We’ve all been there – having a meal with someone who tells the chef they are allergic to something. The eight main food allergens in most cultures are wheat ,egg, dairy, soy, shellfish, seafood, peanuts and tree nuts. There are many others, but, these are the most commonly found worldwide. Sesame, celery, mustard, and more recently, food dyes, are increasing in commonality.
There are different levels of allergic reactions for people from the sublime, to the life threatening. Many people think that “a not so good feeling,” and upset stomach are allergic reactions, but in fact they may be nothing more than a food intolerance or food sensitivity. Many people will often claim to an allergy because of a dislike to a certain food. For a reaction to be classified as an allergic reaction, the body must have an abnormal response by the immune system to a specific protein found in the food consumed. Symptoms can occur in some cases within minutes, to hours. Some food allergies can cause a skin reaction (rash, hives, red itchy areas) digestive tract problems (nausea, vomiting, diarrhea, abdominal cramps), respiratory complications (headache, difficulty breathing, swollen lips, tongue and throats) and even cardiovascular response (a drop in blood pressure, loss of consciousness) and in the more severe cases, anaphylactic shock, which can cause death.
How do you cater for the passenger or crew with a food allergy? First and foremost there must be dialog between the person placing the catering order with the person taking the order. It doesn’t matter if that person is the scheduler, pilot or flight attendant or the other end of the spectrum; the executive chef, take-out cashier or the caterer. Ask to speak with the person in charge, the person who is most familiar with the menu and its preparation – not meaning a conversation with a passing comment that “oh, by the way, our lead has an allergy to gluten or shellfish.” There needs to be an in-depth conversation. Some food may seem innocent enough, but when a true conversation takes place, you may find that hidden beneath the surface are seasonings or flavor ingredients that contain the allergen. For example, shellfish. It would seem simple enough to not order the obvious – no shrimp, crab, scallops, oysters, lobster or other crustaceans. But ask the questions of the chef: “what are the ingredients in the sauce for the filet, and how is it seasoned?” Many Asian foods often use a lobster or oyster sauce as a base for seasoning, even though the food being prepared is not shellfish. Does the restaurant or caterer use the same oil and fryer to deep fry potatoes or chicken that may also be used to fry shrimp? What about a skillet used to sauté a beautiful fresh piece of Chilean Sea bass or prepare shrimp scampi? Is it thoroughly cleaned and sanitized after each use during that meal service? It may be used for shellfish and for other seafood and only wiped clean after each preparation. We don’t like to think this happens, but, it does. You can be allergic to one and not the other. Or consider the char grill surface. Is there a separate grill for each allergen at the establishment or is the food simply segregated to keep fish from cooking on the same area of the grill as beef or chicken or vegetables. ALL PROTEINS in the food can linger on the surface and can cross-contaminate and cause an allergic reaction. For someone with an allergy, this could be deadly.
Let’s discuss gluten. But, what exactly is gluten? It is used to thicken sauces and gravies. It can be a filler in potted meats or meatloaf, it can be on the surface of sautéed meats and fish to allow them to brown perfectly and prevent shrinkage when sautéing. That piece is chicken is obviously not full of gluten, but, in the cooking process may come in contact with gluten. You may find that the soup is thickened with flour which contains gluten. If you don’t dive into the unasked questions the person taking the order may not think beyond the obvious. Caesar dressing contains fish (anchovy) and if pre-made for food service may contain gluten.
And nuts – whether tree or ground, they can be found everywhere. They are easy to spot in the obvious places like nut candies, cookies and other desserts, as a crust on fish or chicken, but, what about that pesto? Nuts also are being used in the oil form such as hazelnut oil, peanut oil, and walnut oil. These can be found in everything from salad dressing to brownies to deep fryers.
Soy is another very common ingredient, but not just in soy sauce. Did you ever see on an ingredient label the words texturized protein? Many prepared items for purchase in a market are stabilized and even stretched using texturized protein, which is soy. Mashed potatoes seem innocent enough to order, right? Maybe not. Did you ask the caterer how they are prepared? Are they “real” potato or part real potato and part instant? Often times a restaurant or caterer may use a blend of the two to “stabilize “the potato in order to pipe or to hold for reheating. If the potatoes are a prepared product produced by an outside company, purchased by the food vendor to save preparation time, they may be coated with soy or even with gluten or chemically treated to increase the shelf life and maintain color of the product. If you don’t ask about the preparation of the product and the source of the product you cannot assume it is free of the allergen your passenger may have.
Dairy is a huge pool of items to be cautious of when ordering catering. We are talking everything from cheese to butter, and milk and cream. Many pastries, boxed mixes and deli meats contain this allergen. You must ask for the preparer to read the ingredient label of all products.
If your passenger or crew member has a severe allergy, you cannot afford the risk of handling their food incorrectly. You must ask for their food to be prepared separately, with freshly cleaned and sanitized equipment. It must be kept separate and packaged separately in order to prevent the likelihood of contamination by another food in the order. Ask for the food containing the allergen to be labeled and identified so it does not cross-contaminate when unpacked on board the aircraft. The flight crew handling the food needs to be trained in the principles of cross-contamination and all other aspects of safe food handling. It is the responsibility of every person in the chain of custody of food to work together as a team to protect that passenger and crew from an allergic reaction.
In 2010, 16% of Medaire calls were related to gastrointestional problems and 3% were specifically food related. We have just touched the surface of food allergies and ways to prevent your crews or passengers becoming unfit to fly or preventing the completion of a mission. Over the next weeks, we will dive into what you can do to keep your passenger and crew from becoming part of the 2011 statistics. Don’t be part of the statistic – learn and act on your food allergen knowledge.