Oct/Nov 08 – May Contain Nuts


Rob Rees asks:

Should we label food more clearly for allergens? Should eateries be trained in giving adrenalin? Have we just turned into hypochondriacs?

Imagine the scene on a busy Saturday night at one of my restaurants  – a packed dining room full of guests. The kitchen is a buzz. Then one of my waiting staff enlightens me to the fact that one of the customers is finding it hard to breath. “Should we call an ambulance?” Don’t panic was the thought. Phone 999 and in the meantime don’t forget to keep the other guests happy.

Almost instantly the lady had symptoms of tingling in her tongue and a rash on her skin, her breathing was becoming difficult and as her blood pressure started to drop there was danger of her experiencing unconsciousness and a fall blown anaphylactic shock.

But enough about her for now…

Food Allergy in the UK is an increasingly growing problem. Along with other allergic problems such as asthma and eczema food intolerance cases are increasing. But there may be a bit of a worry culture here in Britain with almost 30% of the population actually believing they suffer from an allergy. The reality of the figures though is that perhaps 5 – 8% of children and 1 – 2 % of adults are serious food allergy sufferers. It is thought that 10 people per year die from anaphylactic shock.

The mismatch figures are best explained by the fact that allergy and intolerance are different. A full-blown allergy will attack our human immune system causing a serious chemical reaction in our bodies. An intolerance, whilst often very unpleasant and alarming, will not affect your immune system. Of course there may be stomach cramps, vomiting and diarrhoea and feverish temperatures but it is not anaphylaxis. These sufferers are having a very unpleasant aversion to a particular ingredient. To be more specific it is an allergen in a food that is causing the problem for anaphylaxis sufferers.

The most likely suspects that contain such allergens are peanuts, milk, eggs, fish, nuts, sesame seeds and shellfish. That doesn’t rule out others though like watermelon, kiwi fruit, orange, lactose, various additives and all kinds of other products that may contain a combination of allergens.

So what can be done about it?

There are a number of things that we all have to do.

  • Sufferers themselves need to be aware and let friends, family and when eating out caterers know.
  • Your eating experience need not be spoilt as long as those cooking for you are informed and also the food that you buy is correctly labelled so that you are not limited to your selection or put at any greater risk.

‘May contain nuts’ doesn’t really go far enough does it?

  • Industry needs to either say it does or it doesn’t. I spent a day going shopping with a lady called Hazel Gowland from the Anaphylaxis Society and was appalled as to the limitations and dangers that lurked in the supermarket commercial wilderness. To be fair many are starting to improve their production systems, but more needs to happen and faster. It is actually really pleasing to see that at Gloucestershire Farmers Markets product diversity is including gluten free sausages, diabetic chutneys and other growing consumer product needs. Many of those who have such a problem will ware a bracelet stating their particular allergen nasty – this is so that medics will know how to appropriately deal with them.
  • If somebody asks you if a particular dish contains a certain ingredient – don’t blag it, find out the truth. The customer or friend really won’t mind waiting if you do it in the appropriate manner – you may be saving someone’s life.
  • Young people and young adults who suffer need to inform their friends. That late night Chinese takeaway after a club session could cause a problem with all the nuts and satay sauce. Just don’t take the risk. You will still be cool and you are not alone. Schools are more geared up to the problem than ever before, but if in doubt mention it to the teachers and make sure that a policy is documented.

As for my lady guest her special occasion did turn into a nightmare but the great work of the ambulances saved her. She didn’t know she was a sufferer, which proves for some it can have an onset at any stage in life. Adrenalin was administered and as quick as the shock arrived it began to recede and a nighttime stay in casualty monitored her recovery. I made it my problem in those early days of my career as I do now to question clients if they have dietary needs and I clearly label my menus and monitor my processing systems in my kitchens. It’s routine and should be for others in the catering and food-manufacturing sector. They need to make it their problem.

What do you think?


10 Responses

  1. Nice site. Theres some good information on here. Ill be checking back regularly.

  2. When eating out it ishould be the responsibility of the diner to mention to the staff if they have a food allergy or intolerance. I am allergic to kiwi fruit but would not expect kiwi fruit to be mentioned on the menu against gateaux or fruit salad. The whole purpose of information being on the pack is that the manufacturer is not present to ask, whereas you can expect the chef to know what ingredients a food contains if asked.

  3. expect a chef to know? really? with so many buyng in food from distribution centres and just pinging it – do we think they care? maybe the ones cooking from scratch but they are the moniority I should think in Gloucestershire.

  4. If the chef doesn’t know or care Mr Veg, don’t you think he/she has a duty of care if a customer asks?, and isn’t he/she wide open to the ‘where there’s a blame there’s a claim ‘ vultures if their customer croaks?

  5. I am inclined to agree with Mr Veg here. A great deal has been done to educate chefs further to the risks of allergy contamination in recent years. It is also included in the various chef qualifications that are out there. My personal view is though that it still doesn’t go far enough. The process in some bigger kitchens can be – bulk buy deliveries that get broken down into various smaller containers without any labelling; chefs use these ad hoc in their cooking and products enter the chain or get cross contaminated with allergens and the problem arises. Hazel will enlighten us to the fact that the smallest trace can be fatal. I think that “may contain” is still too vague and would love to see a clear does it or doesn’t it rule. That said, organizations like schools and hospitals manage fantastically good systems in minimizing any risks of food allergy incidents – independent restaurants, cafes and other quite often don’t. Unless the full team of chefs, waiting staff and managers are properly trained in what is on the menu then consumers could be put at risk. We know historically that hospitality is poor at investing in upskilling its workforce – especially one made up of so many part time staff.


  6. Lets put this in perspective. Approximately ten people die every year from an allergic reaction to food, many more ending up in hospital. In most cases the food that causes the reaction is purchased from a restaurant, takeaway, public house or hotel.

    With this in mind food businesses absolutely must therefore ensure they know exactly what is going into the food they prepare by not only checking and rechecking ingredients lists on jars and tins etc but by having adequate controls in place to tackle cross contamination in the kitchen. When serving customers, staff need to be aware of the risks associated with food allergy and be trained to deal with customers with a food allergy who enquire about the content of the food on offer. If serving staff are asked about the content of the food on offer, they should be trained to never second guess and ask the chef if not sure.

  7. If your job involves preparing food for allergic people, then you may be interested to know how to ensure that you protect their food from cross contamination and also how to include food allergy risks in your food safety plan.

    Whilst there is no doubt that tiny traces of some foods can trigger symptoms in some people, and also that symptoms can occasionally become severe, and whilst we are still waiting for more scientific research on the subject, there are still a number of very practical steps you can take to protect people with allergies.

    The first step is to really know exactly what is in all the foods you handle. If you don’t know your ingredients, then you can’t tell a customer who asks. In addition you won’t know whether there might be a cross contamination risk to other foods.

    Once you know exactly what is in the food you handle (by checking ingredients in recipes, on labels as well as ‘may contain’ information), your next step is to have a look at controls you already have in place.

    Without realising it, you may already have some very effective controls in place.

    For starters, do you wash your hands properly?

    If you use hot water and soap and spend the recommended 15 seconds washing your hands, you will also help to control any allergen contamination. Whilst using a sanitiser is designed to get rid of bugs, research has shown that it is yet another effective control against allergen contamination.

    Then you need to look at your work areas. In additional to removing ‘gross contamination’ – food residue from previous dishes or products, the use of normal detergents and sanitisers with hot water is effective, as long as you use a CLEAN cloth or paper. Dirty cloths will transfer allergens round your kitchen and service areas. If you are unsure about using a pitted chopping board, then chop up food for an allergic person on a clean stainless steel surface or on a clean plate.

    Washing up and dishwashing

    Once again common sense prevails. If you remove solid food before washing up and pre-rinse crockery, cutlery and utensils, this will mean that your washing up machines / sinks contain less food residues before you start using them. It is important to maintain equipment according to the manufacturer’s instructions. This includes cleaning out filters and other food traps, ensuring that the water is the correct temperature and using the correct programmes and products at the correct dilution. Manual bowl washing is the least effective method of controlling allergens but careful rinsing and ensuring segregation between clean and dirty items are still effective.

    If you have a food business or if you regularly serve food to others, perhaps in a voluntary group or in your home, you may be interested in the SOFHT award-winning Allergy training DVD training pack – Stage 1.

    For further information please see http://www.allergytraining.com.
    This practical training resource usually sells for £50+VAT but there is a current special offer for £20 including VAT. Email celine@hygieneauditsystems.com or ring Celine on 01727 866779 for your copy.

  8. Great website and interesting blog discussion. We’re on the other side of the pond but will return here from time to time to see what intriguing topics are being discussed. I thought the question about epi-pen training for restaurant staff is especially interesting and have put this same question before Food Allergy Buzz readers to see what sorts of different response we get here.

  9. Toni Smith from the Food Standards Agency says:

    1-2% of the population now suffer from some form of food allergy or intolerance. When someone has a food allergy, eating even a small bit of that food can make them very ill or could even be fatal. So, food allergy is a serious business.

    The FSA provides advice about food allergy and intolerance for consumers so that they understand and can use the information provided to them by food businesses. The Agency does this via its website and through published materials to help consumers make informed food choices that will ensure their safety, whilst not unduly restricting the choices available to them.

    The Food Standards Agency also develops policies on food allergies and intolerance that allow consumers to make informed choices about their diet. The Agency does this by negotiating and implementing legislation to improve statutory control on labelling of food allergens, and also by providing best practice guidance for industry and enforcement bodies to encourage greater awareness and control of food allergens through the food supply chain.

    Consumer information:
    Visit http://www.eatwell.gov.uk/allergy for information on allergies and intolerance.

    If you eat out and would like a ‘chef’s card’ so you can let the chef know your requirements without having to talk directly to them then visit: http://www.food.gov.uk/multimedia/pdfs/chefcard.pdf

    Caterers and Business information:
    To see the guidance for caterers and businesses, and the training that businesses can do on-line to improve their knowledge and understanding on food allergy visit:

  10. Interesting website & interesting information!!

    In all this search for separating ingredients and maintaining good hygiene, just remember some of us may be allergic or sensitive to artifical food additives or pesticides or other chemicals… So actually for me knowing about the chemicals used (or not used) in food preparation (including washing etc) would also be important.. And maybe to have the option to have plates&cutlery extra rinsed with hot water etc…

    antibacterial soaps and such have been known to kill the more harmless bacteria and create the more resistent ones in hospitals etc.. so a healthy balance here would be needed..

    Better labelling of food would be good.. though I suppose it can be hard for producers/manufacturers who may then need to resort to stronger cleaning practices of equipment or to buying more gear.. (which then may not be so environmentally friendly or healthy for people allergic to chemicals used, so..hmm..?)
    It wouldn’t be bad for eateries to have a member of staff trained and certified with giving first aid..

    As for hypochondriacs.. you can’t really ‘pretend’ to have an itchy rash or a true allergic shock.. Alas, I think it has more to do with bad air quality, environmental pollution, the number of chemicals in our homes, and vitamin/mineral deficiencies due to too ‘boring’ or too pre-prepared/pre-packaged food.. So limiting those might help decrease allergies too..

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