Sister Maureen Shelby Santin Sarah Goff May 13, 2013

1. Sister Maureen Shelby Santin Sarah Goff May 13, 2013

2. What are Food Allergies? • The body perceives the certain food protein as foreign and harmful. • This produces a reaction to “protect” the body. • Some of these reactions could be life-threatening.

3. 8 Most Common Food Allergies • Dairy • Peanuts • Tree nuts • Eggs • Soy • Wheat • Fish • Shellfish

4. Food Allergy Symptoms • Mild: Not life threatening • Hives • Eczema • Redness of the skin or eyes • Itchy mouth or ears • Nausea or vomiting • Diarrhea • Stomach pain • Nasal congestion or a runny nose • Sneezing • Slight dry cough • Odd taste in mouth • Uterine contractions

5. Food Allergy Symptoms THESE REQUIRE MEDICAL ATTENTION • Severe: could be life threatening • Obstructive swelling of the lips, tongue or throat • Trouble swallowing • Shortness of breath • Turning blue • Drop in blood pressure (failing faint or confused) • Loss of consciousness • Chest pain • A weak pulse • Anaphylaxis

6. Anaphylaxis • A serious allergic reaction that is rapid in onset and may cause death • Symptoms: • Tingling, itchiness, or metallic taste in the mouth • Hives • Difficulty breathing • Paleness (from a drop in blood pressure) • Loss of consciousness • Swelling or itchiness of the mouth and throat • Diarrhea • Vomiting • Cramps and stomach pain • Confusion • Weak pulse • Can occur between a few minutes to several hours after consuming an allergen

7. How to Respond to Anaphylaxis • Call 9-1-1 immediately • Mention that someone is experiencing anaphylaxis • Remove the allergenic foods from the mouth and/or skin

8. What are Food Intolerances? • The body is unable to properly digest the food protein • Symptoms are related to the digestive system • Symptoms include nausea, gas, cramps, abdominal pain, diarrhea, irritability, nervousness or headaches • Examples include lactose intolerance and gluten intolerance

9. Gluten • Natural protein of wheat that gives dough its elasticity • Found in wheat, oats, rye and barley • The demand for gluten-free products has grown from 2004 to 2012

10. Celiac Disease • Auto-Immune Disease • Genetic • Reaction to gluten protein • Consumption of gluten could lead to ulcers, mal-absorption of nutrients and possibly death

11. Where is Gluten Found? • Baked Goods • Sausages, pre-seasoned meats, deli meats • Soups, sauces, gravies • Salad dressing • Seasonings • Processed cheese spreads, powdered cheese mixed • Beer • Anything that contains flour

12. Does it Contain Gluten? CONTAINSGLUTEN • Barley • Bulgur • Einkorn • Emmer • Farina • Farro • Graham • Kamut • Oats (if not certified gluten free) • Rye • Spelt • Triticale • Breadcrumbs • Cereals • Durum flour • All purpose flour • Wheat protein • Whole wheat berries • Semolina • Pasta • Soy sauce • Glucose syrup • Starch GLUTEN FREE • Amaranth • Buckwheat • Corn • Millet • Quinoa • Rice • Tapioca • Teff

13. Food Allergy/Intolerance Stats • 18% increase in food allergies from 1997-2007 • An estimated 15 million Americans live with food allergies • Food allergies account for 30,000 hospital visits and 200 fatalities each year

14. Prevention • No cure for food allergies, the only prevention from a reaction is avoidance.

15. Food Labels

16. Food Labels

17. Food Labels

18. Food Labels

19. Food Labels

20. Food Labels

21. How to Read a Label for a Soy-Free Diet • Some unexpected ingredients that contain soy: • Edamame • Miso • Soybean oil • Soy sauce • Tofu • Textured vegetable protein • Soybean • Soy protein

22. How to Read a Label for a Dairy-Free Diet • Some unexpected ingredients that contain milk: • Whey • Casein • Curds • Custard • Pudding • Sour cream and sour cream solids • Artificial butter flavor • Caramel • Chocolate

23. How to Read a Label for an Egg-Free Diet • Ingredients that contain egg: • Mayonnaise • Meringue • Albumin • Eggnog • Pasta

24. How to Read a Label for a Peanut-Free Diet • Some unexpected ingredients that contain nuts: • Artificial nuts • Peanut oil • Mandelonas • Coconut • Butternut • Pesto (UMD Dining pesto is nut-free) • Praline • Pistachio • Peanuts are sometimes found in the following: • Egg rolls • Enchilada sauce • Marzipan • Baked goods • Chili

25. How to Read a Label for a Shellfish-Free Diet • Types of shellfish: • Barnacle • Crab • Crawfish • Krill • Lobster • Prawns • Shrimp • Ingredients that may contain shellfish: • Fish stock • Seafood flavoring • Bouillabaisse sauce

26. Students with Food Allergies • Dining services is expected to provide allergen, processing and ingredient information • Eating from home can cause anxiety for those suffering from food allergies. • Students rely 100 percent on dining services for safe food options.

27. Lesley Judgment • Lesley University was sued for not providing gluten-free options. • Rights protected under the American with Disabilities Act. • Food services need to provide “necessary reasonable modifications…..to fully enjoy the privileges, advantages and accommodations of its food service meal plan system.”

28. Maryland and Food Allergies • One-on-one meeting with Sister Maureen Schrimpe • Allergy symbols on dining hall monitors • “To go” items are labeled for allergens and special diets • Allergy information online and through kiosks in the dining hall • Gluten-free menus available • Prepackaged allergen-free and vegan desserts now available!

29. Causes of Food Allergy Reactions in Food Service • Poor Communication • Consumers may assume food ingredients from previous experience with food item • Allergy students want to feel normal and may feel uncomfortable asking questions • Servers need to take food allergy requests seriously

30. Causes of Food Allergy Reactions in Food Service (cont.) 2. Hidden Ingredients • Sauces and mixed dishes • Recent product recalls due to undeclared food allergens • Ex: peanut butter in egg rolls

31. Causes of Food Allergy Reactions in Food service (Cont.) 3. Cross-Contact of Allergens • Surfaces • Handlers • Plated food

32. Cross-Contact • Unclean hands or gloves – wash hands before preparing a allergy-free meal • Splashed or spilled food- allergy free meal should be carried by itself from the kitchen • Trays- trays for allergy free meals should be washed with warm soapy water first • Garnishes- only chef or manager should garnish the plates • Refilled serving containers- wash all containers before refilling them with new foods

33. Cross-Contact • AVOID using same utensils and equipment for allergen-free food preparation. • Even dust, crumbs or steam from a allergen-containing meal could contaminant an allergen- free meal! Alcohol wipes do not destroy allergen proteins; only hot, soapy water destroys these proteins!

34. High-Risk Foods for Cross-Contact • Fried food • Desserts • Sauces • Pastry • Combination foods (stews and pot pies) **Advise food allergy consumers that these are high risk options.

35. Front of the House • Refer food allergy student questions to a manager or chef • Be understanding, listen carefully • Have area designated where student can pick up food • Send student’s information to Sister Maureen for follow-up

36. Back of the House • Inform guests of ingredients in unexpected places • Worcestershire sauce contains anchovies and/or sardines • Sweet and sour sauce may contain wheat and soy • Barbecue sauce may contain pecans • If you’re unsure about allergy information do not guess. Simply suggest another menu option for which you have information for

37. Real Life Situation “I got a salad from Salad Sensations area, and I was watching the man making it very carefully, as usual. However, after taking a few bites of the salad, I found a chickpea in it. I called the incident to the attention of one of the managers, and he merely suggested I get something else to eat rather than taking steps to prevent this from happening in the future. I just wanted to let you know in hopes that the way this is handled can change in the future.” Spring 2013

38. Resources • FARE: http://www.foodallergy.org/home • http://www.nacufs.org/resources-overview • “Food Allergy Training Guide for College and University Food Services” The Food Allergy and Anaphylaxis Network, 2005.

39. Thank You. Any Questions? Email me anytime at schrimpe@umd.edu