Food
Allergies
& Sensitivities
Randa Abdallah
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Objectives
q Food allergy overview
q Food intolerance/sensitivity
q Food and Drug Administration
q Food safety at Beaumont, Dearborn
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Food Allergy Background
o When the immune system overreacts to the proteins in a certain food after eating.
o Millions of Americans have allergic reactions to food. Affects 2% of adults and 4-8% of children.
o Most food allergies cause mild and minor symptoms, but some food allergies cause reactions
that may be severe or life-threatening.
o A life threatening allergic reaction is called anaphylaxis.
This can lead to: Each year in the U.S., it is estimated that
1) Constricted airways in the lungs anaphylaxis to food results in:
2) Severe lowering of blood pressure and 1) 30,000 emergency room visits
shock anaphylactic shock 2) 2,000 hospitalizations
3) Suffocation by swelling of the throat 3) 150 deaths
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Top Food Allergens
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Food Allergy Symptoms
o Hives
o Flushed skin or rash
o Tingling or itching sensation in the mouth
o Face, tongue, or lip swelling
o Vomiting and/or diarrhea
o Abdominal cramps
o Coughing or wheezing
o Dizziness and/or lightheadedness
o Swelling of the throat and vocal cords
o Difficulty breathing
o Loss of consciousness
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Food Intolerance/Sensitivity Background
o A food intolerance can cause some of the same signs and
symptoms as a food allergy.
o Digestive problems that occur after a certain food is eaten.
o Food intolerance do not involve the immune system.
o Food intolerance may be prevented. Example: lactose intolerant
patients may drink lactose-free milk or take lactase enzyme pills
(Lactaid) to aid digestion.
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Causes of Food Intolerance
1. Absence of an enzyme that is needed to digest a food.
2. Irritable bowel syndrome that can cause cramping, constipation,
and diarrhea.
3. Food poisoning or toxins in food that is spoiled can cause severe
digestive symptoms.
4. Sensitivity to food additives or preservatives used in the food
industry.
5. Celiac disease is classified as a food intolerance because
symptoms are mainly in the gastrointestinal tract and not life
threatening. However, celiac involves the immune system.
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Celiac Disease Overview
o Celiac Disease: autoimmune disorder in which the bodys
immune system attacks the intestines when gluten is eat.
o Gluten: avoid wheat, barley, rye. Avoid oats due to cross
contamination.
o Continuous exposure to gluten can result in serious long-term
health conditions.
o Screening blood test: IgA test; Genetic testing
o Treatment: gluten-free diet to manage symptoms and promote
intestinal healing.
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What is the Food and
Drug Administration (FDA) Doing?
How Major Food Allergens Are listed:
The name of the food source of a major food allergen must appear:
In parentheses following the name of the ingredient.
Examples: "lecithin (soy)," "flour (wheat)," and "whey (milk)"
OR
Immediately after or next to the list of ingredients in a "contains"
statement.
Example: "Contains Wheat, Milk, and Soy."
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Food Allergen Labeling And Consumers
Protection Act (FALCPA) of 2004
o Improve food labeling information to those who suffer from food
allergies.
o FALCPA is an amendment to the Federal Food, Drug, and Cosmetic Act
and requires that the label of a food that contains an ingredient that is or
contains protein from a major food allergen decreases the presence of
the allergen in the manner described by the law.
o Applies to both domestically manufactured and imported packaged
foods that are subject to FDA regulations.
o Flavors, colors, and food additives are subject to the allergen labeling
requirements.
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Patient Safety: Your Role as a Provider
Prevention & Treatment Options:
o No cure for food allergies
o Education
o Avoid foods that cause reaction
o Identifying food sensitivity through blood tests
o Reading food labels
o Wear a medical alert bracelet or necklace
o Carry an auto-injector device containing epinephrine (EpiPen)
o Seek medical help immediately and go to a nearby emergency room
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Beaumont Health: Oakwood Campus Protocol
o Very strict protocols: no overrides unless removed from EPIC.
o In EPIC: if a food sensitivity or intolerance is noted under an
allergy, and patient states they are not allergic/intolerant, allergy
must be removed prior to receiving any foods with ingredient from
Food and Nutrition due to hospital liability.
o Dietary clerks are trained with all recipes that contain major
allergens and more.
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Example in the Diet Office
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Beaumont Health: Oakwood Campus Protocol
o Food and nutrition supervisor on duty will check and sign every
patient tray that contains any allergen.
Examples:
o Gluten allergy: foods are separate in the freezer with dedicated
toaster for bread items to prevent any cross-contamination.
o Fish allergy: no fried foods to prevent contamination.
o Corn allergy: no high fructose corn syrup including lemonade.
o Tomato allergy: no Mrs. Dash seasoning because of tomato
product.
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Allergies in Epic & CBOARD
Listed below are current allergies mapped between Epic and CBOARD. These allergies will
automatically come over to CBOARD. All other allergies can be manually typed in Other and
then the diet office must be informed because diet clerk must manually enter the allergies into
CBOARD.
*All allergies listed on the ticket will be double checked by the food service manager on duty.
ALLERGEN PEANUT
CORN SEAFOOD
MILK SHELLFISH
EGGS SOY
EGG STRAWBERRIES
FISH TOMATO
GLUTEN TREE NUT
MUSHROOM NUTS
ONION WHEAT
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Beaumont Health: Oakwood Campus Protocol
Remove allergy from EPIC and call diet clerks to manually remove it from CBOARD.
Any urgent allergies please call the diet clerks to manually update it into CBOARD.
Any urgent matters or change in patient lists, notify diet clerks because allergy lists get
updated twice a day.
If patient has an intolerance please call the diet clerks to manually remove it from the
CBOARD, except lactose intolerance.
If patient has a lactose intolerance, please do not put lactose intolerance as an allergy,
instead put the diet order as lactose control.
Cross contamination may occur in the kitchen, please notify the diet clerks to manually
input an intolerance into CBOARD.
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References
1. National Institute of Health. https://www.nlm.nih.gov/medlineplus/magazine/
issues/spring11/articles/spring11pg24-25.html
2. Food and Drug Administration. http://www.fda.gov/food/ingredientspackaginglabeling/
foodallergens/ucm079311.htm#video
3. Celiac Disease Foundation. https://celiac.org.
4. Food Allergies, Celiac Disease and Gluten Sensitivity. Academy of Nutrition and Dietetics.
http://www.eatright.org/resource/homefoodsafety/four-steps/separate/food-allergies-
celiac-disease-and-gluten-sensitivity.
5. Li, James. Whats the difference between a food intolerance and food allergy? Mayo Clinic.
http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-
allergy/faq-20058538.
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