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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
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
Overview of Objectives
  • What is an allergy?
  • Control of allergens
  • Allergen regulations
  • What you can do
  • Food Allergy Action Plan
food allergy vs intolerances
Food Allergy vs. Intolerances
  • Food Allergy- involves the body’s immune system
  • Food Intolerance- does not involve the body’s immune system
what is a food allergy
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

symptoms of a food allergy
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:

who has food allergies
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.
food allergies
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%

food allergy prevention
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

allergy issues
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
undercover allergens
“Undercover” Allergens
  • Soy
    • Lecithin, hydrolyzed plant proteins
  • Wheat
    • Starch, flour, gluten
  • Dairy
    • Whey, sodium caseinate
  • Egg
    • Albumin
medical interventions
Medical Interventions

Epinephrine (adrenaline)

The drug of choice for treatment of anaphylaxisis

Should be followed by trip to hospital

Antihistamines

Storing medication

food intolerances
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
gluten intolerance
Gluten Intolerance

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

  • May affects 1 in 133
  • Causes severe intestinal problems/malabsorption
food intolerances15
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.
some foods sources of sulfites
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
some food sources of sulfites
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
food allergen labeling and consumer protection act of 2004 falcpa
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.

falcpa requirements
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
how have food labels changed
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).

how have food labels changed21
How have food labels changed?

Option #2

Found near ingredient list on label:

Contains wheat, milk, eggs, and soy.

enforcement
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)
legal issues for child care providers
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.

legal issues
Legal Issues

Liability waivers are of little use.

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

managing food allergies
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
education is the best way to manage your liability and minimize risks to children
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

looking at your menu
Looking At Your Menu
  • 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
preventing problems with food allergens
Preventing Problems 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
day to day strategies
Day to Day Strategies
  • 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
resources
Resources

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)

references
References
  • 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
food allergies and menu planning for schools and child care34
Food Allergies and Menu Planning for Schools and Child Care

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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