Allergy Management a n d t h e 411 to Label

ReadingA session addressing how to read the nutrition facts panel as well as to provide general guidelines to carb counts for the

diabetic and allergy sensitive student

Christa Petersen, RD | Registered Dietitian | Christa.Petersen@compass-usa.com | 732-602-8677

Objectives• To identify the scientific

difference between a food allergy and food intolerance• To translate the nutrition facts

label panel for food allergies and diabetics• To provide nutrition resources

for the school nurse• To address the Chartwells

protocol for menu modifications

15 mil l ion p e o p l e h a v e f o o d a l l e r g i e s …

Prevalence of food allergies is increasing. 9 out of 10 of schools say they have one or more students with a food al lergy.

• Food intolerance does not involve the immune system• Symptoms are caused because of an excess of a component where

the body can not break down the food item (for example: Lactose Intolerance)

Food Allergy vs.Food Intolerance

…in contrast…

• Typically our body considers most food items “foreign but safe”• When something goes wrong, a person becomes sensitized to the food

and the immune system determines it to be a threat to the body

Science of a Food Allergy

When a foreign antigen enters the body, a group of specific white blood cells called Lymphocytes (the B-cells and T-cells) are activated • IgE is the most important antibody

in the majority of allergies-the classic allergy of hay fever, asthma, hives, angioedema (tissue swelling) and the anaphylactic reaction

Let’s look closer…1. The Antigen (allergy) presents itself to the cell

5. These are the reactions as a result of the excess release of chemotactic factors

3. They produce IgE antibodies (allergy specific

4. Once IgE antibodies surround the Mast Cell it releases chemicals to cause a reaction

2. T-cells and B-Cells declare this allergen “dangerous”

Elimination Diets• Helps to determine the “culprit” food components by rendering the

allergic person symptom-free of the foods removed• C h a l l e n g e P h a s e : This is when the culprit components

are reintroduced where noticeable, and sometimes measurable symptoms will occur.

• There are three types of diets that try to identify food sensitivities:• Selective elimination: One or a small number of foods are eliminated for a

specified period of time • Few foods elimination diets (oligioantigenic): only a few foods are allowed

for a specified period of time• Elemental diet: Only amino-acid formula. No solid food is consumed.

How is it…That a child forms an allergic reaction to

raw carrots but when it’s cooked they have no reaction?

Oral Allergy Syndrome (OAS) – When someone exhibits a respiratory allergy to tree, weed

or grass pollens there are receptors along the

naso/oral/respiratory tract that release an immune response

Labeling of FoodsThe Food Al lergen Label ing and Consumer Protect ion Act

(FALCPA)This law became effective in 2006 to identify the eight major food allergens that

are responsible for at least 90% of serious adverse reactions to foods in the United States:

SOY

MILK

WHEAT

EGG

FISH

PEANUTS

TREE NUTS

SHELLFISH

Labeling of Foods• The FALCPA law states that a food label : Must specify the type of tree

nut (almonds, pecans, walnuts), the type of fish and the type of crustacean shellfish (crab, lobster, shrimp)

• All food allergies must be listed on the label and usually follow a “c o n t a i n s ” or “m a y c o n t a i n ” statement

Label ExerciseTurkey Chili

Label ExerciseTurkey Chili

Labeling of Foods

Labeling of Foods

General CHO guide…

Portion Food Item

1 slice (1oz) Bread

1-6-inch Tortilla

½ (1 oz) Hotdog bun

¾ cup Ready-to-eat cereal

1/3 cup Cooked pasta or rice

½ cup Beans, peas, corn, sweet potatoes mashed

3 oz Baked potato

Portion Food Item

1 small Fruit

½ cup Canned fruit

¼ cup Dried fruit

1 cup Fat-free/reduced milk

1 cup raw vegetables or ½ cup cooked non-starchy vegetables count as zero carbohydrates

E a c h i t e m b e l o w i s 1 5 g C H O

CHO Label Reading…

Do you think sugar is included in the

total Carbohydrate?

Did you know that if an item has >5g

Fiber you can subtract it from the

total carb?

Nutrislice & Preferred Meals

Nutrislice database shows daily:• Nutrition Facts Panel• Ingredients• Allergy

Nutrislice & Preferred Meals

Preferred Meals will also show:• Nutrition Facts Panel• Ingredients• Allergy

S t e p 1 . ) We receive a request from parent/nurse/caregiverS t e p 2 . ) We must receive a prescription from the doctor stating the allergy, what the child can or cannot eatS t e p 3 . ) We then will provide the parent with a form stating the items we can offer S t e p 4 . ) If the parent/doctor/caregiver approves of the list they will sign it then

Chartwells will agree upon a date for when the altered menu items will be implemented S t e p 5 . ) Dietitian will begin implementing the training for staff members and

coordinating the details to obtain the altered menu

Chartwells Protocol

Thank you!

Christa L. Petersen, RD |Registered Dietitian Woodbridge Township Schools | o. 732-602-8677 | christa.petersen@compass-usa.com

Contact Information:

For More Information…

( 1 ) F o o d A l l e r g y R e s e a r c h & E d u c a t i o nht tp: / /www. fooda l le rgy.o rg /home

( 2 ) C e n t e r s f o r D i s e a s e C o n t r o l a n d P r e v e n t i o n ( C D C )h t t p : / /w w w . c d c . g o v / h e a l t h y s c h o o l s / f o o d a l l e r g i e s / i n d e x . h t m

( 3 ) U n i t e d S t a t e s D e p a r t m e n t o f A g r i c u l t u r e ( U S D A )h t t p : / /h e a l t h y m e a l s . n a l . u s d a . g o v / r e s o u r c e - l i b r a r y / f o o d - a l l e r g i e s /r e s o u r c e s - s c h o o l s # o v e r l a y - c o n t e x t = s c h o o l - g u i d e l i n e s - m a na g i n g - s t u d e n t s - f o o d - a l l e r g i e s