food allergies kendra manwill · 2018. 9. 7. · milk allergy involves immune system can be fatal...

Kendra

Manwill FOOD ALLERGIES

Intolerance

Lack a digestive enzyme

Reactions are not typically life threatening

Can cause similar symptoms to food allergies

Allergy

Abnormal immune response

The protein is usually the allergen

No cure

Strict avoidance

Hard to diagnose

ALLERGY VS INTOLERANCE

Milk

Eggs

Wheat

Nuts (tree)

Soy

Peanut

Fish

Shellfish

TOP 8 ALLERGENS

Skin Reactions

Swelling of lips,

tongue, face

Itchy eyes

Hives

Rash (eczema)

Respiratory Tract

Reactions

Swelling, itching,

and/or tightness

in throat

Shortness of

breath

Dry/raspy cough

Runny nose

Wheezing (asthma)

Digestive Tract

Reactions

Abdominal cramps

Nausea

Vomiting

Diarrhea

COMMON ALLERGIC REACTIONS

Always read labels

Formulations can change without warning

Don’t rely on “safe lists”

Allergens can be in non-food items

Soaps, shampoos, skin products, medications, pet foods

LABEL READING

Milk allergy

Involves immune system

Can be fatal

Milk intolerance

Missing enzyme lactase

Cannot digest milk

Not life-threatening, just causes discomfort

MILK

Avoid Butter

Casein

Cheese

Pudding

Sour Cream

Whey

Be Wary Of Artificial butter

flavor

Caramel

Nougat

Meat (check for

casein as a binder)

OK Calcium lactate

Cocoa butter

Cream of tartar

Lactic acid

Sodium lactate

MILK: FOOD

Second most common allergy

The whites of the egg contain the allergenic protein

Be wary of vaccines

Influenza

EGG

Avoid Albumen

Eggnog

Mayonnaise

Meringue

Ovalbumin

Eggs from duck, turkey,

goose, quail, etc.

Be Wary Of Baked goods

Egg substitutes

Lecithin

Macaroni

Marzipan

Marshmallows

Salted pretzels (egg wash)

Coffee foam top

EGGS: FOOD

Wheat Allergy

Overreaction of immune system to specific food protein

Can often tolerate other grains

Potentially fatal

Gluten Intolerance/Celiac Disease

Autoimmune disease

Affects small intestine

Abnormal immune reaction to gluten specifically

Malnutrition and intestinal damage

Avoid gluten: wheat, rye, barley, sometimes oats

WHEAT

Most common in children

Often outgrown by age 3

Alternatives:

Amaranth

Barley

Corn

Oat

Quinoa

Rice

Rye

Tapioca

WHEAT

Avoid

Bulger

Couscous

Durum

Farina

Kamut

Semolina

Spelt

Wheat grass

Whole wheat berries

Be Wary Of

Glucose syrup

Soy sauce

Starch

Play dough

Potato chips

Batter-fried foods

Candy

Imitation crabmeat

WHEAT: FOOD

TREE NUTS

Lifelong

Tree nuts include:

Walnut

Almond

Hazelnut

Cashew

Pistachio

Brazil nuts

Does not include:

Peanuts (legume)

TREE NUTS

Avoid

Almond

Artificial nuts

Beechnut

Butternut

Coconut

Macadamia nut

Nut meal

Pesto

Shea Nut

Be Wary Of

Natural nut extract

Nut oils

Walnut hull extract

Cereals

Marinades

Nut flavorings

TREE NUTS: FOOD

Most children outgrow allergy by 10

Mild reactions

Increased chance of allergy to other legumes

Peanuts, beans, peas, lentils

Soy lecithin does not have soy, most people are ok

Highly refined soybean oil is ok

SOY

Avoid:

Edamame

Miso

Soy

Soybean

Soy sauce

Textured vegetable

protein

Tofu

Be Wary Of:

Asian cuisine

Vegetable gum/starch

Cereals

High protein energy bars

Infant formulas

Processed meats

Canned broths and soups

SOY: FOOD

PEANUT

Lifelong

Siblings are more likely to have an allergy

More likely to have a legume allergy

Typically avoid tree nuts- cross contamination

Trace amounts can cause a reaction

Highly refined peanut oil is ok

PEANUT

Avoid:

Artificial nuts

Beer nuts

Goobers

Nut meat

Peanut butter

Mixed nuts

Arachis oil (peanut oil)

Be Wary Of:

Baked goods

Chili

Egg rolls

Marzipan

Specialty pizzas

Meat substitutes

Glazes and marinades

African, Asian, Mexican

restaurants

PEANUT: FOOD

Lifelong

~40% develop as an adult

Most common:

Salmon

Tuna

Halibut

Does not mean shellfish allergy

Be careful in cooking areas- fish protein can be

airborne during steaming

FISH

Avoid:

Anchovies

Fish sticks

Mahi Mahi

Pollock

Snapper

Tilapia

Tuna

Be Wary Of:

Caesar salad/ dressing

Worcestershire sauce

Imitation fish (surimi)

Meatloaf

Barbecue sauce

Chinese, African,

Indonesian, Thai,

Vietnamese restaurants

FISH: FOOD

SHELLFISH

Lifelong

~60% develop as an adult

Most common:

Shrimp

Crab

Lobster

Does not mean finned fish allergy

Two kinds:

Crustacean (more severe)

Mollusks (may not be fully disclosed on labels)

SHELLFISH

Avoid:

Barnacle

Crab

Crawfish

Krill

Abalone*

Octopus*

Sea cucumber*

Scallops*

Be Wary Of:

Cuttlefish ink

Glucosamine

Fish stock

Seafood flavoring

Surimi

Asian restaurants

SHELLFISH: FOOD

*Doctor may suggest you avoid these

Be very careful in food preparation

Do not mix:

Serving utensils

Knives

Cutting boards

Skillets

Scoops

Plates

Scraping food off of a plate is not adequate

CROSS CONTAMINATION

LESSON PLAN

Title__Managing Food Allergies___________________ Name__Kendra Manwill __________________________

Target Audience_BYU Staff and Faculty____________ Method__Example/non example, illustrated instruction_

Terminal Objective

By the end of the lesson, learners will be able to identify the top 8

allergens, list some common ingredients to stay away from for

each allergen, and explain why cross-contamination is a hazard.

Domain__Cognitive________ Taxonomic Level_Application_

Terminal Concept

Food allergies can cause serious reactions, but avoidance of

anything tainted by the allergen can allow the individual to live a

normal life.

References

Foodallergy.org

NCM

Krause ch 29

Complete Food and Nutrition Guide ch 21

Preparation

Gather food nutrition labels demonstrating allergens

Print copies of foodallergy.org reading labels handout

Print one copy of each of NCM tips for allergies. If someone wants more information, they can have one.

Create powerpoint

Pre-assessment

Does anyone know what the top food allergies are?

Introduction

Introduce myself

Today we are going to talk about the basics of food allergies, and

what the most common food allergies are.

1 min

Supporting Objectives Content Outline Time Learning Experience (Activity Outline)

Learners will be able to explain

the difference between allergy

and intolerance

Learners will be able to identify

the top 8 allergens

Difference between allergy and

intolerance

Intolerance

Have different causes

For metabolic reasons, people

may not be able to digest a

component of certain foods like

lactose because a digestive

enzyme is deficient.

Some naturally occurring

substances may cause reactions,

but these aren’t life threatening.

Food intolerances can lead to

similar symptoms as food

allergies (nausea, diarrhea,

abdominal cramps).

Allergy

Allergy is an abnormal

immunological response to a

harmless food protein.

Allergen sets off a chain of

immune system reactions

No pharmaceutical intervention

available to prevent reactions.

Strict avoidance is the only way.

Allergies are hard to diagnose,

DO NOT self-diagnose

Estimated 12 million Americans

have food allergies, and it is very

common in the first 3 years of

life.

Up to 90% of kids grow out of it

Top 8 allergens:

Milk

Eggs

4 min

2 min

Show ppt slide 2

Show ppt slide 3

Learners will be able to

recognize common symptoms

of allergies


where to find the allergen list

and the ingredient list


the difference between milk

allergy and lactose intolerance.


Wheat

Nuts (tree)

Soy (legume)

Peanut (legume)

Fish

Shellfish

All of these are required to be listed as

allergens if they are in a food.

Mention common allergic reactions.

Mention symptoms of allergies

Anaphylaxis: severe, potentially

fatal allergic reaction. It can

cause skin symptoms/swollen

lips, difficulty breathing, reduced

blood pressure, GI symptoms

Carry an auto-injector like an

epi-pen

Explain how to look at labels, and

understand the words they use

Milk allergy

Milk allergy is most common

Milk allergy and lactose

intolerance are different

Milk allergy: involves immune

system, can be fatal

Lactose intolerance: missing an

enzyme lactase, cannot digest

lactose. Not life-threatening, just

2 min

2 min

4 min

Show ppt slide 4

Show ppt slide 5

Show ppt slide 6, then 7

common ingredients that are

unsafe for those with milk

allergy.



unsafe for those with egg

allergy.



unsafe for those with wheat

allergy.

discomfort.

Mention food with and without

Egg allergy

Egg allergy is second most

common

Some vaccines contain egg

protein, including the influenza

vaccine

Go over foods

Allergy is to the protein, so some

people can have cooked eggs

Wheat allergy

Wheat: allergy is to protein in

wheat, can often tolerate other

grains

Celiac: autoimmune disease, the

protein gluten isn’t tolerated.

Gluten intolerance is NOT wheat

allergy

Gluten is found in wheat, rye,

barley, oats sometimes

Wheat allergy is the most

common allergy in children

Baking is hard, try alternatives:

amaranth, barley, corn, oat,

quinoa, rice, rye, tapioca. A

combination is often best.

Go over foods

4 min

4 min

Show ppt slide 8

Show ppt slide 9


Show ppt slide 12

Show ppt slide 13


Show ppt slide 16

Show ppt slide 17

Show ppt slide 18



unsafe for those with a tree nut

allergy.



unsafe for those with a soy

allergy.



unsafe for those with a peanut

allergy.

Tree nut allergy

Tends to be lifelong

Includes: walnut, almond,

hazelnut, cashew, pistachio,

brazil nuts

Often is processed in the same

plant as peanuts

Does not include: peanut

(legume), or sunflower seeds

(seed)

Go over foods

Soy allergy

Majority of children with soy

allergy outgrow the allergy by

age of 10

Reactions are typically mild

People with a soy allergy are not

necessarily allergic to other

legumes, but you have a greater

chance (peanut, beans, peas,

lentils)

Most people with a soy allergy

can safely eat soy lecithin and

soy oil.

Highly refined soybean oil is ok

Go over foods

Peanut allergy

Tends to be lifelong

Siblings are more likely to have

an allergy

Greater chance of legume allergy

4 min

4 min

4 min


Show ppt slide 21


Show ppt slide 24

Show ppt slide 25




unsafe for those with a fish

allergy.



unsafe for those with a shellfish

allergy.

(beans, peas, lentils, soybeans)

Usually have to avoid tree nuts

due to cross-contamination

Trace amounts of peanuts may

cause a reaction

Go over foods

Fish allergy

Typically lifelong

~40% have first reaction as an

adult

Most common: salmon, tuna,

halibut. More than half are

allergic to more than one type of

fish.

Does not mean you are allergic to

shellfish.

Fish protein can become airborne

in steam released during cooking.

Go over foods.

Shellfish allergy

Typically lifelong

~60% have first reaction as an

adult

Most common: Shrimp, crab,

lobster

Does not mean you are allergic to

finned fish

Two kinds: crustacean (shrimp,

crab, lobster) and mollusks

(clams, mussels, oysters,

scallops).

4 min

4 min

Show ppt slide 28


Show ppt slide 31


Show ppt slide 34

Learners will understand the

dangers of cross contamination

Crustacean reaction tends to be

more severe.

May only be allergic to one kind,

but recommend avoiding all.

Go over foods

Discuss cross contamination

Be very careful if preparing food.

Make sure the following are only

used for one food item at a time:

serving utensils, knives, cutting

boards, skillets, scoops, plates,

etc

Just scraping the allergenic food

off a plate is not sufficient.

Particles are still present.

2 min

Show ppt slide 35

Show ppt slide 36

Assessment (evaluation)

Can anyone list the top 8 food allergies?

Did anything we learned today surprise you? Do you have any questions?

Closure

There are many people with food allergies, it helps to be aware of what the most common allergies entail. Be very careful to avoid

cross contamination, because even though you may not be serving someone the allergen directly you may transfer it indirectly.

Food Allergy Research & Education (FARE)7925 Jones Branch Drive, Suite 1100

McLean, VA 22102

800-929-4040

[email protected]

© 2013 Food Allergy Research & Education (FARE)

How to Read a Label for a Milk-Free DietAll FDA-regulated manufactured food products that contain milk as an ingredient are required by U.S. law to list the word “milk” on the product label.

Avoid foods that contain milk or any of these ingredients:butter, butter fat, butter oil, butter acid,

butter ester(s)buttermilkcaseincasein hydrolysatecaseinates (in all forms)cheesecottage cheesecreamcurdscustarddiacetylgheehalf-and-halflactalbumin, lactalbumin phosphatelactoferrin

lactoselactulosemilk (in all forms, including condensed, derivative,

dry, evaporated, goat’s milk and milk from other animals, lowfat, malted, milkfat, nonfat, powder, protein, skimmed, solids, whole)

milk protein hydrolysatepuddingRecaldent®

rennet caseinsour cream, sour cream solidssour milk solidstagatosewhey (in all forms)whey protein hydrolysateyogurt

Milk is sometimes found in the following:artificial butter flavorbaked goodscaramel candieschocolatelactic acid starter culture and other bacterial

cultures

luncheon meat, hot dogs, sausages margarinenisinnondairy productsnougat

How to Read a Label for a Soy-Free DietAll FDA-regulated manufactured food products that contain soy as an ingredient are required by U.S. law to list the word “soy” on the product label.

Avoid foods that contain soy or any of these ingredients:

edamamemisonattoshoyusoy (soy albumin, soy cheese, soy

fiber, soy flour, soy grits, soy ice cream, soy milk, soy nuts, soy sprouts, soy yogurt)

soya

soybean (curd, granules)soy protein (concentrate,

hydrolyzed, isolate)soy saucetamaritempehtextured vegetable protein

(TVP)tofu

Soy is sometimes found in the following:Asian cuisinevegetable broth

vegetable gumvegetable starch

Keep the following in mind:• The FDA exempts highly refined soybean oil from

being labeled as an allergen. Studies show most allergic individuals can safely eat soy oil that has been highly refined (not cold pressed, expeller pressed, or extruded soybean oil).

• Most individuals allergic to soy can safely eat soy lecithin.

• Follow your doctor’s advice regarding these ingredients.

How to Read a Label for a Peanut-Free DietAll FDA-regulated manufactured food products that contain peanut as an ingredient are required by U.S. law to list the word “peanut” on the product label.

Avoid foods that contain peanuts or any of these ingredients:artificial nutsbeer nutscold pressed, expeller pressed, or

extruded peanut oilgoobersground nutsmixed nuts

monkey nutsnut piecesnut meatpeanut butterpeanut flourpeanut protein hydrolysate

Peanut is sometimes found in the following:African, Asian (especially Chinese, Indian,

Indonesian, Thai, and Vietnamese), and Mexican dishes

baked goods (e.g., pastries, cookies)candy (including chocolate candy)chili

egg rollsenchilada saucemarzipanmole saucenougat

Keep the following in mind:• Mandelonas are peanuts soaked in

almond flavoring.

• The FDA exempts highly refined peanut oil from being labeled as an allergen. Studies show that most allergic individuals can safely eat peanut oil that has been highly refined (not cold pressed, expeller pressed, or extruded peanut oil). Follow your doctor’s advice.

• A study showed that unlike other legumes, there is a strong possibility of cross-reaction between peanuts and lupine.

• Arachis oil is peanut oil.

• Many experts advise patients allergic to peanuts to avoid tree nuts as well.

• Sunflower seeds are often produced on equipment shared with peanuts.

How to Read a Label for a Wheat-Free DietAll FDA-regulated manufactured food products that contain wheat as an ingredient are required by U.S. law to list the word “wheat” on the product label. The law defines any species in the genus Triticum as wheat.

Avoid foods that contain wheat or any of these ingredients:bread crumbsbulgurcereal extractclub wheatcouscouscracker mealdurumeinkornemmerfarinaflour (all purpose, bread,

cake, durum, enriched, graham, high gluten, high

protein, instant, pastry, self-rising, soft wheat, steel ground, stone ground, whole wheat)

hydrolyzed wheat proteinKamut®

matzoh, matzoh meal (also spelled as matzo, matzah, or matza)

pastaseitansemolinaspelt

sprouted wheattriticalevital wheat glutenwheat (bran, durum, germ,

gluten, grass, malt, sprouts, starch)

wheat bran hydrolysatewheat germ oilwheat grasswheat protein isolatewhole wheat berries

Wheat is sometimes found in the following:glucose syrupsoy sauce

starch (gelatinized starch, modified starch, modified food starch, vegetable starch)

surimi

How to Read a Label for a Shellfish-Free DietAll FDA-regulated manufactured food products that contain a crustacean shellfish as an ingredient are required by U.S. law to list the specific crustacean shellfish on the product label.

Avoid foods that contain shellfish or any of these ingredients:

barnaclecrabcrawfish (crawdad, crayfish,

ecrevisse)krill

lobster (langouste, langoustine, Moreton bay bugs, scampi, tomalley)

prawnsshrimp (crevette, scampi)

Mollusks are not considered major allergens under food labeling laws and may not be fully disclosed on a product label.

Your doctor may advise you to avoid mollusks or these ingredients:

abaloneclams (cherrystone, geoduck,

littleneck, pismo, quahog)cocklecuttlefishlimpet (lapas, opihi)musselsoctopus

oystersperiwinklescallopssea cucumbersea urchinsnails (escargot)squid (calamari)whelk (Turban shell)

Shellfish is sometimes found in the following:bouillabaissecuttlefish inkfish stockglucosamine

seafood flavoring (e.g., crab or clam extract)

surimi

Keep the following in mind:• Any food served in a seafood restaurant may contain

shellfish protein due to cross-contact.

• For some individuals, a reaction may occur from inhaling cooking vapors or from handling fish or shellfish.

How to Read a Label for a Egg-Free DietAll FDA-regulated manufactured food products that contain egg as an ingredient are required by U.S. law to list the word “egg” on the product label.

Avoid foods that contain eggs or any of these ingredients:

albumin (also spelled albumen)egg (dried, powdered, solids, white, yolk)eggnoglysozymemayonnaisemeringue (meringue powder)ovalbuminsurimi

Egg is sometimes found in the following:

baked goodsegg substituteslecithinmacaroni

marzipanmarshmallowsnougatpasta

Keep the following in mind:• Individuals with egg allergy should also

avoid eggs from duck, turkey, goose, quail, etc., as these are known to be cross-reactive with chicken egg.

How to Read a Label for a Tree Nut-Free DietAll FDA-regulated manufactured food products that contain a tree nut as an ingredient are required by U.S. law to list the specific tree nut on the product label.

Avoid foods that contain nuts or any of these ingredients:almondartificial nutsbeechnutBrazil nutbutternutcashewchestnutchinquapin nutcoconutfilbert/hazelnutgianduja (a chocolate-nut mixture)ginkgo nuthickory nutlitchi/lichee/lychee nutmacadamia nutmarzipan/almond pasteNangai nut

natural nut extract (e.g., almond, walnut)nut butters (e.g., cashew butter)nut mealnut meatnut paste (e.g., almond paste)nut piecespecanpestopili nutpine nut (also referred to as Indian,

pignoli, pigñolia, pignon, piñon, and pinyon nut)

pistachiopralineshea nutwalnut

Tree nuts are sometimes found in the following:black walnut hull extract (flavoring)natural nut extractnut distillates/alcoholic extracts

nut oils (e.g., walnut oil, almond oil)walnut hull extract (flavoring)

Keep the following in mind:• Mortadella may contain pistachios.• There is no evidence that coconut oil and shea nut oil/butter are allergenic.• Many experts advise patients allergic to tree nuts to avoid peanuts as well. • Coconut, the seed of a drupaceous fruit, has typically not been restricted in

the diets of people with tree nut allergy. However, in October of 2006, the FDA began identifying coconut as a tree nut. Medical literature documents a small number of allergic reactions to coconut; most occurred in people who were not allergic to other tree nuts. Ask your doctor if you need to avoid coconut.

• Talk to your doctor if you find other nuts not listed here.

© 2013 Food Allergy Research & Education (FARE)

food allergies kendra manwill · 2018. 9. 7. · milk allergy involves immune system can be fatal...

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