All About …
Food Allergies
Food allergies
• Affect 6 to 8% of children 4 years of age and
under
• Affect 5.9 million kids in the U.S. (1 in 13 kids or
about 2 per classroom)
• Affect almost 4% of adults
• Account for 35 – 50% of all cases of anaphylaxis
in emergency care settings
• Cause about 30,000 episodes of anaphylactic
shock with 100 to 200 deaths per year
02
http://www.niaid.nih.gov/topics/foodAllergy/research/Pages/ReportFoodAllergy.aspx
http://www.foodallergy.org/about-food-allergies
http://www.cdc.gov/HealthyYouth/foodallergies/
pdf/13_243135_A_Food_Allergy_Web_508.pdf
What is a food allergy?
• A food allergy is an abnormal reponse triggered
by the body’s immune system to an otherwise
harmless food.
• These reactions can cause serious illness and,
in some cases, death.
02
True or False
An allergic reaction will occur the first time a
person comes in contact with the food they are
allergic to and every time thereafter.
Answer:
False:
According to the National Institutes of Health, the
first time a person with food allergy is exposed to
the food, no symptoms occur; but the first
exposure primes the body to respond the next
time. When the person eats the food again, an
allergic response can occur.
What is a first exposure to food?
• Can be when you eat it
• Can occur without your knowledge
– Example: peanut allergy –
A person who experiences anaphylaxis on the first known
exposure to peanuts may have previously
• Touched peanuts
• Using a peanut-containing skin care product
• Breathed in peanut dust in the home or when close to other
people eating peanuts
What happens in a food allergy?
Components of a food, called “allergens,”
trigger the immune system.
The body produces antibodies that attach to cells
throughout the body. (IgE antibodies)
With the next exposure, antibodies recognize the allergen and
signal the body to release histamine and other chemicals that
cause the physical signs of an allergic reaction.
What are the symptoms of a food allergy?
Allergic reactions can include:
• Hives
• Flushed skin or rash
• Tingling or itchy sensation in the mouth
• Face, tongue, or lip swelling
• Vomiting and/or diarrhea
• Abdominal cramps
• Coughing or wheezing
• Dizziness and/or lightheadedness
• Swelling of the throat and vocal cords
• Difficulty breathing
• Loss of consciousness
• Anaphylaxis (“anaphylactic shock”)
02
How do you know if a person is having an
anaphylactic reaction?
Anaphylaxis is highly likely if at least one of the following three conditions occurs:
1. Within minutes or several hours, a person has skin symptoms (redness, itching,
hives) or swollen lips and either
• Difficulty breathing, or
• A drop in blood pressure
2. A person was exposed to an allergen likely to cause an allergic reaction, and,
within minutes or several hours, two or more of the following symptoms occur:
• Skin symptoms or swollen lips
• Difficulty breathing
• A drop in blood pressure
• GI symptoms such as vomiting, diarrhea, or cramping
3. A person exposed to an allergen previously known to cause an allergic reaction
in that person experiences a drop in blood pressure
http://www.niaid.nih.gov/topics/foodAllergy/
understanding/Pages/anaphylaxis.aspx
Difference between allergy and intolerance
• An intolerance is a reaction to food that does not involve
the immune system or production of IgE antibodies.
• Examples:
– Lactose intolerance – body lacks the enzyme, lactase, to break
down lactose (milk sugar). Symptoms include gas, bloating,
abdominal pain, diarrhea.
02
– Gluten intolerance – associated with Celiac Disease, an
inherited autoimmune disorder in which foods that contain gluten
cause damage to the intestines and can prevent the proper
absorption of nutrients- does not involve IgE antibodies.
– Reactions to additives (msg, sulfites).
How do you know if you have a food allergy?
A physician can use
• diet histories
• diet elimination
• skin tests
• blood tests
02
What foods cause food allergies? – The
“Big 8”
90% of total food allergies are caused by these 8 foods:
• Peanuts
• Tree nuts (such as almonds, pecans, walnuts, etc.)
• Milk
• Eggs
• Soy
• Wheat
• Fish (such as bass, cod, flounder)
• Crustacean shellfish (such as crab, lobster, shrimp, etc.)
02
Do people have to eat a food to have an
allergic reaction?
Some people are so allergic, they can experience
symptoms without ingesting the food.
• Airborne allergens in steam during cooking
• Cross-contamination and the spread of allergens
• Kissing someone who has eaten the allergen
02
What is the treatment for food allergy?
The best treatment for food allergies and celiac
disease is:
strict avoidance
of the foods that cause the problem.
02
Laws about food allergies
Food Allergen Labeling and Consumer Protection
Act of 2004 (FALCPA) effective since 2006
02
• Labels must clearly identify the source of all
ingredients that are — or are derived from — the
eight most common food allergens.
Laws about food allergies
Food Allergen Labeling and Consumer Protection
Act of 2004 (FALCPA) effective since 2006
02
• Labels must clearly identify the source of all
ingredients that are — or are derived from — the
eight most common food allergens.
Label Examples:
Label Examples:
Label Examples:
Label Examples:
“May contain” labeling –
not mandated, but companies may use it to warn
consumers and reduce liability
http://www.fda.gov/forconsumers/consumerupdates/ucm254504.htm
“May contain” labeling –
not mandated, but companies may use it to warn
consumers and reduce liability
http://www.fda.gov/forconsumers/consumerupdates/ucm254504.htm
More Label Reading
More Label Reading
More Label Reading
More Label Reading
In addition to avoidance, additional
treatments that may be prescribed…
• Antihistamines/Bronchodilators
• Epinephrine
Epinephrine
www.epipen.com/en/about-epipen
Directions say patient should always carry 2 doses.
Available in single and 2-pak cartons.
Prevention Starts In the Kitchen!
Food Service should:
•
•
•
•
Keep a list of ingredients in every food served.
Read food labels.
Know what to avoid and how to substitute.
Designate an allergy-free zone where allergy-free meals
can be made.
• Avoid cross-contamination and follow safe food handling
practices.
Preventing exposure to allergens school
cafeterias and throughout the school
Food Service Assistants should:
• Understand the school’s allergy plan.
• Identify the students with documented food allergies.
• Develop standardized cleaning procedures for the
cafeteria.
• Learn to recognize signs of anaphylaxis, and know how
to activate the school’s emergency plan if anaphylaxis
should occur in a student with a life threatening food
allergy.
Handwashing or hand sanitizers?
• Hand sanitizers are not as effective at removing
allergens
• Washing with soap and water is more effective
Wash for as long as it takes to sing
“Happy Birthday” twice!
Hygiene and cleanliness
It is also important for foodservice, teachers in
schools and caregivers to:
• Wash their hands thoroughly and often
• Clean and sanitize utensils, equipment,
surroundings, toys, etc.
Best Methods of “Cleaning”
To Remove Allergens?
According to the National Institute of Allergy and Infectious
Diseases at the National Institutes of Health, U.S. Dept.
of Health and Human Services:
• Simple measures of cleanliness can remove most
allergens from the environment of a person with food
allergy.
• Simply washing your hands with soap and water will
remove peanut allergens, and most household
cleaners will remove allergens from surfaces.
Methods of “Cleaning”
Research has found that:
• Conventional cleaning methods are effective in removing
the protein of a food allergen such as peanut.
• Bar and liquid soaps are effective for removing the
protein from hands, while alcohol-based sanitizer is not.
• Soaps and commercial cleaning agents effectively
removed peanut protein from table tops, while
dishwashing liquid alone did not.
(J. Allergy Clin. Immunol. 2004;113:973-6.)
Resources Available
– Food Allergy – An Overview, booklet from NIH –
National Institute of Allergy and Infectious Diseases
(~40 pages)
www.niaid.nih.gov/topics/foodallergy/documents/food
allergy.pdf
– AAAAI (American Academy of Allergy, Asthma and
Immunology)
www.aaaai.org/conditions-andtreatments/allergies/food-allergies.aspx
– FARE (Food Allergy Research and Education)
www.foodallergy.org/
www.foodallergy.org/most-popular-resources
– About Food Allergies
– Managing at Home
– Dining Out & Travel
– Awareness & Educational Materials
Food Allergy is a Serious Health Threat
• It can be deadly
• Avoidance is the key
All About …
Food Allergies
Judy A. Harrison, Ph. D., Professor and Extension Foods Specialist
Dept. of Foods and Nutrition
College of Family and Consumer Sciences
University of Georgia.
2015
The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of
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