kk food allergies, 16 mei 2014 online version

Food AllergiesKarlijn KoudstaalCrowne Plaza South – AttendAmsterdam May 16, 2014

1

This presentation

• Introduction

• Legislation on food allergens

• In practice: Exercise 1

• Short movie

• Into the deep

• In practice: Exercise 2

• The end

May 16, 2014Food Allergies 2

About me

• Karlijn Koudstaal (28yr) Nutrition and Dietetics

Master Health Sciences

• Working at a women’s healthclub inAmsterdam

• Worked parttime for Crowne Plaza Hotel(food and beveridge department)


Let’s find out some more…May 16, 2014Food Allergies 4

An allergy is…

.. an abnormal reaction by a person'simmune system against a normally harmlesssubstance

.. a multi-organ disease affectingapproximately one third of the population

• Skin Allergies

• Respiratory Allergies (nasal allergies/hay fever)

• Food Allergies

• Insect Allergies

• Drug and Medicine Allergies


Allergies in the hotel

• In many forms and from many resources!!!

• Just a few examples:o Dust

o House mites

o Perfumed sprays

o Washing powders

o Food

o Etc…


Today: all about food

• Food allergen labelling

From December 13, 2014:

“The new regulation, which was published in October 2011,will build on current allergen labelling provisions forprepacked foods and will introduce a new requirement forallergen information to be provided for foods sold non-packed or prepacked for direct sale.”


The 14 food allergens which must be

declared whenever they are used1. Eggs

2. Milk

3. Fish

4. Crustaceans (e.g. crab,lobster, crayfish, shrimp,prawn)

5. Molluscs (e.g. mussels,oysters, squid)

6. Peanuts

7. Tree nuts (almonds,hazelnuts, walnuts, cashews,pecans, Brazils, pistachios,macadamia nuts,Queensland nuts)

8. Sesame seeds

9. Cereals containing gluten(i.e. wheat, rye, barley, oats,spelt, kamut, or theirhybridised strains)

10. Soybeans

11. Celery and celeriac

12. Mustard

13. Lupin

14. Sulphites (at concentration (of > 10mg/kg)


Exercise 1:What’s on your menu?

1. Which allergenic foods can you find?

2. Do we know some products to replacethem?


Movie

http://www.youtube.com/watch?v=7jXDMcqsc38


What is a food allergy?

• An immune reaction that occurs aftereating a particular food of foodcomponent, that body thinks is harmful

• Also known as a food hypersensitivity

Auto immune disease

• Elicits an abnormal immune response to a harmlessfood substance

• Allergen is usually a protein


Classification and Response

• Allergic reactions are classified into non-IgE-mediated, IgE-mediated or mixed response:Non-IgE

- Slower in onset, primarily gastrointestinal reactions

IgE mediated- Causes histamine and other chemicals to be releasedwhich trigger allergy symptoms

- Rapid in onset, symptoms include anaphylaxis

https://www.youtube.com/watch?v=AKVjKC3u9hk


Symptoms 1• Symptoms may vary from

person to person and not allreactions appear the same

• They can occur seconds tohours after ingestion of theallergen

Skin Respiratory Tract Gastrointestinal

Tract

Swelling of lips,

tongue and face

Itching or tightness

of throat

Abdominal pain

Itchy eyes Shortness of breath Nausea

Hives Dry of raspy cough Vomiting

Rash Runny nose Diarrhea

Eczema Wheezing May 16, 2014 13

Anaphylactic shock /Anaphylaxis

• Most severe allergic reaction• Within minutes of exposure

• Involves multiple systems at the same time

• Potentially fatal if medication not givenpromptly

• Peanut/ tree nut allergies in combi withasthma give the highest risk


Anaphylaxis First Aid

1. Place victim in comfortable position

& call an ambulance immediately.

2. Victim needs epinephrine to

counteract reaction. If victim is a

known sufferer he/she may have an

epinephrine injection. Help to

administer this or you give the

injection.

3. If victim becomes unconscious

place in recovery position. Monitor

victim’s breathing and circulation, and be

prepared to resuscitate if necessary.

http://www.youtube.com/watch?v=b-87XDNeoGI


Food Allergy vsFood Intolerance

Examples: Coeliac disease (gluten)Examples: milk, egg, peanut etc

Examples: lactose (milk)intolerancehypersensitivity toward sulphites


Allergenic foods

De famous 8 food allergens:

Milk

Eggs

Soy

Peanuts

Tree nuts

Fish

Shellfish

Wheat (Gluten)


Cow’s milk allergy• Is the most common food allergy

• Common among infants/young children It usually outgrow during childhood, occasionally it can be

lifelong and severe

• Milk can cause life-threatening (anaphylactic)reaction, so any amount might cause problems! Goat’s and sheep’s milk are usually not suitable. Horse and

camel milk is often tolerated. Alternatives: soybean, oatand rice milk.

• See list for products!


Lactose intolerance• Cow’s milk allergy often confused with lactose

intolerance (non immune reactions) - more oftenin adulthoodo Inability or insufficient ability to digest lactose, the sugar

found in milk(products), because of a deficiency of theenzyme lactase.

• Not all people with lactose intolerance havedigestive symptoms, but those who do, may havelactose intolerance.

• Most people can tolerate some amount in their diet(might feel uncomfortable).



(Chicken) egg allergy• Common among young children(2%)vs adults(<1%)

It usually outgrow during childhood, occasionally it can belifelong and severe.

• More (violent) reactions to egg white than to eggyolk

• Raw or cooked: some egg-allergic children can eat well-cooked egg (in cake),

but not raw/lightly cooked egg. Others are also allergic to well-cooked eggs (this type more likely to be severe)

Cross reactive with other birds (duck eggs, goose eggs andquail eggs)



Soy allergy• It is not known how common soy allergy is. Children with eczema and suspected food allergy

have 1-4 % chance of soy allergy. Adults less likely tohave soy allergy.

• Soy is added to prosecessed andcommercial foods to improve nutritionalquality

• Soy oil and soy lecithin usually safe. If verysentive, then avoid



Peanuts and Tree nuts• About 0.5-1% of all children in western countries

has peanut allergies. Most children (±75%) donot outgrow this allergy. Prevalence seems toincrease.

• Peanuts are not related to tree nuts, but there ishigh chance of cross-contamination.

• A minimal amount: might have severe reactions Refined peanut oil should be safe, but no guarantee,

so avoid by high risk

Seeds or seed butters may be alternatives



Fish and Shellfish allergy• About 1% of population allergy to fish or shellfish.

Is more common in countries where people ofteneat fish

• Usually someone does not outgrow these allergies

• After peanuts & tree nuts allergy this is mostcommon cause of anaphylaxis

• The allergenic protein in fish is very heat stable. Theprotein remains allergen, even after cooking.

• Fish oil likely to be contaminated with protein, soavoid if allergic

• See list for products!May 16, 2014Food Allergies 25

Wheat allergy• Wheat allergy is not as

common as glutensensitivity. Precisenumbers are unknown. possibly more common in

children

• Allergic reactions towheat are known to leadto anaphylaxis.

• Other grains are welltolerated.

• In contrast to Celiacdisease.

Non-Wheat Grains Gluten Free GrainsAmaranth Amaranth

Arrowroot Arrowroot

Barley Buckwheat/Kasha

Buckwheat/Kasha Corn

Corn Lentil or pea flour

Lentil or pea flour Millet

Millet Nuts/seed meal or flours

Nuts/seed meal or flours Potato

Oat Quinoa

Potato Rice

Quinoa Soy flour

Rice Tapioca

Rye Pre-made wheat/gluten

free flour mixes

Soy flour

Tapioca

Pre-made wheat/gluten

free flour mixes


Gluten intolerance(gluten sensitivity)

• It is not an allergic disorder, but a commonintestinal disease (also known as Celiac disease) In the Netherlands 16,000 people are diagnosed

Symptoms are not always recognized

• Gluten is a type of protein found in most grains,cereals and breads Found in grains like: wheat, balrey, rye and spelt

• Any amount of gluten can cause symptoms


https://www.youtube.com/watch?v=EmZczwtsbVc


So…allergies…What to do?

The smallest amount: can cause severe symptoms!

Read the food labels!

Know about the allergens on the menu!

Always discuss with the guest!

Ensure: all work equipment is cleaned

Wash hands!

Ensure: no cross contamination during preparation andserving. If a dish comes into contact with that specificallergen, you can’t present it to the allergic guest

Know the anaphylaxis First Aid!


Exercise 2:How would you do it?

• A table with 8 people

2 of them have food hypersensitivity

o 1 has lactose intolerance

o 1 has peanut allergy

• How to handle this?

• We start with the waiter, continue to thekitchen and end with happy and satisfiedguests.


The End

Any questions?


Thank you for your attentionMay 16, 2014Food Allergies 31

kk food allergies, 16 mei 2014 online version

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