University of Massachusetts Amherst

It's MORE Than A Meal


Special Nutrition Needs of Older Adults

food allergies & intolerances

A food allergy or intolerance is an improper reaction by the body to a food or additive. Although there is a difference between food allergies and intolerances, they both cause problems in susceptible people. Symptoms may include wheezing, bronchitis, runny nose, vomiting, diarrhea, rashes, itching or headaches. Some reactions can cause discomfort, while others can be life-threatening.

It is important to: (1) learn about any food allergies or intolerances that your participants may have, (2) recognize the symptoms, and (3) minimize the chance of exposure to foods or additives that cause them. 

Anaphylactic Reactions

Anaphylaxis is a sudden, severe, potentially fatal, systemic allergic reaction that can involve the skin, respiratory tract, gastrointestinal tract, and cardiovascular system. It can involve a reaction to a food, medication, insect sting, or latex.

Anaphylactic reactions can range from mild to life-threatening. Symptoms occur within minutes to 2 hours after contact with the allergy-causing substance. In rare instances, they may occur up to 4 hours later. Life-threatening reactions may progress over hours.

Symptoms may start with a tingling sensation, itching, or metallic taste in the mouth. Other symptoms can include hives, a warm feeling, swelling of the mouth and throat area, difficulty breathing, vomiting, diarrhea, cramping, a drop in blood pressure, and loss of consciousness. If you see someone experiencing an anaphylactic reaction, seek professional medical help quickly.

Peanuts, tree nuts, shellfish, fish, milk, and eggs commonly cause anaphylactic reactions. Some people with latex allergy may also develop reactions when eating certain foods such as bananas, kiwi, avocados, or chestnuts (or less commonly, potatoes, tomatoes, or pitted fruits such as peaches, plums, or cherries). Some people are so sensitive that only a trace amount of a problem food can cause a reaction.


Lactose, or "milk sugar," is found in food products containing milk or milk solids. It is also found as an ingredient in some non-dairy foods, baked foods, and processed foods. Lactose is digested in the body by the enzyme lactase. People with lactose intolerance have too little of this enzyme, and cannot properly digest lactose. They may experience gastrointestinal discomfort such as stomach cramps, gas and diarrhea. Native Americans and people from Africa and Asia are particularly susceptible to lactose intolerance. Some people with lactose intolerance may be able to tolerate certain dairy foods such as yogurt and some cheeses. Lactase pills and lactose-free milk products are available for people who cannot tolerate any lactose

Fish or Shellfish

Allergic reactions to fish and shellfish can be severe. Shellfish allergies appear to be more common in adults than fish allergies. Shellfish known to cause allergic reactions include shrimp, crab, oysters, clams, scallops, mussels, squid, crayfish, and snails. These allergies usually last a lifetime, and the reactions become more severe as the frequency of exposures increases.

Nuts or Peanuts

Nuts or peanuts can cause severe allergic reactions in susceptible people. These people should avoid nuts or peanuts, and any products that contain even small amounts of these foods (such as cookies, crackers, chocolate candy, or certain flavors of ice cream). Read the ingredient lists of products carefully to ensure that you are preventing exposure to these foods in susceptible people.


Soybeans are becoming more common as an ingredient in processed food products.
Soybeans and soy products are sometimes found in baked goods, canned tuna, cereals, crackers, infant formulas, sauces, and soups. Some people have allergic reactions to soybeans and soy products.


Gluten is a protein found in wheat, oats, rye and barley. These grains and their byproducts should be carefully watched in people with gluten intolerance, and strictly avoided by people with celiac disease.


Casein is a milk protein that may be found in non-dairy creamers and baked goods such as crackers. Some people are sensitive to casein. 


Sulfites are often added to dried fruit and vegetables. People with asthma may be sensitive to sulfites.

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Developed for the Massachusetts Department of Education Child and Adult Care Food Program by the University of Massachusetts Extension Nutrition Education Program. Permission is hereby granted by the Massachusetts Department of Education to copy any or all parts of this document for non-commercial educational purposes. The Massachusetts Department of Education, an Affirmative Action employer, is committed to ensuring that all of its programs and facilities are accessible to all members of the public. We do not discriminate on the basis of age, color, disability, national origin, race, religion, sex, or sexual orientation.