NFMNT Chapter 4 Manage Food Allergies, Complementary, and Alternative Medicine

1. Nutrition Fundamentals and Medical
Nutrition Therapy
Manage Food Allergies, Complementary,
and Alternative Medicine
Corresponds with
LEARNING PLAN 4
Copyright 2016 Association of Nutrition and Foodservice
Professionals

2. Objectives
 Describe common food allergies and discuss dietary
implications
 Define alternative therapies
 Identify risks and benefits of alternative therapies
 Classify use of alternative therapies in long-term and
acute care
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

3. Objectives
 List questions to ask in evaluating dietary supplements
and other complementary and alternative treatments
 Explain the concepts of absorption and availability of
nutrients
 Identify the role of basic nutrition concepts in assessment
and implementation of complementary and alternative
therapies
 Explain the role of the Certified Dietary Manager for
assisting clients in alternative therapies
 Differentiate between an allergy and a food intolerance
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

4. Food Allergies and Intolerances
 Food Allergies occur when the immune system targets a
harmless food protein such as wheat
» IgE is released as well as histamine
 Food Intolerances are not true food allergies because
there is no IgE immune response
 Only about 4% of the adult population have a clinical
diagnosis of a food allergy
 5% of children (1 in 13) have a clinical diagnosis of a food
allergy
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

5. Food Allergies and Intolerances
 Allergic reactions can affect one or more body systems
» Skin – rash or hives
» GI Tract – nausea or vomiting
» Respiratory tract – difficulty breathing
» Cardiovascular system – affecting the heart
 Anaphylaxis
» Potentially life-threatening allergic reaction requiring
immediate treatment
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

6. Common Food Allergens
 There are eight top allergens in the USA that account for
90% of food allergies
» Federal law requires food allergy labeling of these eight foods
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4
Egg Fish
Shellfish Milk
Peanuts Tree Nuts
Soy Wheat

7. Brain Break
 Cross-contact is often a
cause of food allergies. List
some ways to avoid cross
contact in foodservice.
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4
» Never remove a sandwich filling
and reuse the bread for another
type of sandwich
» Use separate tongs for foods
causing allergies
» Thoroughly wash hands after
handling foods causing allergies
» Thoroughly wash deli slicers
between meat and cheese
slicing
» If a client has a nut allergy, use
extreme precaution with nut
butters, nut oils, nut toppings or
don’t use them at all

8. Common Food Allergens
 Wheat allergy vs gluten intolerance
» Wheat allergy causes an IgE mediated response
» Gluten intolerance is a digestive disease
 Common sources of gluten in the diet
» Wheat products: Bulgur, durum wheat, farina, triticale,
graham flour, matzo flour, wheat germ, wheat starch, bran
» Barley products: Barley, barley malt, barley malt extract
» Orzo, panko, seitan, udon, farro
» Pasta made from semolina
» Hydrolyzed vegetable protein (HVP)
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

9. Allergy Treatment and Managing
Reactions
 Best way to avoid a food allergy is to avoid the food
allergen
 Role of the Certified Dietary Manager
» Follow the Rule of 3 for reading the label/ingredients
1. Before ordering
2. When unloading/putting away product
3. Before starting a recipe or serving a food
» Have an established policy for documenting food allergies
and procedures for care
» Ensure there is no cross-contact
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

10. Brain Break
 What is the best type of utensil and work surface to avoid
cross contact of allergens?
» Stainless Steel
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

11. Two Approaches to Medicine
Conventional medicine
Traditional or mainstream medicine
» Science used by physicians(Medical Doctors—MDs and
Doctors of Osteopathy—DOs), as well as allied health
professionals, as they are trained in the Unites States.
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

12. Two Approaches to Medicine
 Alternative practices
» Complementary and alternative approaches
- Complementary and alternative medicine (CAM)
» Diverse systems, practices and products not part of
conventional medicine
- Acupuncture
- Ayurveda
- Homeopathic
- Naturopathic
» Check out the National Center for Complementary and
Integrative Health for recalls, tainted products and other
alerts
- http://nccam.nih.gov/news/alerts/
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

13. Types of CAM
 Alternative medical systems
 Mind-body interventions
 Biologically based therapies
 Manipulative and body-based methods
 Energy Therapies
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

14. Herbs and Dietary Supplements
 ‘Natural’ does not necessarily mean safe
 ‘Dietary Supplement’ has a specific definition by the FDA
 1994 legislation determined dietary supplements are
considered foods, not drugs; making them not subject to
the same rigorous controls as prescription and over-the-
counter (OTC) drugs.
 Safe and effective dosages are not well established
 Risk of overdose for several dietary supplements
 Potential for drug (supplement) interaction
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

15. CAM Therapy
 Do not automatically dismiss CAM therapy
 Respect individual preferences
 Encourage full disclosure of CAM therapies your client
may be utilizing
 Carefully evaluate CAM according to scientific research
and accepted practice
 Consider potential for fads, frauds, and quackery
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

16. Brain Break
 A client has a diagnosis of A-fib/AF (arterial fibrillation) of
the heart and is on a prescription blood thinner. The
client also lists an OTC supplement of Ginkgo. What are
the possible risks or side affects of combining these two?
» Ginkgo can interfere with the action of the anticoagulant
medication that could result in excessive bleeding.
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4

17. The Role of the Certified Dietary
Manager
 Recognize individual rights of clients to choose their own
care
 Respect individual preferences
 Communicate with clients and the entire healthcare team
about CAM therapies, especially the use of dietary
supplements
 Inform clients of possible risks; help to educate
Nutrition Fundamentals and Medical Nutrition Therapy • Managing Food Allergies, Complementary, and Alternative Medicine •
Learning Plan 4