Transcript Atoms Template - University of Georgia College of Family

Managing Food Allergies Keeping Children Safe
Objectives
• Identify “big 8” common food allergens and why allergies
occur.
• Gain knowledge of when food allergies occur and
treatments.
• Identify effective methods of eliminating food allergens
from hands .
• Understand food allergy labeling.
• Identify practices to prevent food allergies in foodservice
environments.
• Become familiar with resources available.
Food allergies
• Affect 6 to 8% of children 4 years of age and
under
• Affect almost 4% of adults
• Are the most frequent cause of emergency room
visits for anaphylaxis
• Cause about 30,000 episodes of anaphylactic
shock with 100 to 200 deaths per year
02
What is a food allergy?
• A food allergy is an abnormal reponse triggered
by the body’s immune system to an otherwise
harmless food.
• These reactions can cause serious illness and,
in some cases, death.
02
True or False
An allergic reaction will occur the first time a
person comes in contact with the food they are
allergic to and every time thereafter.
Answer:
False:
According to the National Institutes of Health, the
first time a person with food allergy is exposed to
the food, no symptoms occur; but the first
exposure primes the body to respond the next
time. When the person eats the food again, an
allergic response can occur.
What is a first exposure to food?
• Can be when you eat it
• Can occur without your knowledge
– Example: peanut allergy –
A person who experiences anaphylaxis on the first known
exposure to peanut may have previously
• Touched peanuts
• Used a peanut-containing skin care product
• Breathed in peanut dust in the home or when close to other
people eating peanuts
What happens in a food allergy?
Components of a food, called “allergens,”
trigger the immune system.
The body produces antibodies that attach to cells
throughout the body. (IgE antibodies)
With the next exposure, antibodies recognize the allergen and
signal the body to release chemicals that cause the physical
signs of an allergic reaction.
What are the symptoms of a food allergy?
Allergic reactions can include:
• 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
• Loss of consciousness
• Anaphylaxis (“anaphylactic shock”)
02
How do you know if a person is having an
www.niaid.nih.gov/topics/foodallergy/understanding
anaphylactic reaction? /Pages/default.aspx
Anaphylaxis is highly likely if at least one of the following three conditions occurs:
1. Within minutes or several hours, a person has skin symptoms (redness, itching,
hives) or swollen lips and either
• Difficulty breathing, or
• A drop in blood pressure
2. A person was exposed to an allergen likely to cause an allergic reaction, and,
within minutes or several hours, two or more of the following symptoms occur:
• Skin symptoms or swollen lips
• Difficulty breathing
• A drop in blood pressure
• GI symptoms such as vomiting, diarrhea, or cramping
3. A person exposed to an allergen previously known to cause an allergic reaction
in that person experiences a drop in blood pressure
Difference between allergy and intolerance
• An intolerance is a reaction to food that does not involve
the immune system or production of IgE antibodies.
• Examples:
– Lactose intolerance – body lacks the enzyme, lactase, to break
down lactose (milk sugar). Symptoms include gas, bloating,
abdominal pain, diarrhea.
02
– Gluten intolerance – associated with Celiac Disease, an
inherited autoimmune disorder in which foods that contain gluten
cause damage to the intestines and can prevent the proper
absorption of nutrients- does not involve IgE antibodies.
– Reactions to additives (msg, sulfites).
How do you know if you have a food allergy?
A physician can use
•
•
•
•
diet histories
diet elimination
skin tests
blood tests
02
What foods cause food allergies? – The
“Big 8”
90% of total food allergies are caused by these 8 foods:
• Peanuts
• Tree nuts (such as almonds, pecans, walnuts, etc.)
• Milk
• Eggs
• Soy
• Wheat
• Fish (such as bass, cod, flounder)
• Crustacean shellfish (such as crab, lobster, shrimp, etc.)
02
Do people have to eat a food to have an
allergic reaction?
Some people are so allergic, they can experience
symptoms without ingesting the food.
• Airborne allergens in steam during cooking
• Cross-contamination and the spread of allergens
• Kissing someone who has eaten the allergen
02
What is the treatment for food allergy?
The best treatment for food allergies and celiac
disease is:
strict avoidance
of the foods that cause the problem.
02
Laws about food allergies
Food Allergen Labeling and Consumer Protection
Act of 2004 (FALCPA) effective since 2006
02
• Labels must clearly identify the source of all
ingredients that are — or are derived from — the
eight most common food allergens.
More Label Examples:
“May contain” labeling –
not mandated, but companies may use it to warn
consumers and reduce liability
www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/
FoodLabelingNutrition/ucm059116.htm
Activity – Label Reading
Activity – Label Reading
Activity – Label Reading
Activity – Label Reading
In addition to avoidance, additional
treatments that may be prescribed…
• Antihistamines/Bronchodilators
• Epinephrine
Epinephrine
www.epipen.com/about-epipen/overview
Directions say patient should always carry 2 doses.
Available in single and 2-pak cartons.
Epinephrine
www.twinject.com/auto-injector/learn-more.html
Prevention Starts In the Kitchen!
Food Service Assistants should:
•
•
•
•
Keep a list of ingredients in every food served.
Read food labels.
Know what to avoid and how to substitute.
Designate an allergy-free zone where allergy-free meals
can be made.
• Avoid cross-contamination and follow safe food handling
practices.
NFSMI. 2007. Managing Food Allergies. ww.nfsmi.org/documentlibraryfiles/PDF/20080218101643.pdf
Preventing exposure to allergens continues
in the cafeteria and throughout the school
Food Service Assistants should:
• Understand the school’s allergy plan.
• Identify the students with documented food allergies.
• Develop standardized cleaning procedures for the
cafeteria.
• Learn to recognize signs of anaphylaxis, and know how
to activate the school’s emergency plan if anaphylaxis
should occur in a student with a life threatening food
allergy.
NFSMI. 2007. Managing Food Allergies. ww.nfsmi.org/documentlibraryfiles/PDF/20080218101643.pdf
Handwashing or hand sanitizers?
• Allergens are proteins
• Hand sanitizers do not remove
• Wash with soap and water
Wash for as long as it takes to sing
“Happy Birthday” twice!
Hygiene and cleanliness
It is also important for foodservice, teachers and
caregivers to:
• Wash their hands thoroughly and often
• Clean and sanitize utensils, equipment,
surroundings, toys, etc.
Best Methods of “Cleaning”
To Remove Allergens?
According to the National Institute of Allergy and Infectious
Diseases at the National Institutes of Health, U.S. Dept.
of Health and Human Services:
• Simple measures of cleanliness can remove most
allergens from the environment of a person with food
allergy.
• Simply washing your hands with soap and water will
remove peanut allergens, and most household
cleaners will remove allergens from surfaces.
Best Methods of “Cleaning”
To Remove Allergens?
In J. Allergy Clin. Immunol. 2004;113:973-6, table wipe
samples were obtained after cleaning with each of the
following to remove peanut allergens:
•
•
•
•
•
plain water
dishwashing liquid
Formula 409 cleaner (Clorox Company, Oakland, CA)
Lysol sanitizing wipes (Reckitt Benckiser, Wayne, NJ)
Target brand cleaner with bleach (Target Corporation,
Minneapolis, MN)
Methods of “Cleaning”
Their results indicated that:
• Conventional cleaning methods are effective in removing
the protein of a food allergen such as peanut.
• Bar and liquid soaps are effective for removing the
protein from your hands, while alcohol-based sanitizer is
not.
• Soaps and commercial cleaning agents effectively
removed peanut protein from table tops, while
dishwashing liquid alone did not.
(J. Allergy Clin. Immunol. 2004;113:973-6.)
Regulations affecting
child nutrition programs
Food Allergy and Anaphylaxis Management
Act Became Law Jan. 4, 2011.
• Requires the U.S. Secretary of Health and
Human Services to develop and make available
to schools voluntary, national guidance materials
to manage the risk of food allergy and
anaphylaxis in schools
www.foodallergy.org/page/the-food-allergy-anaphylaxis-management-act
Advice for pregnant women
According to NIH
• If you are not allergic to a food, then there is no
need to avoid that food even if it is one of the
major causes of food allergies.
• There is no conclusive evidence that
avoiding these foods will prevent food
allergy from developing in the infant in the
future.
www.niaid.nih.gov/topics/foodallergy/understanding/
Pages/default.aspx
Advice for mothers of infants
Breastfeeding
• Feed babies only breast milk for the first 4
months of life because of the health benefits of
breastfeeding.
• Unless they are allergic, mothers who
breastfeed do not need to avoid foods that are
considered to be highly allergenic.
• There is no conclusive evidence that avoiding
these foods will prevent food allergy from
developing in infants.
www.niaid.nih.gov/topics/foodallergy/understanding/
Pages/default.aspx
Advice for mothers of infants
Introducing Solid Foods
• Current recommendations are to wait until 4 to 6 months
of age to introduce solid foods.
• There is no conclusive evidence to suggest that
introduction of solid foods should be delayed beyond 4 to
6 months of age.
• There is no conclusive evidence to suggest that
introduction of the most common potentially allergenic
foods (milk, egg, peanut) should be delayed beyond 4 to
6 months of age. Delay will not prevent a child from
developing an allergy in the future.
www.niaid.nih.gov/topics/foodallergy/understanding/
Pages/default.aspx
Resources Available
– Guidelines for managing food allergies at camp
www.foodallergy.org/files/CampGuidelines.pdf
– Resource list on food allergies and intolerances for
consumers, February 2008 from National Ag Library
www.nal.usda.gov/fnic/pubs/bibs/allergy.pdf
– Food Allergy – An Overview, booklet from NIH –
National Institute of Allergy and Infectious Diseases
(~40 pages)
www.niaid.nih.gov/topics/foodallergy/documents/food
allergy.pdf
https://www.foodallergy.org/section/helpfulinformation
https://www.foodallergy.org/section/helpfulinformation
Food Allergy is a Serious Health Threat
• It can be deadly
• Avoidance is the key
www.nal.usda.gov/fnic/pubs/bibs/allergy.pdf