Food Allergy Counseling

Food Allergy Counseling
Sloane Miller, Food Allergy Counselor (Picture © Noel Malcolm 2013)

Monday, August 31, 2009

Children's Hospital Boston, Milk Desensitization

Children's Hospital Boston has done a great job of hitting the blogs to get the word out about this milk desensitization study.

Just in case you missed it, here's a link.

Here's a new link as the patient takes his first sip of milk.

Another video, as the family goes shopping.

Another video with Ming Tsai talking about dining with allergies.

Wednesday, August 26, 2009

Pharmacies and Food Allergies

This cautionary tale comes from an Allergic Girl reader:

I've been reading your cautionary tales and would like to pass on a scary thing that happened to me at the pharmacy a couple of weeks ago. This year, I developed eczema for the first time, and the case had become quite severe. I saw a dermatologist, who sent me home with three prescriptions.

I took them to my pharmacy (a big-box name) and when I handed them to the tech, I said, "I just wanted to confirm that you have in my records that I am allergic to tree nuts and salmon. Could you please double-check to make sure that these scripts are safe for me?"

She updated my record (some how, this information had not been added into my record at the pharmacy, so I'm glad I said something). It was a slow night, so as the pharmacist compounded the medicated lotion for my skin, I noticed the brand he was using and waved at the glass to get his attention. You see, I had seen this lotion before, and didn't buy it because it contained macadamia nuts.

"Is that my script?" I asked. He said yes. "Could you please double-check to make sure it doesn't contain nuts or salmon?"

He flipped the bottle over, read it, then said I was fine with it. He passed the bottle to the tech to ring me up.

I flipped the bottle over, and there, in big letters, were the words MACADAMIA NUTS.

"I can't use this," I said. "It has nuts in it." Sure, I wasn't eating it, but rubbing lotion with macadamia nuts into open wounds didn't seem like a good idea, and I already knew I reacted to scrubs with walnut shells in them.

I refused the medication and called the dermatologist the next day. The called in a different prescription for me and it all worked out. But it just proved how proactive someone with serious allergies has to be. This guy wasn't just some kid serving tables; he was a PHARMACIST. And even he didn't take the situation seriously.

Tuesday, August 25, 2009

Interview with Hersheypark

Last week, I passed along the press release from Hersheypark. I also had a brief conversation with Tony Tinsley, one of the Concessions Area Managers of Hersheypark part of the Hershey Entertainment Complex about what exactly they offer, allergen-friendly food-wise.

Some of the companies with whom they have subcontracted to create allergy-friendly offerings include Divvies, Turkey Hill and French Meadow Bakery. However, there is a very handy ingredients link on the Hersheypark home website the lists everything that they offer onsite.

***

Through Twitter.com, Bestallergysites.com asked some excellent questions that I asked Tony.

BAS: Is it safe to do the choc/candy making tour?


Tony: Hershey chocolate world is run by Hershey Foods which is different than Hershey Entertainment which runs the park. Their website is: http://www.hersheys.com/discover/visit.asp

BAS: Do they still pass out candy at rides/throughout park (worried contam on rides)?

Tony: Due to peanut allergies, they’ve stopped giving out any candy after any ride.

BAS: What are their restaurant guidelines for allergies-do they have a binder with ingredients etc.?

Tony: We have done this for a couple of years. Each of Hersheypark restaurant locations do; however, any outside vendor may not, check on line to verify any information.

***

Tony said the expanded offerings came about because of requests from Hersheypark guests. If you are planning on visiting Hersheypark, it is recommended that you email ahead of time so they can ensure the safest visit possible. The allergen email address is staffed by eight full-time customer service team members, so even if you email from on-site at Hersheypark, someone should be able to respond quickly. Here’s the email address: HersheyparkAllergens@HersheyPA.com


***

Thank you Tony and Hersheypark for taking the time to give us some insights into your wonderful program.

For additional information on Hersheypark or a list of Park locations serving allergen conscious or gluten-free menu items, please call 717-534-3900 or visit Hersheypark

Monday, August 24, 2009

Betty Crocker Gluten-Free Chocolate Chip Cookies



Uh oh, the Betty Crocker gluten-free chocolate chip cookies are a little too good.

I’m glad I only baked one to try. I taste tested a few spoons of the raw cookie dough, it was delish, a bit crumbly as most GF doughs can be but not unpleasant, ho ho, not at all. I made the mix with butter and mixed by hand (as in squished dough through my fingers until it was the right consistency and texture for raw cookie dough). I mixed manually because either my butter wasn’t soft enough (highly possible) or the dry gluten-free flour ingredients weren’t incorporating correctly with the wet ingredients (less possible). Mixing by hand is excellent because you know the exact moment that the cookie dough is incorporated correctly. If you have kids, let them mix with scrupulously clean hands; it’s cool.

(For you no butter folks, here are the no butter directions from the Betty Crocker site.)

The resultant single cookie that I baked (and, er, ate while still warm) was buttery, had that lovely brown sugar taste and I found that there were plenty of chips. Overall, a decent, very close to the “real” thing cookie. Too close. I put the extra dough in the freezer for later use. Oy.

Well done, Betty Crocker.

Friday, August 21, 2009

Cautionary Tale for Both Patron & Restaurant #3

A man walks into a restaurant. He says to his server, “I’m anaphylactically allergic to eggs in any form, cooked, raw, dried, any eggs, anywhere.”

His server takes this very seriously, informs chef and kitchen and they go to great lengths to create an eggless menu for patron.

While the patron and his party are waiting for food, the patron says to the bartender, who was out of earshot of the egg-convo with server, “Can you make me a key lime martini?”

The bartender, not knowing what that drink was, made one up; a “flip” version of a citrus drink. (Eggs in drinks are very hot right now; see Mad Men.)

The patron tasted and said, “How did you get it so foamy? Wait, is there an egg in there?”

“Yes,” the bartender said, “that’s the foam.”

The patron says, “I’m allergic to eggs!”

The bartender says, “Do you have your Epi-Pen? What Can I do to help, I’m so sorry and I had no idea. No one told me you had an egg allergy.”

The patron takes some unspecified medication (not a shot of adrenaline), stays through rest of meal and is apparently okay.

***

This story is told to you third hand, so please add a grain of salt when reading as with the two previous cautionary tales. However, even third hand there is a clear issue here: the patron assumed the bartender knew of his egg allergy, although the patron never directly told the bartender of his needs.

It cannot be underscored enough: the patron must always take responsibility for telling everyone around them of their dietary restrictions. And follow up. And then follow up again.

Mistakes happen in restaurants that are the restaurant’s fault, all the time, absolutely. But just as often it is the patron who has not done their job in communicating their needs clearly to the highest person in charge and then repeating.

Don’t let this happen to you. Speak up with confidence and graciousness, with a smile, to everyone. Never assume and recheck when you’ve received your meal or drink.

Wednesday, August 19, 2009

Bruni's Dinner Companions

"I learned that the world is divided into the hoarders and the sharers, and into the perpetually slighted and the eternally grateful; that the diners who eat the least are the ones who pretend to eat the most..."

Interesting article about dining and the nature of his taste testers/dining companions, by the exiting New York Times food critic, Frank Bruni.

Tuesday, August 18, 2009

Cherrybrook Kitchen Chocolate Chip Pancakes


Cherrybrook Kitchen Chocolate Chip Pancake Mix
is one of Cherrybrook Kitchen’s newest products. I'm so impressed (and grateful) that continue to refine their brand and their gluten-free, vegan, kosher, peanut/tree nut free offerings. CBK sent me a few boxes of the Cherrybrook Kitchen Chocolate Chip Pancake Mix to try. (Disclosure: Cherrybrook Kitchen also supports Worry-Free Dinners events with samples for events).

I'm not much of a chocolate person. Also, I'd rather have a protein breakfast versus a sweet one, so I'm not really their target market but I wanted to try it anyway. I made silver dollar sized pancakes and served them without accoutrements, no butter or butter substitute nor maple syrup; they didn't need it. Very rich, indulgent and not light (these are some substantial little cakes) the CBK mix makes a very desserty breakfast item. The chocolate chips tasted on the bittersweet side of the chocolate spectrum which made the pancakes even richer. I could only finish one for breakfast but that didn't stop me from eating two more, cold, during lunch. They are rich and yum.

If you have that chocolate sweet tooth, love a sweet breakfast, are looking for a special Sunday brunchy addition, and you're gluten-free, dairy-free and peanut/tree nut free, these Cherrybrook Kitchen Chocolate Chip Pancake Mix might be for you.

Monday, August 17, 2009

FAAN/University of Michigan Survey

This Allergic Girl’s allergist colleague Dr. Mathew Greenhawt sent me a copy of this survey last week. Now FAAN has soft launched it and here’s their press release through Facebook:

Researchers at FAAN and the University Michigan have developed an anonymous survey for parents of children with food allergies regarding their experiences at camp this past summer.

The researchers hope to present the results at professional conferences, and publish the results in a professional journal.

If you’re interested in taking the survey, please click here.

Hersheypark Offers Allergen-Conscious Foods

I spoke with Hersheypark about this press release and will be posting those results soon, stay tuned.

Hersheypark Offers Allergen-Conscious Foods

(Hershey, Pa.) – The 2009 National Restaurant Association Chef Survey indicates that allergen-conscious and gluten-free foods are among the biggest culinary trends in 2009. Those survey results come as no surprise to Kevin O’Brien, the director of food and beverage for Hersheypark.

Hersheypark began to offer allergen-conscious and gluten-free menu options in response to the growing number of people – especially children – who have food allergies. Our Park is a very family-friendly destination, and we want to offer menu items that all our guests can enjoy,” said O’Brien. “We continue to receive positive guest feedback for our efforts.”

Hersheypark offers gluten-free wraps, chicken tenders, pizza crust and sandwich rolls. Dessert lovers can indulge with gluten-free brownies and allergen-conscious caramel corn and cookies. In addition, the Waterfront Creamery inside the Park is dedicated to being entirely peanut-free.

For additional information on Hersheypark or a list of Park locations serving allergen conscious or gluten-free menu items, please call 717-534-3900 or visit Hersheypark.

Saturday, August 15, 2009

Andy Kessler, Insect Sting

Insect stings can be deadly. From an AAAAI.org press release:

MILWAUKEE – Legendary skateboarder Andy Kessler’s death after being stung by an insect earlier this week is a reminder that stings can be deadly for those with stinging insect allergy. According to the American Academy of Allergy, Asthma & Immunology (AAAAI.org), up to 5% of Americans are at risk for a severe, potentially life-threatening allergic reaction from insect stings.

Unfortunately, most people are not aware they are allergic to insect stings until after experiencing a reaction. An allergic reaction occurs when the immune system overreacts to the insect venom. When this happens, an allergic person’s body produces an allergic substance called Immunoglobulin E (IgE) antibody, which reacts with the venom. This triggers the release of histamine and other chemicals that cause allergic symptoms and, in the most severe of cases, a rapid fall in blood pressure, loss of consciousness and sometimes even death.

Because a severe and sometimes fatal reaction can occur, it is important to know what common stinging insects look like. The most common stinging insects in the United States include:

• Yellow jackets – black with yellow markings, found in various climates

• Honeybees – a round, fuzzy body covered with dark brown and yellow markings

• Paper wasps – slender, elongated bodies that are black, brown or red and have yellow markings

• Hornets – black or brown with white, orange or yellow markings and are larger than yellow jackets

• Fire ants – reddish-brown ants living in large mounds, mostly in warmer climates

It is also critical for anyone with allergies to insect stings to take precautions to avoid a potentially dangerous reaction. The AAAAI.org recommends the following tips to avoid being stung:

• Avoid the “territory” of the stinging insect’s nest. These insects are most likely to sting if their homes are disturbed.

• Remain calm, quiet and slowly move away from stinging insects. Do not swat them.

• Avoid brightly colored clothing and perfume outdoors that may attract stinging insects.

• Be careful when cooking, eating or drinking sweet beverages outdoors. Keep all food and beverages covered until consuming them.

• Avoid loose-fitting garments that can trap insects between material and the skin.

When to see an allergy specialist: If you have experienced a reaction to insect stings or you think you may be allergic, consult with an allergist/immunologist to accurately diagnose your condition. An allergist/immunologist is the best qualified medical professional trained to manage the prevention, diagnosis and treatment of allergies and asthma.

An allergist might also suggest allergy shots, also known as immunotherapy treatment. Venom immunotherapy shots take effect within just a few months. Venom immunotherapy is the closest thing to a “cure” for allergic reactions. It is shown to be 97% effective in preventing future allergic reactions. Patients should see an allergist/immunologist if they:

• Have reactions possibly due to insect stings for accurate identification of the specific allergen and consideration for immunotherapy (allergy shots).

• Have systemic reactions possibly due to biting insects, for accurate identification of the specific allergen.

• Have an allergic reaction (anaphylaxis) without an obvious or previously defined trigger.

• Have had anaphylaxis attributed to food, drugs or insect stings.

Friday, August 14, 2009

Ragweed Alert from AAAAI, August 2009

Beware oral allergy syndrome (OAS) peeps, this AAAAI.org press release is for you:

Ragweed season strikes again

MILWAUKEE – Another battle against sneezing, itchy eyes, runny nose and congestion is right around the corner for the estimated 36 million Americans who suffer from seasonal allergies. August 15 marks the unofficial beginning of ragweed season, which is the number one cause of fall allergies, according to the American Academy of Allergy, Asthma & Immunology (AAAAI.org).

Ragweed is common in most regions of the United States from mid-August through the first frost. Each plant produces 1 billion pollen grains in an average season, and the grains can travel up to 400 miles with the help of the wind.

Many individuals with ragweed allergy also experience symptoms while eating certain fresh fruits and vegetables. Known as oral allergy syndrome (OAS), it can also cause itchiness and mild swelling around the mouth. Common foods that cause OAS in people with ragweed allergy include bananas, cucumbers, zucchinis and melons.

Treatment for ragweed allergy includes allergy shots, which are effective in up to 90 percent of patients. There are also easy steps individuals can take to limit their exposure and reduce their symptoms:

* Keep your windows closed at night. If possible, use air conditioning, which cleans, cools and dries the air.
* Try to stay indoors when the pollen or mold counts are reported to be high. Wear a pollen mask if long periods of exposure are unavoidable.
* Check your area's pollen and mold levels from the National Allergy Bureau at www.aaaai.org/nab.
* Avoid mowing the lawn or raking leaves because it stirs up pollen and molds. Also avoid hanging sheets or clothes outside to dry.
* Take a shower before bed to wash pollen from your hair and face, which prevents it from ending up on your pillow.

To find out if your symptoms are due to seasonal allergies or another allergic condition, visit The Virtual Allergist™, which is the AAAAI’s new interactive, online symptom-checker. Then schedule a visit with an allergist/immunologist, the best-qualified medical professional to diagnose and treat ragweed allergy and other allergic diseases.

Wednesday, August 12, 2009

J & J - Repost

Since the movie is finally in a theater near you and there's been a review in every possible media and new media outlet, here's my original posting about Julie & Julia. Go see it, it's really fun and the food is gorge.

Gluten-Free Culinary Summit East Edition

I'm going...will I see you there?

From the press release: The Fourth Annual Gluten-Free Culinary Summit East Edition will be presented at The Culinary Institute of America (CIA) in Hyde Park, New York on September 12 – 13, 2009.

Food and nutrition lovers of all inclinations, whether gluten-intolerant or not, are invited to partake in this weekend symposium featuring cutting-edge menus of gluten-free baking and cooking demonstrations, recipe tastings, seminars, interactive panel discussions with the chefs, and the Summit's new Gluten-Free Baking Today Variety Show.

Celebrating both the sweet and the savory that utilize a treasury of gluten-free artisanal ingredients, the Summit presentation cast will teach a diverse range of hot topics with innovative recipes that reveal the latest developments in gluten-free culinary and baking know-how.

Some of the Gluten-Free Culinary Summit East Edition’s presenters include: Professor Richard Coppedge of The Culinary Institute of America (Hyde Park, NY) and author of Gluten-Free Baking with The Culinary Institute of America; Professor David Kamen of The Culinary Institute of America (Hyde Park, NY), Corporate Chef Scott Uehlein of Canyon Ranch® Resort (Tucson, AZ); George Chookazian of Foods By George (Mahwah, NJ); Lori Sobelson of Bob’s Red Mill Natural Foods, Inc.(Milwaukie, OR); Chefs Joel and Mary Schaefer of Allergy Chefs, Inc. (Winter Garden, FL); Editor and Publisher Ann Whelan of Gluten-Free Living Magazine (Hastings-On-Hudson, NY); and much more.

For Gluten-Free Culinary Summit East Edition class schedules, group lodging information and registration please visit theglutenfreelifestyle.com or call 303-368-9990. Prices range: $189 - $279.

Thursday, August 06, 2009

Lactaid Vanilla Ice Cream

Only available in two or three states nationally (NY, Florida and Texas, what’s that about Lactaid?) I could barely hope that the Lactaid ice cream would be as delicious as it was or that this lactose intolerant girl’s stomach would tolerate it. But it was a big yes on both accounts.

A few years ago I became lactose intolerant. That means, I aged out of producing the enzyme lactase, the one responsible for breaking down the sugars in milk (that’s the lactose). More on lactose intolerance from the Lactaid site:

Lactose intolerance is the inability to digest a sugar called lactose that's found mainly in milk and dairy products. Normally, the small intestine produces an enzyme called lactase, which breaks down lactose into two simple sugars (galactose and glucose) so it can be absorbed into the bloodstream. People whose bodies don't make enough lactase can't fully digest lactose, causing mild to severe side effects within 30 minutes to two hours of eating dairy. About 75% of the world's population is lactose intolerant. The condition is more common among people of African descent, Hispanics, Asians and Native Americans than among those of Northern European descent. It also affects adults more than children, since the body produces less lactase enzyme as people age.

Symptoms of lactose intolerance (which affect 50 million Americans by the way) are: diarrhea, bloating and gas. Lovely, I know.

I haven’t had ice cream since 2005 when I went dairy-free on an elimination diet. Once it was determined through a year of dairy elimination then adding milk back in and seeing the very clear cause and effect, Lactaid milk became my new friend and we’ve been happy ever since.

I had heard about a mythical Lactaid ice cream but hadn’t seen in my local grocers and honestly was so focused on helping sort out my stomach issues that ice cream has been the last thing on my mind.

This past weekend I put it on the forefront of my mind. I bought some vanilla ice cream, because yes, I am also a vanilla girl. And my first bite tasted exactly like Breyer’s ice cream or what I remember Breyer’s tasting like. Flecked with prominent dots of vanilla bean, a very white color (not a French custard style of ice cream), but totally ice creamy and delicious, I was very happy. And the tummy verdict? A couple of gurgles which could be because I haven’t had any ice cream is so long my stomach had forgotten or the corn syrup, which is not a regular part of my diet but it wasn’t enough of a gurgle-a-thon to not have any in the future. Or again the next day.

***

I contacted Lactaid about their allergen policy as they also make a butter pecan ice cream. They didn’t have an answer but their products are made by Hood Dairies. On the Hood website they had an allergen statement, of sorts:

All of our products are in compliance with the FDA regulations for allergen labeling. All allergens are clearly identified in the ingredient declaration located on the side or back panel of the package.


I had no issues allergy-wise or intolerance-wise and I generally trust that most companies practice good manufacturing practices, most of the time. But that’s me. I encourage you to reach out to Hood or Lactaid and talk to them directly if you have cross contamination questions or concerns. Meanwhile, I’m having another bowl of ice cream.

Tuesday, August 04, 2009

Betty Crocker, Allergen Statement

I was in upstate New York recently and the gluten-free Betty Crocker mixes were up there, just waiting for me, in the cake mix aisle, all four types: chocolate cake, vanilla cake, brownies and chocolate chip cookies. Given what I’ve read on twitter and what Catherine of A Gluten Free Guide said last week over dinner, I chose what seem to be the top two winners: brownie and cookie mix.

But I’m not only a gluten-free girl. Ho no, I have some other questions, like what about tree-nuts in the Canadian gluten-free facility?

I called the Betty Crocker customer service number in Minnesota (the 800 was all automated and too slow) and spoke to a rep. She was able to email General Mills/Betty Crocker’s allergen statement, a portion of which I’ve reprinted below.

“This is the most current information for your needs. If one of our products contains any of the top 8 allergens (peanuts, tree nuts, dairy products, eggs, soy, wheat, crustaceans, and fish) or if it contains sesame, sunflower or mollusks, that ingredient is always listed in the ingredient panel, and also in bold letters just below the list of ingredients. If a product is exposed to any of these allergens in the manufacturing facility the allergen will be listed in bold in the ′Contains Statement′ just below the list of ingredients. This list is your ingredient assurance for that package. It is not intended for other packaging of the same product. Ingredients may vary from one package to another due to product reformulation. If you have allergy concerns, please read each package ingredient panel.”

Alrighty now, so let the Betty Crocker tasting begin.

Have any of you GF/DF/FA/NA/PA/SWF peeps tried it yet?

Monday, August 03, 2009

Cautionary Tale for Both Patron & Restaurant, #2

This link came from a dear friend and loyal Allergic Girl reader (Hey Stevie!).

Keep in mind the story is in translation, and there seems to be a basic misunderstanding about the difference between food allergies, food intolerances and celiac disease.

However the Russian-origin Reaganism: “Trust, But Verify” before dining with any special dietary request couldn’t be truer here (and everywhere).

Question: why would anyone serve “pasta” to a group of celiac diners? And why would a celiac diner feel safe looking down at a bowl of “pasta”?

Bottom line: it is always “diner beware”, always. And always, “Trust, but Verify” before dining.

The meal had been arranged for around 60 participants from across Europe attending a youth summer camp in Germany for sufferers of a type of lactose and gluten intolerance known as celiac disease.

“A few hours after the luncheon people began throwing up,” 18-year-old Henrik Tornberg, one of three Swedes who attended the meal, told the Dagens Nyheter (DN) newspaper.

“Everyone thought it was strange; we had filled out forms requesting gluten-free food.”

But the banquet, which had been organized by the Swedish Celiac Youth Society (SCUF), featured pasta made from spelt, a grain related to common wheat which contains moderate amounts of gluten.


More here.