Food Allergies Food Intolerances and Disabilities

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

What is the difference? Food Allergy Food Intolerances Disability

8 Foods included in food allergy labeling required by FDA Milk Eggs Peanuts Tree Nuts Fish Shellfish Soy Wheat Mayocliic.com The FDA requires food labels to list common allergens in language that's easy to understand. Allergens are listed either in the ingredients list, after the list or right next to it. Food labeling laws require food allergens to be identified even in very small amounts — but only when they're contained as an ingredient. Manufacturers aren't required to include warnings about food allergens accidentally introduced during manufacturing or packaging (cross contamination). Many manufacturers voluntarily include warnings, but these advisory labels aren't always clear. And, manufacturers have different ways of saying a food allergen may be present. For example, labels may say "manufactured in a factory that also processes wheat" or "may contain soy." The FDA is working to make the format of these advisory labels more consistent so that it's easier to identify which products contain allergens. When in doubt about whether a product contains something you're allergic to, it's best to avoid it.

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 Webmd: Food allergies arise from sensitivity to chemical compounds (proteins) in food. They develop after you are exposed to a food protein that your body thinks is harmful. The first time you eat the food containing the protein, your immune system responds by creating specific disease-fighting antibodies (called immunoglobulin E or IgE). When you eat the food again, it triggers the release of IgE antibodies and other chemicals, including histamine, in an effort to expel the protein "invader" from your body. Histamine is a powerful chemical that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system. Mayoclinic.com Affects estimated 6-8% children under 5 and 3-4% adults

Food allergies Involve 2 features of the human immune response 1) Production of immunoglobulin E ()IgE) A type of protein called an antibody that circulates through the blood 2) Mast cell releases histamine, 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 Webmd.com

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 Webmd.com

The Allergic Reaction An allergic reaction to food can take place within a few minutes to hours. Hives - Eczema Itching in Mouth Diarrhea BP may drop Vomiting Throat tightness Breathing Difficulty Anaphylactic Shock

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 Mayoclinic.com From webmd.com As a result of this response, food allergy symptoms occur. The allergy symptoms you have depend on where in the body the histamine is released. If it is released in the ears, nose, and throat, you may have an itchy nose and mouth, or trouble breathing or swallowing. If histamine is released in the skin, you may develop hives or a rash. If histamine is released in the gastrointestinal tract, you likely will develop stomach pains, cramps, vomiting or diarrhea. Many people experience a combination of symptoms as the food is eaten and digested. Often run in families

No cure for food allergies Avoid the Offending Food is the only way to prevent a reaction

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 Mayoclinic.com

Anaphylaxis 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 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 Mayoclinic.com

Brochure What is a food Allergy? What are some common Food Allergies? Identify the Symptoms related to Food Allergies What do I do in case of an Allergic Reaction? At least 4 Pictures

Tell the difference? ALLERGY Allergies can be triggered by even small amounts – occur every time food consumed Advised to avoid offending foods completely INTOLERANCE Intolerance is dose related Found through trial and error (food diary) Elimination diet and reintroduce foods one at a time

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 Nausea Stomach Pain Gas, cramps, bloating Vomiting Heartburn Diarrhea Headaches Irritability or Nervousness From webmd.com

Disability 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

Common Food Related Disabilities Diabetes Celiac Disease PKU

Diabetes 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 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 Body’s own immune system destroys the insulin-producing cells in pancreas Insulin is key to sugar entering the cells

Diabetes 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 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 High sugar or high fat – difficult to incorporate High fat foods – fat slows digestion so may cause spike in blood sugar levels several hours later When starting new exercise program monitor blood sugar more often Medical statement should give you guidance on managing blood glucose levels – have a target blood glucose range Limit simple sugars and fats. Provide adequate complex carbohydrates and proteins

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 Genetically-based autoimmune disease characterized by sensitivity to the protein gluten From NFSMI presentation

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 Disease Where is Gluten found? Read food labels 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 From NFSMI presentation

Phenylketonuria (PKU) Cannot process the amino acid phenylalanine Dietary treatment: Low protein diet (to prevent increase in phenylalanine) Special formula to provide protein