What we learned about food allergies in India
By ghummakadz. Created on Nov 5th, 2012. Last updated on Mar 4th, 2013.
Most important, there is little or no awareness about food allergies, expecially in the remoter places. My family has this apocryphal joke that most Indian cooks don't know much about allergies, because any allergic folks are dead already. Seriously though, many Indian restaurants don't understand the seriousness of allergies, and don't pay much attention to things like cross-contamination from using the same utensils in different dishes. Vegetarians have the same problem with mixed-cuisine restaurants. You're really on your own with keeping allergic reactions down to a minimum.
Here are some of the lessons we learned about having allergies in Northern India. Maybe someone can add something about their experiences in the South.
Before you go
- Stock up on Benadryl, Epi-pens, inhalers, and other meds. Pack more than you think you could ever use.
- Read up on Indian cuisine, so you're familiar with the main ingredients in common dishes like curries, biryani, tikki, and so on. The Lonely Planet phrasebook has a whole subsection on food that includes a food glossary. Be sure to study up on regional specialties as well.
- Find out the Hindi/Bengal/Tamil names for the stuff you're allergic to. This will come in handy for reading package labels and recipes--many times ingredients lists will be half English, half Hindi.
- A company called Select Wisely sells laminated allergy translation cards for use while traveling. These cards include pictures of the foods with a big red circle on them, as well as questions as to whether stuff has the allergen in it. You can custom order language and ingredient combinations. My card set includes Hindi and Tibetan translations for questions like "Does this food contain nuts or nut oil?" and statements like "I need a doctor".
- You can get carriers for Epi-pens that are rugged, include slots for other meds, and are easily labeled with your name and medical info.
Once you're there
- Make sure any folks traveling with you know how to get to your meds if you can't. Also make sure they know about Epi-pens and how to use them. You can get 'trainer' pens so you can show folks what to do.
- If you'll be using a cell phone in India, always make a contact entry labelled 'ICE'. ICE stands for "In Case of Emergency". This contact should list the name and phone number of the person to call if something happens to you. If there's a notes or memo field, you can include info doctors need to know like "Asthmatic" or "Allergic to Penicillin". It's becoming a standard practice in many countries for paramedics and ER doctors to check for this entry on patient cell phones.
- In restaurants you cannot be too emphatic about your allergies. Stress that screwing up means a trip to hospital and that you could possibly die from a mistake. Just saying certain foods make you ill might not register, because hey, it's India - tourists get sick all the time. Otherwise waiters and cooks tend to tell you what you want to hear.
- In Northern India, what we've found is that nuts are an expensive ingredient to use for everyday cooking, so many foods with nuts as an ingredient tend to 'advertise' by having a lot of nuts garnished on top.
- We found that cookies and ice creams that were "Butterscotch" flavor tend to include pecans and cashews.
- Familiarize yourself with the local versions of snacks and drinks--know what you can eat, and what you can't. For example, if you buy "Cheetos" in Rewalsar you may end up with a spicy tomato variation that bears no resemblance to what's sold in the States. Sometimes a wallah selling "ice cream" is really selling "kulfi", a frozen treat made with almond milk.
- For long bus or train trips, pack a lunch if you don't think you'll be able to handle the dhabas at rest stops. If you forget, many of the big dhabas along the roadway tend to have several stalls selling different things, usually including one that sells packaged snacks and drinks.
- Street food is tricky, but not impossible. I tend to stay away from mixed treats like bhel puri, because although you can order the stuff to be made without nuts, the possibility for cross contamination is too great. Single-ingredient snacks like roasted corn, fresh fruit juice or fried potatoes work better.
- If you're staying for a long time, you can work things out with hotel staff or a dhaba-wallah to get your needs met. Make friends with a dhaba cook. He can custom-cook something up for you if you buy the ingredients for him, pay a small 'pot fee' and give him plenty of notice.
- Read the labels on cosmetics, too. I discovered that almond milk (also labelled as 'milk badam' or 'doodh badam') is often a major ingredient in creams and soaps.
Latest comments for What we learned about food allergies in India
- Join Date:
- Jan 2010
You may notice you feel sick to your stomach after eating a certian food. Try to narrow it down by eating just that thing and seeing if you start feeling sick within the next hour.Other people may feel like they have tingling or swelling in their mouth.
You can get an allergy test at the doctor to see what you may be specifically allergic to. However, there are things like celiac disease wherein a person reacts to wheat. Celiac disease is actually an autoimmune disease triggered by the gliadin protein found in wheat and a few other things. It can be tricky because wheat is a hidden ingredient in so many things. There is a blood test for this too.
- Join Date:
- Sep 2009
- San Francisco/Mumbai
My mother has celiac disease and lives in Mumbai. We've been trying to find a good doctor (GP and specialists) to monitor her health. But most docs we've come across seem to put celiac disease in the same category as unicorns at worst, or have only the sketchiest knowledge of it at best. Do you know of any doctors in Mumbai that one may contact?
As far as I know, there's no cure for celiac disease. I never saw a doctor for my problems, but I decided to try eliminating gluten from my diet and my symptoms (continual diarrhea and dermatitis) disappeared within two weeks. I haven't knowingly eaten gluten in 3 years (though it can be lurking in things where you wouldn't expect it). I have since mentioned it to my doctor who then wanted to test me for celiac disease. My response was why bother because I now know that I can't eat gluten and as long as I don't eat it I'm fine. I guess my point is that the only thing a doctor will tell you about celiac disease is not to eat gluten, so there's no particular reason to have a doctor that's knowledgeable about it when one can determine what has gluten and what does not with a bit of research (and if in doubt, don't eat it), though I would certainly be uncomfortable seeing a doctor for any ailment if they put celiac disease in the same category as unicorns.
- Join Date:
- Sep 2009
- San Francisco/Mumbai
Thanks for getting back to me. And absolutely- no cure as far as I know. By the way, my mother's symptoms were diarrhea and dermatitis too.
It is hard to make sure you don't get glutened in India- since there's wheat even in foods with recipes that don't traditionally require it. For example, as an anti-caking agent in 'heeng,' a ubiquitous ingredient in Indian food, especially in Western Indian food.
My mother has overcome those issues by generally carrying her home cooked meals with her everywhere she goes. But sometimes she gets glutened- like when her neighborhood sorghum or millet flour supplier sends her contaminated flour by mistake (although now, she's just got her own flour mill, so hopefully that should take care of that).
But when she gets glutened like that, she gets severe celiac crisis, unable to keep anything down for 5 days at a time, and losing weight at an alarming rate. We can't get her tested now because she's been off gluten for over two years. We don't want to get a biopsy unless we can find a doctor that knows what they're doing.
Even the best doctors we've come across have told her 'it's all in your head', it's IBS, etc.
She was never tested, a doctor we knew, now passed on, helped her narrow this down through elimination after she dropped over 25 kilos in a year and a half.
Our problem is- we don't quite know how to get medical help for her in times of other illnesses, since other meds might be harmful for her (either by containing wheat or by being harmful e.g. antibiotics being bad for gut bacteria- already compromised in a celiac).
We also don't know how to help her when she's glutened. She's definitely malnourished from what I could see in my last visit home. She's also discovering new allergies, as celiacs do, as time goes by.
It would help if we could find her a doctor (even a GP) who is at least aware of celiac disease and can work with it whenever she needs medical help and doesn't just dismiss it the way most doctors we've come across so far have done.
I would really appreciate it if any of the celiacs/gluten intolerant people on the forum could suggest celiac friendly doctors in Mumbai.