FOOD ALLERGIES & DIETARY RESTRICTIONS
Currently, the revenue lost from food-allergy families avoiding restaurants and caterers is estimated at $45 million per week. Additionally, the global food market for those with food allergies is projected to exceed $25 billion by 2020. Are you letting this market pass you by, or are already on the bandwagon?
The 2013 Food and Drug Administration Food Code recommends that the person-in-charge (i.e., the manager, chef, owner) be knowledgeable about food allergies. The "person-in-charge" is also responsible for ensuring that employees are properly trained in food safety, including food allergy awareness. Laws about food-allergies vary by state with some being extremely strict, so it would be wise to brush up on the specifics in your state to keep yourself protected and informed. Federally, a life-threatening food-allergy is considered a disability (YES, a disability) under The Americans with Disabilities Act, meaning that "reasonable accommodations" MUST be made for the food-allergy community. The organization Food Allergy Research & Education (FARE) encourages food allergy training for all new restaurant/catering employees before they begin serving patrons, and periodic training updates for current staff members. However, the findings in this report indicate that employee training might not be occurring according to recommendations. Are you among the guilty? Approximately half of surveyed restaurants and caterers did not provide food allergy training for their staff, and the training that was provided often did not cover important information such as how to identify the signs and symptoms of anaphylaxis and what steps to take in order to safely prepare food for food-allergic individuals.
FARE stresses the importance of staff members understanding and responding appropriately to allergic reactions. I know for many of us in the food-industry this may be frustrating, but it's life-saving and critical to your clients. Besides, it's not as intense as you think, with a few simple steps put in place you can open up an entirely new revenue stream…
- Be consistent
- Know the top 8 allergens
- Know the difference between an allergy and an intolerance
- Consider using symbols for allergens on your menu or having multiple menus
- Establish a plan for special orders
- List ingredients
- Communicate with customers
- Get details
According to EHA Consulting Group, allergen-related issues cost the food-industry $25 million every year as a result of lawsuits, fines or other consequences. These are HUGE numbers, and you don’t want to be caught up in that mess. Here are some things you should know that will help you navigate these waters and create safer food for your food-allergic clients…
The Top Eight Allergens
WHAT IS A FOOD ALLERGY?
A food allergy is an immune system reaction that occurs soon after eating a certain food. Even a tiny amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms, or a life-threatening reaction known as anaphylaxis. This can be a challenging predicament to face in the food-industry, but the epidemic is rising and won’t be going away, so we need to learn how to embrace it and welcome this community into our arena.
THE FOOD-ALLERGY EXPERIENCE -
People in the food-allergy community are used to restaurant/caters rolling their eyes and being unwilling to accommodate their needs, and typically this is for a child. This is why food-allergy families RARELY eat out. Statistically more than half of all anaphylactic reaction occurs outside of the home. When a restaurant/caterer shows a lack of respect, it begins to trend on social media almost immediately. Do you know what happens when a restaurant/caterer welcomes members of the food-allergy community and isn't afraid to offer them a "safe" meal…? YES, it also trends almost immediately. The food-allergy community is a very close group of people. When they find somewhere they like, especially a place that can provide a safe meal for their child, they will travel hundreds of miles just to go to or order from that place. With 15+ million Americans suffering from life-threatening food-allergies, that's quite a bit of business.
Currently, there are 15 million Americans living with "life-threatening" food-allergies, and experts predict that number to be higher by at least 6 million people. Food-Allergies are responsible for over 30,000 emergency hospital visits each year and kill over 200 people. Every 3 minutes someone is rushed to the Emergency Room because of a food-allergy. When you add in people with sensitivities, intolerances, dietary preferences, religious beliefs, vegans, vegetarians, etc. that number could double, even triple. That's A LOT of business to turn away.
Life-threatening food-allergies is a legally binding disability under the American with Disabilities Act. Just like all disabilities, you are required by law to make "reasonable accommodations" for your client and cannot refuse service. In the same respect that you couldn't turn away a patron in a wheelchair, you cannot turn away a patron because of life-threatening food allergies.
NEVER TURN AWAY A CLIENT -
All too often members of the food allergy community hear, "Sorry, we can't serve you" (which, in addition to being against the law), is not truthful. You CAN, in fact, serve that client by taking a few extra steps. Try saying to your client, "What are your allergies? We would love to accommodate you. However, please be aware that some of our products come from outside suppliers, and we're not familiar with the facility practices, but we would be happy to give you a copy of the label. Let me discuss this with my chef; I'm sure we can create something safe for you to eat off of our menu." YOU, my friend, have just opened up a whole new market of people!
DON’T FREAK OUT! -
When customers with food allergies appear on the scene, it seems to throw the whole well-oiled machine into an all-out frenzy. This is not the end of the world, and it doesn't have to be significantly life-altering. Serving customers with food allergies are no different than serving those without food-allergies, in that, what they are looking for from you is a safe, tasty meal that they won't die from, plain and simple. With well trained staff and some precautionary measures in place, this is easy to accomplish
According to statistics, at this time restaurant/caterers receive little to no training when it comes to food allergies. Let this change with YOU! FARE (Food Allergy Research & Awareness) recommends that all staff be knowledgeable and trained in and FDA approved Food Allergy Program. Be sure to document ALL your records. FARE has a training program for the food-industry, you can access it here https://www.foodallergy.org/education-awareness/fare-training/restaurant-workers
INGREDIENT LISTS -
Approximately one-fourth of surveyed managers reported having no ingredient lists or recipes for menu items. This MUST change. Ingredient lists are important to help the staff determine which menu items contain common allergens. FARE recommends that a restaurant/caterer be able to supply, upon request, a list of ingredients for any menu item. It's also helpful to have ingredient lists on-hand during off-site events. To make things easier, just take a pic of the label on your phone and have it with you in case someone asks for it. Don’t worry about giving away your secret recipe, you don’t need to list amounts, just ingredients.
A recent FARE survey showed that the majority of food-service operations do not have dedicated equipment for preparing allergen-free food. This is concerning because proteins from allergens can remain on equipment even after it is wiped clean, and dedicated equipment for making allergen-free food can reduce the risk of cross-contact. Dedicated equipment can be color-coded for quick identification (i.e., cheese slicer, meat slicer). Designating areas in the kitchen can be used for preparing allergen-free meals. These small steps can greatly reduce the risk to your clients with food allergies. Also, having a separate pick-up area can prevent problems such as delivering the wrong food to patrons, adding inappropriate garnishes, or exposing allergen-free meals to cross-contact with a food allergen (e.g., unclean hands, trays, or splashed food).
Pathogens can be spread from food or unwashed hands to prep areas, equipment, utensils or other food. Fortunately, there are steps you can take to prevent this.
- PERSONAL HYGIENE -
To lessen the possibility of food handlers contaminating food, institute a good personal hygiene program that includes policies addressing critical hand practices like proper hand-washing, hand care, and glove use. Also address staff cleanliness and work attire, focusing on topics such as bathing, clean clothing, the proper use of hair restraints and prohibited jewelry. Finally, policies should be put in place to make sure food handlers come to work healthy. Include actions such as reporting illnesses and covering wounds.
- HAND-WASHING -
This is especially important after using the restroom and after handling raw meat, seafood and poultry. Once employees have washed their hands, ensure they use a single-use paper towel or hand dryer, rather than any part of their uniform, to dry. NOTE: Hand-sanitizer does not kill food proteins, so you are still contaminated if all you used is hand sanitizer. You MUST wash with soap and water.
- SEPARATE EQUIPMENT -
Each type of food should be prepped and handled with a separate piece of equipment in a separate area of the kitchen (far away from nut-products or the client's allergen) For example, use one set of cutting boards, utensils, and containers for raw poultry. Use another set of raw meat, use the third set for produce and the fourth set for nut-fee. Some operations use colored cutting boards, and utensil handles to help keep equipment separate. If this system is not possible at your establishment/restaurant, prep food at different times. Make sure worktops and all the equipment used are thoroughly cleaned. This includes chopping boards, knives, mixers, bowls, pots, pans, griddles and utensils. Thorough cleaning can be achieved by the use of detergent and hot water. Where relevant, dismantle equipment to ensure that all allergen residues are removed. Do not use equipment which is encrusted with carbonized food residues, e.g. woks.
- SANITIZE -
All work surfaces, equipment and utensils should be cleaned and sanitized after each task. Simply rinsing equipment is not enough to eliminate pathogens that can contaminate food.
- OIL: -
Deep fryers that are used to cook several different foods can contain protein from previously fried foods; therefore, restaurants should consider designating a fryer for one type of food. (Gluten free, shellfish free, etc.) These recommendations for separate equipment, preparation and pick-up areas, and fryers might be difficult for many restaurants to implement, given resource and space limitations. If you cannot designate fryers, don’t turn your client away. Try an alternate method commonly used in restaurants with limited resources or space. Simply fry items in a pot on the stove with separate fresh uncontaminated oil. Be sure that equipment and workspaces are cleaned thoroughly according to Food Code guidance before preparing an allergen-free dish.
Current recommendations for preventing allergic reactions in restaurants/catered events are based on actual cases of allergic reactions in restaurants and with caterers. These recommendations by Expert Opinion are based on research regarding how allergen proteins react. However, limited evaluation data currently exist on the effectiveness of the recommendations, and more research is needed on this topic. Food allergies are a serious food safety issue. Food-service operators should ensure that all staff members are knowledgeable about food allergies, from preventing cross-contact to knowing how to respond in an emergency. Investing in and using dedicated equipment and designating areas for preparing allergen-free food can also reduce the risk of cross-contact as we discussed above. Increasing staff knowledge and awareness of food allergens can help restaurants/caterers better accommodate patrons with food allergies and increase the probability of a safe dining experience. These steps also secure your position in this large sector of the marketplace.
ALLERGY FRIENDLY MENU -
While it is great to have a separate allergy menu, it's totally fine if you don't. It's not very hard to go through your menu and make it completely allergy friendly. In those case where we're starting from scratch, we may use a different method and outline every item including all ingredients on a separate menu. However, if you don't, we can implement s system of symbols that represent the top eight allergens (peanuts, tree-nuts, soy, wheat, milk, egg, shellfish, fin-fish) What we would do here is go through your menu and put a symbol next to each dish containing that item. That way your clients can easily determine what is safe for them to eat an what is not. Remember to include sauces; those can often get overlooked. So there, easy peasy right?
Once the special meal has been prepared, it should be kept labeled and protected from contamination. It should be kept separate from other meals until served. The manager or nominated staff member/delivery representative should deliver it, on its own, to the table of the allergic person to ensure that no mistakes are made. At that time the delivery person should reiterate the food the client is receiving and reassure them that it is safe to eat.
Here are some examples of possible cross contaminations that can occur if the restaurant staff does not have the appropriate knowledge or training:
- Picking nuts off a salad thinking it will be safe.
- Thinking the temperature of the fryer oil destroys allergens.
- Taking a spoon used to serve cream soup and stirring milk-free soup.
- Chopping nuts and a salad on the same block.
- Sharing mixers, pans, etc., in preparation of multiple foods.
Unlike dining at a restaurant, caterers are less in the control of the guest with food allergies. Caterers must be aware that they are dealing with a "captive audience"—while food-allergic patrons at restaurants can choose to go elsewhere, food allergic guests at catered meals may not have this option. In a sense many important "screening" steps and decisions may be taken out of the control of food allergic guests, including not having the opportunity to assess the food allergy knowledge and policies of the location of their corporate event.
Another complicating factor in easily communicating allergy needs is the scale of the meal or meals being prepared and served. In these cases, many menu items are pre-made or at least “prepped” prior to delivery/set-up. It is important to follow the safety steps outlined above in order to ensure safe-handling practices and prevent prevent cross contact (the most common cause of allergic reactions with restaurants/caterers).
Safety depends on effective communication and partnering between the person placing the order and the food-service team. (consisting of any staff responsible for any part of the food eaten by guests with food allergies) To better prepare (and protect) yourself, be proactive about food-allergies & dietary restrictions. Ask your clients if anyone in their party requires special accommodations. This early communication can help your operation plan for safe alternatives when possible. It also gives guests time to work through acceptable and safe alternatives.
Additional precautions include:
- Offering a wide variety of food to accommodate all allergies and restrictions. Provide simple options that can be made from scratch for specific guests.
- Always labeling all food offerings and requiring staff to confirm/double check for food allergens and cross contaminations. However, this requires that the caterer is extremely aware of ingredients and how meals were prepared in order to label food specifically enough to allow a food-allergic consumer to eat it safely.
- Informing your delivery team of any specific allergies so that they are knowledgeable and can communicate on-site with the party requiring accommodations.
- Reiterating and repeating concerns at every step of the planning process and in every communication.
- All catering staff, which includes front of the house, back of the house, management, etc., must have protocols for dealing with food allergy, as well as thorough training. The training should include communication, label reading, knowledge of hidden ingredients, prevention of cross-contact and/or cleaning techniques and processes for promptly dealing with allergic and other medical emergencies.
Know the Facts:
- About 4 percent of the U.S. population – 15+ million Americans – have a food allergy.
- These 8 foods; Milk, eggs, peanuts, tree nuts, shellfish, soy, and wheat, account for 90 percent of all food allergy reactions.
- Seafood allergies affect 6.9 million Americans.
- Peanut and tree nut allergies affect 3.3 million Americans.
- There is no cure for a food allergy; strict avoidance of the allergy-causing food is the only way to prevent a reaction.
- A severe or life-threatening allergic reaction is called anaphylaxis (pronounced ana-fa-lax-is).
- The Centers for Disease Control and Prevention estimates that food allergies account for approximately 300,000 ambulatory care visits in the U.S. for children under the age of 18 each year.
- Even a trace amount of an allergy-causing food is enough to trigger an allergic reaction that could result in death.
Since even a very small trace of food may trigger a reaction, it is important for food service employees to be extra careful. The only way to prevent an allergic reaction is to avoid the problematic food ingredient altogether. This can be done by using all of the steps outlined above; a separate prep space, keeping the safe-foods separated, using only freshly sanitized utensils and cookware, having your employees change their gloves each time they leave and return to the safe station, just to name a few.
If your clients have to educate you and your staff on the severity of food allergies, or the difference between an intolerance and an allergy, your client or potential client, may not feel comfortable ordering from you. Food-allergies should not be taken lightly, and the result of failing to treat an allergy warning or substitution request could have dire consequences. Every single person on your staff should be thoroughly trained on food-allergies and how to accommodate a client who has one.
Allergic reactions are unlikely to occur with the proper protocol in place. It is important to know, however, that food-allergic individuals are not always going to notify you of their condition, which poses the risk of an allergic reaction. Should this occur, there is a chance that you could potentially be liable. To prevent this from happening, it is suggested that post a clear message on your menu and on your website requesting that your clients notify you of any food-allergies upon ordering. This not only protects you, but it also allows for you and your staff to work with your client to create a safe-alternative.
Secret recipes are common in the food business; however, if your clients don't know what's in your food, they can't be sure that you're serving them a safe meal. Often, members of the food-allergy community want to see the ingredients before ordering. It's not necessary to list out ingredients for the general public after all secret recipes are just that...secrets. However, if a food-allergic individual requests an ingredient list, then it would best suit you to have one on hand. You can keep your recipe secret by leaving out portion amounts. If you outsource something or don't know all of the ingredients in a certain item, BE HONEST.
Create a protocol for special orders. FARE (Food Allergy Research & Education) suggests having a resident expert on allergens, like the catering manager or chef, who can assist clients with food allergies and special requests. The kitchen staff should wear gloves when preparing the food and work on “safe” (sanitized) work surfaces. Your ordering system should always include warnings that are bold and clearly understood. Whatever your chosen method is, be sure that everyone is trained and that protocol information is easily accessible.
Some caterers, especially chains and third-party portals, have separate allergy menus that outline the top allergens. Several use the method of identifying allergens on the menu by placing symbols next to the item. For example, an item containing cheese would have a symbol representing "dairy" before/after the item. These procedures can serve clients with dietary restrictions and intolerances as well. According to Eater, Texas-based restaurant Odd Duck prints seven different menus each night, including gluten-free, shellfish-free, vegan and vegetarian menus. If a restaurant can do this on a nightly bases, then a corporate catering division can certainly do this on what would most likely be a weekly basis at the most. Not only would this system make it easier for your clients, who after all do come first, but it places you in a position to be recognized as an allergy-friendly caterer, which WILL bring you more business.
Understand common misconceptions:
- The food will be safe as long as the nuts (allergens) are picked off.
- Fryers destroy allergens.
- It’s okay to use spoons that have stirred a cream-based sauce in milk-free soup.
- It’s not a problem to prepare burgers with wheat buns on the same table surface as allergen-free burgers.
- Touching food that contains a food allergen and then handling allergen-free food is okay.
These are just some of the ways those suffering from food allergies/intolerances can be exposed to allergens during a catered meal. Unfortunately (especially those with food allergies), even the smallest particle of food can cause a life-threatening reaction such as anaphylaxis. Which is something you definitely don’t want your establishment to be responsible for.