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Food Allergies Food Intolerances and Disabilities. August/September 2012 CACFP Training. What are the Rules?. Medical or Religious Reason for needing food substitutions Disability Allergy or Religious Reason Parent Preference Milk Let’s go through the Handout. Next …. Food Allergy

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food allergies food intolerances and disabilities

Food Allergies Food IntolerancesandDisabilities



CACFP Training

what are the rules
What are the Rules?
  • Medical or Religious Reason for needing food substitutions
    • Disability
    • Allergy or Religious Reason
  • Parent Preference
  • Milk

Let’s go through the Handout

Next ….
  • Food Allergy
  • Food Intolerances
  • Disability
  • Examples of some common Diseases
    • Diabetes
    • Celiac Disease
    • PKU
food allergy
Food Allergy
  • Sensitivity to chemical compounds (proteins) naturally found in food
  • Develop after exposure to a food protein that body thinks is harmful
  • It’s an abnormal response of the immune system to a particular food or food component
8 foods included in food allergy labeling required by fda
8 Foods included in food allergy labeling required by FDA
  • Milk
  • Eggs
  • Peanuts
  • Tree Nuts
  • Fish
  • Shellfish
  • Soy
  • Wheat
food allergies involve 2 features of the human immune response
Food allergies Involve 2 features of the human immune response

1) Production of immunoglobulin E ()IgE)

A type of protein called an antibody that circuclates through the blood

2) Mast cell, a specific cell that occurs in all body tissues but is especially common in areas of body that are typical sites of allergic reactions (including nose & throat, lungs, skin & gastrointestinal tract

forming ige
Forming IgE
  • Inherited predisposition
  • First has to be exposed to the food
  • As food is digested, it triggers certain cells to produce IgE in large amounts
  • IgE released and hooks to Mast Cells
  • Next time person eats the food it interacts with specific IgE & triggers the mast cells to release chemicals such as histamine



Itching in Mouth

Hives - Eczema

BP may drop

Throat tightness

Anaphylactic Shock

Breathing Difficulty

The Allergic Reaction

An allergic reaction to food can take place within a few minutes to hours.

symptoms of food allergy
Symptoms of Food Allergy
  • Rash or hives or eczema
  • Abdominal pain, diarrhea, nausea, vomiting
  • Tingling or itching in the mouth or skin
  • Wheezing, nasal congestion or trouble breathing
  • Dizziness, lightheadedness or fainting
  • Swelling of the lips, face, tongue, and throat, or other parts of the body Anaphylaxis
no cure for food allergies
No cure for food allergies

Avoid the Offending Food is the only way to prevent a reaction

exercise induced food allergy
Exercise-induced food allergy
  • Some people have an allergic reaction to a food triggered by exercise
  • Eating certain foods may cause person to feel itchy and lightheaded soon after they start exercising
  • Not eating a couple of hours before exercising & avoiding certain foods may help prevent this problem
  • Most severe allergic reaction
  • Involves multiple systems at the same time
  • Potentially fatal if medication not given promptly
  • Can occur within minutes of exposure
  • Peanut/tree nut allergies in combo with asthma is the highest risk
  • If child has life-threatening allergies it is considered a disability in Child Nutrition
symptoms of anaphylaxis
Symptoms of Anaphylaxis
  • Skin reactions, including hives along with itching, flushed or pale skin (almost always present with anaphylaxis)
  • A feeling of warmth
  • Constriction and tightening of airways
  • A swollen throat or the sensation of a lump in the throat that makes it difficult to breathe
  • Weak and rapid pulse
  • Dizziness, lightheadedness or loss of consciousness
food intolerances
Food Intolerances
  • Lacks the chemicals called enzymes, necessary to properly digest certain proteins found in food
  • Intolerances to some chemical ingredients added to food to provide color, taste, or protect against growth or bacteria
  • Sulfites can be a source of intolerance (naturally or added to prevent growth of mold)
  • Salicylates are group of plant chemicals found in many fruits, veg, juices
symptoms of food intolerance
Symptoms of Food Intolerance
  • Nausea
  • Stomach Pain
  • Gas, cramps, bloating
  • Vomiting
  • Heartburn
  • Diarrhea
  • Headaches
  • Irritability or Nervousness
tell the difference
Tell the difference?


  • Allergies can be triggered by even small amounts – occur every time food consumed
  • Advised to avoid offending foods completely


  • Intolerance is dose related
  • Found through trial and error (food diary)
  • Elimination diet and reintroduce foods one at a time
  • Anyone who has a physical or mental impairment, which substantially limits one or more of he major life activities, has a record of such impairment, or is regarded as having such an impairment.
  • Determination can only be made by a licensed physician
  • What is disability
  • How it restricts diet
  • Major life activity affected
  • Foods to be omitted
  • Foods to be substituted
    • Easiest way is to use our medical statement
common food related disabilities
Common Food Related Disabilities
  • Diabetes
  • Celiac Disease
  • PKU
  • The body cannot produce or use insulin
  • Insulin = a hormone that helps the body to use glucose as energy
  • Type 1
  • Type 2 (typically in adults)
type 1 diabetes
Type 1 Diabetes
  • Normally, the hormone insulin helps glucose enter the child's cells to provide energy to the muscles and tissues.
  • When working properly, once a child eats, the pancreas secretes more insulin into the bloodstream and it circulates & opens doors so sugar can enter the body’s cells.
  • Type I -Pancreas produces little or no insulin
  • Blood sugar monitoring – many times a day
  • Glucose monitoring (CGM) – newest way to monitor blood sugar levels (used as an additional tool to blood sugar monitoring)
  • Insulin treatment
diabetes lifestyle considerations
Diabetes Lifestyle Considerations
  • Healthy Eating - high in nutrition and low in fats and calories
  • Fruits & vegetables, Whole Grains, Low fat/low sugar
  • Physical Activity – can affect blood sugar levels up to 12 hrs. after exercise
type 2 diabetes
Type 2 Diabetes
  • Most common in adults but on the rise in children – fueled by obesity
  • Pancreas stops producing enough insulin
  • Treated with diet/exercise and oral meds
  • Prevention:
    • Eat healthy foods
    • Get more physical activity
    • Manage weight
celiac disease
Celiac Disease
  • Genetically-based autoimmune disease characterized by sensitivity to the protein gluten
celiac disease1
Celiac Disease
  • Dietary treatment
  • Only treatment is gluten-free diet
  • Cannot eat the protein from the following grains:
    • Wheat, barley, rye, and hybrids of these grains
  • These grains may be eaten:
    • Corn, rice, sorghum, teff, wild rice, millet, amaranth, quinoa, and buckwheat
celiac disease2
Celiac Disease
  • Where is Gluten found?
    • Flour, bread, bread products (e.g. pizza crust), pasta, and breakfast cereals
    • May be an ingredient in many other foods including soups, hotdogs, gravies, and French fries
  • Read food labels
    • Wheat, barley, rye, malt, oats (due to gluten contamination), brewer’s yeast, modified food starch, Dextrin, Semolina, farina, durum flour, enriched flour, and graham flour
phenylketonuria pku
Phenylketonuria (PKU)
  • Cannot process the amino acid phenylalanine
  • Dietary treatment:
    • Low protein diet (to prevent increase in phenylalanine)
    • Special formula to provide protein
for mor e information see nfsmi

For More Information see NFSMI

Special needs training