Food Allergies And Food Intolerances

By Elizabeth Schmitt

For those who suffer from food allergies or intolerances, food can seem like an enemy.

People struggle daily reading food labels, carefully ordering at restaurants, and double-checking everything they eat.

This is of special concern for food-service professionals at camp, for according to the Food Allergy and Anaphylaxis Network, one in 20 children will have a food allergy, and that number is growing.

It is extremely important that kitchen staff members are aware of the seriousness of food allergies and intolerances, and know how to handle special dietary needs from checking labels to serving the food.

Awareness also goes beyond the kitchen. Counselors and staff personnel should note campers’ allergies as well. Preparation of camp policies, procedures, and staff training are critical in preventing any harmful food reactions.

When talking about special diets, allergies and intolerances are usually grouped together, but they are completely different reactions that occur in the body.

What is a food allergy?
A food-allergy reaction occurs when someone consumes a food product and the immune system responds to a specific protein found in that food. Symptoms of a food allergy include hives, swelling, itching, and in severe cases anaphylaxis, or difficulty in breathing.

These may seem like simple symptoms, but they can be uncomfortable, dangerous, and even result in death, depending on the severity of the allergy.

The “Top 8” allergens are:

• Milk
• Eggs
• Peanuts
• Tree nuts
• Soy
• Wheat
• Fish
• Shellfish.

The most common allergy is to peanuts. Peanuts can also be the most severe, causing reactions in some cases merely when someone is in the same room with the allergen.

Many schools and facilities have even gone peanut-free to prevent such reactions. If your facility has not taken this step, it is important to check labels before serving anything to someone who has a food allergy.

Ingredients labels can be confusing, and allergens are often found in unexpected food products or a food that "may contain traces of nuts,” meaning the item could have been produced in a factory that also makes other products with nuts.

Luckily for those in food service who have to deal with these allergens, the Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004 addressed these food allergies. The FALCPA requires food manufacturers to disclose in plain language whether a food product contains one of the eight allergens in any form, even in colors, flavors, or spice blends. It is mandated that the common name be listed among the ingredients or immediately following, with the word “Contains: ____.”

This act makes it easier for food-service professionals to identify whether a product contains a certain allergen.

The “Top 8” allergens make up 90 percent of all food-allergy reactions, but what about the other 10 percent? When serving meals to large numbers of people, such as at a camp, one is bound to come across uncommon allergies as well.

Just this past summer at one camp, some campers had allergies to carrots, melon, strawberries, bell peppers, red dye, and even the spice rosemary. To handle these allergies, a list of special dietary needs must be created and examined before each meal to decide how to handle each person’s special need.

For example, in the case of the rosemary allergy, the camper couldn’t have any marinara sauces; when pasta or pizza appeared on the menu, there was a separate preparation of pasta with sautéed veggies and olive oil, or a margarita-style pizza.

An allergy must be considered individually to ensure safe food is being served to everyone.

What is food intolerance?
The main difference between food intolerance and food allergy is the reaction that occurs when the food is ingested. An allergic reaction is an immune response, while an intolerance reaction is a digestive-system response.

With food intolerance, the digestive system may become irritated, causing symptoms such as stomachache, diarrhea, bloating, cramps, etc., or it may be difficult to digest or break down that food properly, sometimes causing nutrient deficiencies.

Also, those with food intolerances may be able to consume small amounts of the food with no reaction, unlike with allergies, where the food must be avoided completely.

The most common food intolerance is to lactose, which is not the same thing as a milk allergy. A milk allergy causes an immune response to a protein in milk, while with lactose intolerance an individual cannot digest the sugar (lactose) in milk, causing digestive symptoms.

Gluten intolerance can also be referred to as gluten-sensitive enteropathy, Celiac Sprue, or the more common Celiac Disease. While this condition does produce an immune response, it is not to be confused with a usual wheat allergy.

Gluten intolerance does not produce immune reactions such as sneezing and hives because a different antibody is involved that causes the body to attack the lining of the intestines when gluten is present. The damaged intestines then cause nutrients not to be absorbed, which leads to vitamin deficiencies and the underlying health problems caused by the deficiencies.

There is no cure for Celiac Disease; it can only be managed by adhering to a gluten-free diet. Gluten is a protein found in wheat used in a great deal of bread and packaged snacks.

There is no law at present that requires manufacturers to state whether the product contains gluten, so one must be aware of uncommon names, or stay with gluten-free labeled products. If these products cannot be accessed, campers may want to bring in their own foods and have the kitchen staff prepare their meals.

How do I handle allergies and intolerances safely?
The best way to handle special diets at camp is to have one person in the kitchen responsible for these dietary meals. This person should be trained and knowledgeable in reading food labels for allergies and intolerances, balancing protein needs for vegetarians, and even counting carbohydrates for diabetics.

This food-service worker should be responsible for cooking the meals and ensuring they are served to the right person. It should also be the worker’s responsibility to keep in contact with the camp nurse to make sure there is an accurate and up-to-date list for each camp session.

Even though there is one person dedicated to special dietary needs, the entire kitchen staff needs to be aware of what type of special diets are needed for each week, and the list should be prominently displayed in the kitchen. With everyone aware of special diets, there is less risk of cross contamination.

For example, if making peanut butter and jelly sandwiches, one must not use the same knife or cutting board as someone who is preparing a meal for a camper with a peanut allergy. Also, the counselors, the nurse, and any other camp staff that may come in contact with the camper must be aware of the allergy.

There also needs to be a set of procedures to follow if a reaction were to occur, such as who can administer an epinephrine pen in severe cases, or how to get to the nearest emergency-care center. These procedures should be posted in the nurse’s office, but also in or near the kitchen, as this is the most likely place for a reaction to occur.

The most important component to dealing with campers’ special diets is effective communication among parents, camp staff, counselors, campers, and the kitchen staff. Reactions can be prevented, and campers can be served safe, delicious meals.

Elizabeth Schmitt is a Nutrition Specialist at Signature Services Corporation.