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Food Allergies and Menu Planning for Schools and Child Care. Lynn James, M.S., R.D., L.D.N. Janice Ronan Fran Alloway, M.A., R.D., L.D.N. Penn State Cooperative Extension. Overview of Objectives. What is an allergy? Control of allergens Allergen regulations What you can do

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Food Allergies and Menu Planning for Schools and Child Care

Lynn James, M.S., R.D., L.D.N.

Janice Ronan

Fran Alloway, M.A., R.D., L.D.N.

Penn State Cooperative Extension


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Overview of Objectives

  • What is an allergy?

  • Control of allergens

  • Allergen regulations

  • What you can do

  • Food Allergy Action Plan


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Food Allergy vs. Intolerances

  • Food Allergy- involves the body’s immune system

  • Food Intolerance- does not involve the body’s immune system


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What is a Food Allergy?

  • Food Allergy:

    The body’s adverse reaction to food caused by the immune system of sensitive individuals

  • Allergen (food protein) :

    The substance that causes the

    adverse reaction


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Symptoms of a Food Allergy

Within 2 minutes -2 hours of eating the food,

body’s cells make Histamine that can cause:

  • Itching in mouth

  • Stomach cramps, diarrhea, vomiting

  • Blood pressure drops

  • Skin hives or eczema, dermatitis

  • Asthma in lungs

  • Death by anaphylactic shock (nuts leading cause)

    Over 160 foods are identified as causing food allergies, but 8 are the most common:


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Who Has Food Allergies?

  • 1/3 think they or a family member

    have a food allergy

    Research states:

  • 2-4 % adults; 5-8 % infants and young

    children

  • Approximately 30,000 consumers require emergency room treatment yearly

  • 150 Americans die each year because of allergic reactions to food.


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Food Allergies

  • Symptoms can worsen after each exposure

  • So far, cannot be “cured” but can be outgrown

  • Percent of children who outgrow:

    milk, egg, soy – 50 - 80%

    peanut, tree nuts and shellfish -15 - 20%


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Food Allergy Prevention

1. Breastfeeding

Exclusive breastfeeding for first 4 mo.

Feeding hypoallergenic formulas if not breastfed – some evidence

2. For Families with Food Allergies, Infant feeding Guidelines:

  • Delay introducing solid food until 4-6 mo.

  • Not conclusive that avoiding allergens early prevents allergies

    Source: American Academy of Allergy, Asthma, & Immunology www.aaai.org ; American Academy of Pediatrics


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Allergy Issues

Cross-Reactivity- allergy crosses over to like allergens-

  • e.g. different kinds of nuts

  • shrimp, crab, lobster, crayfish

    Oral Allergy Syndrome- a kind of cross-reactivity, severe mouth itching

  • e.g. ragweed & melons

  • birch and apple peels


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“Undercover” Allergens

  • Soy

    • Lecithin, hydrolyzed plant proteins

  • Wheat

    • Starch, flour, gluten

  • Dairy

    • Whey, sodium caseinate

  • Egg

    • Albumin


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Medical Interventions

Epinephrine (adrenaline)

The drug of choice for treatment of anaphylaxisis

Should be followed by trip to hospital

Antihistamines

Storing medication


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Food Intolerances

Lactose Intolerance

Body lacks lactase enzyme to digest milk sugar

  • Affects 10% population

  • Foods: milk, soft cheese, ice cream

  • Causes gas, bloating, abdominal pain, sometimes diarrhea


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Gluten Intolerance

Or Celiac Disease- bodyreacts to gluten- proteins in wheat, barley, and rye.

  • May affects 1 in 133

  • Causes severe intestinal problems/malabsorption


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Food Intolerances

Food Additives-often confused with food allergy, some can cause problems in sensitive individuals:

  • MSG- monosodium glutamate- flavor enhancer in many foods

  • Sulfites -Sulfur-based compounds that may occur naturally or may be added as a preservative.


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Some foods sources of sulfites

  • Baked goods

  • Soup mixes

  • Canned or frozen fruits and vegetables

  • Dried fruit

  • Trail mix

  • Potato chips

  • Jams

  • Fresh or frozen shrimp

  • Molasses


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Some food sources of sulfites

  • Alcohol, beer, and wine

  • Sparkling grape juice

  • Apple cider

  • Bottled lemon juice and lime juice

  • Tea

  • Many condiments

  • Maraschino cherries

  • Dehydrated, pre-cut or peeled potatoes


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Food Allergen Labeling and Consumer Protection Act of 2004(FALCPA)

Requires that the label of all packaged food sold in the US under FDA that contains an ingredient that is or contains protein from a “major food allergen” must display a “Contains” statement OR plain English labeling of allergens in ingredient statement OR both

Currently no thresholds for allergens

Effective for food products labeled on or after January 1, 2006—domestic and imported.


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FALCPA Requirements

  • Declare food allergens on label

  • Manufacturers and processors must ensure no undeclared allergens from:

    • Ingredients

    • Processing aids

    • Cross-contamination-food allergen from one food inadvertently gets into another food


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How have food labels changed?

Labeling Option 1: Name food source after name of ingredient

Ingredients: Enriched flour (wheat flour, malted barley, niacin, folic acid), sugar, whey (milk),eggs . . . . . lecithin (soy).


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How have food labels changed?

Option #2

Found near ingredient list on label:

Contains wheat, milk, eggs, and soy.


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Contains statement

FALCPA Compliant Label

Allergens


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Enforcement?

  • Enforced by FDA as part of its routine regulation and inspection.

  • Applies to packaged FDA regulated foods.

  • Does not apply to foods wrapped or packaged at the request of the consumer (bakery, doggie bags)


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Legal Issues for Child Care Providers

Children with potentially life-threatening food allergies may be considered disabled and covered by federal laws:

  • Rehabilitation Act of 1973, Section 504

    Preschools and child care centers that receive federal funds or services must comply.

  • Americans with Disabilities Act of 1990

    Titles II and III may impact centers run by state or local governments and private centers.


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Legal Issues

Liability waivers are of little use.

Parents cannot enter into an agreement that denies their children necessary care and protection.



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Managing Food Allergies

  • Become educated about foods that contain the problem allergens.

  • Work together as a team with parents, staff and food service

  • Have an Allergy Action Plan in place


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Education is the best way to manage your liability and minimize risks to children.

Work together with

  • Child’s parents

  • Child’s physician

  • Staff-teachers and food service

  • School nurses, emergency medical

    personnel


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Looking At Your Menu minimize risks to children.

  • Which foods include the problem allergen?

  • Can substitutions be provided?

  • Can ingredients be changed?

  • Will cross contamination be a problem?

  • Should you eliminate that food

    from menu?

  • Non-allergenic snacks


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Preventing Problems minimize risks to children.with Food Allergens

Avoid Cross-contamination:

  • clean hands with soap and water between tasks

  • clean and sanitize work surfaces and utensils

  • Frequently check food labels for food allergens and cross-over foods that may carry allergens- eg peanut oil


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Day to Day Strategies minimize risks to children.

  • Frequently read labels

  • Prepare allergy-free foods first

  • Prevent Cross Contamination

  • Prepare allergy-free foods in large quantities and freeze

  • Prepare a policy on preventing cross contamination and food allergies, train staff


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Resources minimize risks to children.

Food Allergy & Anaphylaxis Network (FAAN) Fairfax, VA

800-929-4040

www.foodallergy.org

FDA: Information about Food Allergies

National Library of Medicine: MedlinePlus Food Allergy

International Food Information Council (IFIC)


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References minimize risks to children.

  • http://www.niaid.nih.gov/publications/pdf/foodallergy.pdf

  • http://www.datcp.state.wi.us/fs/business/food/training/allergens.jsp

  • US Food & Drug Administration, Information for Consumers: Food Allergen Labeling And Consumer Protection Act of 2004Questions and Answers, December 12, 2005; Updated July 18, 2006


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Food Allergies and Menu Planning for Schools and Child Care minimize risks to children.

Prepared by:

Lynn James, M.S., R.D., L.D.N.

Janice Ronan

Frances Alloway, M.A., R.D., L.D.N.

Extension Educators, Penn State Cooperative Extension


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Penn State Cooperative Extension minimize risks to children.

Working for you in your county.

Penn State is committed to affirmative action, equal opportunity, and the diversity of its workforce.


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