12/02/2007

For most people, deciding what to choose from a menu is easy. They can, in Bridget Jones style, tot up the calories and go for a healthy option, or, if they are veggies or vegans, choose a dish untouched by hooves or webbed feet. If they get it wrong, so what? They can order another meal or eat it anyway – after all it won’t kill them.

But for approximately one in 300 people in the UK, eating out can be a matter of life or death. For those suffering from food allergies, a mere mouthful of a dish that contains a ‘lethal’ ingredient (such as gluten, nuts or wheat) can trigger a life-threatening reaction.

Here, AllFoodScotland.com offers some tips on how, with a bit of organisation and careful menu wording, you can offer these customers an enjoyable meal out.

Allergy versus intolerance

Most people avoid particular foods because they give them a grumbly stomach or a headache, but the differences between a 'food intolerance' and 'food allergy' are vast. According to the Food Standards Agency, while food intolerance will not trigger a life-threatening response, a food allergy is “an abnormal response to a food mediated by the immune system” – whereby the allergen is seen as 'foreign' and a violent immune response is initiated. Allergy UK, a charity set up to support food allergy sufferers, says there is six reported deaths in Britain each year due to food-induced anaphylaxis.

Staff swot up

While the catering industry have widely accepted that a menu should include at least one vegetarian choice, if not one vegan choice, very few restaurants cater for people with allergies. But a few simple changes can alleviate problems for these diners.

“It doesn’t take much to devise a system whereby there is always at least one member of staff on duty who has access to accurate ingredient information,” said an Allergy UK spokesman. “If a customer realises they have ordered a dish that contains nuts, it is not good enough to simply pick the nuts off the dish and return it to the customer – tiny traces may be fatal.”

Chris Curry, restaurant manager, at The Village Bakery Restaurant in Penrith, Cumbria, which caters for vegans, vegetarians, coeliacs and people with wheat and dairy allergies, says: “I used to work in the hotel business and I would have people ringing up and asking if we catered for coeliacs. I just said 'yes sure' but of course, when they arrived we failed miserably. I leant very quickly that it’s a serious disease, which cannot be ignored.”

So, why not organize a training session for your staff on allergies? Make sure all staff know what each allergy means and teach them to take customers seriously. A person suffering from a food allergy can be dead within 10 MINUTES of eating their trigger food, so including an ‘allergy response’ in your first aid training is essential.
 
Stating the obvious…and not so obvious

Exotic and interesting names for dishes may entice customers but it makes it hard for people with food allergies to avoid choosing a dish that contains their lethal ingredient. Many restaurants now use a standard ‘N’ on the menu, demonstrating that the meal contains nuts, but it may also be worth making sure the menu name reflects the ingredients too. So a Waldorf salad could be renamed a ‘walnut and carrot salad’.

In the kitchen

Good organization at front of house is essential, but if the chef isn’t aware of the dangers, allergens can enter meals without the waiting staff or the customer knowing. Minimise risks by seeking to avoid situations where cross-contamination can occur and where possible, keep certain preparation areas designated as ‘nut free zones’.

Curry says this doesn’t mean you have to compromise on taste: “Catering for special diets has been imbedded in our philosophy from the beginning, but it would be no good making all the wheat and gluten-free items exclusively for those with allergies – we want to make food that is tasty and appeals to everyone,” he says. “Taste is the key to our success and it’s a real challenge for the chef to make things taste as good as possible while not using the conventional ingredients. Suppliers are now more switched on to this too and offer great alternatives.”

Try and avoid the indiscriminate use of nuts e.g. powdered nuts as a garnish, and watch out for ‘hidden’ allergens in seemingly innocuous ingredients. This includes nuts in salad dressings, gluten in batters and wheat flour in sauces. “Get your supplier to provide accurate written details of all ingredients, including any planned changes,” says Allergy UK. “Or, try to use alternative ingredients – flours such as cornflour, buckwheat (made from rhubarb) and tapioca flour are gluten free and can be bound together using grated apple, or eggs.”


Food Allergy Facts

Coeliac Disease

What? This is a very serious auto-immune disease, also known as gluten-sensitive enteropathy, and is a condition that affects the small intestine.
Allergic to… Gluten – found mainly in wheat, rye and barley. Sufferers must avoid bread, biscuits, cakes and pastries, pasta, breakfast cereals and some manufactured soups and sauces. Gluten is also 'hidden' in some foods such as crisps and similar snacks, as well as chips. Cooking oil (or mixed vegetable oil) can contain wheat-germ oil. Malt vinegar, soy sauce, mustard and mayonnaise contain gluten. Beer and whisky are made from grain containing gluten, but other alcoholic drinks, such as wine or cider are gluten-free.
Symptoms? Blistering skin rash, mouth ulcers, gradual weight loss, anemia, diarrhoea, constipation, and stomach cramps.
Who has it? One in 300 people in the UK and in Ireland, one in 100.

Wheat Intolerance/Allergy

What? Sufferers are allergic to a protein called gliadin, found in wheat. (This protein is also found in gluten; however, wheat allergy and coeliac disease are different conditions). Wheat ‘intolerance’ is not as serious as wheat allergy and will not lead to an anaphylactic shock.
Allergic to… Anything that contains wheat. This can range from breadcrumbs, croutons, durum wheat, macaroni, noodles, pasta and some cereals.
Symptoms? Can include some of the following; asthma, itchy skin, bloating, chest pains, depression or mood swings, diarrhoea, eczema, feeling dizzy or faint, joint and muscle aches, nausea or vomiting.
Who has it? One in three people claim to have a wheat intolerance but the amount of people who have a wheat ‘allergy’ is unrecorded.

Nut Allergy

What? When people with the allergy eat peanuts or tree nuts it can cause a severe allergic reaction called anaphylaxis (extreme low blood pressure). This is a rapid allergic reaction usually involving more than one part of the body that can be severe enough to kill.  
Allergic to… Peanuts and tree nuts including: cashews, walnuts, Brazils, hazel nuts, almonds, pecans, pistachios, chestnuts, cobnuts, macadamias and pistachios – as well as sesame seeds. Sufferers need to avoid confectionary, biscuits and Indian/Chinese/Asian and Thai food. In rare cases even minute traces can cause a reaction, such a skin contact with someone who has eaten or been in contact with nuts.
Symptoms? Anaphylactic shock which can include symptoms of itching, swelling of the throat and tongue, difficulty in speaking, difficulty in breathing, hives, feelings of weakness (normally a drop in blood pressure), leading to collapse and unconsciousness, and sometimes death.
Who has it? One in three people in the UK.