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'Extend A Little Grace' — Navigating Food Allergies And Sensitivities At Thanksgiving

A food allergy, sensitivity, or intolerance can make the difference between passing the mashed potatoes — and passing on them.
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A food allergy, sensitivity, or intolerance can make the difference between passing the mashed potatoes — and passing on them.

Out of all the Thanksgiving dishes Kim Yates has helped prepare for her large family over the years, one batch of mashed potatoes stands out clearly in her memory.

About 30 guests were gathered that year, at her sister's home in Palo Alto, Calif., and Yates had made a point of taking on responsibility for the mashed potatoes so that her young daughter Tessa (who was dealing with extreme food allergies to eggs, dairy, wheat, peanuts, tree nuts and shellfish) would have at least one safe side dish to eat.

The kitchen was crowded and chaotic that day, Yates remembers, and she stepped away from the counter for just a moment. That was long enough for a relative to pick up the handheld mixer and plunge it into the pot of steaming potatoes.

"He thought the beaters were clean, but my dad had just been using them to beat the eggs for eggnog," Yates says. "There was no way we could serve those to Tessa. Hours of work, down the drain."

"That's when I was like, 'I'm done — I will never do another Thanksgiving with this many people. It's just too hard,' " she says.

"I have a big family, and I adore them, and I'm so unbelievably blessed that they try to be caring about food allergies," Yates adds. "But even still, holidays are stressful and stuff happens. I can't imagine what it's like for people whose families are not as thoughtful."

As many as 8% of U.S. children and 5% of adults have some type of food allergy. The most common culprits, according to the Centers for Disease Control and Prevention, are milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts and tree nuts.

Typical food allergy symptoms include hives and swelling, or stomach or intestinal distress. But food allergies also can become life-threatening — sending a child or adult into anaphylactic shock.

Meanwhile, food intolerances such as lactose-intolerance are not immediately life-threatening, but can cause miserable GI symptoms, if a Thanksgiving side dish contains undisclosed dairy, for instance. And regardless of whether someone suffers from gluten sensitivity, a wheat allergy, or Celiac disease, even a dusting of flour can be enough to cause symptoms.

For families with food issues, the trouble with holidays like Thanksgiving is that emotions run high around the ritual and tradition of a shared family meal. So it can be hard to negotiate health needs without offending anyone or facing suspicions that a food sensitivity isn't "real."

"It can be very difficult for the parents to explain to aunts and uncles and grandparents what's safe for their child," says Marté Matthews, a family therapist who works with kids and families with allergies in Northern California.

Running up against rituals can make for a "poignant conversation," she says, when parents of a child with a food allergy — or intolerance or sensitivity — have to ask their relatives to change a traditional recipe, or leave something off the menu entirely. Many families have some version of Great Aunt Velma's famous cranberry relish that no one actually enjoys eating but everyone agrees "it wouldn't be Thanksgiving" without.

Want to short-circuit that particular brand of holiday stress this year? Try these tips:

Reach out ahead of time to the host

It might be a little late for this Thanksgiving, but in general, if you or your child with food issues are headed to another home for the big meal, reach out to the hosts early. Tell or remind them that there are certain foods you or your child can't eat. Then brainstorm with that friend or family member about easy solutions that take the allergy into account. Sometimes that will mean you'll bring a dish you've prepared, and other times, the host's recipes can be tweaked.

Sometimes friends or family simply don't realize the severity of the risk. Supplying more information about food allergies from a reputable source might get them on board. Matthews recommends resources from FARE as a good start.

Pick your battles

Remember that this is a dinner, not a debate stage. You needn't convince everyone at the table that your food issue is real to be able to get through the event safely. "Simplify your objective," advises Tamara Hubbard, a licensed clinical professional counselor in the greater Chicago area who specializes in working with people managing food allergies. "Do you really need to change that person's mind? Or can you ask yourself 'What do I need to get through this one specific holiday get-together?' "

Diffuse defensiveness with humor, empathy and collaboration

When a change to a cherished recipe is proposed, some people default to "No!" ("But, we always put marshmallows on the mashed yams!")

Figuring out how to encourage someone to accept a new idea is "the million dollar question," says Pauline Tsai, a cultural psychologist and assistant professor at Georgetown University. "I think it's about starting where everyone is at. And be sure that when you're making requests about food, they don't come across as judgmental."

Ask the host for their help in keeping the child who has allergies safe, says Matthews. "Showing vulnerability can keep the conversation from getting overheated."

Start a new tradition

Allergen-free doesn't have to mean bland. Hubbard, who has a lot of food allergies in her own family, now goes out of her way to bring tasty, allergen-free desserts to holiday meals that everybody can enjoy.

"People don't always go willingly toward change, but it's a constant in life," Hubbard says. Who knows, maybe 2-ingredient chocolate truffles or Rosemary-lemonade popsicles will spark a new holiday tradition, at your table — the internet abounds with alternatives to pumpkin pie.

Tips for hosts: Take a deep breath and be flexible

Once you've already taken on cleaning the entire house, decorating the table and shifting the feast's start time so it doesn't conflict with your nephew's new girlfriend's flight schedule, it might feel impossible to also factor in every guest's food needs.

So, take a deep breath. If you're annoyed by the very request, try to remember that your guest feels awkward, too. "People with food allergies — it's not something they have control over," says Jamie Saxena, a nurse practitioner at the Sean N. Parker Center for Allergy and Asthma Research at Stanford University. "And it's not something they want to have to ask people to accommodate."

If you can't meet their request, for whatever reason, it's OK to ask the guest to bring a prepared dish that works for them and your menu.

Give thanks for each other

No matter whether you're the host or a guest, recognize that holidays are often stressful, even when joyous. Chances are, most people gathered around your table will be trying their best.

"Whether we're talking about food allergies, or politics," Matthews says, "or all those other things that come up around the Thanksgiving table and over the holidays — try to extend each other a little grace."

Emily Vaughn is an intern on NPR's Science Desk.

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