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