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Food Allergy Awareness

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.

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Food Allergy Awareness

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  1. Food Allergy Awareness Dana Magee ARAMARK Dietetic Intern May 3, 2013

  2. Overview What is a food allergy? Top 8 food allergies Lactose intolerance Celiac Disease Food labeling How to stay safe

  3. 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

  4. Food Allergy Experiences in Nutrition Links?

  5. 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

  6. Adverse Food Reaction

  7. Top Eight Food Allergens These 8 make up 90% of all food allergies!

  8. 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

  9. 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

  10. 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

  11. 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”

  12. 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

  13. Diagnosis of Food Allergies Board certified allergist Don’t self diagnose Skin prick test Blood test Oral food challenge Elimination diet

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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)

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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)

  24. 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

  25. What is gluten free?

  26. 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

  27. Celiac disease: Complications • GF foods may not be fortified • Malabsorption: osteoporosis • Calcium, vitamin D • Diarrhea: replete electrolytes and fluids • Multivitamin • Develop lactose intolerance

  28. 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

  29. 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

  30. 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

  31. Food Allergy Research and Education Tool

  32. 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.

  33. 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

  34. 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

  35. 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

  36. 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

  37. Gluten Free Voluntary Labeling

  38. Gluten Free Flour (1 lb.)vs. All Purpose Flour (5 lb.)

  39. Where is the labeling?

  40. 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.

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