2.3 Food Allergens

Food allergies affect approximately 32 million Americans, including 1 in 13 children. For those with severe allergies, even trace amounts of an allergen can cause life-threatening reactions. As a food service manager, understanding and preventing allergic reactions is a critical safety responsibility.

The Big Nine Major Allergens

The FDA identifies nine major food allergens responsible for over 90% of food allergic reactions in the United States. These are often called the Big Nine:

Critical Update: Sesame became the 9th major allergen on January 1, 2023, under the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act. This is heavily tested on current ServSafe exams.

Understanding Allergic Reactions

Food allergy - An abnormal immune system response to a food protein. The body mistakenly identifies the protein as harmful and launches an immune attack.

Allergic reaction symptoms:

• Mild to Moderate: Hives, itching, swelling (lips, face, tongue), stomach cramps, vomiting, diarrhea
• Severe: Difficulty breathing, wheezing, tightness in throat, rapid pulse, drop in blood pressure
• Life-Threatening: Anaphylaxis (can cause death within minutes)

Anaphylaxis: A Medical Emergency

Anaphylaxis (pronounced "an-uh-fuh-LAK-sis") is a severe, potentially life-threatening allergic reaction that can occur within seconds to minutes of exposure.

Symptoms of Anaphylaxis:

• Difficulty breathing or shortness of breath
• Swelling of throat and tongue (airway obstruction)
• Rapid, weak pulse
• Drop in blood pressure (shock)
• Dizziness, loss of consciousness
• Skin reactions (hives, flushed or pale skin)

Emergency Response:

1. Call 911 immediately
2. Help person use epinephrine auto-injector (EpiPen) if available
3. Have person lie down with legs elevated (unless difficulty breathing)
4. Monitor breathing and pulse
5. Be prepared to perform CPR if needed
6. Even if symptoms improve, person MUST go to hospital (symptoms can return)

For the Exam: Know that anaphylaxis is a medical emergency requiring immediate 911 call. Even if symptoms improve after epinephrine, the person must still receive medical attention.

Cross-Contact vs. Cross-Contamination

Important Distinction:

Cross-Contamination - Transfer of pathogens (bacteria, viruses) from one food to another

• Example: Raw chicken juice drips onto salad

Cross-Contact - Transfer of food allergens from one food to another

• Example: Peanut butter knife used to spread jam, then served to peanut-allergic guest

Critical: The ServSafe exam uses the term "cross-contact" specifically for allergens. Using "cross-contamination" for allergens is technically incorrect.

How Cross-Contact Happens

Preventing Cross-Contact

Preparation:

• Use separate, clean equipment for allergen-free orders (cutting boards, knives, pans)
• Prepare allergen-free meals first before cooking allergenic ingredients
• Use dedicated fryers for allergen-free items when possible
• Store allergen-free ingredients separately in covered containers

Service:

• Change gloves between handling allergenic and allergen-free foods
• Wash hands thoroughly before preparing allergen-free meals
• Use clean utensils for each dish
• Label allergen-free meals clearly in the kitchen
• Deliver allergen-free meals separately (different server or trip if possible)

Communication:

• Verify orders with kitchen staff ("This is the dairy-free meal for table 5")
• Confirm with servers what allergens to avoid
• Double-check ingredients in sauces, seasonings, garnishes

Responding to Allergen Inquiries

When a guest asks about allergens, never guess. Follow this procedure:

1. Listen Carefully

• "Do you have a food allergy or intolerance?"
• "Which ingredient(s) do you need to avoid?"
• "How severe is your allergy?"

2. Check Everything

• Review recipe ingredients (including hidden allergens)
• Check manufacturer labels for processed items
• Verify cooking methods (shared fryers, grills)
• Ask chef if unsure

3. Communicate Clearly

• Tell the truth: "This dish contains [allergen]" or "I'll check with the chef"
• Explain risks: "We fry multiple items in shared oil"
• Offer alternatives: "Our grilled chicken is safe, and we can prepare it separately"
• Never say "I think it's safe" or "probably no allergens"

4. Notify Kitchen Staff

• Alert chef about allergen request
• Mark ticket clearly ("NO SHELLFISH - ALLERGY")
• Supervise preparation if possible
• Confirm allergen-free preparation before serving

For the Exam: Know that staff must take allergen requests seriously, verify ingredients, and clearly communicate with guests. Never guess or minimize the risk.

Hidden Allergens

Many ingredients contain hidden allergens that aren't obvious:

Prevention:

• Train staff on hidden allergens
• Read all ingredient labels thoroughly
• Keep updated ingredient lists for recipes
• Ask suppliers about ingredient changes

Special Considerations

Labels and Menus:

• Federal law requires allergen labeling on packaged foods
• Many establishments voluntarily list allergens on menus
• Use clear symbols or statements: "Contains: Milk, Eggs, Wheat"

Buffets and Self-Service:

• High risk for cross-contact (shared serving utensils)
• Label all dishes with allergen information
• Provide individual serving utensils for each dish
• Consider advising guests with severe allergies to avoid buffets

Special Dietary Needs:

• Celiac disease - Requires strict gluten-free diet (wheat, barley, rye)
• Lactose intolerance - Different from milk allergy (digestive issue, not immune)
• Vegetarian/Vegan - Not allergies, but may overlap with allergen requests