Food Allergies & Food Intolerances

Food allergies or food intolerances affect nearly everyone at some point. One out of three people either say that they have a food allergy or that they modify the family diet because a family member is suspected of having a food allergy. However, only about 2% of adults and between 2-4% of children have clinically proven allergic reactions to foods. 

This difference between the clinically proven prevalence of food allergy and the public perception of the problem is in part due to reactions called "food intolerances" rather than food allergies. A true food allergy is an abnormal response to a food triggered by the body's immune system. Food intolerances, such as glucose intolerance, lactose intolerance, and reactions to food additives like sulfites, can cause symptoms that can resemble those of a food allergy. However, intolerances do not trigger the body's immune response as in a true food allergy. 

It is extremely important for people who have true food allergies to identify them and prevent allergic reactions to food because these reactions can cause devastating illness and, in some cases, be fatal. In fact, the Centers for Disease Control and Prevention (CDC) estimates that food allergies cause 30,000 cases of anaphylaxis, 2,000 hospitalizations and 150 deaths annually.

Allergies are an inherited predisposition. Generally, people with a food allergy come from families in which allergies are common - not necessarily food allergies, but perhaps hay fever, asthma, or hives.

What foods are most likely to cause allergic reactions?

In adults, the most common foods to cause allergic reactions include: shellfish such as shrimp, crayfish, lobster, and crab; peanuts (a legume that is one of the chief foods to cause severe anaphylaxis, a sudden drop in blood pressure that can be fatal if not treated quickly); tree nuts such as walnuts; fish; wheat; soy and eggs.

In children, the pattern is somewhat different. The most common food allergens that cause problems in children are eggs, milk, and peanuts. Adults usually don't lose their allergies, but children can sometimes outgrow them. Children are more likely to outgrow allergies to milk or soy than allergies to peanuts, fish, or shrimp.

The foods that adults or children react to are those foods they eat often. In Japan, for example, rice allergies are more common. In Scandinavia, codfish allergies are more common.

What do restaurant owners/operators need to know about food allergies?

The 2005 Food Code requires the person in charge to be able to describe the eight foods identified as major food allergens and the symptoms that major food allergens could cause in a sensitive individual. The eight major food allergens are: 

• Milk 
• Egg
• Fish
• Peanuts
• Shellfish
• Soy
• Tree Nuts (such as almonds, pecans or walnuts)
• Wheat

Symptoms of a reaction to a food allergy can include one or more of the following:

• A tingling sensation in the mouth
• Selling of the tongue and throat
• Difficulty breathing
• Hives
• Vomiting
• Abdominal cramps
• Diarrhea
• Drop in blood pressure
• Loss of consciousness, and even death

Symptoms typically appear within minutes to two hours after a person has eaten a food to which he or she is allergic. To reduce the risk of illness via food allergy in your restaurant, make sure your staff are informed of the 8 major food allergens, and if they have a question from a customer, remember the "Four Rs" and follow these helpful guidelines:

1. Refer the customer to the manager, person in charge or chef so that the question is handled appropriately. 
2. Review the food allergy with the guest and check the ingredients to see if the item ordered contains the allergen.
3. Remember to check the preparation for potential cross contamination with the food allergen. For example, if a guest is allergic to fish, make sure the chicken they ordered is not fried in the same oil as the fish is. 
4. Respond to the guest & inform them of your findings. Because in today's modern world, all food has been processed or handled by someone before it was delivered to your restaurant, you cannot guarantee the item the guest has ordered is free of the substance. You should inform the guest of the precautionary measures you have taken and let them make an informed decision as to whether or not they would like to order an item.

Where can I get more information?

Washtenaw County
Environmental Health Division
(734) 222-3800