Nutrition Fundamentals and Medical Nutrition Therapy
Manage Food Allergies, Complementary, and Alternative Medicine
Corresponds with LEARNING PLAN 4Copyright 2016 Association of Nutrition and Foodservice Professionals
4
Objectives
Describe common food allergies and discuss dietary implications
Define alternative therapies
Identify risks and benefits of alternative therapies
Classify use of alternative therapies in long-term and acute care
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Objectives
List questions to ask in evaluating dietary supplements and other complementary and alternative treatments
Explain the concepts of absorption and availability of nutrients
Identify the role of basic nutrition concepts in assessment and implementation of complementary and alternative therapies
Explain the role of the Certified Dietary Manager for assisting clients in alternative therapies
Differentiate between an allergy and a food intolerance
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Food Allergies and Intolerances
Food Allergies occur when the immune system targets a harmless food protein such as wheat» IgE is released as well as histamine
Food Intolerances are not true food allergies because there is no IgE immune response
Only about 4% of the adult population have a clinical diagnosis of a food allergy
5% of children (1 in 13) have a clinical diagnosis of a food allergy
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Food Allergies and Intolerances
Allergic reactions can affect one or more body systems» Skin – rash or hives» GI Tract – nausea or vomiting» Respiratory tract – difficulty breathing» Cardiovascular system – affecting the heart
Anaphylaxis» Potentially life-threatening allergic reaction requiring
immediate treatment
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Common Food Allergens
There are eight top allergens in the USA that account for 90% of food allergies» Federal law requires food allergy labeling of these eight
foods
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Egg Fish
Shellfish Milk
Peanuts Tree Nuts
Soy Wheat
Brain Break
Cross-contact is often a cause of food allergies. List some ways to avoid cross contact in foodservice.
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
» Never remove a sandwich filling and reuse the bread for another type of sandwich
» Use separate tongs for foods causing allergies
» Thoroughly wash hands after handling foods causing allergies
» Thoroughly wash deli slicers between meat and cheese slicing
» If a client has a nut allergy, use extreme precaution with nut butters, nut oils, nut toppings or don’t use them at all
Common Food Allergens
Wheat allergy vs gluten intolerance» Wheat allergy causes an IgE mediated response» Gluten intolerance is a digestive disease
Common sources of gluten in the diet» Wheat products: Bulgur, durum wheat, farina, triticale,
graham flour, matzo flour, wheat germ, wheat starch, bran» Barley products: Barley, barley malt, barley malt extract» Orzo, panko, seitan, udon, farro» Pasta made from semolina» Hydrolyzed vegetable protein (HVP)
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Allergy Treatment and Managing Reactions Best way to avoid a food allergy is to avoid the food
allergen
Role of the Certified Dietary Manager» Follow the Rule of 3 for reading the label/ingredients
1. Before ordering2. When unloading/putting away product3. Before starting a recipe or serving a food
» Have an established policy for documenting food allergies and procedures for care
» Ensure there is no cross-contact
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Brain Break
What is the best type of utensil and work surface to avoid cross contact of allergens?
» Stainless SteelNutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Two Approaches to Medicine
Conventional medicineTraditional or mainstream medicine
» Science used by physicians(Medical Doctors—MDs and Doctors of Osteopathy—DOs), as well as allied health professionals, as they are trained in the Unites States.
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Two Approaches to Medicine
Alternative practices» Complementary and alternative approaches
- Complementary and alternative medicine (CAM)» Diverse systems, practices and products not part of
conventional medicine- Acupuncture- Ayurveda - Homeopathic- Naturopathic
» Check out the National Center for Complementary and Integrative Health for recalls, tainted products and other alerts- http://nccam.nih.gov/news/alerts/
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Types of CAM
Alternative medical systems
Mind-body interventions
Biologically based therapies
Manipulative and body-based methods
Energy Therapies
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Herbs and Dietary Supplements
‘Natural’ does not necessarily mean safe
‘Dietary Supplement’ has a specific definition by the FDA
1994 legislation determined dietary supplements are considered foods, not drugs; making them not subject to the same rigorous controls as prescription and over-the-counter (OTC) drugs.
Safe and effective dosages are not well established
Risk of overdose for several dietary supplements
Potential for drug (supplement) interaction
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
CAM Therapy
Do not automatically dismiss CAM therapy
Respect individual preferences
Encourage full disclosure of CAM therapies your client may be utilizing
Carefully evaluate CAM according to scientific research and accepted practice
Consider potential for fads, frauds, and quackery
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
Brain Break
A client has a diagnosis of A-fib/AF (arterial fibrillation) of the heart and is on a prescription blood thinner. The client also lists an OTC supplement of Ginkgo. What are the possible risks or side affects of combining these two?
» Ginkgo can interfere with the action of the anticoagulant medication that could result in excessive bleeding.
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4
The Role of the Certified Dietary Manager Recognize individual rights of clients to choose their own
care
Respect individual preferences
Communicate with clients and the entire healthcare team about CAM therapies, especially the use of dietary supplements
Inform clients of possible risks; help to educate
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine • Learning Plan 4