The FASTER Act: What It Is and Why it Matters December 9, 2020

Moments ago, the Senate unanimously passed the FASTER Act introduced by Senator Tim Scott (R-SC) and Senator Chris Murphy (D-CT). This is fantastic news for all patients with food allergies – and particularly exciting for the millions of Americans who are allergic to sesame seeds.

What is the FASTER Act?

The Food Allergy Safety, Treatment, Education, and Research (FASTER) Act is a bill aimed at increasing safety for those with food allergies and analyzing data and allocating resources for research and treatment.

Also known as S.3451/H.R. 2117, the FASTER Act proposes:

• An update to the food allergy labeling laws to include sesame.
  • Currently, sesame is not required to be labeled by its common name and can be hidden under general terms, making it both difficult and dangerous for the 1.5+ million Americans living with a sesame allergy.

• Requires the government to analyze promising opportunities for research so that they may diversify approved treatment options.
  • Currently, there is only one approved treatment option (oral immunotherapy – OIT) which can only benefit some patients with peanut allergy.

Photo by Pixabay on Pexels.com

Why is this important?

The FASTER Act increases transparency on ingredient labels for those with sesame seed allergies. This could set the stage for the labeling of other allergens that are hidden in ingredient labeling (such as corn). Allergy to sesame seeds are on the rise, the reactions to this allergen tend to be severe and this labeling change falls in line with how most other industrialized nations are approaching the allergen.

To learn more about sesame seed allergy, please read:

Sesame: the 9th Food Allergen?

Open Sesame: Prevalence of Sesame Seed Allergy & Progress in Labeling

FDA Issues Guidance Regarding Sesame Labeling

Food Allergy Advocacy – A Day on Capital Hill

The FASTER Act will also allocate funds so that the CDC can analyze data and encourage promising research for all food allergic patients. The most popular treatment for those with food allergies is “food avoidance” which is difficult, costly and filled with potentially costly mistakes. The only FDA- approved treatment to date is Palforzia, primarily aimed at children with peanut allergies. This bill could create opportunity for future treatments to emerge for other food allergies, increasing the number of people who can tolerate their allergen, reducing cost, worry and greatly improving quality of life.

What’s next?

This bill represents a compromise of H.R. 2117 and S.3451 – one that representatives from both the House and Senate have created together based on the original bills (House bill H.R. 2117 and Senate bill S.3451). Now that this new bill has passed the Senate, it will head back to the House for final approval. Following that, the FASTER Act will hopefully land on the President’s desk to be signed into law before this Congress comes to a close in January 2021.

Allergy Shmallergy/AllergyStrong will keep you posted on this exciting development!

Celebrities with Food Allergies (4th Edition) November 17, 2020

• 

• 

• 

• 

• 

• 

• 

  Actress Gina Rodriguez at the 2014 Alma Awards

• 

Just another reminder that you are not the only one with a food allergy! 1 in every 10 adults has a food allergy and 1 in every 13 children do as well.

Bethany Frankel (reality star, Skinny Girl founder): fish

Jason Mantzoukas (actor, comedian):  egg

Tia Mowry (actress):  parent to a child with peanut allergy

Zhaire Smith (NBA 76ers player): peanuts, sesame

Patrice Evra (Juventus Soccer player): eggs

Alex Kerfoot (NHL Avalanche player):  peanuts

Ben Lovett (Mumford & Sons):  tree nuts

Jon Stewart (comedian): parent to child of celiac disease.

Sean McDermott (head coach, Buffalo Bills): food allergy parent

Alan Branch (Football Player, Patriots): food allergy parent

Elliott Sadler (NASCAR driver): parent of child with peanut allergy

Courtney Hope (Bold & The Beautiful, Actress):  dairy, gluten, corn yeast

Gina Rodriguez (actress):  blueberries

Jessica Vosk (Broadway actress): peanuts, tree nuts, sesame seeds, shellfish

Henri Laaksonen (tennis player):  salmon and possibly other fin fish

Daniel Robertson (baseball player, Tampa Bay Rays): pecans

Jameela Jamil (actress): gluten (celiac disease)

Justin Bieber (singer):  celery, gluten

Nina Dobrev (actress):  undisclosed food allergy

Heidi Collins (journalist):  gluten (celiac disease)

Britney Spears (singer and food allergy parent): son allergic to an ingredient in fried chicken.

Kylie Jenner (beauty mogul and food allergy parent): daughter allergic to peanuts, tree nuts

Holly Robinson Peete (actress and food allergy parent): four children allergic to multiple allergens

Jenna Fischer (actress):  sweet potatoes/yams

Mark Cuban (Maverick’s owner and Shark Tank investor): parent to a child with food allergies (tree nuts)

Lauren Conrad (reality TV star and designer): parent to a child with food allergies (dairy)

Blake Martinez (NFL player: NY Giants, former Green Bay Packer): dairy and egg allergy.

(All photos files are licensed under the Creative Commons Attribution-Share Alike 4.0 International license.)

FDA Issues Guidance Regarding Sesame Labeling November 13, 2020

FDA APAC Mtg Re: AR101

On November 10, 2020, the US Food and Drug Administration issued draft guidance to manufacturers regarding the labeling of sesame seeds and in food products. Allergy Shmallergy and AllergyStrong have tirelessly advocated for better labeling for sesame seeds alongside the Allergy & Asthma Network and others for years. We see this is a positive first step in achieving our goal of mandatory labeling.

Currently, sesame is the 9th most common allergen in the US and is not required to be clearly labeled on food ingredient labels. Unlike the requirement to label allergens in the “Top 8” (the eight most common food allergens) by their common, most recognizable name, sesame can be hidden under alternate, foreign names (like “tahini” or “bene seed”) or general terms such as “spices” or “natural flavors.” This means that patients who have a sesame seed allergy never truly know whether a food is safe for them by reading an ingredient label.

In the draft guidance, the FDA encourages (but does not require) food manufacturers to label for sesame. Susan Mayne, Director of the FDA’s Center for Food Safety and Applied Nutrition states, “Many Americans are allergic or sensitive to sesame, and they need the ability to quickly identify products that might contain sesame.” She notes that while most products that contain sesame are labeled properly, some ingredients are made from sesame seeds but are labeled otherwise. Consumers may not be familiar with these alternative names on a product label’s ingredient list.

Sesame seed allergies are on the rise in the United States. A 2019 study conducted by Dr. Ruchi Gupta and her team at Northwestern University shows that sesame allergy affects 0.23% of the U.S. population amounting to over 1.5 million patients nationwide – making it almost as common as soy or pistachio allergies which are required to be labeled as part of Food Allergen Labeling and Consumer Protection Act (FALCPA). And 4 out 5 patients with sesame allergy report having at least one additional allergy to manage.

1 in 3 patients with a sesame allergy have reported serious reactions. Given its rising prevalence combined with potentially dangerous reactions, it is surprising that updated guidance hasn’t been issued sooner. This move by the FDA is a positive first step towards mandatory labeling. Continued education about sesame seed allergy is needed so that lawmakers and food manufacturers can better protect their allergic consumers and bring the US labeling laws into better alignment with the other major Westernized nations. Currently, Canada, the United Kingdom, the European Union, Australia and New Zealand require sesame to be labeled in ingredient lists on all food products.

In the meantime, the Food Allergy Safety, Treatment, Education & Research (FASTER) Act, H.R. 2117, S. 3451 has been introduced in both the House and Senate with the hope of getting it signed into law before the end of the year. Among the items included in the the FASTER Act is the proposal to update the current labeling laws (under FALCPA) to include sesame seeds.

Another Pitch for Food Allergy Education October 28, 2020

Following my fascinating time teaching a senior writing seminar at a local high school (see What Does Food Mean to You?), I was struck by two things:

1. These high school seniors were impressively thoughtful, creative and bravely willing to share their rich and rewarding stories (and souls) with their peers. And,
2. They wanted to talk about food allergies more than any of that.

It’s FUN to talk about food – who doesn’t love to tell stories about their food adventures, a favorite meal, a holiday celebration, their dream dessert…?! As robust as our conversation was about writing and food, the conversation that followed was absolutely enlightening.

When I mentioned to the class that, in addition to my other writing, I often write about food allergies, hands went up immediately.

“How is a food allergy different than a food intolerance?”
“Can you outgrow a food allergy?”
“Do adults acquire new food allergies?”
“Are there treatments available?”
“What that medication people carry? How does it work?”
“How can I support my friend who has a food allergy?”

We spent 45 minutes – half of their class time – talking about food allergies that day. Forty-five minutes before we needed to cut them off and return to writing.

I spend a lot of time talking to school administrators about the value of food allergy education – especially for young children through early adolescence. This experience not only underscores the importance of food allergy education, but it highlights the continuing need to discuss it.

Two kids in every classroom have at least one food allergy. But as teenagers grow into young adults, they’ll soon find that EVEN MORE adults have food allergies than children. According to a study by Dr. Ruchi Gupta and her colleagues at Northwestern, 1 in 10 adults live with food allergies – 25% of whom acquired a new allergy AS an adult.

Administrators often see the value of a short unit about food allergies to health education, but don’t often add it to their curriculum. Why? Because, they say, these days kids grow up around food allergies. They know all they need to know from being around their peers.

But, based on my time in the classroom, it is clear this theory that students are absorbing food allergy lessons by osmosis doesn’t cover it. Young children don’t understand what a food allergy is and why some people have them. Pre-teens may lack understanding of the frequent obstacles and dangers their peers with food allergies face day-to-day. Teenagers are expected to help keep their friends safe but don’t know what it’s really like to have food allergies and don’t know how to help. And young adults may need to know how to recognize symptoms of food allergies and use an epinephrine auto-injector to save someone’s life.

Students hear the words “food allergy” and only have a vague sense of what it means. Even by age 18, students hadn’t learned what they felt they needed to know about the food allergies that they encounter. They were left with so many questions, I could have filled several sessions answering their questions.

If we expect our children and young adults to be empathetic to their peers who are physically, socially and emotionally affected by food allergies (and other medical conditions), we need to give them a proper introduction and equip them with the age-appropriate skills to become supportive friends and classmates.

At this time, most schools STILL don’t formally teach their students about food allergies despite the fact that there are nut-free classroom, peanut-free tables, and gluten-free options in the cafeteria. A short lesson would go a long way in fostering community, building empathy, empowering helpers and protecting students.

What Does Food Mean to You? September 23, 2020

Although I’m not a teacher, I often find myself in the classroom with students. I’m called upon to teach a wide variety of subjects to students of all ages. Last year, I was a guest lecturer for a senior writing seminar class titled, “Food, Travel and Adventure.” As a current writer, food enthusiast and former diplomat, this class was right up my alley.

There are many different types of writing: narrative, journalistic, scientific… You could use any of these styles to write about food. However, sometimes when you’re writing about food, you’re not writing about food at all.

For example, in the book Julie & Julia, author Julie Powell dedicates page after page to descriptions of ingredients, recipes and preparations. But what she’s really writing about in this autobiography is self-discovery:

“Julia taught me what it takes to find your way in the world. It’s not what I thought it was. I thought it was all about-I don’t know, confidence or will or luck. Those are all some good things to have, no question. But there’s something else, somethng that these things grow out of. It’s joy.” 

In his book, Yes, Chef, Chef Marcus Samuelsson verbally fans the aroma of each ingredient from his kitchen through the pages to the reader to vividly envision and inhale. But Samuelsson isn’t writing about food either, he’s writing about culture and communication.

“Food and flavors have become my first language. Not English, not Swedish, not Amharic…”

Food critics, who write exhaustively about taste, texture and flavors are not ONLY writing about food. They are also writing about creativity, artistry and talent.

“Magical dishes, magical words: a great cook is, when all is said and done, a great poet. . . . For was it not a visit from the Muses that inspired the person who first had the idea of marrying rice and chicken… Parmesan and pasta, aubergine (eggplant) and tomato…?”
‘Cinquante Ans a Table’ (1953) 
Marcel Étiennegrancher (1897-1976)

When I write about food, it is born out of my own experience. When you have food allergies, food may mean something different to you. When food can both sustain you and do you harm, your relationship to food may be complicated – or not!

When I write about food and food allergies, I am writing about inclusion, respect, and trust. I am writing to express my appreciation, a pot boiling over with gratitude. I am illuminating my belief that access to safe and healthy food is a right and a necessity – one that creates opportunity for learning, growth and a better future. Finding safe food can be a creative challenge that offers hope, pleasure and a platform for fun times spent with friends and family.

Most of all, as a person who adores someone with food allergies: food – and its sometimes endless hours of preparation and worry – represent love. Pure (and hopefully delicious) love.

COVID Life: Food (Allergies) in the Classroom this Fall? July 2, 2020

 

U.S. Department of Agriculture – Fruit-bar-pic—Web, Public Domain, https://commons.wikimedia.org/w/index.php?curid=17799829

The American Academy of Pediatrics (AAP) came out with a statement in favor of in-person schooling for children wherever schools can do so safely.  In it, they cite the importance of school on child and adolescent mental health and academic engagement as well as the lower rate of transmission and contraction of the coronavirus. [Read the AAP’s full statement here.]. The AAP’s statement also offers guidance to schools about how they might resume in-person education while protecting students as much as possible.

 

In May 2020, the Center for Disease Control (CDC) also published guidance about schooling during the COVID-19 pandemic.  At that time, AllergyStrong co-signed a letter urging the CDC to balance their guidance with the concerns of life-threatening health conditions facing students including food allergies – which they did.  [Read the CDC’s updated guidance here.}

 

Both the AAP and CDC recommended that students eat meals in the classroom rather than the cafeteria in order to promote social distancing and limit contact between classes (cohorts) and grades.  And, both AAP and CDC mention the need to be cognizant of food allergies in that scenario.

 

 

How do you bring food into the classroom safely?

The AAP and CDC guidance leaves many parents wondering how can teachers, staff and administrators help protect their students from food allergic reactions while following this guidance?

1. Enforce a “No Sharing” food policy.  

This must be strict and plainly stated to protect classmates from food allergic reaction which can be serious.

2.  Wash hands.  

This is doubly important in the age of COVID.  But unlike a virus, food allergens are not eliminated by hand sanitizer.  Hand washing with good-old soap and water is what is recommended to prevent cross-contamination and cross-contact with food protein that can cause a severe reaction.

3.  Cleaning shared surfaces.

It is critical to clean common surfaces (again doubly so with the coronavirus at play) to prevent accidental cross-contact and protect students with food allergies.  Cleaning with soap and water is best.

4.  Review symptoms of an allergic reaction.

It is imperative for teachers and classroom staff to re-familiarize themselves with the signs and symptoms of an allergic reaction as well as how a child might describe those symptoms [Read, The Language of a Food Allergic Reaction for more information.].

5.  Know how to respond to an emergency.

Minutes matter during a food allergic reaction.  Severe reactions, called anaphylaxis send patients to the hospital and can be fatal.  Review a student’s 504 plan and any Emergency Action Plans available.  Know where epinephrine auto-injectors are stored, how to use them and WHEN to use them.

6.  Take advantage of the stock epinephrine program.

Under the School Access to Epinephrine Emergency Act, also referred to as the Stock or Unassigned Epinephrine Act, schools are allowed to keep on-hand epinephrine auto-injectors that are not prescribed to a particular patient for use in emergencies.  This program is available in 49 states and is used to save the life of any student, teacher or staff member having an allergic reaction regardless of whether they have epinephrine on file.  Up to 25% of stock epinephrine use in schools is with people who have no history of diagnosed food allergies.

 

 

What can parents do to protect their children?

1. Establish/Review the student’s 504 plan.

Section 504 of the Americans with Disabilities Act protects a student’s access to equal education and academic success while preserving safety.  Provisions in a 504 plan for a student with food allergies might include class-wide hand washing, a voluntary refrain from bringing allergens into the classroom, communication with parents about allergens, or approval for a student to carry his/her own epinephrine auto-injectors. Now is the perfect time to work with your school to establish a written 504 plan for your food allergic child should you feel they need it.  [Read Kids With Food Allergies Sample Section 504 Plans for Managing Food Allergies for more information.]

2. Practice how to respond to situations with food with your child.

Because eating may be done in the classroom, a child’s peers may have questions or comments about his/her food allergy.  Practice answering these questions with your child so they feel comfortable and confident to handle anything that comes their way. [Read Armed with Words:  Teens and Food Allergies to get your conversation started.]

3. Review symptoms of an allergic reactions with your child.

It is critical that everyone with food allergies know the signs and symptoms of an allergic reaction.  Teach these symptoms in an age-appropriate way so as not to scare younger children.  Let kids know that these symptoms typically appear soon after eating and tell them to speak up (even interrupting a teacher) if they are concerned they are having an allergic response.  [Read: React? Act! to help teach this important lesson.]

4. When age-appropriate, demonstrate how to carry/use epinephrine auto-injector.

Carrying an auto-injector is a big responsibility and a big relief to some children.  Teaching kids how to carry their epinephrine auto-injector (always have it with you, don’t let your friends play with it, etc) and how to use it is key.  In fact, invite one or two close friends over and demonstrate how to use the auto-injector with the trainer or firing off an old one on an orange or grapefruit will also help protect your child should an emergency arise.  We’ve adapted an old medical school mantra from my father-in-law for food allergies, “If you think you need to use the auto-injector, you DO need to use it!” Remember, administer epinephrine and go to the hospital immediately for further treatment and monitoring.

Important Update: FDA Temporary Labeling Policy June 22, 2020

 

AllergyStrong has participated in several discussions with the US Food & Drug Administration in partnership with several passionate food allergy advocacy organizations to ensure protections for food allergy consumers.

 

Our most recent meeting offered an opportunity for the food allergy community to voice its concerns based on our daily challenges with food purchasing.  Additionally, we were able to learn more about the policy itself as well as manufacturers initial reactions.

 

The food allergy community should feel reassured that the FDA understands our concerns and is working with advocates to keep patients safe.  They underscored their commitment to transparency in our meeting and demonstrated their willingness to respond to our concerns.

Background:  The FDA relaxed it requirements for food labeling on May 22, 2020 in order to preserve the food supply chain during the COVID-19 pandemic.  In short, this temporary policy allows manufacturers to substitute minor ingredients without issuing a label change. [Read FDA Issues Temporary Policy Allowing Some Substitutions in Food for details of this policy.]

 

The FDA is trying to balance food safety with food security during the COVID-19 pandemic.  They believe this guidance provides the flexibility needed by manufacturers with guardrails to ward against adverse health effects.

 

 

 

 

FDA’s Stance on Food Allergies in Relation to this Policy:

• Although the FDA gives limited flexibility to manufacturers to substitute minor ingredients, it does not compromise on food allergens because they represent a health and safety risk.
• The Top 8 allergens (peanut, tree nuts, milk, egg, soy, wheat, fish and shellfish) cannot be substituted in for another ingredient without an appropriate label change.
• Additionally, gluten, sulfites, glutamates and other ingredients known to cause sensitivity in people cannot be substituted in for another ingredient.
• Finally, manufacturers are warned against substituting in priority allergens (such as sesame, celery, lupin, buckwheat, molluscan shellfish, and mustard) that are common in other parts of the world without a label change.

 

 

Latest Information and Clarification:

• We urged the FDA to require more transparency from manufacturers when they need to substitute an ingredient.  Advocates and the FDA agreed that a sticker that sits on top of the ingredient label on packaging to indicate the most current ingredients would be best.
• The FDA is also recommending that substitution information to be listed on manufacturers websites and signage be placed at the point of sale.
• Following conversations with the food industry, the FDA stated that manufacturers do not want to make changes to their products unless forced to by circumstance.  They expect to see this policy employed rarely and to see omissions rather than substitutions.

 

In response to our conversation, the FDA issues an FAQ page on this policy with further clarifications.

 

AllergyStrong will continue to track this policy and keep you informed.  We will continue our conversations with the FDA to best support food allergic consumers and ensure food safety and transparency for all.

 

 

 

IMPORTANT: FDA Issues Temporary Policy Allowing Some Substitutions in Food May 26, 2020

 

The FDA just released a temporary relaxation of its food labeling policy.  This temporary change comes into effect to prevent shortages and manage delays in the food chain supply during the COVID-19 crisis.  This policy will remain in effect through the end of the public health crisis.  Although the policy takes food allergies into consideration, it may have an affect on the safety of food particularly for those who allergies fall outside of the Top 8 (peanut, tree nut, dairy, egg, wheat, soy, fin fish, and shellfish).

 

“The food industry has requested flexibility when manufacturers need to make such minor formulation changes… that may cause the finished food label to be incorrect, but that do not pose a health or safety issue and do not cause significant changes in the finished food due to the temporary formulation modifications.”

 

The policy allows manufacturers to:

• Make minor formula changes consistent with the product’s taste, texture and integrity; and
• Continue labeling their original ingredient list without noting changes made.

 

[Read FDA’s statement summary here.]

 

Image by Kevin Phillips from Pixabay

 

The specifics of the policy offer a few important details:

1. On page 6, FDA encourages manufacturers to make label changes whenever possible noting that consumers rely on those labels to make informed choices. They are not, however, required to alter their labels during this time.  If labeling cannot be changed on the package, the FDA recommends companies use alternative means of informing consumers for transparency, such as posting information on their website or applying stickers to packaging.
2. As always, flexibility remains in place for formulations of generically grouped ingredients, such as “spices”, “flavoring” or “color,” and can be changed without relabeling.
3. The FDA is authorizing this flexibility for minor ingredient changes.  When considering these “minor” ingredients, the FDA highlights:
   • Safety: does the ingredient substitution cause an adverse health effect (such as food allergens)?;
   • Quantity: the substitution must generally be for ingredients that comprise 2% or less of the finished food/final product;
   • Prominence: the substitution should not conflict with a major component of the product (for example, wheat in a muffin);
   • Characterizing Ingredient: the substitution/omission should not represent the ingredient that defines the product (such as raisins in a raisin bagel); and
   • Nutritional/Other Claims: the substitution should not misrepresent nutritional or other claims made about the product.

 

Faced with supply issues of their own, manufacturers can now reduce the amount of ingredient they use or choose to omit it altogether.  Additionally, they may temporarily substitute an ingredient that is less than 2% of its finished product.  The FDA encourages manufacturers to consider allergens (the Top 8 allergens as well as many common allergens beyond) before making a change and suggest labeling should such a change be necessary [page 8].  

The FDA policy outlines several areas where it will not object to substitutions [page 10].  One area of possible note for those with food allergies is Fats and Oils.  The FDA will not object to a swap of fats and oils as long as they do not pose an obvious allergenic risk (say using peanut oil instead of vegetable oil) and is derived from the same source (plant, animal, etc) and are highly refined.  They specifically mention a hypothetical scenario where a manufacturer might substitute canola oil for sunflower oil.  Speak to your allergist about your personal risk with refined oils and these possible substitutions.

 

As we strive to understand how this policy will impact our community, we recommend that those with food allergies:

• Read ingredient labels carefully, looking for stickers or other notifications of ingredient substitutions;
• Call manufacturers and/or check on their websites frequently to understand which products may be affected by substitutions; and
• Speak with your allergist about these changes and how they may affect your specific allergies.

 

 

[Read the FDA’s full policy here:  Temporary Policy Regarding Certain Food Labeling Requirements During the COVID-19 Public Health Emergency: Minor Formulation Changes and Vending Machines]

 

The FDA has issued this guidance without public comment due to the emergency circumstances.  However, their policy notes, “This guidance document is being implemented immediately, but it remains subject to comment in accordance with FDA’s good guidance practices.

Comments may be submitted at any time for FDA consideration. Submit written comments to the Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Submit electronic comments to https://www.regulations.gov. All comments should be identified with the docket number FDA-2020-D-1139 and complete title of the guidance in the request.”

Food Allergies at the Food Pantry – Information and Resources for Food Pantries May 18, 2020

 

According to a study conducted by Dr. Ruchi Gupta and her colleagues in 2013, having a food allergy in the house costs an additional $4,000 per year.  Among the many factors that go into that figure is the cost of food allergy-friendly food.  Safe food can cost two to five times as much as their regular counterparts.  For example, a jar of peanut butter currently costs $1.19 and a jar of peanut-free sunbutter costs $6.29. It’s the same story with dairy-free milk and gluten-free pasta. These differences are enough to blow almost any budget.

 

 

Food banks and food pantries should be aware that about 10% of all of their clients and client families have a food allergy.  This doesn’t even include those with celiac disease which also requires a restrictive diet. When one family member has a food allergy, the food is often excluded from the home out of an abundance of caution. While food allergies directly affect 10% of the population, they indirectly affect the entire family by impacting their food selection.  This leaves food allergy families with few viable options when seeking out assistance.

 

As you can imagine, the inability to afford safe food disintegrates an already delicate situation quickly making mealtimes even more dangerous or sparse.

 

Resources for Food Pantries

 

• Ask clients directly if they or a member of their household has a food allergy.  Some patients volunteer their food allergy diagnosis, but many do not.

 

• If you hear a client describing their experience with food with any of the following symptoms, they will likely need to avoid that food and should seek advice from a doctor.

 

• Symptoms of food allergy vary from reaction to reaction.  They include: hives, swelling, wheezing/trouble breathing, nausea/vomiting, fainting/dizziness, and tightness in the throat among others.  [Please see Anaphylaxis 101: Familiarize Yourself With the Symptoms for a full list of symptoms and what to do if they occur.]. These symptoms usually occur soon after eating.

 

• A food allergy is different than a food intolerance in several ways – the most important distinction of which is that food allergies are life-threatening whereas food intolerances are not. But, they BOTH require a patient to avoid certain foods. Strict avoidance is necessary for food allergies.

 

• U.S. food manufacturers are required to label for certain allergens by their common name. And “Made in a facility with…” or “May contain…” statements are completely voluntary.  Read about food labeling laws here [The Ins and Outs of Reading Food Labels] and offer this information to your clients who may have a food allergy.

 

• If food is being prepared on site, please familiarize yourself with “cross contact” also referred to as “cross contamination.”  This occurs when an allergen touches another food directly or indirectly by touching a shared surface.  For example, this can happen on counters, cutting boards, in pots, on pans, cooking and serving utensils, plates, etc.  And although you may not be able to see the allergen with the naked eye, there may be enough protein present to trigger a life-threatening reaction.  It’s important to clean work surfaces, pots/pans, and cooking/serving utensils when preparing safe food for clients with food allergies.

 

• When trying to remove an allergen, always use soap and water.  Hand sanitizer (which is effective in killing bacteria, viruses and germs) does not remove allergens  (which are made up of proteins) from hands or surfaces.  Always wash your hands before preparing a safe meal for clients with food allergies.

 

Food Allergies at the Food Pantry – Need Assistance? May 12, 2020

 

Photo by Monirb CC BY-SA 4.0

Affording safe food is on the minds of many right now.  With layoffs, furloughs and unemployment, more people are turning to food pantries than ever.  But if you have a food allergy, you may be concerned about facing challenges to obtaining safe food.

 

If you have food allergies and need food assistance, here are some things to keep in mind.

 

Tips for Those Who Need Assistance

 

• If you’re lucky to live near one, there are a few food allergy-specific food pantries operating in the United States.  Note: some have suspended operations due to COVID-19. They may, however, still be a resource for information during the lockdown.  Check out each organization’s page for eligibility requirements.
  • Food Equality Initiative – operating in and around Kansas City, MO
  • Mend Hunger – operating in and around Chicago, IL
  • S.A.F.E. – serving people in and around Howard County, MD
  • Garden of Health – serving people in and around Montgomery County, PA
  • The Rachel Way – operating in and around Plymouth, PA
  • The Gluten-Free Food Bank – operating in Massachusetts

 

• There are many local food pantries kindly serving the public right now and some are willing or already stocking safe supplies.

 

• If you’re looking for specific allergy-friendly (or “free-from”) staples, those goods may be harder to find.  Sometimes, food pantries will shop for/hold items for those with medically necessary diets.  Call your local food pantry and explain your family’s needs.

 

• Rather than relying on staff, check the food choices for you/your family personally, taking time to read labels.

 

• Many of us are relying on brands we haven’t used before.  Read the ingredient labels of all food carefully.  Remember that allergens outside of the top 8 (dairy, eggs, wheat, soy, peanuts, tree nuts, fish, and shellfish) are not required to be labeled by their common name.  And manufacturers are not required to label for possible cross-contamination.  Call the manufacturer directly for more information.

• If there are prepared meals on site, ask a supervisor about whether the staff receives food allergy training and/or take measures to prevent cross-contact and always have your epinephrine auto-injector with you as usual.

 

• Many schools are offering free lunches to their students.  Some are naturally free of certain allergens (often peanuts and tree nuts).  Call your local school district and speak with the food services manager to get details on how your district handles food allergies in these packaged meals.

 

• The Supplemental Nutrition Assistance Program (SNAP) and Women Infant Children (WIC) supplemental program are governed by each state.  Each have their limitations when it comes to food allergy-friendly food, but both SNAP and WIC may help in getting you staples as well as fresh produce and meat for your pantry.

 

• It was just announced that SNAP recipients can buy groceries through Amazon. Shoppers get free delivery when they spend over $25.  Visit amazon.com/snap-ebt for more information.

 

• The SNAP program goes a long way at farmers markets.  If there is one open near you, find out how you can take advantage of this promotion safely.

 

• Make your resources go further!  Use fresh food first, followed by frozen foods and pantry items.  Planning meal ahead of time with a thought towards how to incorporate leftovers into future meals helps eliminate waste and makes the best use of your food.

 

• Food substitutions may be more practical than expensive free-from products.  For example, using applesauce ($2.75/jar) when baking may cheaper than buying specialty egg-replacer ($6.99/box). There are many great places to find these substitutions, like this one from Kids with Food Allergies.

 

 

Free-From Manufacturers Who SHIP TO YOU! April 18, 2020

Photo by Wonderland via Flickr, Attribution 2.0 Generic (CC BY 2.0)

 

It’s rough getting groceries these days!  You never know what you’ll see or miss at the supermarket.  One day it’s bread, the next it’s chicken!  And, those empty shelves can be a little disheartening.  It is even worse when you rely on a specific product to keep you safe and out of the hospital.

 

While most consumers can get by with a different brand here and there, families with food allergies can’t.  They depend heavily on specific brands and products to keep them fed and safe from experiencing a severe allergic reaction called, anaphylaxis.  “Free-from foods” are often in smaller supply than their  regular counterparts without a global pandemic. Because many consumers are buying in bulk (or sometimes panic buying) as they shelter-in-place, it often means food allergy-friendly essentials are unavailable to those whose health depends on them.

 

Let’s take a look at how to get the food you or your family needs as they STAY HOME and shelter-in-place:

Good tip:  Some companies are running a little behind on shipment (only a week) so order BEFORE you need something urgently.

 

We’ve noticed that some big box stores are selling certain free-from items online and are willing to ship things like gluten-free pastas (whereas boxes of regular pasta are often “in-store only” products). It’s worth taking a quick peek at these sites if you need a product more urgently since they tend to ship food fairly quickly.

 

Cold products (those that need to be refrigerated or frozen) are best purchased directly at the store or through a local delivery service (such as Instacart, PeaPod, etc).

 

Some items that are hard to find in person, are easy to find online.  Some free-from/allergy-friendly brands are shipping directly to their customers.  Look at all the manufacturers who are working overtime to ensure you get the products you need!

 

If you’re looking for a big or little treat, why not try a food allergy-friendly bakery?  Some are local (for pick up) and others you can order online.  Here’s Allergy Shmallergy’s list of Allergy Friendly Bakeries.

 

Allergic Living also compiled an excellent list of how manufacturers are handling the increased need for their products during the coronavirus – read here.

 

(Do you have a free-from product you’ve been purchasing directly?  Leave us a comment and we’ll add it to the list for other families!)

 

Schar  – offers gluten-free products including breads, snacks and pasta

Enjoy Life – offers products free from the Top 14 allergens!  Enjoy Life makes snack foods as well as baking supplies (chocolate chips, flour, pizza flour, etc).

Vermont Nut Free Chocolate – this feels critical to me!  I’ve already had enough chocolate to become a living, breathing chocolate Easter bunny.

Namaste – recommended by a baker, this is a great resource for gluten-free and allergy-friendly baking and waffle mixes, soups and pasta mixes.

Made Good – known for their granola bars and cookies, Made Good is currently offering 35% off plus free shipping!

Ener-G – Known widely for its egg-free egg replacer and gluten-free products.

WowButter – a tree nut and peanut-free sunflower butter now ships directly!

The Gluten and Grain-Free Gourmet – offers gluten, dairy and soy-free products.  Paleo friendly.

Safely Delicious – snacks that are free from gluten, peanuts, tree nuts, dairy, soy, and egg PLUS they are donating a portion of their proceeds to SpokinCares and Food Equality Initiative.

Eleni’s New York – the delicious, safe nut-free cookies can be delivered right to your door!!

The Gluten-Free Bar – selling gluten-free granola bars and bites!  On sale now…. stock up!

Cherrybrook Kitchen – their gluten, dairy, peanut, nut-free baking and breakfast mixes have been a staple of many pantries.

No Whey Chocolates – Chocaholics rejoice.  These are dairy, peanut, tree nut and soy-free.

ZEGO Foods – These healthy bars and mix-ins are full of the good stuff with none of the allergens.  For real – they are free of the Top 14 (check out their allergen statement!)

OWYN – selling plant-based protein drinks as well as dairy-free milk!

Kate’s Safe and Sweet – free from peanuts, tree nuts, soy, wheat, fish, shellfish, dairy and eggs (as well as pea, legume, sesame, chickpea and coconut-free!), Kate’s cake mixes, frosting, food coloring and accessories ship quickly straight to you!

Senza Gluten – This 100% gluten-free restaurant and bakery in NYC is closed through May 1st, but lucky for us they ship!

Kips – Who doesn’t love Top 8 free granola bark?!  Free from peanuts, tree nuts, dairy, eggs, wheat, soy, fish and shellfish.

Baked Cravings – Too many amazing tree nut and peanut free treats to name!  Ships nationally!

Simple Kneads – Small batch baked goods in a dedicated gluten-free facility.  I can smell the bread from here!

Partake Foods – Makers of delicious gluten-free, vegan (dairy and egg-free) cookies.

 

But wait, there’s more!

Should you need an epinephrine auto-injector refill and wish to avoid the pharmacy, remember that many pharmacies are delivering prescriptions free of charge.  And, Auvi-Q continues to serve patients through its excellent home delivery program that ships straight to your door!

Food Allergies, Eczema, Asthma and the Coronavirus (COVID-19) March 26, 2020

 

What strange times we’re living through!

 

Because we’re dealing with a novel virus (that means “brand new!” – lucky us…), everyone has LOTS of questions.  Many food allergy, asthma and eczema patients are concerned how COVID-19 interacts with their condition(s).  This information is best guidance from experts given what we currently know about the coronavirus, COVID-19. As always, speak to your own doctor about your personal health and follow best guidance issued by the Center for Disease Control (CDC).

 

We will keep updating this page as questions and answers arise.

 

Are patients with food allergies more susceptible to the coronavirus?  

No, having a food allergy does not put you at increased risk for COVID-19.  Even if a patient has experienced anaphylaxis, they are not considered immunocompromised or at a higher risk of catching the coronavirus.

Sources: Allergic Living

 

What about patients with asthma?

Patients with asthma are at the same risk of acquiring the coronavirus as the general public.  However,  because COVID-19 is a respiratory virus, outcomes for patients with asthma are unknown.  In addition to best prevention practices (social distancing, washing hands, not touching your face, etc), asthma patients are urged to continue maintaining their asthma – keeping it well-controlled is key.

 

For more clarification and more detailed information, please see AAFA’s coronavirus guidance here and speak to your personal doctor.

 

If I’m experiencing a severe allergic reaction, should I avoid the emergency room?

No.  We urge patients to continue being cautious (read labels, stick with brands you trust and ALWAYS carry epinephrine).  However, if you are experiencing severe symptoms of an allergic reaction (called anaphylaxis, learn to recognize the symptoms here), use your epinephrine auto-injector immediately, call 911 and get to the emergency room for additional care and monitoring.

 

Should I be aware of any food allergens in COVID-19 treatments?

It appears that there isn’t a universal medicine that doctors can prescribe to combat the coronavirus at this time.  The current treatments are all experimental and vary from hospital to hospital and patient to patient.  Wear a medical bracelet if you have one detailing your food allergies and mention your allergies should you need to see a doctor or be prescribed medication.

 

For more on this topic, please read the detailed answers from FARE’s Chief Medical Advisor, Dr. Tom Casale.

 

I hear there are spot shortages of inhaled albuterol.  Is it still safe to use a nebulizer for my asthma?

Nebulizers are believed to spread coronavirus by aerosolizing contagious virus particles, so hospitals are turning to inhaled albuterol to help COVID-19 patients (thus the shortage). However, using your nebulizer at home as prescribed is still safe. (Albuterol itself is still being produced at a normal pace.)

 

IF YOU SUSPECT YOU HAVE COVID-19, know that virus particles can remain in the air for several hours.  Be sure to use your nebulizer in an area away from other household members so as to minimize their risk of infection.

 

For more information, please see the American College of Asthma, Allergy and Immunology (ACAAI) site.

 

Is there an epinephrine shortage?

No, epinephrine auto-injectors are not experiencing a shortage.  Check the expiration date on your auto-injectors.  Should you need a new one, contact your doctor or local pharmacy.  Many pharmacies are delivering prescriptions as well as other supplies with no minimum and Auvi-Q operates on a direct delivery system.

 

I have eczema, is there anything I should do to prevent infection?

Eczema is a break in the skin’s natural barrier, so it’s critical to take extra care of your hands and face during the coronavirus outbreak to prevent discomfort and unnecessary touching of the face.  Currently experts do not believe having eczema poses an increased risk of contracting the coronavirus which is typically transmitted through the mouth, nose, and eyes to the respiratory system.

According to the National Eczema Association, there is no need to wash with harsh antibacterial soap.  If the skin on your hands are already cracked or prone to stinging, try soap formulated for sensitive skin, making sure to wash for 20 seconds as recommended.  Additionally, use lotions as usual to continue to heal the affected areas and use anti-inflammatory creams as needed.

 

I’m in the middle of oral immunotherapy (OIT).  How do I proceed?  Do I go to my regular visit?

This is a discussion best had with your doctor.  Many practices are delaying updosing during this time.  But food allergies vary from patient to patient as does oral immunotherapy treatment protocols.  Contact your doctor for detailed guidance.

 

Here are some additional places to reference with expert medical guidance and vetted facts:

Allergy and Asthma Network (AAN, The Network)

Asthma and Allergy Foundation of America(AAFA)

Food Allergy Research Education (FARE)

American Academy of Allergy, Asthma and Immunology (AAAAI)

American College of Allergy, Asthma and Immunology (ACAAI)

Center for Disease Control (CDC)