Transcript Food allergies and intolerances

Food allergies and intolerances –
module 1
Introduction to allergens and
intolerances
Welcome
• Welcome to University of West London and
the one day course on Food allergens and
intolerances.
• Timing of the course
• Test and certificate
• While you are here……
What this course is all about
• To provide information and understanding about the 14
allergens identified in EU No. 1169 2011 which comes
into force in December 2014.
• The information applies to all hospitality and catering
operations, and all staff working in the businesses. All
staff need to be aware of allergen hazards, and how to
reduce risk of harm.
• Offering a full understanding of allergies and intolerances
and how to manage these hazards in the business.
• The course is divided into 4 areas with some Key Points
and Revision at the end.
Module 1 - Introduction
1.
The risks that everyday foods can bring to your
customers
2.
What is an allergen?
3.
What is an allergic reaction and its symptoms?
4.
What is an intolerant?
5.
What is food intolerance and its symptoms?
6.
Understanding the responsibilities to your customer
14 foods or ingredients have been
identified by EU Legislation as allergens
• How many can you name?
Analise
• 5 year old Analise’s
parents knew she reacted
to some foods and avoided
the main allergens.
• They informed her new
school of problems and
provided her with an
‘allergen free’ lunchbox.
• First day had a severe
reaction due to sitting
near a child eating a nut
product.
Jonathan
• On a school trip where
children were staying in a
hostel with food provided.
• Party leaders chose a
vegetable pasta dish as
suitable for everyone.
• The vegetables were fried
in an oil with some
sesame content.
• He had a severe and rapid
reaction.
Emily
• 18 months old out on a
riverside walk with her
parents. Stopped at pub for
lunch.
• Barbeque pork sate was
being cooked in the garden
near to their table.
• Rapid and severe reaction
including difficulty with
breathing.
• She had never had a reaction
to food before.
All of these may be reactions to allergens
and there are more.
Dangers of allergens
• Some people can have rapid and frightening reactions to
certain ingredients and food. The reaction can prove to be
fatal if not treated quickly.
• This is not a common occurrence but very serious for the
allergic person.
• The allergy foods do not affect everyone. Good
communication between the food provider and customer
is essential.
Reactions (Jonathan)
• The party leader had checked there were no nuts in the
dish being served
• In the kitchen they had run out of the usual vegetable oil
but the person doing the cooking saw another bottle of oil
and used it.
• It was an oil from various sources including sesame.
• His reaction was rapid. Medication was applied quickly –
otherwise he could have died.
The 14 Allergens stated on 1169/2011.
The identified allergens
• An allergen a substance
that can cause certain
people to become
seriously ill when they
have contact with it.
• People can react to all
kinds of things including
pollen, insect bites or
stings and latex or rubber.
Here we are only
concerned with food
allergens.
The 14 Allergens stated on 1169/2011.
Not always obvious
• People who know that they have an allergy to certain
foods or ingredients will avoid them but allergy ingredients
can be hidden such as in Jonathan’s pasta dish.
• Worcestershire sauce contains fish extracts, egg often
listed on food labels as ‘emulsifier’ wheat flour used to
keep black pepper free running.
• Other examples………………………………………
• May contain
• Not suitable for….
Allergen ingredient not in the food but may be present – why?
The risks
• Concerns because the risk of with a particular allergen is
so great. A seafood restaurant cannot avoid shrimp
contamination a Thai restaurant serving Satay dishes
cannot avoid peanut contamination.
• A "sensible" allergy sufferer is likely not to go to a
restaurant specialising in dishes containing the allergen,
but typically young people in groups do sometimes take
risks.
• You must always give the safest, most truthful advice at
all times.
Can you change an allergen in food?
• There are some allergens that when cooked can become
harmless to some sufferers but this is never certain so
best not to take the risk.
• When a customer says they are allergic to any food or
ingredient do not serve it raw, processed or cooked.
• If in doubt, never think that it will be all right. Don’t serve it!
Tomato allergy
• A medical professional told a woman with a tomato allergy
it was all right to use bottled, processed bolognaise sauce
to cook for her children.
• However sauces vary between brands. She opened a
glass jar with chunky tomato pieces, breathed the air
from the jar and died in hospital four days later. This was
a severe allergic reaction and clearly shows the
importance of always giving accurate information.
What is an Allergy?
• Everyone has defence systems to protect from illness - the
immune system. Immunity from illness is achieved either by
having already had the disease or by vaccination which has
saved many lives around the world.
• Immunity is when the body has experienced the disease or a
small sample by vaccination. The immune system fights it off
and ‘remembers’ it for the future. Illness either does not occur
or will be in a minor form.
• A person with an allergy has come across the allergen but the
body has not remembered it correctly so does not react
properly and fights against itself; in the most severe cases
shutting the whole body down and killing the person.
• This type of reaction is called an anaphylactic shock.
Reasons for allergy are still not fully
understood but suggestions include:
Some people in infancy experienced contact with peanut crumbs
through the skin, because of skin being broken (as with eczema)
triggering the wrong information in the immune system.
Increased use of nuts and nut oils in processed foods affecting
unborn babies and those in infancy
Allergies can develop through life - much is still unknown.
Generally there are no cures for allergies just avoidance of the
allergens, medication to reduce the symptoms with hope that the
body itself will change and so “correct” the immune system.
Anaphylactic shock
• The symptoms are severe, frightening and deadly if not
treated. People at risk of anaphylactic shock will carry an
adrenaline pen. (Called an EpiPen - it contains
epinephrine, (adrenaline).
• Adrenaline is used in heart failure to keep a person alive.
The same applies here.
• During an anaphylactic shock the blood pressure drops
very low, and this will cause death. There is urgent need for
adrenaline from
the EpiPen, and urgent hospital treatment.
How do they feel?
• It may start with just an itchy throat and a tingling on the
•
•
•
•
lips then the swelling and red rash, called uritica.
The soft tissue of nose, throat and lips swell which can
restrict airways
Sufferers feel a sense of impending doom –that they feel
that they are going to die.
Very frightening alarming for sufferer and those around
them.
This all happens very quickly.
Managing Allergies
• Not all reactions are as severe as described, but they will
make people very ill, and sometimes it can take time,
even hours after the person has left the restaurant.
• Food allergies are increasing and especially in children, it
is estimated that close to 7 per cent of all children suffer
from at least one allergy.
• Medical science is still working on the reasons why there
is an increase in allergies.
• Now more awareness of allergy. Diagnosis is better so
ability to identify more allergy sufferers and manage the
dangers.
Just to confuse matters!
• Not everyone with a reaction to certain foods has a true
ALLERGY.
• Sometimes it is an INTOLERANCE which causes a
different kind of reaction.
What is an Intolerant?
• An intolerant causes a different type of reaction in
digestive system
• It sometimes goes wrong and the digestive system fails to
process food properly, illness results because the foods
are not being broken down properly.
• Worse - nutrition is not being taken from the food which
can result in serious illness rather like starving to death
but not feeling hungry.
• The body’s reacts with symptoms such as, diarrhoea,
wind and severe cramps so a different
type of reaction to allergy.
More about intolerants
• Intolerants, tend to be grouped together with Allergens
when providing food for customers. Both must be totally
excluded from the guest’s meal.
• Both allergens and intolerants must be considered as
hazards!
• Two kinds intolerances will be considered one caused by
milk - lactose intolerance, and the second caused by
gluten, found in flour, called coeliac disease.
Intolerances – Lactose intolerance
• Lactose intolerance - inability to digest the sugar in milk
and milk products.
• About 10,000 years ago domestication of cattle began so
that we could drink their milk. Gradually, evolution
favoured those people who continued to drink milk and
consume milk products such as cheese.
• Most people continue to produce the enzyme lactase,
enjoying eating cheese and drinking milk. Yet some
people still do not produce lactase so become ill when
they have any milk product..
Apart from milk itself how many products
are made from or contain milk?
Intolerances - Coeliac Disease
• Gluten - two combined proteins in flour, that react with the
digestive system to cause inflammation, swelling,
discomfort and diarrhoea. The intestine fails to absorb
vital nutrients from the food.
• Coeliac disease is complex because food is absorbed by
the villi, small protrusions on the inside wall of the
intestine. These villi are shrunk by the reaction and cannot
absorb food in the normal way.
• Person starts to suffer from malnutrition, so must avoid all
food that contains gluten even in small amounts.
Difficulties with Coeliac disease
• With gluten in all common flours a wide range of foods
must be avoided, bread, all pastries, pasta.
• All these foods can be prepared from alternative, gluten
free flour. It is important to recognise which are gluten free
foods and food containing gluten.
• It is essential that these foods are properly labelled and
stored separately so that no confusion occurs.
The food provider’s responsibility
• As a food professional it is your responsibility, to know all
the foods and ingredients in your kitchen that contain milk
and gluten, so you can safely serve your customers
suffering with either coeliac disease or lactose
intolerance.
• The letters GF beside a menu item means that it is gluten
free?
Allergies and Intolerances
• Knowing the differences between allergies and
intolerances it will help you to understand and
communicate with your customer.
• These fairly common diseases related to food show that it
is vital for you to communicate well with your customer
and a little understanding will go a long way.
Key Points and Revision
1. Allergies can be fatal; therefore a person with an allergy must
never come into contact with the particular allergen.
2. An anaphylactic shock is where a person’s body literally
closes down, going towards death.
3. Allergens are the food items that cause an allergic reaction,
many of which may be small ingredients in processed foods;
these are known as "hidden allergens".
4. Allergies are the result of a failure of the immune system,
which normally protects the body from disease and infection.
The immune is turned against the body by having the wrong
reaction to the allergen.
5. An intolerance is a fault of the digestive system, which causes
serious discomfort, and in certain cases malnutrition.
Key Points and Revision cont.
6. Allergens and intolerants must be equally treated as
hazards and therefore extreme care must be taken when
preparing food for any guest with either intolerance or an
allergy.
7. The slightest contamination of a sufferer’s meal will have
the most serious of consequences.
8. More children are being diagnosed with allergies each
year. Therefore those working with the young need to
ensure the strictest allergen control in daily working
practice.
9. The final and important point is that if you feel that it is
not safe to serve a customer you must politely tell them so.
Remember stay safe – stay legal