Food Allergy Counseling

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

Wednesday, February 29, 2012

Chicago White Sox, Peanut-Free Game, April 2012

Interesting press release:

WHITE SOX HOST A “PEANUT-CONTROLLED ZONE”
Reserved Seating Area Will Provide Haven for Fans
Who Suffer Severe Peanut Allergies

CHICAGO – The Chicago White Sox will host a “Peanut-Controlled Zone” on Tuesday, April 17, 2012 at 7:10 p.m. against the Baltimore Orioles.

To provide fans who suffer from severe peanut allergies with the safest environment possible, no peanuts, nor anything containing peanuts, will be allowed or sold in three reserved sections of the Club Level at U.S. Cellular Field.   The concession stands closest to those special sections will not sell peanuts and the area will be meticulously cleaned and inspected prior to the game.

“This is another example of us responding to fan feedback,” said Brooks Boyer, White Sox senior vice president of sales and marketing.  “Hopefully, some of our fans and families who typically could not attend a White Sox home game due to potential allergic reactions will be able to enjoy an evening of White Sox baseball at U.S. Cellular Field.”

The tickets are specially priced at $36.50 and include $10 in “Bonus Bux” that can be used to buy food and beverage at any permanent club level concession stand.  There are approximately 200 seats available, so fans are encouraged to order tickets early.

For the least peanut-exposed path to the game, the club suggests entering through the Chicago Sports Depot near Gate 5 on the north side of 35th Street. From the second level exit of the store, escalators lead up to a bridge over the street which ends at the Club Level concourse.

Fans interested in purchasing tickets and seating in the peanut-free section should email or call Dustin Milliken at dmilliken@chisox.com or (312) 674-5186.

Friday, February 24, 2012

NIAID, Food Allergy Guidelines


Have you read the NIH/NIAID guidelines for food allergies yet?  

From the NIH/NIAID website:

Guidelines for the Diagnosis and Management of Food Allergy in the United States:
Food allergy is a public health problem that affects children and adults and may be increasing in prevalence. Currently, there is no treatment for food allergy; the disease can only be managed by allergen avoidance or treatment of symptoms. The diagnosis of food allergy also may be difficult because non-allergic food reactions, such as food intolerance, are often mistakenly classified as food allergies. To address these concerns, NIAID worked with 34 professional organizations, federal agencies, and patient advocacy groups to develop concise clinical guidelines for healthcare professionals on the diagnosis and management of food allergy and the treatment of acute food allergy reactions.


And here are the guidelines.  

Download them and highlight any questions you have to discuss at your next appointment with your board certified allergist.
 







Thursday, February 23, 2012

How Waiters Read Your Table, WSJ


In my book Allergic Girl, I spend a whole chapter on strategies for dining out with dietary restrictions. It’s called Read The Restaurant and I assert that it is our job to read a restaurant for their ability to serve us safe food. I go through all the steps it takes to get a true reading of how your potential dinner with severe dietary restrictions might go (safely and well is what I hope for and usually get!). However, I didn’t make up this expression. In the foodservice and hospitality industry, servers are trained to "read the table". On February 22, 2012, the Wall Street Journal published an article about how the trend is for more “reading” of your table (not less) even in fast casual restaurants like Denny's or T.G.I. Friday's and what they are trained to read.

“Called "having eyes" for a table, or "feeling" or "reading" the table by restaurant workers, it's how the best waiters know what type of service you prefer before you tell them. From fine dining to inexpensive chains, restaurants are working to make service more individualized as the standard script ('I'm so-and-so and I will be your server tonight") is sounding dated.” - Sarah Nassauer, WSJ

Under the section of the article called “The Signals You May Be Sending” it says:“If you ask about the menu... Food questions are a sign that you either like learning about everything you might eat or you feel lost and need guidance. One menu question could lead to a long, full menu description. If you seem overwhelmed, the waiter might try to steer you toward a particular order."
 
I’d add in many restaurants in major metropolitan areas, asking specifics about a menu or ingredients in a dish signals to your server that there may be a dietary restriction at the table like food allergies or celiac disease. I say: Be that guest. Ask about the menu, ask about ingredients and get the answers you need before you dine. 


First and foremost, and better for everyone, disclose your restrictions and needs in a clear and concise manner before you even step into the restaurant. Read more about how restaurants read you in WSJ. Read more about how to read the restaurant in my book, Allergic Girl.

Tuesday, February 21, 2012

Pediatrics, Food Allergy


Last year Pediatrics, the journal of the American Academy of Pediatrics published a groundbreaking study.   

From FAI: According to a national survey of 38,480 families, 8 percent of children in the United States suffer from a food allergy – a considerably higher number than reported in previous studies. In addition to estimating that 5.9 million children under age 18 now have a food allergy, the new study, published in the July 2011 issue of Pediatrics, the journal of the American Academy of Pediatrics, provides a wealth of important new information.
The study’s findings include:
·       8% of children had at least one food allergy, a projected total of 5.9 million children across the U.S. population
·       2.4% of the children in the study had multiple food allergies, nearly one-third of those with allergies.
·       The prevalence of severe food allergies among the children studied was 3.1%, or 38.7% of the children with allergies.



And here's a copy of the study itself through a PDF copy.

Monday, February 20, 2012

366 Ways to Go Bananas, Dole, 2012


Dole contacted me recently about a promotion they are running to promote bananas: "366 ways to go Bananas". I didn’t need any convincing to blog this campaign for Dole; bananas are one of my go-to safe snacks, especially when traveling. As they have their own wrapper, they have little to no possibility for contamination. They are also so nutritious: filled with fiber, potassium and lots of natural yummy sugar for a quick healthy lift. For a special treat, I love an healthier version of an Elvis sandwich (Smucker’s organic natural peanut butter & bananas on GF bread) which probably tastes just as delicious with a PB substitute like Soy NutButter, Sunbutter or a tree nut butter. Bananas are top eight allergen free, easily accessible at your local supermarket, here in NYC street vendors sell fresh fruit including bananas on street corners; and economical.



As a special treat, Dole is doing a contest giveaway for my newsletter: coupons good for a month’s worth of bananas for six [6] readers! But you can only win if you sign up here or on the right of this blog. The next newsletter comes out soon so don’t delay. 

*Contest rules: contest open for 24 hours from when newsletters is mailed, winners are picked using random.org and limited to residents in the 50 United States.*



If you are a latex, kiwi, avocado allergic check with your board certified allergist before consuming bananas.

Friday, February 17, 2012

Anthony Shadid, Asthma Death

From the front page of the New York Times today, February 17, 2012: Anthony Shadid, a New York Times Reporter, Dies in Syria. His cause of death: a fatal allergic and asthmatic reaction. From the New York Times story:

"But Mr. Hicks said that Mr. Shadid, who had asthma and had carried medication with him, began to show symptoms as both of them were preparing to leave Syria on Thursday, and the symptoms escalated into what became a fatal attack. Mr. Hicks telephoned his editors at The Times, and a few hours later he was able to take Mr. Shadid’s body into Turkey…

The assignment in Syria, which Mr. Shadid arranged through a network of smugglers, was fraught with dangers, not the least of which was discovery by the pro-government authorities in Syria. The journey into the country required both Mr. Shadid and Mr. Hicks to travel at night to a mountainous border area in Turkey adjoining Syria’s Idlib Province, where the demarcation line is a barbed-wire fence. Mr. Hicks said they squeezed through the fence’s lower portion by pulling the wires apart, and guides on horseback met them on the other side. It was on that first night, Mr. Hicks said, that Mr. Shadid suffered an initial bout of asthma, apparently set off by an allergy to the horses, but he recovered after resting. 

On the way out a week later, however, Mr. Shadid suffered a more severe attack — again apparently set off by proximity to the horses of the guides, Mr. Hicks said, as they were walking toward the border. Short of breath, Mr. Shadid leaned against a rock with both hands. 

“I stood next to him and asked if he was O.K., and then he collapsed,” Mr. Hicks said. “He was not conscious and his breathing was very faint and very shallow.” After a few minutes, he said, “I could see he was no longer breathing.” 

Mr. Hicks said he administered cardiopulmonary resuscitation for 30 minutes but was unable to revive Mr. Shadid."

I’m allergic and asthmatic. And I’m highly allergic/asthmatic to horses. This scenario is my worst nightmare: being far from home, allergic, asthmatic, emergency medications (where were they?); no one’s deeply aware of how to help me in that situation – no Medic Alert bracelet, no emergency action plan, no help.

But there’s another side to this extraordinary story and life and it's my highest hope for all of us with a serious medical condition. Anthony Shadid did not let his medical condition stop him from pursing what he loved most – being… “a two-time Pulitzer Prize winning reporter who covered the Middle East for nearly two decades at The New York Times, The Washington Post, The Boston Globe and The Associated Press.” And that is incredible. 

From the New York Times: “In an email to The New York Times newsroom, Jill Abramson, executive editor, described him as 'our brilliant and beloved colleague.' 'Anthony died as he lived — determined to bear witness to the transformation sweeping the Middle East and to testify to the suffering of people caught between government oppression and opposition forces.'”

My heart goes out to his beloved family and colleagues.

And to you dear readers, a question: have you filled out an asthma action plan for your self or your loved one? Do you have carry it with you (in your phone, purse or bookbag)? Have you made safe friends at work or school who would know how to help you?

Here is the asthma action plan I have hanging in my kitchen from AAAAI.org. Confer with your medical provider about filling it out today.

Thursday, February 16, 2012

Safe Friends, Finding

I was at brunch last Saturday with a new friend. An Israeli ex-patriot start-up whiz with a day job at a major global telecommunications company, we met at an event I attended a few weekends back called Start Up Weekend Mobile. We follow each other various social media outlets (like Twitter) and he knows my handle and brand is Allergic Girl and that I have food allergies. So, I wasn't that surprised when at brunch he asked me some more details about my food allergies, specifically:

"Do you have your Epi Pen?"

"Yes, two." And I indicated they were in my purse.

"Well, I know how to use them. I was a paramedic for one and half years before I went into the army. So, if you have any issues, I'm your man."

There. Instant safe friend. Gets that food allergies are serious and offers instant support, free of judgment. Done.

As I was thinking of this easy exchange, I realized that over the last six years of writing this blog, creating a brand presence and a food allergy coaching practice, safe friends have been finding me. Which is beyond wonderful. And it got me to wondering as more and more of you disclosure publicly that you have a medical need or a dietary restriction in your social media biographies on Facebook or Twitter, for example, are safe friends finding you?


Said another way, for those of you who have allergy in their social media names" or handles or write about food allergies in your bios – do you find that announcing your food allergy-ness helps you find safe friends faster?

Quick safe friends definition: non-judgmental, supportive, understanding, flexible, open, understanding about your medical needs.
 

Tuesday, February 14, 2012

Easy Lamb Stew, Recipe


Easy lamb stew one fourth of the way done

“This is the perfect meal.”

I didn’t say that but one of my eleven guests on a recent winter night did. About my meal. That is the most satisfying compliment ever. What did I serve that was allergen-friendly and Sloane-safe? Here’s the full menu and the recipe is below for the lamb stew of love.

Drinks:
Juice, water and wine

Appetizers:
Manchego cheese

Entrée:
Lamb Stew of Love (see recipe below)
Baked sweet potatoes
Steamed broccoli florets
Steamed white rice

Dessert:
Orange segments and strawberries

More wine

***
 
Easiest Lamb Stew of Love Recipe

I adapted my short ribs recipe, looked at the Food52.com cookbook and used some of Secret Ingredient Beef Stew directions and added a soupcon of method from Food & Wine’s Syrah-Braised Lamb Shoulder.

Makes 10-12 servings

Ingredients
5 pounds lamb stew meat with bone–in (all shoulder meat or stew meat. Make sure to trim any extra, extra fat, a little extra fat is okay)
Kosher salt
1-2 T olive oil
1 yellow medium-sized onion, peeled and chopped
1 small shallot, minced
2-3 medium carrots, chopped
4-5 cloves of garlic, chopped
1 cup good, drinkable dry red wine (I used a Cabernet Merlot blend)
15 ounce can of diced tomatoes
48 ounces of water or stock or a mixture (I used Swanson’s 33% less sodium chicken broth that’s GF)


Method
1. Preheat oven to 350°F. Rinse and pat dry the lamb. Season with salt on all sides. Heat olive oil in a large, heavy bottomed ovenproof dutch oven or stew pot over medium-high heat. Add the stew pieces in a single layer, making sure not to crwod the meat (it will need to be done in stages). Sear the meat on all sides. Add more olive oil if needed so bottom of the pan doesn’t burn. Set browned pieces aside in a big bowl or platter that will gather any juices.

2. Use the rendered fat to sauté the, carrots and onion, until softened, about 5 - 7 minutes. Then add the garlic and sauté for 2 minutes or until cooked through. Add the wine, deglazing the pan and scraping off any browned bits from the bottom of the pan. Boil the wine / veggie mixture for 10-15 minutes until slightly reduced and fragrant.

3. Return the lamb to the pan with any juices; add the stock and the can of tomatoes, making sure the liquid covers the lamb. Bring to a boil and then turn off the heat. Cover with foil (or tight fitting lid) and place in the oven. Braise the meat, cooking in the oven, until the meat is fork-tender, 2 to 2 1/2 hours. (I cooked mine for 2 hours.)

a. If you are making the day before go directly to step 4.

b. If serving now,  take out the lamb and place into a bowl. Put the sauce on to a low boil to reduce whilst shredding the lamb, discarding bones and any gristle and adding it back into pot. Taste, should be beyond good by now and ready to serve over rice (or quinoa, gluten-free pasta or any healthy steamed grain of your choice).

4. Once the meat is tender, take out of the oven. Allow the lamb to cool in the pot, then cover and refrigerate overnight. The next day, about one hour before you are ready to serve, remove the excess fat that has solidified at the top from the overnight chilling. Remove the lamb and boil the liquid until it has reduced by half, about 20 minutes. Taste for seasonings - should be adequately seasoned from the chicken broth but if you used water, adjust. Place lamb back into the pan with cooking liquid and cook over medium heat.  Serve over rice or gluten-free noodles (or any healthy steamed grain of your choice)

Monday, February 13, 2012

Allergen-Free Chocolate Mousse?


I haven’t tried this recipe yet but I dare you to with your favorite allergen-free chocolate.

(NB: suggestions for allergen-free chocolate are on my newsletter  – sign up on the right!)

What is it? It’s a mousse made with two ingredients, chocolate and water. Read more from the Food52.com website and make sure to watch the video.

I’m so trying this for my next get together.Or next evening home with a friend. Who likes chocolate.

Thursday, February 09, 2012

Home Free Treats, Newsletter Contest, February



Home Free Treats is a fave in the Allergic Girl household. I first wrote about them in 2008 and then again in 2011,when they introduced a soft GF oatmeal cookie which has become my newest fave. They also sell safe chocolate chips, cocoa powder and flowers and baking kits which I haven't tried but how wonderful!



What I admire about Home Free Treats is that have a clear mission; allergen policy and procedures; and a helpful FAQ. The products are delicious and they are created in a facility that has: "No peanuts, tree nuts, eggs, wheat or dairy, soy (except lecithin), fish, shell fish, or sesame are permitted in our facility for any reason at any time. The only soy in our facility and some of our products is soy lecithin, which is tolerated by most (but not all) people with soy allergies."

This month they have kindly offered a giveaway on my newsletter: four boxes of cookies to four lucky winners: gluten free mini vanilla and gluten free mini chocolate chip cookies are up for grabs.

But you can only win if you sign up here or on the right of this blog. The next newsletter comes out soon so don’t delay.


*Contest rules: contest open for 24 hours, winners picked using random.org and limited to US residents.*

Wednesday, February 08, 2012

Gluten Sensitivity, WSJ.com


Going gluten-free? The Wall Street Journal reports on a "New Guide to Who Really Shouldn't Eat Gluten". From the Wall Street Journal:


"Aiming to clarify the situation, a group of 15 experts from seven countries is proposing a new classification system for the gluten-related disorders plaguing a growing number of people around the world for unknown reasons. The proposal defines a spectrum of illnesses based on the kind of immune defenses people mount to gluten, from wheat allergies to autoimmune responses, such as celiac disease, in which the body mistakenly attacks its own tissue. Other autoimmune forms include dermatitis herpetiformis, which causes itchy skin lesions, and gluten ataxia, which affects brain tissue, resulting in unsteady gait and lack of motor control. The experts also propose a third category for "gluten sensitivity," in which patients report the same symptoms as celiac disease but test negative for telltale antibodies. Some doctors have dismissed such complaints as imaginary, or fueled by the boom in gluten-free foods."

Read more on The Wall Street Journal website.

Tuesday, February 07, 2012

Resources, Allergen-Free Baking Class




What a fun afternoon we had on Saturday, talking, laughing and baking in Brooklyn with me, Heidi, Brooklyn Allergy Mom and new friends!



This event was another example of my motto: Just because you have a restricted diet does not mean you have a restricted life. Including cake!  Here are some of the baking resources we discussed.

Do you have more ingredients sources, books or blogs names to add? Please do!

**

Ingredients suggestions/resources:

Chocolate: Hershey’s cocoa powder, Enjoy Life Chocolate chips
Flours: Maseca, Argo Corn Starch, Sweet Rice Flour, Glutinous Rice Flour, Arrowhead Mills Brown Rice Flour, Authentic Foods flours
Baking Soda: Arm & Hammer
Baking Powder: Davis Baking Powder (Double Acting) gluten-free and peanut-free
Shortening: Spectrum Organic Shortening (Palm)
Non-dairy “milk”: Rice Dream Rice Milk
Red coloring: McCormick Red Food Dye
Vanilla: Nielsen-Massey Vanillas, Inc. Madagascar Bourbon Pure Vanilla Extract (gluten-free)
Sugar: Domino Sugars (Brown Sugar, White Sugar + Confectioners Sugar)
Gums: Bob's Red Mill Xanthan Gum

Cookbooks:
Allergen-Free Baker’s Handbook - Quite simply the source for top eight free baking for home cooks/bakers.
Food52.com - Crowd sources cookbook by expert home cooks. Lovely tome.
Cake Mix Doctor Bakes Gluten Free - If you want to play with pre-made mixes this is an easy fun book with some allergen substitutions.
Gluten-Free Baking - Chef Coppedge uses almond flour but well constructed recipes for chef students.

Restaurant lists for NYC:
Food allergy friend list by Allergic Girl
Gluten-free friendly list by GFbird


 I frosted these red velvet cupcakes. Can you tell how much I love frosting?

Thanks everyone for participating in this frosted fun!

Monday, February 06, 2012

Emailing the Restaurant, Food Allergies



Recently I had a staycation booked with three grade school best friends at a hotel here in NYC. As they are non-allergic girls they said, “You pick the restaurant.” As it was for a Saturday night, I picked Craftbar, a place to I’ve been many, many times, I know the menu, the management and the chef and they have even hosted Worry-Free Dinners in the past.

But in looking over the menu two days prior to our “trip” I saw the menu had radically changed; gone were some of my old fave dishes like the hanger steak and now it was a lot of fish, fish and more fish. Not good for this Allergic Girl. The hanger steak still existed though, I discovered, but now it was on the lunch menu. So I gave it a shot: that the restaurant might reserve a lunch dish for my dinner.

Creating a long-term relationship with a restaurant is for just this purpose: as a long-time loyal customer, they may make an extra special exception or in this case set aside a lunch dish for dinner.

I bet you will find yourself in a similar situation at some point (at least something close, so here is the outline of the email I sent:

***

Dear General Manager of Craftbar,

I hope this finds you very well! I’m coming in on Saturday with three dear friends for our combined birthdays.

The dinner dish of hanger steak with potatoes and onions is gone from the dinner menu but still on the lunch menu. The rest of dinner menu is fish heavy which I can’t do because of severe food allergies. Might it be possible to get that lunch steak dish for dinner? 


Gentle reminder, my food allergies are ________.

Let me know.
Thanks!


***

And here was the response:

Chef has saved 1 hanger steak for you. These options can also be tailored to your restrictions:

Pancetta-Wrapped Guinea Hen  25.

Berkshire Pork  25.

Roasted Sweetbreads & Braised Veal Breast 23.

Best,

General Manager/Wine Director
craftbar


***

When I got there, I checked in with the manager who said, "We are all ready for you!" And I double-checked everything with the server. He said, "We have everything all ready!" and he even had a print out of all of my restrictions. I still went over all of my food allergy needs and requested that they use a fresh pan, fresh gloves and tongs. Even if/when a restaurant knows you and your needs; even if you are a weekly or nightly regular, *it is always our responsibility to communicate, repeat, underscore and clarify our needs.*

The server said: “Don’t’ worry. This order will be like DEFCON 2 when it gets back there.”

That’s what we like to hear. The steak was perfect and dinner was lovely.

Have you created a relationship with a local chef or restaurant lately? Do tell!

Thursday, February 02, 2012

Connecting, Food Allergies



On this week’s date with a new guy, he suggested a non-food activity: music at the Blue Note to hear Morley. Afterwards, we went to have a cup of tea at Caffe Dante, one of the few remaining original coffee houses in Greenwich village. A traditional Italian café spot, they have lots of desserts including homemade gelati and sorbetti - many with nuts. 

He asked if I wanted dessert. Of course I said no. But he really, really wanted to get me something besides a mint tea. 
Finally I said, “I have severe food allergies to nuts and nothing in here is really safe. Lots of lovely nutty desserts. But not really any that are safe for me.”

“So, you have your Epi?”

“Yes. I have two in my purse.”

“Is it severe enough that if the pans or tongs have touched nuts…”

“Yes, that could cause a major issue.”

“Hmm. I almost died once. And had to get an injectable.”
See what he just did? Got that food allergies are serious and medical and connected to me and that with his own medical story. Feel like food allergies make you separate, different, other than? You can also use this as a way to connect or someone can use as a way to connect with you.

Food allergic adults, go get your date on!

Wednesday, February 01, 2012

Dr Oz, Food Allergies


This is from an article last week on Dr. Mehmet Oz’s site written by Dr. Mark Hyman. It's called "The Anti-Allergy Diet" and this is the lead: "Are hidden food allergies making you gain weight? Mark Hyman, MD, has a 3-week anti-allergy diet to help get your system back on track so you can start shedding pounds."

Food allergies are very serious and can be life threatening; a food allergy does not cause weight gain. The only “anti-allergy” diet for those of use with an IgE mediated food allergy is strict avoidance of the allergen. Go to reliable medical source for information about the difference between food allergy and food intolerance. If you suspect you have a food allergy, see a board certified allergist.

Here's a helpful video about food allergy (specifically peanut allergies) from Dr Robert Wood at Johns Hopkins hospital (through Kids with Food Allergies).

Here's another helpful series of slideshows and videos about food allergies from my colleague Dr. Mike Pistiner.

And you can find all the top websites for reliable food allergy information on my website Allergic Girl.