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

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

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

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 •

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

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

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

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

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,

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

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

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,

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

• 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 •

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

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

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

In the cafeteria and on the line • Labeling • Separating • Communicating

Know your school’s protocol • Your school should have a plan for how to

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

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

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,

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

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)