1. Introduction to food allergies
About this course
This course is intended to provide everyone involved in preparing and/or serving food with the basic knowledge to be able to prepare foods free from certain allergenic ingredients and to be able to communicate effectively with customers about food allergies and intolerances.
The information in this course is offered as guidance only. While significant effort has gone into making it as relevant, accurate, and up to date as possible, the recommendations contained should not be applied without careful consideration to your specific setting and after consulting with appropriate specialists, agencies and authorities.
Food allergies versus food intolerances
Every year in the UK thousands of hospitalisations and multiple deaths occur as a result of allergic reactions to certain foods. Many people are also affected by food intolerances. Food allergies and intolerances present serious life-threatening consequences to sufferers. Everyone connected with the production, sale and service of food should understand how food allergies occur and what to do when confronted with a potential allergy emergency.
A food allergy occurs when the body's immune system reacts unusually to specific foods.
The allergic reaction can range from mild, for example a rash, to violent and life-threatening, for example difficulty breathing and even death. The more serious reactions are referred to as Anaphylactic shock which usually happens within seconds or minutes of eating even a small amount of the food. A typical food people develop a serious allergy to is peanuts. In some cases even breathing in a tiny amount of peanut fragments or dust can be sufficient to trigger a life threatening attack.
A food intolerance occurs when someone has difficulty digesting certain foods and can have an unpleasant though rarely life-threatening physical reaction.
Symptoms can range from mild bloating and stomach pain to severe digestive system disorders. Food intolerances usually occur over a longer period, often building up over time. A common food intolerance that people can be born with or develop an intolerance to is wheat. Wheat contains gluten and around 1% of people in the UK are gluten intolerant, hence the rise of gluten-free products.
Coeliac disease
Coeliac disease is a life-threatening condition linked to the presence of wheat (gluten) in the diet.
Coeliac disease is a serious condition where the presence of even small amounts of gluten in the diet can permanently damage the body’s ability to digest food. Gluten is found in cereals including wheat, oats, barley and rye, all used extensively in the food industry including in the production of flour. Coeliac sufferers need to avoid all gluten, even gluten-removed foods.
Anaphylaxis and emergencies
As you've already discovered, anaphylaxis is the name given to a sudden and severe reaction to a specific substance. Anaphylactic shock can be distressing to witness let alone experience, and untreated can lead in the worst cases to death within minutes. It's vital to recognise the symptoms and to offer appropriate help. Symptoms include vomiting, swelling, difficulty breathing, disorientation, panic/distress, and loss of consciousness. Don’t assume someone is drunk or under the influence of drugs, it may be anaphylactic shock!
Emergency response
- Call 999 and ask for an ambulance or paramedic.
- Ask the sufferer if they are carrying an EpiPen. Help them find and administer it.*
- Ask the sufferer if they are carrying an Asthma inhaler. Help them find and administer it.**
- Keep them calm and reassured while seeking help from a first aider.
- If they pass out make sure their airway is clear of food and other choking hazards and lie them on their side (recovery position).
* An EpiPen; a single ready-to-use injection that can help prevent anaphylactic shock from becoming fatal.
** Anaphylaxis caused by a food allergy and a severe asthma attack can have almost identical symptoms (difficulty breathing, distress, passing out). A prescribed emergency inhaler can prevent an asthma attack becoming fatal.
What does ‘allergen-free’ mean?
‘Allergen-free’ usually refers to the food product being ‘free’ of a particular allergenic ingredient, for example ‘gluten-free’. It’s possible a food you’ve attempted to prepare as free of a particular allergenic ingredient could still end up still containing that ingredient due to factors out of your control. It’s unwise to claim that any food product you make or serve is guaranteed 100% free of any particular ingredient.
If you offer any allergen-free foods, your premises should have a food allergy policy and customer statement that explains what ‘allergen-free’ means at your premises. If possible, get hold of this policy now, or the customer statement or any other communication used to explain how food allergies and intolerances are dealt with at your premises.
Prevention is better than the cure
Mistakes with food allergies threaten the health of allergy sufferers, your employer’s reputation and even your own liberty as you'll discover in the next chapter which deals with the law, fines and other penalties. So how can this threat be controlled? The answer lies in basic planning, training and communication.
Basic planning by the business owner or supervisor should put policies and processes in place to deal with this issue. Completing training and following your supervisor's instructions fully can give you the confidence to act appropriately and communication between the customer, front-of-house/server staff and kitchen staff can ensure no disastrous errors are made.
Follow your supervisor’s instructions and approved food preparation processes, and if you are unsure about anything, ask your supervisor or a senior person in the kitchen for clarification. Never take risks with food allergies or intolerances.