Food Allergy Awareness Dana Magee ARAMARK Dietetic Intern May 3, 2013.
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Transcript of Food Allergy Awareness Dana Magee ARAMARK Dietetic Intern May 3, 2013.
Overview
• What is a food allergy?
• Top 8 food allergies
• Lactose intolerance
• Celiac Disease
• Food labeling
• How to stay safe
Application to the Nutrition Links Program• Paperwork includes a question about food
allergies
• Label reading to keep food demonstrations safe to those with allergies
• How to recognize a reaction in class and what to do
• Underdiagnosed in this population may encourage to see their doctor
Food Allergies
• Affects about 15 million Americans
• 1 in every 13 school age children
• CDC found 18% increase between 1997-2007
• Other diseases affecting immune system have been increasing
Adverse Food Reaction
Adverse Food Reaction
Food Allergies: adverse immune reaction
to food protein with a range of symptoms and potentially anaphylaxis
Food Intolerances: adverse reaction to food
that does not involve immune system but the
digestion of the food
What causes a food allergy?• Our immune system responsible for fighting off
illnesses
• When exposed to something foreign (germ) our body recognizes it as dangerous and fights it off and creates antibodies to remember it
• Abnormal response to food- can be any food
Signs and symptoms of a food allergy• Hives, eczema, red around eyes, itchy ears/
mouth, runny nose, cough
• Nausea, vomiting, diarrhea, stomach pain
• Anaphylaxis: breathing and circulation problems – Teen and young adults at highest risk
– Asthma increases risk
Anaphylaxis• Anaphylaxis: breathing and circulation problems – LIFE THREATENING
– Swelling of lips, throat, tongue
– Trouble swallowing
– Turning blue
– Drop in blood pressure
– Chest pain/ weakness
– Loss of consciousness
Anaphylaxis – Described by a child• “This food is too spicy”
• “My tongue is burning”
• “It feels like something’s poking my tongue”
• “My mouth itches”
• “There’s a frog in my throat”
• “My tongue feels heavy”
Treatment of Anaphylaxis• Epinephrine prescribed by
physician in auto- inject pen
• Always go to the emergency room
• 25% of people have a second reaction called biphastic anaphylaxis
• Doctor may treat with steroids in ER
Diagnosis of Food Allergies• Board certified allergist
• Don’t self diagnose
• Skin prick test
• Blood test
• Oral food challenge
• Elimination diet
Peanut Allergy• One of the most common, tripled from
1997- 2008
• 20% can outgrow this allergy
• Having sibling with allergy increases risk
• Can cause anaphylaxis
• Treat by avoiding peanuts and peanut products
Peanut Allergy
• Even a small amount ingested can trigger life threatening response
• Touching peanuts can cause a reaction if then touch eyes/nose/mouth
• 25-40% also have tree nut allergy– Often manufactured on same equipment so
best to avoid
Tree Nut Allergy• Can cause anaphylaxis
• Walnuts, almonds, hazelnuts, cashews, pistachios, brazil nuts etc.
• 9% children will grow out of it
• Siblings at greater risk
• Coconut: fruit vs. nut- must be cleared by allergist
• Careful of shampoos, lotions, and soaps
Finned Fish Allergy• Can cause anaphylaxis
• 40% people have first reaction as an adult
• Lifelong allergy
• 20,000 fish species: salmon, tuna, halibut most common
• Shellfish are separate allergy
Shellfish Allergy• Can cause anaphylaxis
• 60% experience first reaction as adults
• Most common: shrimp, crab, lobster- crustaceans
• Mollusk family: clams, mussels, oysters, scallops– May be less severe- one or both families
• Can be airborne: avoid seafood restaurants, fish market, cooking fish (steam)
Soy Allergy
• Most common in babies and 0.4% of children
• Usually outgrown by age 3-10
• Mild reaction but chance of anaphylaxis
• In many processed foods
Egg Allergy
• Second most common in children
• Symptoms of hives to anaphylaxis
• Most outgrow it
• It is the egg white, whole egg must be avoided
• Vaccines, MMR is safe, flu shot may not be
Cow’s Milk Allergy • Most common food allergy in infants and children
• Hives to anaphylaxis
• 2.5% under three have this allergy, most outgrow it
• Careful of kosher labeling of “D” or “pareve” may contain milk
• In cooking substitute milk with water or fruit juice in equal parts
Milk protein allergy vs. lactose intolerance• Milk protein allergy– Body starts an attack
– Can lead to life threatening anaphylaxis
• Lactose intolerance: – “milk sugar” is not
properly digested
– Not life threatening
Wheat Allergy
• Usually in children and outgrown by age 3
• Symptoms of hives to anaphylaxis
• Wheat free: amaranth, barley, corn, oat, quinoa, rice, rye, tapioca (may also be allergic to some of these)
Celiac Disease
• Genetic, exposure to gluten, environmental trigger, autoimmune response
• Gluten is the protein in wheat, rye, and barley
• Symptoms: bloating, gas, diarrhea, constipation, headaches, itchy skin, mouth sores, nausea, anemia, ADD, bone pain, depression, enamel effects, failure to thrive, fatigue, infertility
• Biopsy diagnosis, blood work
Celiac disease
• Doesn’t cause anaphylaxis
• Flattens the villi and elongates crypt cells
• Affects secretory, digestive, and absorptive ability
• Leads to micronutrient or macro nutrient deficiency
Celiac disease: Complications• GF foods may not be fortified
• Malabsorption: osteoporosis– Calcium, vitamin D
• Diarrhea: replete electrolytes and fluids
• Multivitamin
• Develop lactose intolerance
Gluten Free Diet• Even small amounts
can cause this reaction
• Cross contamination is a huge concern!
• Substitutions for wheat flour:
• Rice flour, potato starch flour, soy flour, corn flour
Food labeling• Food Allergen Labeling and Consumer
Protection Act (FALCPA)-2006
• Any packaged food with peanuts, milk, eggs, crustacean shellfish, tree nuts, wheat, and soy must be listed on label
• “ Contains…”
• If in small amounts (food coloring, flavor, spices etc.)- in parentheses
Food labeling• Meat, poultry, eggs, alcohol not under this law
• Always check labels: manufacturers can change ingredients
• Any questions: call the manufacturer
• In process of “May contain…” labeling
Food safety at home• Everyone learn to read food labels
• Wash hands before, during, after handling food
• Clean surfaces and preparation equipment with soap and water
• Avoid cross contamination with separate cutting boards, utensils, bowls etc.
Food safety at home
• Designate different shelves
• Control areas of house where food can be eaten
• If cooking two meal: cook allergen free first
• If suffer from airborne allergens allow 30 minutes after prep
Eating out safely• Ask allergist or friends with allergies for
suggestions
• Look at the menu ahead of time
• Call and speak with manager ask about ingredients, cross contamination
• Go at less busy times
• Bring chef card
• Bring emergency medications
Eating out safely• Sit away from the kitchen if have an airborne
allergy
• How is it prepared? Grill or fryers cross contamination
• Alert the waiter, ask for manager or chef
• Careful of desserts not made on site
• If uncomfortable with ability to eat safely DO NOT eat
• Order steamed veggies or baked potato
Babysitter Training• Set time for babysitter to come over while you are
there
• Make sure to explain all allergies and what to avoid
• Take time to answer any questions
• Address take out food
• Go over emergency allergy plan
References• Gupta R. Study: Food Allergies in Children Becoming More Common, Severe [Video]. PBS Newshour;
2011.
• Food Allergy Research & Education. Facts and Statistics. FARE. http://www.foodallergy.org/facts-and-stats. Updated 2013. Accessed May 3, 2013.
• U.s. Department of Health and Human Services. Food Safety. HealthyPeople.gov. http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=14. Updated April 10, 2013. Acessed May 3, 2013.
• The Ohio State University Extension. Cultural Diversity: Eating in America African American. The Ohio State University Extension. http://ohioline.osu.edu/hyg-fact/5000/pdf/5250.pdf. Published 2010. Accessed April 18, 2013.
• Philadelphia Department of Public Health. Overview of Chronic Disease and Healthy Eating and Active Living Indicators for Philadelphia Adults and Children. Philadelphia Department of Public Health. http://www.phila.gov/health/pdfs/Philadelphia_obesity%20and%20chronic%20disease%20health%20indicators_2010.pdf. Published May 5, 2011. Accessed May 3, 2013.
• Penn State Extension. 2012 EFNEP Fact Sheet. Penn State Extension. http://extension.psu.edu/health/nutrition-links/about/annual-reports/2012/nutrition-links-annual-report-2012-efnep.pdf/view. Updated 2013. Accessed May 3, 2013.
• City-data.com. Philadelphia County, Pennsylvania (PA) Religion Statistics Profile Philadelphia. City-Data.com. http://www.city-data.com/county/religion/Philadelphia-County-PA.html. Accessed April 18, 2013.