Controlling Allergens: Preparing and Serving Food Safety in School Kitchens - PowerPoint Presentation

1. Controlling Allergens:Preparing and Serving Food Safety in School KitchensBen Chapman, PhDKatrina Levine, MPH, RD, LDNMay 28, 2015

2. What is a Food Allergy?Immune system has a negative reaction to something in a foodSomething in the food causes the immune system to produce antibodies (IgE). When the person has that food component, it triggers the antibodies, which alert the immune system to react, causing an allergic reactionNOT a food sensitivity or intolerance

3. Why are they important?Affects 4-8% of children and 2% of adults in the U.S.Leading cause of anaphylaxisEach year, anaphylaxis due to food causes 30,000 emergency room visits2,000 hospitalizations150 deaths

4. Building Blocks of FoodAll foods are built of macro- and micromoleculesMacromolecules:ProteinsNucleic acidsCarbohydratesLipids (fats)Micromolecules include:VitaminsMinerals

5. What is an Allergen?Allergens are always proteinsProteins are macromolecules composed of one or more chains of amino acidsProteins are found in all living organisms, so in most food productsProteins should not be confused with oils and sugarsRefined/filtered oils only contain lipids and won’t cause allergic reactionsLactose is a sugar, so lactose intolerance is not an allergy

6. 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 substanceThe immune system produces antibodies to protect against the allergenWhen the body detects the protein again it reacts as if the substance is harmful, releasing a storm of immune substances, stimulating a reactionIn some cases, only a trace amount of the protein is required to produce an immune reaction

7. What does an allergic reaction look like?HivesFlushed skin or rashTingling or itchy sensation in the mouthFace, tongue, or lip swellingVomiting and/or diarrheaAbdominal crampsCoughing or wheezingDizziness and/or lightheadednessSwelling of the throat and vocal cordsDifficulty breathingDrop in blood pressureLoss of consciousness

8. How child describes reactionPut 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”

9. Top 8 Allergens (90%)EggsMilkSoyWheatPeanutsTree nuts (almonds, walnuts, pecans, etc.)Fin fishShellfish (crab, shrimp, lobster, etc.)

10. Food IntoleranceMore common than allergiesHistamine toxicity (cheese, wine, fish)Lactose intoleranceFood additives (MSG)Gluten intolerance (small intestine)Corn productsTrue allergy – avoid food (immune system)Intolerance – small amount is ok (digestive system)

11. What about gluten?Damages the intestines in people with Celiac DiseaseImmune system responds differently in people with Celiac vs. sensitivity or intoleranceFDA Final Rule in 2014 on definition of “gluten-free” for packaged productsFDA does not regulate labeling of “gluten-free” in schools

12. Allergens in the kitchenHidden sources of allergensSoups, sauces, dressings, mixes, cookies, crackers, baked goods, etc.Cross-contaminationDirect contamination of equipment and surfacesIndirect contamination through particles in air

13. What to look for:Dairy: whey, casein, milk/cheese (any form)Egg: albumin, globulin, egg (any form)Wheat: bran, flour (any form), durum, glutenSoy: lecithin, edamame, soy proteinPeanuts & Tree nuts: nuts (any form), marzipan, artificial nutsFish & Shellfish: surimi, seafood flavoring, fish/shellfish (any form)There are many more aliases as wellBy law, labels must alert to all potential allergens in the producthttp://www.corbisimages.com/stock-photo/rights-managed/42-16456772/food-allergy-warning-label-on-package-of

14. Equipment and surfacesEverything from mixers and pans to utensils to tabletopsCleaning and sanitizing critical between usesDishwashing methodStoring equipmentCoveredUpside down

15. Particles in the airDust from things like flour or mealMaking pizza and breadCoating pans to prevent stickingCan settle on equipment, surfaces, utensils, food or ingredients

16. Other ways to cross-contactCooking oil used in fryingGarnishes and toppingsHands and gloves

17. In the cafeteria and on the lineLabelingSeparatingCommunicating

18. Know your school’s protocolYour school should have a plan for how to handle food allergiesKnow the protocol and how you fit into itTalk to your school nurse or CND

19. Labeling is important13-year-old Natalie Giorgi died at a family camp after eating a Rice Krispie treat with traces of peanut butter in the marshmallowCamp had failed to properly label foods, as they had in the pastEpiPen was not effective and she died of anaphylactic shockhttp://www.sacbee.com/news/local/health-and-medicine/article2596198.html

20. Cross contactSabrina Shannon, 13, died of cardiac arrest due to anaphylactic shockSabrina ate plain french fries that had been served with tongs used for cheese friesCross contact of dairy protein caused the reaction

21. Establish a Food Allergy ExpertA food allergy expert:Knows the recipes, ingredients, and potential allergensKnows the students with food allergiesKnows how to respond in a food allergy emergencyhttp://3.bp.blogspot.com/-O4NR28njoXU/UnDHqvETv0I/AAAAAAAAY7M/ehE4Nsf62Is/s1600/Fotolia_35754864_M_Expert.jpg

22. Resources“Food Allergy Training Guide for Hospital and Food Service Staff,” American College of Allergy, Asthma & Immunology (http://www.foodallergy.org/document.doc?id=149)