Food Allergies in Foodservice Rotations

While being in my Institutional Food Service, Production, and Management rotation this summer, a common concern from management has come to my attention. And this concern would be…  Food Allergies!

A food allergy is the body’s immune system reaction to certain foods. Symptoms of an allergic reaction include itching or swelling in or around the mouth, face, and scalp; tightening in the throat; wheezing or shortness of breath; hives; abdominal cramps, vomiting, diarrhea; loss of consciousness; and even death.

Food allergies are a growing public health concern. As many as 15 million people in the U.S. have food allergies. An estimated 9 million, or 4%, of adults have food allergies. Nearly 6 million, or 8%, of children have food allergies with young children affected the most. Although children allergies to milk, egg, wheat, and soy generally resolve in childhood, they appear to be resolving more slowly than in previous decades, with many children still allergic beyond age 5 years. Allergies to peanuts, tree nuts, fish, or shellfish are generally lifelong allergies.

The top food allergens are categorized into eight food groups. These eight food groups account for 90% of all food-allergic reactions. They include: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. The estimated prevalence among the American population is:

          Milk and eggs: based on data within and obtained outside the United States, this rate is likely to be 1-2% for young children and 0.2-0.4% in the general population.

          Peanut: 0.6-1.3%

          Tree nuts (e.g., walnuts, almonds, cashews, pistachios, pecans): 0.4%-0.6%

          Fish: 0.4%

          Crustacean shellfish (e.g., crab, lobster, shrimp): 1.2%

          All seafood: 0.6% in children and 2.8% in adults

The Centers for Disease Control and Prevention reported that food allergies result in more than 300,000 ambulatory-care visits a year among children under the age of 18 years. From 2004 to 2006, there were approximately 9,500 hospital discharges per year with a diagnosis related to food allergy among children under age 18 years. Even small amounts of a food allergen can cause a reaction. Most allergic reactions to foods occurred to foods that were thought to be safe. Allergic reactions can be attributed to a form of mislabeling or cross-contact during food preparation. Food allergy is the leading cause of anaphylaxis outside the hospital setting. Every 3 minutes a food allergy reaction sends someone to the emergency department. This is approximately 200,000 emergency department visits per year, and every 6 minutes the reaction is one of anaphylaxis. Teenagers and young adults with food allergies are at the highest risk of fatal food-induced anaphylaxis. Symptoms of anaphylaxis may recur after initially subsisting and experts recommend an observation period of about 4 hours to monitor that the reaction has been resolved. Individuals with food allergies who also have asthma may be at an increased risk for severe or fatal food allergic reactions. Children with food allergy are 3-4 times more likely to have other related conditions such as asthma and other allergies, compared without food allergies. It is possible to have anaphylaxis without any skin symptoms (no rash or hives). Failure to promptly (i.e., within minutes) treat food anaphylaxis with epinephrine is a risk factor for fatalities.

Chemical contamination can occur when high-acid foods are prepared or stored in metal-lined containers. Poisoning may result if brass or copper, galvanized, or gray enamelware containers are used. Fruit juices should never be stored in gray enamelware with lead glaze or tin milk cans. Cases of poisoning have been recorded that have been attributed to use of improper metal utensils. Sauerkraut, tomatoes, fruit gelatins, lemonade, and fruit punches have been implicated in metal poisonings.

Toxin metals also have been implicated in food poisoning cases. Copper may become poisonous when it is in prolonged contact with acid foods or carbonated beverages. The vending industry voluntarily discontinued all point-of-sale carbonation systems that do not completely guard against the possibility of backflow into copper water lines. Also, food such as meat placed directly on cadmium-plated refrigerator shelves may be rendered poisonous.

Mayo Clinic

NIH

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Chain Restaurants Impact on Kids’ Meals and their Health

Kids Meals Get an “F” in Nutrition at Chain Restaurants

Nearly all of the meal possibilities offered to kids at America’s top chain restaurants are of poor nutritional quality. A report released today found that fried chicken fingers, burgers, French fries, and sugar drinks continue to dominate kids’ meal setting, with 97% of the nearly 3,500 meal possibilities not meeting CSPI‘s nutrition criteria for 4- to 8-year-olds.

And if you don’t believe CSPI, ask the National Restaurant Association (NRA): 91% of kids’ meals at America’s major chains do not even meet the nutritional standards of the industry lobbying group’s Kids LiveWell program.

One out of every three American children is overweight or obese, but it’s as if the chain restaurant industries didn’t get the message. The Institute of Medicine (IOM) released “Accelerating Progress in Obesity Prevention” and addressed these health concerns for further research and studies to use in the fight against childhood obesity.

Two-thirds of adults and almost one-third of children in the United States are overweight or obese, representing young and old, urban and rural, and majority and minority populations. This epidemic of excess weight is associated with major causes of chronic disease, disability, and death. Obesity-related illness is estimated to carry an annual cost of $190.2 billion.

Most chains seem stuck in this time warp, serving the same dated meals based on chicken nuggets, burgers, macaroni and cheese, fries, and soda. I know that they can come up with healthier, cost-effective, nutritionally beneficial meals that are more current than these.

One chain that has gotten the message is Subway. All eight of Subway restaurants’ Fresh Fit for Kids meal combinations met CSPI’s nutrition criteria. Subway is the only restaurant chain that does not offer sugar drinks as an option with its kids’ meals, instead including low-fat milk or bottled water along with apple slices with all of its kid-sized subs.

“Our goal has always been to provide the most nutritious, balanced kids meals in the industry and we are proud to be recognized by CSPI for achieving that goal,” said Lanette Kovachi, corporate dietitian for the Subway brand.

To meet the CSPI’s nutrition criteria, kids’ meals must be at or below 430 calories, no more than 35% of calories from fat, or no more than 10% of calories from saturated plus trans-fat. Meals that meet CSPI’s criteria cannot have more than 35% added sugars by weight or more than 770mg. of sodium. The criteria require meals to make a proactive nutritional impact either by providing at least half a serving of fruit or vegetable, including an item that is 51% or more whole grain, or including specified levels of vitamins or fiber. CSPI’s criteria exclude sugar drinks in favor of water, juice, or low-fat milk. The NRA’s standards are quite similar, though they allow more calories.

Here are some of the least healthy kids’ meals available at chain restaurants:

–        Applebee’s Grilled Cheese on Sourdough with Fries and 2% Chocolate Milk has 1,210 calories with 62g of total fat (46% of kcal), 21g of saturated fat (16%), and 2,340mg. of sodium. That meal has nearly three times as many calories, and three times as much sodium, as CSPI’s criteria for four-to eight-year-olds allow.

–        Chili’s Pepperoni Pizza with Homestyle Fries and Soda has 1,010 calories, 45g of total fat (40% of kcal), 18g of saturated fat (16% of kcal, and about as much saturated fat as an adult should consume in an entire day), and 2,020mg. of sodium.

–        Denny’s Jr. Cheeseburger and French Fries has 980 calories, 55g of total fat (50% of kcal), 20g of saturated fat (18%) and 1,110mg. of sodium. Denny’s does not include beverages with kids’ meals.

–        Ruby Tuesday’s Mac ‘n Cheese, White Cheddar Mashed Potatoes, and Fruit Punch has 860 calories, 46g of total fat (48% of kcal) and 1,730mg. of sodium. Ruby Tuesday’s does not disclose saturated or trans-fat content on its menus or website.

–        Dairy Queen’s Chicken Strips, Kids’ Fries, Sauce, Arctic Rush (a Slushee-type frozen drink) and Dilly Bar has 1,030 calories, 45g of total fat (39% of kcal), 15g of saturated fat (13% of calories), and 1,730mg of sodium.

At 19 chain restaurants reported on, not a single possible combination of the items offered for children met the CSPI’s nutrition standards. Out of these restaurants, 9 (that included McDonald’s Popeye’s, Chipotle, and Hardee’s) not a single kids’ meal met the National Restaurant Association’s Kids LiveWell standards. At Wendy’s, only 5% of 40 possible kids’ meals met the CSPI’s standards. Most of these items were either too high in sodium or saturated fat. At Burger King, just 20% of the 15 possible kids’ meals met CSPI’s criteria.

The last time the CSPI reviewed the nutritional quality of kids’ meals at chain restaurants, in 2008, it is reported that these restaurants have made little progress. In 2008, just 1% of kids’ meals met the CSPI nutrition standards, compared to only 3% in 2012. Only one-third of the chains had at least 1 meal that met the nutritional standards in 2008. This number scaled to 44% in 2012- good, but not great improvement.

While the CSPI report recommends that companies consider several changes, it also encourages the chains to participate in the NRA’s Kids LiveWell program. For these restaurants to do so, they would need to restructure their kids’ meals to meet these standards. The bottom line is that these restaurants should offer more fruits and veggies, and to offer these fresh options as an alternative side to French fries. Whole grains should be offered more, as well as removing soda or other sugar sweetened beverages from the kids’ menus. And just because Subway was the only chain restaurant to meet CSPI’s criteria for all kids’ meals, it should increase the whole grain content of its breads and continue to lower sodium.

The long-term problem I see in this article is that the chain restaurant industry is conditioning children to accept a really narrow range of food options. More chains are adding fruits and veggies at this point, but realistically- a lot more could offer these options. And given the childhood obesity epidemic that America is currently attempting at combating- you would think that more restaurants would want to take action in the health of their future consumers.

CBS News Clip

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This is a standard Subway Kids’ Meal option

Southern Grocery Shopping

Southern Grocery Cart

It’s easy to throw healthy eating habits out the window when you’re away from home and your regular routine. Andrea D’Ambrosio, RD talks about ways to create a healthy winter routine while staying on a budget.

Plan ahead and stick to a list
Being prepared before you grab your grocery cart will help you avoid impulse purchases. It also gives you time to look at flyers, find sales and clip coupons. Try taking advantage of no-name products and avoiding shopping while you’re hungry.

Shop in season and avoid being wasteful
Buy in-season foods from local farmer’s markets, which is cheaper, and be resourceful with leftovers, using up excess food before it goes to waste, she says.

Consider vegetarian alternatives
If you study your grocery bill, meat products are often among the most expensive items. Consider planning meals with vegetarian alternatives like lentils, beans and soy. Check out vegetarian websites for heart- and budget-healthy meal ideas, she suggests.

Here are 5 friendly foods and the reasons you should add them to your grocery list:

  1. Fresh, seasonal fruit: A favorite snack to boost energy levels between meals if you feel a little hungry (power of carbs) and allows you to benefit from vitamins, minerals and antioxidants.
  1. Low-fat (1 percent) or non-fat milk: In order to maintain our bone density, we need to consume adequate dairy to receive calcium, phosphorous, magnesium and protein, which are all essential for bone growth and development.
  1. Whole grains: According to the Journal of Nutrition (2011), oats, barley, rice and quinoa all lower risk of chronic diseases such as coronary heart disease, diabetes and cancer, as well contribute to body-weight management and gastrointestinal health. Try buying whole-grain pasta and remember to look for the words “whole grain” on the label.
  1. Almonds: But just a handful a day, and make them unsalted! A portion-controlled (quarter cup) serving of almonds is excellent for lowering cholesterol because of the unsaturated fats, making them a heart-healthy choice. Almonds are high in vitamin E, a powerful antioxidant, and are naturally high in fiber and a good source of protein!
  1. Edamame: Green soybeans, made popular in Japanese cuisine but available in grocery stores, add a nice nutritional punch. These tasty soybeans can be added as a side dish, steamed in the pod or consumed as a snack or appetizer. Nutritionally speaking, they are another heart-healthy source of protein, fiber and vitamins.

http://www.thestar.com/specialsections/snowbirds/article/1301135–fill-your-southern-grocery-cart-with-healthy-foods

http://www.dieteticdirections.com/

groc shopp

Shingles and Nutrition

shinglesShingles and Your Diet

Shingles, also known as herpes zoster, is a viral infection that causes a rash that can be painful. According to MayoClinic.com, shingles typically resolves on its own, but medications can help hustle up the healing process and relieve pain. Certain nutrients have displayed pain-relieving assets, and incorporating these into your diet can help with shingles or painful difficulties.

First

Add foods to your diet that are rich in lysine. Or you can take a lysine supplement. Lysine is an amino acid that may prevent herpes virus outbreaks, says the University of Maryland Medical Center. Dietary sources of this amino acid include meat, cheese, sardines, eggs, soybeans, beans and legumes. Fenugreek seed is also a good source of lysine.

Second

Eat shellfish, eggs, beef and dairy products, all of which contain vitamin B-12.

Third

Take a vitamin E supplement. Mount Auburn Hospital recommends taking 1,200 to 1,600 international units per day of vitamin E for postherpetic neuralgia. Dietary sources of vitamin E include almonds, spinach, broccoli, mangoes, tomatoes, peanuts and peanut butter.

Fourth

Stock up on foods high in vitamin C and zinc. MayoClinic.com states that shingles outbreaks can occur due to an impaired immune system, and vitamin C and zinc are essential in promoting a healthy immune system. Good sources of vitamin C include oranges, strawberries, broccoli, leafy greens, peppers and potatoes. Oysters, red meats, chicken, legumes and whole grains are also good sources of zinc.

What to Avoid when you have Shingles

Shingles

According to the Mayo Clinic, shingles are red, raw and very painful blisters that can appear anywhere on your body but typically appear as blisters that wrap around your torso. If you have previously had chicken pox, are over 50 and have a weakened immune system, you are most at risk for contracting shingles. The CDC advises you to stay away from infants, pregnant women and others who have compromised immune systems until your shingles outbreak has passed.

Foods to Avoid

Avoiding certain foods can help alleviate symptoms of shingles. Arginine is an amino acid that your body produces naturally, but you should avoid foods that contain it. Arginine helps the herpes zoster virus to replicate. Chocolate, nuts and gelatin contain high levels of arginine. Also, don’t consume foods such as saturated fats or refined carbohydrates, because those might cause further inflammation. In addition, avoid alcohol and caffeine because these can weaken the immune system.