All You Need to Know About Holiday Eating Without Worry


Editor’s Note: This video is part of the ongoing allergy series in partnership with Columbia Allergy. To learn more about allergies, eczema, and related topics, please refer to our Allergy Guide!

Thanksgiving is a joyful time for families to gather around the dinner table to celebrate and give thanks. It’s also a likely time of year to send children and adults to the emergency room with allergic reactions and food poisoning. According to the Centers for Disease Control and Prevention, there are nearly 76 million food poisoning cases yearly, with about 325,000 hospitalizations and approximately 5,000 deaths. In less severe cases, you may have experienced post-feast discomfort – from bloating and indigestion to tummy ache and migraines.

Food poisoning generally causes stomach pain, vomiting, and diarrhea and usually appears within four to 12 hours after eating or drinking contaminated food or drink. For the elderly, children, pregnant women, and people suffering from compromised immune systems, food poisoning can be severe and sometimes fatal.

According to Dr. Stuart E. Heard, executive director of California Poison Control (CPCS), food poisoning is extremely preventable during holiday feasts. All we have to do is follow these simple handling, cooking, and storage suggestions. CPCS offers the top 10 safety tips for the holiday season and throughout the year:

  1. Wash your hands often especially when handling food.
  2. Rinse fruits and vegetables thoroughly under cool running water and use a produce brush to remove surface dirt.
  3. If you purchased a turkey fresh and not frozen, refrigerate it immediately. Do not rinse a turkey in water as that spreads salmonella. If you bought a frozen turkey, allow lots of time for it to thaw…24 hours of thaw time per five pounds of turkey.  As the bird thaws, water will accumulate, so keep the bird in a high-walled pan and do not let the water touch any other food. Store on the bottom shelf of the refrigerator.
  4. It is safest to not stuff a turkey, but rather put herbs inside the cavity to season it. Exotic stuffing with meat or shellfish/oysters is risky. Always cook these on the stovetop or in the oven, and not in the turkey. After carving, remove all stuffing from the bird before refrigerating it.
  5. The biggest risk of food poisoning comes from undercooking the turkey. You can’t tell it’s done by how it looks. While recipes give you hints about testing for doneness, such as a golden brown color or seeing juices run clear, these are not enough. The only way to make sure your bird is cooked sufficiently to be safe to eat is to measure the internal temperature with a meat thermometer. It must reach 165 degrees F.
  6. It may not be in mom’s recipe, but bring the gravy to a full boil before serving.
  7. Be sure to wipe down counters, cutting boards, and utensils in between recipes especially if you have raw meat or leafy greens on the cutting board, both of which can carry salmonella. Use soap and hot water or, preferably, a sanitizer – especially if preparing to chop fruits or vegetables that will be served raw. Use different color cutting boards for meat vs. vegetables to avoid confusion.
  8. Keep cold food like salads, gelatin molds, and salad dressing refrigerated at 35 degrees F until just before serving. Once dinner is over, refrigerate leftovers. Food is not safe to eat if it has been sitting out for two hours or more. Toss it.
  9. While store-bought cookie dough and eggnog should be safe, be sure to purchase pasteurized eggs to use in homemade recipes.
  10. After taking the remaining meat off the bird, store it in a shallow container in the refrigerator. Don’t put an entire carcass into the refrigerator — it won’t cool down quickly enough.

Call Poison Control at 1-800-222-1222 (the number is the same in all states) for help. Trained pharmacists, nurses, and other providers are available to help 24 hours a day, seven days a week. The service is free, confidential and interpreters are available. Get weekly tips about safety by texting TIPS to 20121 for English or texting PUNTOS to 20121 for Spanish. CPCS is part of the University of California San Francisco School of Pharmacy and is responsible to the California Emergency Medical Services Authority.

You are invited to have a FREE discovery session at Columbia Allergy’s beautiful Redwood City clinic – all you have to do is call (650) 503-9770 and mention SFBAM!

In some cases, you may find yourself thinking, is it really food poisoning? Could it be a food intolerance or perhaps on a more serious scale, a food allergy? Food allergies can develop in adulthood, and many times without much of a warning. We’ve turned to renowned allergies and immunologist Dr. Sanjeev Jain from Columbia Allergy to address what to look out for when our bodies have a reaction after holiday eating.

What is FPIES?

FPIES is the acronym for food protein-induced enterocolitis syndrome. This condition is a gastrointestinal food hypersensitivity that leads to multiple episodes of vomiting and sometimes diarrhea after ingestion of a particular food. The reaction is not IgE mediated, which means it is hypersensitivity and not a true allergic reaction. FPIES can lead to severe dehydration and lethargy in children. Soy and cow’s milk are the foods that are most commonly associated with FPIES. The exact reason why FPIES occurs is unknown, so it is put in its own category.

What is the difference between food sensitivity, food intolerance, and food allergy?

A “true food allergy” involves the activation of a response from the immune system. A “true allergy” will cause the immune system to produce IgE antibodies to protect itself in response to exposure to a food allergen that the body has identified as foreign. Symptoms of an allergic reaction can include hives, vomiting or stomach cramps, wheezing, cough, or shortness of breath, swelling in your tongue or mouth, tight and hoarse throat, dizziness, weak pulse, and anaphylaxis (typically at least 2 symptoms from 2 different body systems).

Food intolerance refers to difficulty digesting or metabolizing a component of food. Food intolerances are more common than food allergies. They are typically caused by a missing enzyme or the ability to break down a specific component of a food. For example, persons with lactose intolerance are found to be missing the lactase enzyme needed to break down the lactose found in dairy products. Food intolerances will not cause systemic symptoms, and will only cause gastrointestinal upset. The severity of symptoms is typically related to the amount of food ingested. For example, a person with lactose intolerance would develop more significant symptoms when eating a whole bowl of ice cream versus eating just a scoop of ice cream. Food intolerance symptoms typically include gas, bloating, abdominal pain, and diarrhea.

Food sensitivities are not as well defined as food intolerances and food allergies. The term food sensitivity is typically used to refer to symptoms that may develop after eating that are not explained by a food allergy or known food intolerance. This term has become more popular as companies such as EverlyWell test for this type of food reaction by analyzing IgG markers, another type of immune mediator released by the immune system. Symptoms typically related to this category include more vague symptoms like bloating, stomach pain, diarrhea, headaches, and joint pain. There is limited scientific evidence related to this category at this time.


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