Introduction
Allergy risks aren’t limited to international packaged snacks or imported treats — they’re right here in our local fare too. In Singapore, where hawker culture and homegrown favourites shape daily meals, hidden allergens can quietly pose a threat — especially to those with autoimmune or allergic sensitivities.
This blog unpacks three common Singaporean staples — satay sauce, otah, and Milo mixes — and reveals the surprising ingredients that could trigger allergic or autoimmune reactions. Whether you have a formal diagnosis or are monitoring sensitivities, it pays to be label-literate and aware.
1. Satay Sauce – Not Just Spicy, It’s Packed With Peanuts
Satay sauce is iconic in Southeast Asian cuisine — rich, nutty, spicy, and usually served warm over skewered meat. But behind its flavor lies one of the world’s most common food allergens: peanuts.
Peanuts are a known allergen that can trigger reactions ranging from mild itching to anaphylaxis. For individuals with autoimmune conditions, even non-anaphylactic reactions like skin flares or gut inflammation may follow exposure to peanut proteins. Satay sauces sold in jars, hawker centres, or home mixes may not always list full ingredients — especially if homemade or not pre-packaged.
Key takeaway: Always ask hawkers if peanuts are included. Even “peanut-free” satay sauces may use peanut oil or traces from shared equipment.
2. Otah – What’s Really in That Fragrant Leaf?
Otah-otah (or simply otah) is a grilled fish cake wrapped in banana leaves, made from ground fish meat, spices, and coconut milk. But the ingredient list rarely ends there.
Many commercial versions include seafood paste (often squid or shrimp), preservatives, and sometimes binding agents that contain egg or soy derivatives. For individuals with shellfish allergies, consuming otah can pose significant risks. In autoimmune diseases like lupus or dermatomyositis, seafood-based histamine reactions may also mimic disease flares.
In addition, coconut milk — though generally safe — can contain thickeners that include casein (a milk protein) when in powdered form. This matters for people avoiding dairy-related triggers such as in autoimmune thyroid conditions or inflammatory bowel diseases.
Key takeaway: Not all otah is created equal. If you’re unsure of its source or allergy profile, skip it or opt for homemade versions with clear labeling.
3. Milo Mixes – Nostalgic, But Not Always Safe
Milo is a household name in Singapore, loved by kids and adults alike. But while it fuels memories of school canteens and late-night study snacks, it also contains several ingredients that may irritate sensitive immune systems.
Instant Milo mixes typically contain malt extract (derived from barley, containing gluten), milk solids (dairy), and sometimes soy lecithin. For patients with autoimmune conditions like coeliac disease, multiple sclerosis, or Type 1 diabetes, these ingredients may aggravate inflammation or digestion issues.
In addition, commercial powdered Milo products often include additives like carrageenan or stabilisers — which can exacerbate gut permeability (“leaky gut”) linked to autoimmune progression.
Key takeaway: Consider low-allergen alternatives like homemade cocoa with oat milk, or check for Milo variations that are labelled gluten-free and dairy-free.
What You Can Do as a Consumer in Singapore 🛒
Singapore’s food labelling laws require clear identification of major allergens in packaged goods. However, hawker food, restaurant dishes, and home-prepped items may not follow the same disclosure standards. Here are some practical tips:
✔ Always check for allergens in sauces, condiments, and pastes — even when they’re served as sides.
✔ Ask about ingredient sourcing — particularly in traditional or home-style eateries where recipes may include secret blends.
✔ If dining out frequently, consider carrying allergy cards in multiple languages that list your known sensitivities.
✔ Keep a diary of flare-ups to identify potential dietary links over time.
What About Autoimmune Risk — Is It the Same as a Food Allergy?
Not quite. Food allergies typically involve an IgE-mediated immune response, often leading to immediate symptoms like rashes or swelling. Delayed hypersensitivities and autoimmune reactions, on the other hand, are slower, often triggered by complex immune signaling, and may present with gut discomfort, fatigue, or systemic inflammation.
However, certain foods — especially those that contain common allergens — can increase immune activation in both allergy and autoimmune patients. This is especially true for individuals with overlapping diagnoses, such as coeliac disease and eczema, or lupus and food sensitivities.
At Aaria Rheumatology, we see patients across the allergy-autoimmune spectrum. Our team supports label literacy, personalised food reviews, and tailored allergy testing for better peace of mind and disease control.
Final Thought
Familiar foods don’t always mean safe foods — especially when you live with food sensitivities or autoimmune conditions. The next time you reach for a childhood favourite or indulge at a hawker stall, take a moment to ask: what’s really inside?
