1. Food Allergies in Food Service By Jen Ryan Sodexo Dietetic Intern

2. What is a Food Allergy? The job of the body’s immune system is to identify and destroy germs (such as bacteria or viruses) that make you sick A food allergy results when the immune system mistakenly targets a harmless food protein – an allergen – as a threat and attacks it The immune system produces abnormally large amounts of an antibody called immunoglobulin E — IgE ▫IgE antibodies fight the “enemy” food allergens by releasing histamine and other chemicals, which trigger the symptoms of an allergic reaction.

3. There are 8 food allergens that account for 90% of all allergic reactions

4. Food Allergy Statistics Up to 15 million people in the United States have a food allergy Affects 1 in every 13 children (under 18 years of age) in the U.S. According to a study released in 2013 by the Centers for Disease Control and Prevention, food allergies among children increased approximately 50% between 1997 and 2011

5. Food Allergy Symptoms An allergic reaction to food can affect the skin, the gastrointestinal tract, the respiratory tract, and, in the most serious cases, the cardiovascular system Reactions can range from mild to severe, including the potentially life-threatening condition known as anaphylaxis Symptoms typically appear within minutes to several hours after eating the food to which you are allergic ▫Keep in mind that children may communicate their symptoms in a different manner than adults

6. Mild Symptoms Hives (reddish, swollen, itchy areas on the skin) Eczema (a persistent dry, itchy rash) Redness of the skin or around the eyes Itchy mouth or ear canal Nausea or vomiting Diarrhea Stomach pain Nasal congestion or a runny nose Sneezing Slight, dry cough Odd taste in mouth

7. Severe Symptoms Obstructive swelling of the lips, tongue, and/or throat Trouble swallowing Shortness of breath or wheezing Turning blue Drop in blood pressure (feeling faint, confused, weak, passing out) Loss of consciousness Chest pain

8. Anaphylaxis During anaphylaxis, allergic symptoms can affect several areas of the body and may threaten breathing and blood circulation Food allergy is the most common cause of anaphylaxis At present, strict avoidance of problem foods is the only way to prevent anaphylaxis

9. Epinephrine A medication that can reverse the severe symptoms of anaphylaxis Given as a “shot” and is available as a self-injector, also known as an epinephrine auto-injector Epinephrine is a highly effective medication, but it must be administered promptly during anaphylaxis to be most effective Delays can result in death in as little as 30 minutes ▫The individual who was treated with epinephrine should always be taken to the emergency room for further evaluation and treatment

10. Cross-Contamination Any food can become contaminated with the protein of a food known to cause a food allergy or sensitivity Food allergens can be spread by equipment used for more than one food item (fryers, slicers, utensils, cutting boards, etc.)

11. Steps to Prevent Cross-Contamination 1.Cleaning and sanitizing all food equipment, food contact surfaces, food containers, tableware and utensils before and after each use 2. Avoiding spills and splattering during preparation and cooking 3. Using separate cooking and serving utensils for each food item 4. Washing hands thoroughly and often

12. Following the Recipe Ingredients in a recipe should never be substituted without changing menu boards, menu signage and other point of sale material, as appropriate All servers, managers and supervisors must know about such substitutions before service begins Employees must refer all food allergy questions to a manager or supervisor No one should ever guess the ingredients of a product or recipe. ▫If a customer asks for this information and we are not sure, we must say so!

13. Handling an Allergic Reaction Employees must notify a Sodexo manager or supervisor immediately if someone has an allergic reaction Say that a manager, supervisor or another person in charge will call 911 immediately

14. QUIZ 1.True or False The eight foods known to cause ninety percent of all food allergies among Americans are: Peanuts, tree nuts, fish, crustacean shellfish, eggs, milk, pork and soybeans.

15. False

16. 2. True or False When the salad maker added chopped walnuts to the chicken salad mixture, she accidentally spilled some nuts on her prep table. She was only working with ready-to-eat ingredients. Therefore, it was acceptable to simply wipe off the table with a clean, dry cloth.

17. False

18. 3. True or False The chef knows that she always must tell managers, supervisors and servers if she has substituted an ingredient in a recipe with one of the eight foods known to cause most food allergies.

19. True