Transcript Food Allergies

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SERVING GUESTS WITH SPECIAL
HEALTH NEEDS
Food Allergies
Chapter 13
Learning Objectives
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Differentiate food allergies, intolerances and
aversions
Describe the symptoms of a food allergy
Describe importance of eliminating allergens from a
patrons food
Discuss prevention of cross contamination in kitchens
Identify ways the patron can assure allergen free
foods
Describe how to identify and find allergens on a food
label
Identify the most common allergens and at least 10
foods that include each of them
Food Allergies and Intolerances
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Food Allergy
A food allergy occurs when a food protein is attacked by the
immune system. This attack triggers a sudden release of histamine,
among other chemicals, and results in allergic reaction symptoms
Food
Intolerance
A food intolerance is characterized by unpleasant symptoms, such as
stomach cramps or diarrhea that occur after consuming certain
foods. People with a food intolerance can eat minimal amounts of
the food in question without experiencing major symptoms. The
amount of food tolerated varies greatly from person to person
Food Aversion
A food aversion is neither an allergy nor intolerance. It is an intense
dislike that may cause a biological response (nausea). Aversions
usually have psychological and/or physiological causes or effects.
Many aversions are based what foods are acceptable within one's
culture
Food Allergies
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Affects about 4% of children
 Affects about 1% to 2% of adults
 About 12 million Americans have food
allergies
 Immune system-antibody response to protein(s)
in foods
 Symptoms
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Mild to severe
Usually occur immediately, up to 2 hours after ingestion
More severe with each exposure to allergen
Common Symptoms
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Skin
 Rash, hives, itching, swelling, watery eyes
GI
 Vomiting, cramping
Respiratory
 Trouble breathing, wheezing, runny nose
 Anaphalaxis
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Airways close, unable to breathe
Death
Cardiovascular
 Rapid heart rate
“The Peanut Reaction”
 http://www.youtube.com/watch?v=31hptHYscX4
8 Most Common Allergens
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90% of food allergies
Milk
Eggs
Peanuts
Tree nuts
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Fish
Shellfish
Wheat
Soy
Food Allergies
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Tiny traces of an allergen can trigger reactions
 Often, a potential allergen is not obvious or
recognizable in foods
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Restaurants and Food Allergies
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http://www.youtube.com/watch?v=Oa74l_ogZac
Food Allergies – Cross-contamination
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Cross-contamination is one of the leading causes
of food allergy reactions in restaurants
Clean utensils and work surfaces thoroughly before
preparing food for allergic guest
Aware of cutting boards, slicers, other kitchen
equipment that may have been used before
Traces of egg, flour or nuts may adhere to rubber
gloves, parchment paper or a spatula
Key Points- Food Allergies
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Complete avoidance of allergenic ingredient is
critical
Read food labels, particularly ingredient lists
Encourage diners with allergies to call ahead, confirm
accommodations, pre-order, so the chef can check
ingredients, use appropriate equipment
Chef/restaurant employees should understand
importance of ingredients, communication of food
allergy
 Creative adjustments i.e adding a bit of flour to
thicken or butter to enrich can cause a dangerous
reaction
Allergen Labeling
The Food Allergen Labeling and Consumer
Protection Act (FALCPA) of 2004
• The label of a food that contains an ingredient
that is or contains protein from a major food
allergen declare the presence of that allergen
Allergens on the Food Label
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Ingredient list or:
The word “Contains” followed by the name of the major
food allergen
A parenthetical statement in the list of ingredients – for
example, “albumin (egg)”
Allergenic ingredients must be listed if present in any amount,
even in colors, flavors or spice blends.
Manufacturers must list the specific nut (almond, walnut,
cashew) or seafood (tuna, salmon, shrimp, lobster) used
Gluten is not included in FALCPA
Milk Allergy: Dairy Products to Avoid
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Acidophilus milk
Butter
Buttermilk
Cheese
Cheese food
Coffee creamer
Condensed milk
Creamed soups
Custards
Evaporated milk
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Ice cream
Margarine containing
milk solids
Milk chocolate
Puddings
Sour cream
Whipped cream
Whole, skim, and lowfat milk
Yogurt
Milk Allergy: Ingredients to Avoid
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Ammonium caseinate
Binding agents
Butter flavorings
Calcium caseinate
Caramel or caramel flavorings
Carob
Casein
Casein hydrolysate
Ghee
Lactalbumin
Lactate
Lactic acid
Lactoferrin
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Lactoglobulin
Lactulose
Malted milk
Milk protein
Non-dairy creamer may contain
casein
Nougat
Protein hydrolsate
Rennet casein
Simplesse™
Skim milk solids
Sodium caseinate
Whey
Whey protein hydrolysate
Milk Allergy: Foods Commonly
Containing Milk Products
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Baked goods, cakes, cookies
Biscuits
Bread
Breakfast cereals
Butter, alone, in or on foods
Candy, fudge, milk chocolate, caramels
Canned tuna, some brands contain casein
Cheese
Cocoa mixes
Crackers and cereals
Cream sauces
Custard
Deli meats, cold cuts with casein as binder
Egg substitutes
Foods fried in batter
Gravies
Ice cream
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Instant drink mixes
Instant potatoes
Hot dogs (unless kosher)
Margarine
Mayonnaise
Pancakes, waffles
Salad dressings
Sausages
Sherbet
Soups
Sour cream
Soy/vegetarian cheese
Specialty coffees, latte, cappuccino
Tofu
Vegetables in cream or cheese sauces
Whipped toppings
Milk Allergy
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Tips for chefs
 Have soymilk, rice milk or almond milk in the kitchen
to substitute for cows' milk
 Use vegetable oil instead of butter when possible
 Offer a tapenade or hummus as a spread for
bread instead of butter
 Kosher foods marked pareve, are acceptable with
meat meals, thus contain no milk or dairy products
Egg Allergy:
Terms That Imply Egg Protein is Present
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Albumin
Globulin
Lecithin
Livetin
Lysozyme
Simplesse ™
Vitellin
Words starting with "ova" or "ovo," such as
ovalbumin or ovoglobulin
Egg Allergy:
Foods and Ingredients to Avoid
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Angel food cake
Cholesterol-free egg
substitutes (usually
contain egg whites)
Cream pies
Custard
Eggs, egg whites, egg
yolks
French toast
Hollandaise sauce
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Mayonnaise
Meringue
Pancakes
Puddings
Soufflés
Surimi
Egg Allergy:
Foods Commonly Containing Eggs
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Baked goods, muffins, rolls, cakes
Béarnaise sauce
Beer
Breaded or battered foods
Breads, such as challah or others with egg in the
dough or an egg glaze
Broth (clear), consommé or stock clarified with eggs
Casseroles made with eggs
Cream-filled chocolates
Cookies
Custard
Divinity and fondant
Foam in milk toppings on specialty coffee drinks
Fried food (with eggs used in the batter)
Fudge
Ice cream
Jelly beans (some)
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Marshmallows
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Marzipan
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Mayonnaise-containing products
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Meat loaf, meatballs
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Newburgh sauce
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Nougat
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Pastas
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Pretzels
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Root beer
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Salad dressings
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Sausages (some)
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Sherbet
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Sweet rolls and pie crusts (with egg glaze)
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Tartar sauce
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Wine (some are clarified with egg)
Replacing Eggs in Recipes
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If the eggs are used for leavening
For 1 egg use:
 1½ tablespoons liquid + 1½ teaspoons oil + 1
teaspoon baking powder
 1 teaspoon baking powder + 1 tablespoon liquid + 1
tablespoon vinegar
 1 teaspoon yeast + ¼ cup warm water
 ½ teaspoon baking powder + 2 tablespoons liquid
 2 tablespoons flour + 1.2 tablespoons shortening + ½
teaspoon baking powder + 2 tablespoons liquid
Replacing Eggs in Recipes
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If the eggs are used as a binder
For 1 egg use:
 1 packet of plain gelatin + 2 tablespoons warm
water
 1 tablespoons of fruit puree
 1/3 cup of water blended with 1 tablespoon of
flax seeds (for 1 egg)
 Soft tofu
Peanut Allergy
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Peanuts are not actually nuts; they are legumes. Also known as groundnuts or
monkey nuts
Exposure can occur in three ways:
Direct contact
The most common cause exposure is eating peanuts or peanutcontaining foods. Sometimes direct skin contact with peanuts can
trigger an allergic reaction
Cross contact
The unintended introduction of peanuts into a product is generally
the result of exposure during processing or handling of a food
product
Inhalation
An allergic reaction may occur if dust or aerosols containing
peanuts is inhaled – for example, peanut flour or peanut oil
cooking spray
Peanut Allergy: Ingredients to avoid
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Peanuts
Peanut oil
Peanut butter
Peanut Allergy
Foods Commonly Containing Peanut
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African, Chinese, Indonesian,
Thai, Vietnamese and
Mexican dishes (Thai dipping
sauces, salads, pad Thai, etc.)
Sauces, such as pesto, gravy,
mole sauce and peanut sauce
Artificial nuts (peanuts
reflavored as pecans or
walnuts)
Nuts roasted in peanut oil
Baked goods
Chocolate candy and peanut
brittle
Egg rolls
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Foods that contain extruded,
cold-pressed or expelled
peanut oil, which may contain
some peanut protein
Ice cream
Salad dressing
Seeds, such as sunflower
seeds and soy nuts made or
processed on equipment
shared with peanuts
Some vegetarian and vegan
food products, especially
those sold as meat substitutes
Sweets, such as puddings,
cookies and hot chocolate
Tree Nut Allergy
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Almonds
Beech nut
Brazil nuts
Cashews
Chestnuts
Coconuts
Ginko nut
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Hazelnuts/Filbert
Hickory nuts
Lichee nut
Macadamia nuts
Pecans
Pinenuts
Pistachios
Walnuts
Tree Nut Allergy
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Most people allergic to tree nuts are also allergic
to peanuts
Water chestnuts are actually part of a plant root
and are not nuts. They, like nutmeg, are safe for
someone allergic to tree nuts
Tree Nut Allergy
Foods Commonly Containing Tree Nuts
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Barbecue sauce
Breading for chicken or fish
Cereals
Chocolate candy
Cookies and desserts
Crackers
Fois gras ( sometimes
pistachios)
Honey and chestnut honey
Mandelonas (peanuts soaked
in almond flavoring)
Meat-free burgers
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Mexican coffee (uses pinon)
Mortadella (may contain
pistachios)
Natural flavorings and
extracts (pure almond extract)
Nut butters, nut oils
Nut-flavored coffee/liqueurs
(Amaretto, Frangelico®)
Pancakes
Piecrust, some pies and tarts
Salads and salad dressings
Spreads - almond paste,
chocolate nut, nougat,
Nutella®, nut paste
Fish Allergy
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Fish and shellfish allergies tend to be severe
Fish protein can become airborne during cooking
People who are allergic to fish should avoid
seafood restaurants because of the risk of
contamination of non-fish meals
Fish Allergy: Foods to Avoid
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All fish with fins and scales
Bass
Flounder
Cod
Salmon
Tuna
Halibut
Fish Allergy:
Foods Commonly Containing Fish
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Asian fish-based sauces
Barbecue sauce (some are made from Worcestershire)
Bouillabaisse, chowder, gumbo, Jambalaya and cioppino
Caesar salad (may contain anchovies in the salad of dressing)
Caponata and sweet/sour relishes that may contain anchovies
Imitation fish or shellfish (surimi)
Meatloaf and meatballs (may contain Worcestershire sauce)
Salad dressings
Steak sauce
Surimi
Worcestershire sauce
Shellfish Allergy
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Shellfish allergy is one of the most common and
severe food allergies
Those with shellfish allergy may have an allergic
reaction to only certain kinds of shellfish or may be
allergic to all varieties
People with shellfish allergies are often sensitive to
iodine as well
Nori rolls and other seaweeds contain high levels of
iodine
Shellfish Allergy
Common Allergy-causing Shellfish
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Crustaceans
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Crabs
Crayfish
Lobster
Langoustines
Prawns
Shrimp
Mollusks
Bivalves
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Clams
Mussels
Oysters
Scallops
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Gastropods
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Limpets
Periwinkles
Snails (escargot)
Abalone
Cephalopods
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Squid
Cuttlefish
Octopus
Wheat Allergy
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People who are allergic to wheat have a specific
intolerance to wheat protein
This allergy is not the same as gluten intolerance
(celiac disease)
Many wheat-allergic children outgrow this allergy
For those with wheat allergy, alternative grains such
as quinoa and rice should be offered
Wheat Allergy
Foods and Ingredients to Avoid
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All-purpose flour
Bread (unless wheat-free)
Bran
Breadcrumbs
Bulgur
Cake flour
Cracked wheat
Durum flour
Enriched flour
Gelatinized starch
Gluten
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Graham flour
Kamut®
Miller’s bran
Modified food starch
Pastry flour
Semolina
Spelt
Starch
Vegetable gum
Wheat germ
Whole-wheat flour
Wheat Allergy
Foods Commonly Containing Wheat
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Beer
Bouillon base and cubes
Breads (many corn or rye breads also
contain some wheat flour) and rolls
Breakfast bars
Breakfast cereals
Candy
Cakes and muffins
Coffee substitutes
Condiments, such as ketchup
Couscous
Cookies
Dairy products, such as ice cream
Deli meat products, cold cuts and sausages
Farina
French fries
Gelatinized starch
Hot dogs
Hydrolyzed vegetable protein
Ice cream
Imitation crabmeat
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Malt
Meat, crab or shrimp substitutes
Modified food starch
Natural flavorings
Noodles
Pancakes, pancake and waffle mixes
Pasta
Processed meats
Sausage
Soup mixes
Soy sauce
Tempura batter
Vegetable gum
Waffles
Wheat germ
Wheat starch
Soy Allergy:
Ingredients to Avoid
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Artificial flavorings
Asian cuisine flavoring
Bouillon cubes (beef, chicken, vegetable, etc)
Chicken broth
Edamame
Emulsifier
Glycine max
Hydrolyzed plant protein
Hydrolyzed protein
Hydrolyzed soy protein
Hydrolyzed vegetable protein (HVP)
Lecithin
Miso
Mono- and diglyceride
Monosodium glutamate (MSG)
Natto
Natural flavoring
Plant protein
Protein extender
Protein filler
Shoyu
Sobee® and other soy formulas
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Soy albumin
Soy fiber
Soy flour
Soy grits
Soy meal
Soymilk
Soy nut butter
Soy nuts
Soy protein isolate
Soy sauce
Soy sprouts
Soya
Soybeans
Soybean butter
Soybean granules or curds
Tamari
Tempeh
Texturized vegetable protein (TVP)
Tofu
Vegetable broth
Vegetable gum
Vegetable starch
Worcestershire sauce
Soy Allergy
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Soybeans have become a major part of processed
food products such as baked goods, canned items,
cereals, crackers, sauces, and soups
Avoiding products made with soybeans can be
difficult. Check for soy as an ingredient in anything
labeled as vegetarian or vegan as soy products are
often added to boost nutrient value
Read labels carefully