Controlling Allergens Preparing and Serving Food Safety in
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Controlling Allergens: Preparing and Serving Food Safety in School Kitchens Ben Chapman, Ph. D Katrina Levine, MPH, RD, LDN May 28, 2015
What is a Food Allergy? • Immune system has a negative reaction to something in a food • Something in the food causes the immune system to produce antibodies (Ig. E). When the person has that food component, it triggers the antibodies, which alert the immune system to react, causing an allergic reaction • NOT a food sensitivity or intolerance
Why are they important? • Affects 4 -8% of children and 2% of adults in the U. S. • Leading cause of anaphylaxis • Each year, anaphylaxis due to food causes – 30, 000 emergency room visits – 2, 000 hospitalizations – 150 deaths
Building Blocks of Food • All foods are built of macro- and micromolecules • Macromolecules: – – Proteins Nucleic acids Carbohydrates Lipids (fats) • Micromolecules include: – Vitamins – Minerals
What is an Allergen? • Allergens are always proteins • Proteins are macromolecules composed of one or more chains of amino acids • Proteins are found in all living organisms, so in most food products • Proteins should not be confused with oils and sugars – Refined/filtered oils only contain lipids and won’t cause allergic reactions – Lactose is a sugar, so lactose intolerance is not an allergy
What Causes an Allergy? • • • An allergy is a immune response to a protein (allergen) The body is exposed to a protein and mistakes it for a harmful substance The immune system produces antibodies to protect against the allergen When the body detects the protein again it reacts as if the substance is harmful, releasing a storm of immune substances, stimulating a reaction In some cases, only a trace amount of the protein is required to produce an immune reaction
What does an allergic reaction look like? • Hives • Flushed skin or rash • Tingling or itchy sensation in the mouth • Face, tongue, or lip swelling • Vomiting and/or diarrhea • Abdominal cramps • Coughing or wheezing • Dizziness and/or lightheadedness • Swelling of the throat and vocal cords • Difficulty breathing • Drop in blood pressure • Loss of consciousness
How child describes reaction • Put hands to mouth, pull or scratch tongues, voices may change • “Food is too spicy” • “My tongue is hot, something is poking it” • “My mouth is tingly, itches, or feels funny” • “My tongue feels full, my throat feels thick”
Top 8 Allergens (90%) Eggs Milk Soy Wheat Peanuts Tree nuts (almonds, walnuts, pecans, etc. ) • Fin fish • Shellfish (crab, shrimp, lobster, etc. ) • • •
Food Intolerance • • More common than allergies Histamine toxicity (cheese, wine, fish) Lactose intolerance Food additives (MSG) Gluten intolerance (small intestine) Corn products True allergy – avoid food (immune system) Intolerance – small amount is ok (digestive system)
What about gluten? • Damages the intestines in people with Celiac Disease • Immune system responds differently in people with Celiac vs. sensitivity or intolerance • FDA Final Rule in 2014 on definition of “gluten-free” for packaged products • FDA does not regulate labeling of “gluten-free” in schools
Allergens in the kitchen • Hidden sources of allergens – Soups, sauces, dressings, mixes, cookies, crackers, baked goods, etc. • Cross-contamination – Direct contamination of equipment and surfaces – Indirect contamination through particles in air
• What to look for: By law, labels must alert to all potential allergens in the product • Dairy: whey, casein, milk/cheese (any form) • Egg: albumin, globulin, egg (any form) • Wheat: bran, flour (any form), durum, gluten • Soy: lecithin, edamame, soy protein • Peanuts & Tree nuts: nuts (any form), marzipan, artificial nuts • Fish & Shellfish: surimi, seafood flavoring, fish/shellfish (any form) • There are many more aliases as well http: //www. corbisimages. com/stock-photo/rights-managed/42 -16456772/food-allergy-warning-label-on-package-of
Equipment and surfaces • Everything from mixers and pans to utensils to tabletops • Cleaning and sanitizing critical between uses – Dishwashing method • Storing equipment – Covered – Upside down
Particles in the air • Dust from things like flour or meal – Making pizza and bread – Coating pans to prevent sticking • Can settle on equipment, surfaces, utensils, food or ingredients
Other ways to cross -contact • Cooking oil used in frying • Garnishes and toppings • Hands and gloves
In the cafeteria and on the line • Labeling • Separating • Communicating
Know your school’s protocol • Your school should have a plan for how to handle food allergies • Know the protocol and how you fit into it • Talk to your school nurse or CND
Labeling is important • 13 -year-old Natalie Giorgi died at a family camp after eating a Rice Krispie treat with traces of peanut butter in the marshmallow • Camp had failed to properly label foods, as they had in the past • Epi. Pen was not effective and she died of anaphylactic shock http: //www. sacbee. com/news/local/health-and-medicine/article 2596198. html
Cross contact • Sabrina Shannon, 13, died of cardiac arrest due to anaphylactic shock • Sabrina ate plain french fries that had been served with tongs used for cheese fries • Cross contact of dairy protein caused the reaction
Establish a Food Allergy Expert • A food allergy expert: – Knows the recipes, ingredients, and potential allergens – Knows the students with food allergies – Knows how to respond in a food allergy emergency http: //3. bp. blogspot. com/-O 4 NR 28 njo. XU/Un. DHqv. ETv 0 I/AAAAY 7 M/eh. E 4 Nsf 62 Is/s 1600/Fotolia_35754864_M_Expert. jpg
Resources • “Food Allergy Training Guide for Hospital and Food Service Staff, ” American College of Allergy, Asthma & Immunology (http: //www. foodallergy. org/document. doc? i d=149)
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