On March 20th, we held our first webinar “Serving It Allergy Free” hosted by our very own Debra Zwiefelhofer RDN, LD. The webinar was complimentary for FCS Professionals and attendees received one hour of continuing education credit in the comfort of their own homes.
What is a food allergy? It is an abnormal response to a normal food. The protein in the food item is the “enemy” and the body’s immune system is triggered. This reaction may be immediate or could be hours after exposure and the reaction can range from mild to severe. Also the reaction must be repeatable to be considered a true allergy. The reaction can vary between oral discomfort (itching, swelling, hives), abdominal discomfort with digestion (vomiting, bloating, diarrhea), or in the bloodstream (drop in blood pressure, hives, eczema, or wheezing). The most severe reaction is anaphylaxis which accounts for two hundred deaths annually in the United States.
A food intolerance or sensitivity is different from an allergy in that the reaction is not due to the protein in food and the response is not related to the body’s immune system. The response may be due to an absence of chemicals or enzymes to digest a food (think lactose intolerance), an inability to absorb nutrients, or could be pharmacologic (a natural/artificial food chemical sensitivity). The response can be less obvious and can be dose or exposure dependent. Symptoms vary greatly and affect different parts of the body:. Skin: rash, hives, dermatitis, eczema Respiratory: nasal congestion, sinusitis, throat irritation, asthma, cough GI: mouth ulcers, cramping, nausea, gas, diarrhea, IBS.
So how can you tell the difference? Deb described a food allergy as the body at war against the food. An intolerance is when the body doesn’t know how to deal with a food.
Oral Allergy Syndrome is when an allergy to pollen creates a raw food reaction because the proteins are similar. The reaction is localized to the mouth/oral cavity/throat. Usually the reaction is to a raw food and often the same food item is tolerated when it is cooked.
The top food allergens in the US are eggs, cow’s milk, fish, shellfish, peanuts, tree nuts, soy, and wheat. Deb spent time going through each of the top allergies.
Can we prevent food allergies? In the past, there have been recommendations for pregnant women to restrict certain foods and also for breastfeeding moms. That advice is no longer given. When introducing foods to infants, it is also no longer recommended to avoid foods like peanut butter, but finding that it is better to introduce small amounts earlier.
As professionals, what do we need to know to protect our customers and patients? Food labeling laws state that labels must use common names for allergens i.e. sodium caseinate (milk), any ingredient source must be disclosed, species must be declared for nuts, fish and shellfish i.e. tree nuts (almonds). To be labeled gluten free, no gluten, free of gluten, or without gluten the food must not contain: an ingredient that is a gluten containing grain, and ingredient derived from a gluten containing grain unless it has been processed to remove the gluten. There are certain foods that are not subject to the labeling law including raw foods (whole fruits and vegetables), foods approved as exempt (highly refined peanut and soy oils), molluscan shellfish (oysters, clams, mussels, scallops). Deb warned that when it comes to labeling, it is “buyer beware” as any law is only as good as the ability to enforce it. It can be particularly tricky with imported goods–they are supposed to follow the rules of the destination country but that does not always happen. Deb said it’s similar with the old food safety saying, “When in doubt throw it out!”. With food labeling, if you are in doubt–leave it out! Better to err on the side of caution when it comes to food allergies. Deb also reminded the group that it is not enough to just buy the right foods. Cross-contamination is an issue with food allergies. The majority of fatal allergic reactions occur outside the home and desserts are the biggest culprit in the nut/peanut reactions. How can we prevent these reactions? 1. Know ingredients in prepared foods/recipes (know that ingredients change–check often!) 2. The identification of a food allergy should ignite a process in any eating venue 3. Know what to do in the event of an allergic reaction. Deb ended her presentation with this closing thought, “It’s not necessarily our task to distinguish between allergies, intolerances and aversions. If an individual doesn’t want a particular food item, it is our job to avoid serving it to them.”