Food Allergies: What Food Service Needs to Know

1. Food Allergies: What Food Service Needs to Know Lynn James, M.S., R.D., L.D.N. Janice Ronan Fran Alloway, M.A., R.D., L.D.N. Penn State Cooperative Extension

2. Overview of Objectives • What is an allergy? • Control of allergens • Allergen regulations • What you can do… • Food Allergy Action Plan

3. What Is a Food Allergy? Definition: The body’s abnormal response to food triggered by the body’s immune system in sensitive individuals. Foods that create reactions contain proteins (allergen) that cause the body to produce antibodies to attack the food.

4. Symptoms of a Food Allergy Within 2 minutes - 2 hours of eating a food allergen, the body secretes Histamine, that can cause: • Itching in mouth • Stomach cramps, diarrhea, vomiting • Blood pressure to drop • Skin hives or eczema • Asthma in lungs • Death by anaphylaxic shock (nuts leading cause) Over 160 foods are identified as causing food allergies, but only 8 are most common:

6. Who Has Food Allergies? • 1/3 think they or a family member has a food allergy Research states: • 2 - 4% adults • 5-8 % infants and young children • Approximately 30,000 consumers require emergency room treatment yearly • 150 Americans die each year because of allergic reactions to food.

7. Food Allergies • Symptoms can worsen after each exposure • Cannot be “cured” but can be outgrown milk,egg,soy - 50 – 80% peanut, fish, shellfish, tree nuts – 15 - 20% • Cross-Reactivity- allergy crosses over to like allergens- e.g. nuts • Oral Allergy Syndrome

8. “Undercover” Allergens • Soy • Lecithin, hydrolyzed plant proteins • Wheat • Starch, flour, gluten • Dairy • Whey, sodium caseinate • Egg • Albumin

9. Food Intolerances Not an immune response by our body, but body has adverse reaction: • Foodborne Illness- illness caused by bacteria, virus, mold, mold toxin, yeast or chemical in food • Foodborne Intoxication- bacterial toxin in food • Histamine toxins in food by bacterial growth usually from improper refrigeration (tuna, mackerel) that cause a reaction

10. Food Intolerances Lactose Intolerance body lacks lactase enzyme to digest milk sugar • Affects 10% population • Foods: milk, soft cheese, ice cream • Causes gas, bloating, abdominal pain, sometimes diarrhea

11. Gluten Intolerance Or Celiac Disease- bodyreacts to gluten- proteins in wheat, barley, and rye • May affect 1 in 133 • Causes severe intestinal problems/malabsorption

12. Food Intolerances Food Additives-often confused with food allergy, some can cause problems in sensitive individuals: • MSG- monosodium glutamate- flavor enhancer in many foods, causing rapid: - flushing - head ache - chest discomfort - feeling detached

13. Food Intolerances Sulfites -Sulfur-based compounds that may occur naturally or may be added as a preservative. • Banned by FDA in 1986 on fruits and vegetables that are eaten raw and on fresh meat and poultry products. • Manufacturers using sulfites in processed products must list it on product labels. • Can cause breathing spasm in asthmatics

14. On labels look for: • Sulfur dioxide • Potassium bisulfite or potassiium metabisulfite • Sodium bisulfite, sodium metabisulfite or sodium sulfite

15. Some foods sources of sulfites: • Baked goods • Soup mixes • Canned or frozen fruits and vegetables • Dried fruit • Trail mix • Potato chips • Jams • Fresh or frozen shrimp • Molasses

16. Some food sources of sulfites • Alcohol, beer, and wine • Sparkling grape juice • Apple cider • Bottled lemon juice and lime juice • Tea • Many condiments • Maraschino cherries • Dehydrated, pre-cut or peeled potatoes

17. Food Allergen Labeling and Consumer Protection Act of 2004(FALCPA) Requires that the label of all packaged food sold in the US under FDA than contains an ingredient that is or contains protein from a “major food allergen” to display a “Contains” statement OR plain English labeling of allergens in ingredient statement OR both Currently no thresholds for allergens Effective for food products labeled on or after January 1, 2006—domestic and imported.

18. FALCPA & Food Processors • Declaration on label of food allergens • Adjust process/formulation to ensure no undeclared allergens from: • Ingredients • Processing aids • Cross-contamination

19. How have food labels changed? Option #1 Name the food source in parenthesis following the usual name in the list of ingredients when it does not appear elsewhere in the ingredient statement Includes the Big 8 Food allergens

20. Example: Option #1 Ingredients: Enriched flour (wheat flour, malted barley, niacin, folic acid), sugar, whey (milk),eggs . . . . . lecithin (soy).

21. How have food labels changed? Option #2 Use the word “Contains” followed by the food source from which the allergen is derived, immediately after or adjacent to the list of ingredients, in type size that is no smaller than that used for the list of ingredients.

22. Option #2 Contains wheat, milk, eggs, and soy.

23. Contains statement FALCPA Compliant Label Allergens

24. Enforcement? • Enforced by FDA as part of its routine regulation and inspection. • Applies to packaged FDA regulated foods. • Does not apply to foods wrapped or packaged at the request of the consumer (bakery, doggie bags) • Watch for product recalls- what is your plan?

25. FDA Efforts • Increase public awareness • Educate inspectors of food processing plants • Sharing of best practices in the food processing industry • Allergy labeling program

26. Preventing Food Allergen Problems in Food Service Be proactive- have a policy and procedure (Food Allergy Action Plan) Staff training needed to ensure: • Cooks and servers are familiar with food ingredients. • Menu items identified when contain Big 8 food allergens • Cross-contamination avoided, especially when alerted by customer of food allergy.

27. Preventing Food Allergen Problems in Food Service Cooks and servers are familiar with food ingredients that can cause a food allergy or intolerance Activity #1 • List what is on your menu that could cause food allergy symptoms or intolerances. • Do any menu descriptions need an update to identify top 8 food allergens or MSG or sulfites? • How do you prepare allergen-free food?

28. Preventing Food Allergen Problems in Food Service Avoid cross-contamination Activity #2 • Discuss how cooks and servers can avoid cross-contamination of food allergens.

29. Preventing Food Allergen Problems in Food Service A food allergen inadvertently gets into food in restaurant when alerted by customer of food allergy Activity #3 • Discuss what you would do as server, cook, manager. Discuss how you can prevent.

30. Preventing Food Allergen Problems in Food Service How to avoid cross-contamination when alerted by customer of food allergy Answers: • Clean hands with soap and water between tasks • Clean and sanitize work surfaces and utensils • Frequently check food labels for food allergens and cross-over foods that may carry allergens- eg peanut oil

31. Preventing Food Allergen Problems in Food Service What does your policy state on serving customers a dish that contains the allergen when they tell you they have food allergies? • Refer to policy on serving other potentially hazardous food such as Consumer Advisory when serving under cooked hamburger or eggs (PA Food Code 2004)- possibly include a statement of refusal to serve. • PA Department of Agriculture food code-keep up to date

32. References & Resources • http://www.niaid.nih.gov/publications/pdf/foodallergy.pdf • http://www.datcp.state.wi.us/fs/business/food/training/allergens.jsp • US Food & Drug Administration, Information for Consumers: Food Allergen Labeling And Consumer Protection Act of 2004Questions and Answers, December 12, 2005; Updated July 18, 2006 • Food Allergy & Anaphylaxis Network: www.food allergy.org

33. Prepared by: Lynn James, M.S., R.D., L.D.N. Frances Alloway, M.A., R.D., L.D.N. Janice Ronan Extension Educators Penn State Cooperative Extension

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