is a digestive disorder. Most wheat allergies are triggered by albumin or gliadin. Symptoms are often immediate and can be caused by eating or inhaling wheat; they present as hives, eczema, asthma, and anaphylaxis (Asthma and Allergy Foundation of America, 2005). Foods to avoid for those with a wheat allergy are located at www.kidswithfoodallergies.org/ resourcespre.php?id=52. Soy Soy allergy may be outgrown eventually, but it can also last into adulthood. Soy allergy symptoms are usually mild, such as hives or itching of the mouth, but they can rarely cause anaphylaxis (Kattan, Cocco, & Jarvinen, 2011). A soy avoidance list is located at www.kidswithfoodallergies.org/ resourcespre.php?id=51. The eight major food allergens are so predominant in America that the Food Allergen Labeling and Consumer Protection Act (FALCPA) was passed in 2004. FALCPA requires U.S. food manufacturers and packagers to list the eight major allergens on all packaging and include the specific type of allergy, such as salmon (fish) or almonds (tree nuts). Further, the law states that the print must minimally be the same size as all other ingredients. Food items to which FALCPA does not apply include meat, poultry, eggs, fruits, and vegetables (Kim & Sicherer, 2011). Australia, Europe, Canada, and New Zealand also have labeling laws for food allergens; however, food allergens required to be listed differ. The European Union outlines twelve food items as allergens, including sulfites — which Australia, Canada, and New Zealand also consider to be an allergy — whereas the U.S. defines them as a food intolerance. This difference brings us to non-allergens classified as food intolerances in the U.S. (Kim & Sicherer, 2011). Food Intolerance Food intolerance is defined as a nonallergic, adverse digestive system response caused by foods (Medical News Today, 2013). Like food allergy, food intolerance can cause stomach pain, nausea, vomiting, and diarrhea. Symptomatically, food intolerance is different in that it can also present with gas, cramps, bloating, heartburn, headaches, and irritability. The most common food intolerances are: • Lactose (discussed earlier) • Tyramine — amino acid based and used to smoke, pickle, or preserve • MSG — a flavor enhancer added to soups, Chinese food, canned foods, processed meats, etc. • Non-celiac gluten sensitivity — similar symptoms to celiac disease, but without the intestinal damage • Additives • Preservatives • Artificial sweeteners and colors Although the FDA Food Advisory Committee released a statement in 2011 saying there are possible, minimal, behavior-related reactions to artificial colorings in some children, with or without ADHD (Weiss, 2012), studies at Purdue University (Stevens, LJ, et al., 2011) and University of Australia Melbourne (Rowe & Rowe, 1994), have proven that intolerances to artificial food colors can greatly exacerbate issues such as restlessness, irritability, and sleeplessness in children with behavioral disorders from ADHD. Strickland’s Eating for Autism concludes that artificial colors, flavors, sweeteners, and preservatives, especially BHT, effect autistic children adversely through behavior, based on research (2009). Our Role in Food Allergy Accommodation A recent American Camp Association (ACA, 2013) public policy article discussed judgment brought by the U.S. Department of Just ice against Lesley University (Massachusetts) regarding accommodations to dining hall plans for students with food allergies under the Americans with Disabilities Act (ADA). Some residential students, after purchasing the required meal plan, were unable to eat some foods offered on the plan without food allergy symptoms. While this judgment was made for a university and not for the camp setting, the related guidance document released by the Department of Justice (DOJ) details new requirements for the Lesley University food service, which can serve as a tool for food allergy accommodation in camp food service. The DOJ stated that per the ADA, all public food service venues are not required to serve allergen-free foods, but suggest at a minimum for restaurants/food services to answer questions about food ingredients and to substitute or omit allergens where possible. Training Food Staff Food service staff should have annual training but can have ongoing education and training to accommodate special dietary needs in various ways. I was fortunate to employ a summer intern, Julia Nelson, who has a BS in nutrition, is a registered dietician, and has previous special diets administration experience. While on staff, not only did her expertise fine-tune our food allergy process, but Julia transformed my food allergy notes and copies of allergen lists into a booklet for staff training titled “Food Service Special Diets and Allergies Book.” This is now used for annual staff training and is available to staff at any time for reference. Food Allergy Safety Zone In Serving People with Food Allergies, Joel J. Schaefer (2011) makes some of the following suggestions in order to safely serve allergen-free menu items. Determine a “Food Allergy Safety Zone” where only foods without the Big Eight allergens are prepared. This can be a designated work table or other kitchen area with the following basic items to be used ONLY for prep in this area: • Skillets, pots, sauté pans • Baking sheets with covers • Small griddles/grills for meats/pancakes • Waffle iron for gluten-free waffles • Small fryer • Individual steamer • Counter top oven • Microwave • Undercounter refrigerator for allergenfree perishables • Designated utensils for allergen-free cooking/serving only • Cutting boards • Shelves above prep area for bowls, plates, etc., designated for allergen-free foods only • An undercounter dishwasher, or builtin sink at one end of work table • Nonlatex gloves • Food allergy recipe book with recipes designed/converted for large groups The following tips are important for decreasing cross-contamination: 1. It is imperative that one cook is responsible for that work station, and that this person does not prepare foods there that contain allergens — or work in areas of the kitchen that contain CAMPING magazine • March/April 2014 41
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