On the Radio – Food Allergies: The Deadly Dish September 27, 2016

 

This summer, I visited our local fire department to learn more about how epinephrine is carried on ambulances [see Does Your Ambulance Carry Epinephrine?].

 

I discussed my findings – and surprise – with Megan Lynch, fellow food allergy parent and reporter for CBS Radio.  Megan created a series about food allergies with topics ranging from an introduction to and insights into the realities of living with food allergies to issues of concern to the food allergy community such as bullying and emergency care.

 

 

Megan and I discussed many things related to food allergies, but one subject that we circled back to was emergency response.  I shared with her what I had learned in my research and at the fire department.  In short: not every ambulance carries epinephrine and not all emergency medical personnel are authorized to use it even when it is present.  More than one medical professional I spoke with mentioned an unfortunate irony.  Narcan, a drug used to reverse the effects of heroin (and other opioid) overdose, is widely available (without a prescription in several states) and yet epinephrine is not universally available even to ambulances and EMTs to save the life of someone suffering anaphylaxis who may have accidentally eaten a trace amount of peanuts or milk, taken the wrong medication or been stung by a bee.

Narcan (by PunchingJudy via Flickr)

 

We spoke at length about the rising cost of EpiPens and the effect that has had on low-income families  [Read: The High Costs of High Prices: EpiPen’s Real Cost to Families].  Megan asked me what advise I had for lawmakers and for parents.

1.  More transparency is needed so the public can understand why epinephrine isn’t available on all ambulances and to discuss how it could be; and more communication is needed to inform us where it is and isn’t so people can have appropriate expectations.
2. Consider making epinephrine available to all emergency personnel and training them on its use.  (*Kudos to Illinois who joined several other states in allowing public venues to keep stock epinephrine (just as they do defibrillators) and for allowing the police to carry epinephrine.)
3. I reminded parents to familiarize or RE-familiarize themselves with how to use their epinephrine auto-injectors and when to use them.  Train everyone who cares for your children as well: babysitters, family members, after school program managers… If you have a pre-teen or teenager, now is a great time to train their close friends on the signs of a severe allergic reaction and prep them on how to respond.
4. Finally, carry your epinephrine auto-injectors with you at all times.  Even when it’s inconvenient.  This is especially important to underscore to teenagers and college age students.  In a life-threatening situation, every minute counts.  Having epinephrine on hand is critical during anaphylaxis.

 

Check out Megan’s five part series about food allergies – it’s sure to be both interesting and informative.  Be sure to listen all five episodes, airing this week both on the radio and on the internet.

 

Listen on the radio (locally in the St. Louis area): KMOX NewsRadio 1120

or

Online at CBS Radio St. Louis

Food Allergies: The Deadly Dish – Part 1

Food Allergies: The Deadly Dish – Part 2

Food Allergies: The Deadly Dish – Part 3

Food Allergies: The Deadly Dish – Part 4

 

I’ll keep updating the list as they air segments.  Check in everyday this week to catch more of Megan’s excellent and thorough coverage.

 

No Bake, Almost Everything-free Granola Bars September 20, 2016

It’s only the third week of school and I’m not going to lie: packing school lunches are weighing me down.  Each day I struggle with not just what to pack each day but how to streamline the process so I can get the kids out the door on time.  After I make five meals inside 40 minutes (not to mention rounding up shoes and homework and instruments and sports equipment…), there isn’t time to think about baking safe snacks.  I’m exhausted just writing about it…

 

Food allergic families cannot often rely on convenient, pre-packaged foods like breakfast bars and snack bags due to unsafe ingredients or cross-contamination.  Here’s an easy no bake recipe for peanut-free, tree nut-free, egg-free, dairy-free and optionally gluten-free granola bars that you can make ahead of time and freeze for your child’s lunch box or a quick after school snack.  These granola bars are the perfect combination of salty and sweet; I dare you not to eat one once the kids jump on the bus!

 

No-Bake, Almost Everything-Free Chocolate Chunk Pretzel Granola Bars (Dairy-Free, Egg-Free, Nut-Free, Vegan and optionally Gluten-Free)

 

 

Granola bars are traditionally hard to find without dairy or cross-contamination with nuts. And, gluten-free varieties are costly. These no-bake granola bars are as easy to make as they are to consume! Once made, you can wrap and freeze the bars so that they’re ready to pop into a lunchbox in the morning or into a hungry mouth in the afternoon.

 

Ingredients:

¼ cup honey

¼ cup dairy-free butter

¼ cup brown sugar

1 Tbsp Sunbutter or other safe peanut butter substitute

½ tsp vanilla extract

2 cups regular or gluten free quick oats

1 cup Rice Krispie cereal or Erewhon Crispy Brown Rice cereal (a gluten-free alternative)

1 cup pretzel or gluten free pretzel pieces

1 cup dairy free chocolate chips (I used Enjoy Life Chocolate Chunks)

 

 

Place parchment paper in 9×13” baking pan.

 

In large bowl, combine oats, cereal, pretzel pieces and chocolate chips. Set aside.

 

Over low heat, melt honey and butter together. Remove from heat and whisk in brown sugar, Sunbutter and vanilla extract. Pour over dry mixture. Fold repeatedly to thoroughly coat dry mixture.

 

Pour contents of bowl into baking pan. Press down firmly and evenly to distribute the mixture. Place in refrigerator for 1 hour before cutting into squares or rectangles (like supermarket bought granola bars).

 

Wrap unused bars in plastic wrap and place in the freezer for best quality.

 

Enjoy!
  

Always Allergy-Friendly Philly Swirl September 1, 2016

This is a sponsored post.

 

Summer’s not over yet!  I, for one, am riding out my free-wheeling, fun-loving summer mentality well into September.

Which is why we said “yes” to trying new PhillySwirl products that are always allergy-friendly and easy to share.

 

First, we shared PhillySwirl’s Lemonade Swirls with my kids and their playdates.  I’m a sucker for lemonade flavors.  My particular favorite was the Pomegranate pop, which offset the tartness of the lemonade with the gentle sweetness of pomegranate.  There are a few clever pairings, like Blueberry and Watermelon Lemonade pops.  But if you’re a classic combo person, you’ll be happy to know these come in Classic Lemonade, Strawberry and Lime.

Next, we handed out PhillySwirl’s Icee Mix It Up pops at our barbeque.  My daughter loved the Green Apple & Watermelon both for the flavor combination and the colors (she’s going through a pink thing!).  The Strawberry & Kiwi got rave reviews.  And the Red & White Cherry and Blue Raspberry & White Cherry flavors would have been perfect for our 4th of July party!

Finally, we sampled the Organic Jungle Swirls.  The interesting flavor combinations got my children’s attention.  But the organic and always allergy-free ingredients got mine!  These would be great for a post-game or a back-to-school classroom snack.  My son even wants me to bring these into school for his birthday treat – what a great, easy idea!

Gluten-free, peanut-free, dairy-free, and containing no high fructose corn syrup, it’s easy to say yes to PhillySwirl.

 

 

 

BEST Gluten-Free (and Optionally Egg-Free) Chocolate Chip Cookies from Cole’s Moveable Feast August 31, 2016

Lucky us, Nicole Seevers of Cole’s Moveable Feast didn’t just answer my questions… she also shared her BEST Gluten-Free Chocolate Chip Cookies recipe (which contains instructions for an egg substitute)!  Now’s a great time to make a batch to pop into lunch boxes… or mouths.

Nicole, taste buds everywhere are thanking you!

BEST Gluten-Free Chocolate Chip Cookies

1 cup (2 sticks) unsalted butter or dairy-free margarine, room temperature (my favorites are Earth Balance Soy Free Buttery Sticks or Fleischmann’s Margarine)

1 cup packed light brown sugar

1/2 cup granulated sugar

2 eggs or equivalent egg substitute for cookies (below)

1 teaspoon vanilla extract

2 1/2 cups gluten free flour blend (King Arthur Gluten Free Multipurpose Flour is my favorite off-the-shelf blend)

1 teaspoon baking soda

1/2 teaspoon salt

1 1/2 cups semisweet chocolate chips (Enjoy Life Mega Chunks are my favorite)

 

Directions:

1. In a stand mixer, cream together butter/margarine and sugars until light and fluffy. Add eggs (or substitute) and vanilla and beat until just combined.
2. In a separate bowl, combine gluten free flour, baking soda and salt. Add flour mixture to butter mixture; beat on low until just combined. Stir in chocolate chips.
3. Refrigerate dough for at least one hour.
4. When ready to bake, heat oven to 400°F. Line baking sheet with parchment paper.
5. Scoop dough out in tight rounded mounds (I like to use an ice cream scoop) and place about 3 inches apart on baking sheets. (You will need to do multiple batches ~ refrigerate dough between batches). Do not flatten the dough.  Bake cookies 10 to 12 minutes until golden brown at the edges. Let cookies cool 5 minutes on baking sheets, then transfer with a spatula to cooling racks to cool completely.
6. COOKIE EGG SUBSTITUTE:
7. For EACH egg, combine 2T unsweetened applesauce, 1t ground flaxseed meal and 1/2t baking soda. Allow to stand a few minutes before using in cookie recipe.

Motivations: Food Allergy Baker, Nicole Seevers and Cole’s Moveable Feast August 29, 2016

 

My hats are off to all the parents out there who are taking time out of their lives to make life better for all of us with food allergies.

 

I’d like to introduce you to one such parent, fellow food allergy mom, Nicole Seevers of Cole’s Moveable Feast.  On a quest to ensure her son always feels included, she began experimenting in the kitchen.  The results aren’t just safe and delicious for her son, Cole; they are scrumptious for everyone!

 

We were the lucky recipients of the above OUTSTANDING allergy-friendly dessert: iced tea cupcakes with lemonade frosting – possibly my favorite flavor combination of all time. I opened the box and thought they might be almost too beautiful to eat.  Almost.  Their mouth-watering aroma sucked me in immediately.  I’m usually more of a frosting girl (and, oh my gosh, was this frosting good), but it was the moist and tasty cake that balanced the tart and sweet original frosting so well that just made the treat.  My kids loved them and my extended family had no idea they were made without wheat, dairy, peanuts or tree nuts.  I’m planning on ordering these again for my next brunch.  And my food allergic son has requested I call Nicole for his next birthday.  That’s ONE thing off my party planning list!

 

Nicole can cater to almost any allergy and any occasion.  Check out her gallery of goodies at Cole’s Moveable Feast.  And, for those outside her delivery area, please check out our ever-growing list of allergy-friendly bakeries on Allergy Shmallergy’s Allergy Friendly Bakeries page.

 

Inspired by her story and motivation, I took a moment to ask Nicole a few questions…

 

1.  Tell us about how you got into the baking business?  Were you always a baker?
Not long ago, a lot of my friends and family would have been surprised to see the word ‘baker’ connected to my name.  I grew up here in Virginia, and like most people, food was a big part of my family life.  My mom and my grandmother were wonderful cooks, and the desserts were especially good. I learned a lot from them, but it wasn’t a passion for me. I headed to New York after college and stayed there for 12 years, practicing law and eating a majority of my meals in restaurants. My husband is a great cook, but it was never really my thing.  When we did eat at home, I was usually in charge of dessert (I have a big sweet tooth). But things got more complicated when our second child was born.

 

2.  What inspired you to bake allergy-friendly goods?
My son Cole. As soon as we introduced solid food, we knew. His first taste of yogurt made him sick. He vomited and started wheezing. Eggs did the same thing. Over the course of the next few months, we learned he was allergic to dairy, eggs, tree nuts, buckwheat, sesame and shellfish. He also has asthma and spent nearly a year avoiding gluten to try to reduce inflammation. I think under normal circumstances, it could have been overwhelming, especially for someone who didn’t spend a lot of time in the kitchen. But I had watched my own mom handle it. My younger brother struggled with the same allergies and more … including wheat, soy and corn. Those are tough allergies anyway, and in the ’70s, there was no popping into Whole Foods for an allergy-free snack. But my mom rolled up her sleeves and dealt with it.

So for me, it meant figuring out how to make sure Cole didn’t feel deprived or left out. Celebrations are big in our family. I wanted to learn how to make treats we could all enjoy. And it turns out, I LOVED baking. But what about when Cole was invited to a birthday party? Or when he started school, and had to say ‘no thanks’ every time a parent brought in cupcakes for a celebration. I was spending so much money on expensive, processed snack foods that were allergy-friendly but kind of bland. I thought, I can’t be the only one who wants better options. So this spring, I launched Cole’s Moveable Feast.

 

3.  Do you cater only to the food allergic community?
At first I did, but then people started asking me to do “regular” cakes for their events also.  But I’d say 90% of what I do is customized around specific allergies. Frankly, I like some of my allergy-free goodies more than the regular kind! I probably shouldn’t admit that, huh?

 

4.  What are some of your biggest challenges in the kitchen?
Time and space! It’s me, one oven, one dishwasher and two mixers.  I have a separate pantry and fridge for bakery ingredients and dedicated cabinets for equipment. But allergy-free recipes, especially those without gluten or eggs, require additional steps and ingredients, so it takes longer and makes a bigger mess.  And I’m fastidious about sanitizing surfaces and equipment, especially between orders. That takes more time than you’d think. So I’m starting to think about next steps … my dream is a bakery where anyone can walk in and find something on the menu board. Cole has never experienced that.

 

5.  Is there any allergen/other obstacle you’ve had a hard time accommodating?  How do/did you overcome obstacles?
Oh yeah. It’s hard enough to bake without egg, dairy and gluten. In fact, I had to come up with my own gluten-free flour blends and egg substitutes, because I just couldn’t get my baked goods where I wanted them with commercially-available substitutes. But when you take soy and corn out of the equation, it gets even harder. Those ingredients are everywhere because they’re cheap (and genetically-modified and federally-subsidized, but that’s a rant for a different day). But I’ve gotten there, after lots of research and working closely with my customers … and throwing out a TON of failed experiments. I am so thankful for the Internet, for all those people that forged ahead of me and blogged about it. And for companies like Earth Balance, Authentic Foods and Enjoy Life, among others, that are dedicated to producing high-quality allergy-free ingredients.

 

6.  Has taking customized orders forged a connection to your clients?
YES! That was the biggest surprise in all of this. I figured, if I got lucky, word would get out and I’d get a nice flow of orders listing the ingredients that needed to be excluded. I didn’t realize that nearly every single order would come with a unique story. The mother that was told a party venue could handle her child’s food allergies … until they heard it was soy. The child with a severely restricted diet that hasn’t had cake in years. The adult struggling with health issues. Everyone has something they’re dealing with, but we’re wired to connect and comfort, love and celebrate, through FOOD. When I can be part of that connection, it’s  awesome. Baking for someone can be a very intimate act.

 

7.  What has been the most rewarding aspect of starting your company?
Well first and foremost, it’s that connection I was talking about. I really can’t believe I get to do this. Meet interesting people, help them out, bake and get paid for it?! It’s pushing me out of my comfort zone, forcing me to connect, solve puzzles, make mistakes, rethink. But also, my three kids are SO excited about it.  I love letting them be a part of this, letting them witness the fact that you can find what brings you joy and go after it.  My dad has always pushed me to do that: to have a vision and do the hard work to make it happen. I want my kids to learn that lesson too.

 

The High Cost of High Prices: EpiPens’ Real Cost to Families August 25, 2016

With all the talk about rising cost of EpiPens, it’s important to remember who this situation impacts the most.  At-risk and food insecure families.  There has been a lot of media attention recently focused on the price of EpiPens, but these families, who are already living paycheck to paycheck, have been bearing the burden of added anxiety over whether they can afford the only life-saving medication available for their children for years.  Add in what I most recently learned about the limitations of some ambulances to carry and use epinephrine and there may be a healthcare superstorm brewing on the horizon.

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By way of background…

 

It’s all over the news:  EpiPen prices have climbed over 400% in the last 10 years, making this one and only lifesaving drug nearly – if not completely – unaffordable for many families.  Ten years ago, a pair of EpiPens cost between $75 and $100.  Today, they are sold for $600-700.  Understanding that families need multiple sets (for school, aftercare programs, home and on-the-go), the financial burden becomes even greater.

 

While there may be programs that do benefit families with certain kinds of healthcare plans and help mitigate the cost of EpiPens, there are a significant number of families who are struggling to justify the cost of this medication.  These aren’t always low income families, some are typical middle class families who earn just enough to take care of their current needs.  The rising cost of EpiPens is tipping that delicate balance unfavorably.

 

As EpiPen prices soar, so does the cost of NOT carrying them.

 

Given the high cost of EpiPens coupled with their relatively short shelf life, families are being forced to make a difficult choice.  And some are choosing to forego filling their prescriptions. More and more, families whose finances are stretched thin are relying on emergency responders as their first line of defense should a severe allergic reaction occur.  They are operating without a safety net and hoping that emergency medical care will catch them.

 

But what do you do if the ambulance you’re waiting for isn’t carrying epinephrine?  What if the EMT that arrives isn’t authorized to administer it?

 

This is the case in many cities and counties across the United States.  The ability to carry epinephrine as well as the local protocols authorizing EMTs to administer it vary from place to place. [Please read: Does Your Ambulance Carry Epinephrine?]

 

This collision of high EpiPen costs and the inconsistent ability of emergency responders to help may cause a far larger problem.  Already low income families* pay 2.5 times more per year on emergency room visits and hospital care than higher earning families.  And, in a 2013 study conducted by FARE, results showed that when people suffering from anaphylaxis used emergency care, epinephrine was not usually used to treat their condition.  It appeared to the researchers that even seasoned emergency medical professionals were reluctant to use epinephrine – despite the fact that it is known to be a safe drug with few short-term side effects.

 

In FARE’s study, 58% of those who called 911 administered epinephrine before an ambulance arrived.  In a life-threatening situation when every second counts, what will happen if more cases of anaphylaxis arrive at the emergency room without having received epinephrine on scene OR en route?  It appears many will also not receive it in the emergency room either.

 

How will lower-paying municipalities compete with higher paying counties and cities to retain competent, capable paramedics and advanced EMTs (those most often allowed to administer epinephrine)?

 

What role does cost play in local government decision-making regarding whether or not to stock ambulances with EpiPens and who has the authority to administer them?

 

These are only some of the unanswered questions that are starting to boil to the surface.   I hope Mylan’s expanded efforts to get EpiPens in more hands helps some of these at risk families.   But I remain concerned that the confluence of high prices and inconsistent policies governing emergency medical use of epinephrine will continue to cause a ripple effect across the healthcare spectrum.  I just hope it remains a ripple and not a tidal wave.

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* A study, co-authored by Dr. Richi Gupta, published in Pediatrics defined low income families as those earning less than $50,000 per year.

The Ins and Outs of Reading Food Labels August 23, 2016

 

Here’s the latest article I wrote for Allergy & Asthma Today (Fall 2016), a publication from Allergy and Asthma Network.

 

Look at the beautiful layout and graphics here:  The Ins and Outs of Reading Food Labels.  And, check out the full issue, featuring Sarah Jessica Parker here:  Allergy & Asthma Today, Fall 2016.

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Hibiscus Popsicle, uploaded by JohnnyMrNinja, author Joey  

 

When my son was in first grade, he joined his class in celebrating the completion of a school-wide charity project. All the students were so proud and the faculty even more so. The teachers planned to reward the students with popsicles — just the kind of unexpected treat kids live for!

 

Knowing my son’s food allergies, the teacher went to the administrative offices to check the ingredients. The coordinator read off the ingredient list one by one, all safe relative to my son’s peanut, tree nut and dairy allergies. And then she read a final statement, “Contains trace amounts of milk…”

 

“So that should be fine,” the coordinator said.

 

“NO!” replied his teacher, who also has food allergies. “He’s allergic to dairy! Milk is dairy!”

 

My son avoided an allergic reaction that day thanks to his teacher’s quick thinking and familiarity with reading food labels.

 

Many parents, teachers, school nurses and administrators are called upon to make food allergy decisions based on food labels. Deciphering ingredients and warning statements can sometimes feel like reading a foreign language.

 

Understanding the requirements that govern food allergy labeling makes those decisions much easier. In 2006, the Food Allergen Labeling and Consumer Protection Act (FALCPA) went into effect with the goal of improving food labeling information for families with food allergies.

 

1. Under FALCPA, companies are required to label the top 8 allergens: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soy. These account for 90% of food allergy reactions in the U.S.

 

2.  FALCPA also requires companies to label any ingredients made with proteins derived from those allergens.

 

3.  This law gives manufacturers a choice of how to label the food source allergen.  They can either: 1)  List the allergen in the ingredient list, such as “whey (milk) or lecithin (soy)”; or 2) Use a “Contains” statement, such as “Contains tree nuts, eggs and shellfish.”

 

4. Manufacturers might use the same facility or equipment to produce two different food products, and if one is an allergen, there is potential for cross-contact. If the manufacturer thinks there’s a chance an allergen may be present in a food product, they can voluntarily put a “May contain…” or “Made in a facility with…” statement. For example, a soy milk label might say “May contain tree nuts” if it was produced on the same equipment as almond milk.

You’ll need to be extra diligent when reading labels to avoid an ingredient outside of the top 8 allergens. Learn alternative names for your allergen that manufacturers sometimes use. For example, sesame seeds may be listed as “tahini” (which is sesame paste), benne seed or generically as “spices.”

Because manufacturers change their ingredients and production methods all the time and without warning, it is very important to read the labels every time you purchase an item.

And if you’re unsure about what’s in a food product but still want to purchase it, call the manufacturer.

AAT Fall 2016