pills, nasal sprays or eye drops can help reduce immune reactions and relieve symptoms, according to the Mayo Clinic.

For more severe or persistent allergies, immunotherapy may be recommended, including allergy shots or sublingual tablets that gradually desensitize the immune system. Those with life-threatening allergies may need to carry emergency epinephrine to manage severe reactions. At-home remedies like saline nasal rinses, dust and mold control and HEPA-filtered vacuuming can also help manage symptoms. Additionally, acupuncture may offer some relief from hay fever, though more research is needed to confirm its effectiveness.

Does honey help?

While the idea of eating local honey to relieve seasonal allergies is popular, especially as climate change worsens pollen levels, it’s more of a myth than medicine, according to WebMD. The theory, based on the concept of gradually desensitizing the body through exposure to local pollens, sounds similar to allergy immunotherapy, but it doesn’t hold up scientifically. That’s because the pollen causing most allergies comes from trees, grasses and weeds, not flowers, which bees use to make honey. Even if allergy-causing pollens did make it into honey, their amounts would be unmeasured and likely too low to trigger a useful immune response.

Unlike medical immunotherapy, which uses precise, increasing doses of known allergens under medical supervision, honey offers no such control or consistency. Although honey is generally safe (except for infants under 12 months), studies show no clear benefit for treating allergies. Proven treatments like allergy shots or tablets offer far better outcomes, with up to 90% of patients reporting significant improvement.

Cross-contact and labeling concerns

You know you’re a dietitian in 2025 when you’re less worried about calories and more worried about if that cookie was baked in a nut-adjacent facility. As awareness of food allergies grows, so does the emphasis on avoiding allergen cross-contact. Many clients now question food labels for advisory statements like “may contain…” “produced in a facility with…” or “processed on shared equipment,” and often turn to RDs for help understanding what these terms mean and how to respond. For clients with severe allergies, even trace amounts of an allergen can pose a serious risk, making label literacy and kitchen safety essential parts of your counseling.

This need for clarity is amplified by the popularity of minimally processed and clean-label foods, which may lack comprehensive allergen disclosures or be produced in smaller facilities where cross-contact protocols vary. Your expertise in reading between the lines can help clients make safer, more informed choices.

Cultural awareness also plays a growing role in allergen guidance as global cuisines become more mainstream. Ingredients like sesame, coconut, lentils, chickpeas and tamarind are increasingly common in both restaurants and packaged foods, but may not always be flagged as allergens depending on ever-evolving labeling laws or cultural norms. (This recent article from the ARC Health and Wellness Community details the FDA’s 318-page rule which redefines the criteria for labeling foods as “healthy.”) For example, tamarind, common in Latin, Indian and Southeast Asian cooking, can be an unrecognized trigger.

Substitutions

One of the most practical ways dietitians can support clients during Food Allergy Action Month and year-round is by recommending safe and nutritious substitutes for common allergens.

For dairy, fortified plant-based milks such as soy, oat, rice or flax are excellent options; it’s important to guide clients toward brands fortified with calcium, vitamin D and B12.

Egg replacements like flax or chia “eggs,” applesauce or aquafaba work well in baking and cooking, while also addressing texture and nutritional gaps.

For peanut and tree nut allergies, sunflower seed butter, soy nut butter and roasted chickpeas are great alternatives, though it’s essential to verify safety for those with multiple allergies or risk of cross-contact.

Wheat can be replaced with certified gluten-free grains like quinoa, millet and sorghum, while attention to fiber and B-vitamin intake helps prevent nutrient shortfalls.

For soy allergies, options like coconut aminos in place of soy sauce and pea protein-based products offer comparable flavor and protein.

In fish and shellfish allergies, omega-3-rich algae supplements and jackfruit (as a textural stand-in) are helpful tools.

And as sesame gains recognition as a major allergen, substitutions like sunflower or pumpkin seeds and tahini-free hummus are becoming more widely available.

While substitutions are critical, your role goes far beyond swapping ingredients. You can educate on safe food handling practices to prevent cross-contact, especially in shared kitchens or schools. You can promote label literacy, especially as food labeling laws evolve. You can also support clients emotionally, helping them cope with food-related anxiety or social limitations. In pediatric populations, food allergies can lead to disordered eating or anxiety around mealtimes, making your guidance even more important. Staying connected to advocacy organizations such as FARE, Kids With Food Allergies and being familiar with local school policies allows you to serve as a trusted resource within your communities.

Food Allergy Action Month is a time to reaffirm your commitment to evidence-based, empathetic care. Food allergies are more than a list of foods to avoid, they’re a daily reality that affects nutrition, social connection and emotional wellbeing. By staying informed on trends, embracing cultural awareness and promoting safe and nourishing substitutions, you can help your clients live safely and eat joyfully.