Dave Bloom from Snack Safely wrote a great article about the shingles and MMR Vaccine (measles, mumps, ruebella) … if you have an allergy to Beef, Pork, Gelatin or Alpha Gal Allergy, you definitely want to read this information!
As many of you know, periodically we send out some of our food to a lab for allergen testing. Even though our facility is free of allergens, we also count on suppliers to provide us with some ingredients. Periodically testing our products gives us that extra confidence. (you can see report at the bottom)
This time we tested our Chocolate Cupcakes, “Rye” Bread and a Blue Menu Cheese Pizza. We have the lab test for the following allergens: Peanut, Almond, Egg, Hazelnut, Total Milk Protein, Casein Protein, Gliadin (Gluten) Walnut, Shellfish (Crustacea), Soy, Sesame, Cashew and Pistachio.
It is important to understand how testing works. The lab has a very specific way of testing food for the presence of allergens. The results come back in ppm (parts per million). I am going to make this as simple as possible to understand. The first thing you need to understand is that zero ppm does not exist; below, I explain why.
When an item is being tested, they assume it is at 0 ppm of the allergen. They take the sample and inject 2.5 ppm (or some quantity) of the allergen into it. Then they test it to see how many ppm of the allergen it contains. If it comes back at 2.5ppm, then there is no allergen detected..because they put 2.5ppm of the allergen into the food item. If it comes back at 5ppm. they know it contained 2.5 ppm of the allergen before injecting the allergen into it. For an item to be called GF it must test less than 20ppm of gluten.
Some companies are certified to 10ppm (GIG), we are certified to 5ppm by the Celiac Support Association. These companies who give GF Certification require the company to test their products and they charge the company an annual fee to stay in compliance. Companies that do this are those that take it seriously! Remember, the federal law only encourages companies making a GF Claim to test their products..it is not required by the law and the type of testing is not mandated either. Look for CSA seal or GIG seal to be sure it is GF!
So, when you hear people saying that they want 0 ppm test results; it is just not possible. The test results show what the Detection Limit is (as low as the lab can go at detection) and the Methods they used to test the product. Usually it ranges between 2.0 and 2.5 ppm. For gluten the testing can only go as low as about 5ppm.
How do I visually understand a Part Per Million?
“If you divide a pie equally into 10 pieces, then each piece would be a part per ten; for example, one-tenth of the total pie. If, instead, you cut this pie into a million pieces, then each piece would be very small and would represent a millionth of the total pie or one part per million of the original pie. If you cut each of these million minute pieces into a thousand little pieces, then each of these new pieces would be one part per billion of the original pie. To give you an idea of how little this would be, a pinch of salt in ten tons of potato chips is also one part (salt) per billion parts (chips).” *SOURCE: Cornell click here for more
When gluten is being tested, it is a little bit different. If they are testing Gliadin; only 50% of gluten is available as gliadin…so to calculate the results you need to multiply the gliadin ppm by 2! So, if it is 2.5 on gliadin, it would be 5 ppm for gluten.
Testing is not cheap, this round of testing cost several thousand dollars. Here is what our testing results looks like!
AllergyEats is the leading web based guide to finding allergy-friendly restaurants nationwide. I had the pleasure of interviewing Paul Antico. He shares why he founded the site and how he handles dining out with three children with multiple different food allergies and how he feels mainstream restaurants respond to food allergic diners.
What inspired you to found the AllergyEats Website?
About 10 years ago, my wife and daughter were out of town, leaving me and my 2 food-allergic boys to enjoy a “guy’s weekend.” I wasn’t as well-practiced in managing my kids’ food allergies as I am now, though I knew how to protect them (and, of course, how to use an epinephrine auto-injector). On Saturday night, I took the boys out to eat around 7PM (first mistake – prime time). We went to one of our “go-to” restaurants, but the wait was 75 minutes, so we moved on. At our second “go-to,” the wait was about an hour. Same as our third. We didn’t want to wait that long anywhere. Unfortunately, I had run out of “go-to” restaurants and realized that I wasn’t terribly comfortable determining on-the-fly if a restaurant could accommodate our boys or not. We ended up driving for about 2 hours – the boys crying in the back of the car – until we ended up at a “greasy pizza joint” that had egg-free pasta and could serve both my kids. But as I was driving, and reflecting on the many times my family has gone an hour or two trying to find a restaurant we’d be comfortable at – be it in a big city like New York or a smaller town like Lack Placid – I kept saying to myself “I wish there was a guide! I wish there was a guide!” Being in the business world for 15 years, at that point, I realized there was an unmet need and a market of food-allergic diners and their families that really needed such a guide. So 2 years later, when I left my job in the financial markets, I decided it was time to start AllergyEats and fill that void.
What allergies do your children have?
I now have 5 children, 3 of whom have food allergies. My 19-yo son has had a tree nut allergy his whole life, experiencing 2 anaphylactic events (not including the few we didn’t understand before he was diagnosed – we got lucky!). My 16-yo daughter has no food allergies. My 14-yo son currently has allergies to tree nuts and sesame. He has outgrown eggs entirely – baked and raw – and even outgrew peanuts. He also has EoE (eosinophilic esophagitis) that reacts to dairy. My 9-yo son has no food allergies. And my 7-yo daughter has had an egg allergy her whole life, with – so far – no sign of outgrowing it.
What is the main goal of the AllergyEats website and app?
There are two primary goals of AllergyEats. The most important, of course, is to provide a valuable tool to the food allergy community that hopefully makes the dining out process easier and more comfortable by providing them with crowd-sourced information showing which restaurants have been better choices than others for food-allergic diners. The secondary goal is to reward those restaurants that make the effort to properly accommodate our community and thus incent other restaurants to take the appropriate steps themselves.
What is the biggest challenge that you see facing people with food allergies who want to dine out?
The biggest problem is accepting that there is ALWAYS risk – no restaurant is perfect (though One Dish Cuisine may cause me to re-think that) – and making the decision about whether you can accept that or not. It’s not easy – anaphylaxis can be terrifying, even when you know you have your epinephrine with you. Of course, you want to minimize your risk by choosing an appropriate allergy-friendly restaurant, which is where the AllergyEats app and website come in. And, most importantly, YOU have to do your part by: a) never dining out without epinephrine, b) ALWAYS disclosing all your allergies to your server (and possibly the manager or chef), and c) visually inspecting your food as best as possible before eating it. I’ve found that the “bad events” that happen at restaurants usually involve a breakdown of responsibility by BOTH the restaurant and the diner. We need to take care of our end of the bargain, so those 3 points above are critical.
Are mainstream restaurants taking food allergies more seriously than they have in the past?
Absolutely. It’s becoming harder and harder to ignore with so many restaurant diners disclosing food allergies, and even the stingiest of restaurants/chains will eventually understand the spending power of the food allergy community and those they dine with. I find that smaller, nimble chains seem to be on the front-end of the wave. Many independents are there too. The laggards tend to be larger chains, though that is by no means universal. AllergyEats publishes a list of the Top 10 Allergy-Friendly Restaurants in America each year (coming at the end of February this year), and you can see that there are large chains that do “get it”, though the average score – from AllergyEats users themselves – is generally much higher for the smaller chains.
What are the biggest obstacles a restaurant has to overcome if they want to provide allergen safe meals?
The biggest obstacle is also the simplest – commitment. It truly is that easy. Whether the owner of an independent restaurant or the CEO of a chain, that individual’s attitude toward accommodating food-allergic diners will set the tone for all employees. The training is easy. The financial burden is minimal. The disruption to operations in making appropriate changes is almost nil. So it all comes down to commitment. Find me an owner who cares about food allergies and I’ll show you an allergy-friendly restaurant. The reverse is also true. Find me a CEO who pooh-poohs food allergies and I’ll show you a chain that isn’t safe for our community.
Is there a way for mainstream restaurants to be trained in handling food allergies?
Absolutely. There are very basic programs online that, while they won’t make a restaurant very allergy-friendly, they will incrementally increase the knowledge of a restaurant’s staff. But there are also bigger, all-encompassing programs as well for those restaurants that are ready to make the all-in commitment. The one that is making the most headway is AllerTrain. AllerTrain does on-site training and well as train-the-trainer programs for larger chains. They are training restaurants, colleges, entertainment venues, and more. They do have online modules as well, but the most comprehensive training is provided face-to-face, generally onsite. Outside of AllerTrain, there are independent trainers as well. And many restaurants develop their own programs from the knowledge or experience of key employees.
How many times a week do you dine out with your allergic children?
We don’t shy away from dining out. When we’re home, we usually go out about once every two weeks, though about once each week in the summer. However, we travel a lot. We have family in 4 different cities, we like to vacation, and our kids – like so many others – are involved in a ton of activities, some of which have us doing overnight travel. We also now have to visit our oldest son in college! When we travel, we eat out most nights. So I guess my best estimation is that we eat at restaurants probably 50 times a year. We probably order in another once per week. And while we certainly have our “go-to” restaurants at home and in some of our destinations, we do like to explore and gain some variety where possible. So, using AllergyEats of course, we find new favorites as we go.
How do you handle vacations with three of your five children having food allergies?
We’re old pros at this! After 19 years, we’ve developed a routine. Really, though, we generally do not have problems dining out. Using AllergyEats, we do our homework in advance. Sometimes we have to take a flyer on a restaurant that’s not yet rated on AllergyEats. Either way, we periodically come across a restaurant that we just don’t feel comfortable can keep our kids safe and we politely leave before ordering. But that’s rare and we no longer have to search for an hour or two to find a restaurant like we used to. We find most restaurants want to accommodate our food-allergic kids, so we just have to work with them regarding what they have, what is safe, and how to prepare it safely in the kitchen. I’m happy to say that in all our years of travel and dining out, “the system” (the dual responsibility of the restaurant and ourselves) has only broken down once, exposing my middle son to dairy. And the mistake was 100% on our end. Certainly, other restaurants have made mistakes, but not without either us or them catching the errors in time. So think about it – our family has had hundreds of meals from restaurants without a single mistake on their part that hasn’t been caught! Of course, our epinephrine auto-injectors are with us wherever we go and we usually have some basic food like soy nut butter and crackers in our room for a quick, safe snack.
How do you educate schools to keep your children safe?
Fortunately, I haven’t had to be a pro at this. The primary/middle school my kids have attended from age 3 through 8th grade, Inly School in Scituate, MA, is extremely allergy-friendly. They won an award from FAAN (Food Allergy and Anaphylaxis Network), one of the precursors to FARE (Food Allergy Research and Education), in 2011 for food allergy excellence. All staff members are diligently trained and the processes and procedures in place are great. The school has become known for this and actually brings in some students BECAUSE they are so allergy-friendly. As the kids have moved onto High School and now College, we’ve found that these schools generally have a program and set of rules in place. They aren’t as safe as Inly School, by any means, so our kids have to be smart about keeping their epinephrine with them, asking the right questions, taking proper precautions – basically, they have to do what they’ve learned and seen my wife and I do for all these years. And so far, so good.
How do you handle it if there is an accident and one of your children needs to use their Epi-Pen?
Fortunately, in all these years, we have only had 2 incidents that needed an epinephrine injection. The first was a tricky delayed onset reaction. I say tricky because our kids react to many of their allergies without anaphylaxis, needing only Benadryl to ultimately feel better. In this case, my oldest (with a tree nut allergy only) ate a chocolate ball at a nut-free event. His throat started to itch, as it does when he has non-dangerous oral allergy syndrome from exposure to some fruits, but this one was a little worse. Regardless, with us thinking the food was nut-free and the signs pointing to OAS, we went with Benadryl. Unfortunately, the symptoms weren’t improving. One could definitely say we should’ve used the auto-injector then (if not earlier), but we actually tried another dose of Benadryl. Same result. I prepared my son until he eventually made the decision for us. “Hit me.” Boom. Immediately, he felt better. (Turns out he had a biphasic reaction – a second anaphylactic event in the hospital – so we were very lucky we finally took the appropriate action.) We believe, by the way, that the chocolate ball was cross-contamination with tree nuts. A year later, while teaching at a farm camp, this same son thought he might have accidentally ingested something with tree nut residue in it. He wasn’t sure, but was feeling symptoms. Realizing how easily and quickly the epinephrine auto-injector worked the last time, he didn’t hesitate to use it himself. In hindsight, and while we can’t be sure, I don’t think he was having an allergic reaction – I think anxiety symptoms made it hard to tell. Yet, either way, he did the right thing. When in doubt, use the epinephrine. It is generally considered a very benign treatment that can rarely do any harm to you. And do not wait as long as we did in that first event. Anaphylaxis can spiral out of control quickly, even if delayed, and getting epinephrine in the body early is critical.
Do you blame yourself when an accident happens? What emotions do you go through?
Of course I do. Isn’t that true when anything goes wrong with one’s kids? In fact, forgetting food allergies for a second, I’m constantly wondering how ALL my past and current actions are affecting the lives of my kids. (I hope that just makes me a good father and not a lunatic!) However, I understand that I’m human and mistakes happen, so while I feel terrible and guilty, I apologize to my son or daughter and move on. They understand that these things happen too. It stinks, but it’s life – and we all need to accept it.
What would be the ideal dining out situation for you and your family and do you ever think you will feel totally comfortable dining anywhere.
Fortunately, we’ve had many, many very comfortable restaurant meals, but that is also a product of our long experience. We’ve been doing this long enough to know the best questions to ask and to “read” the staff’s responses well (verbal and physical). In the optimal case, we would find a restaurant known for their ability to accommodate food-allergic diners (yes, you know where we find them), have a conversation with the staff that shows a real proactive zeal for wanting to satisfy us, and have them proactively reaffirm all the steps they took when the bring the meal (separately or clearly marked) to our table. That all said, we do still have some “on edge” experiences where we believe the restaurant can accommodate us, but we’re not entirely secure with their food allergy knowledge. In those cases, we usually have to walk through their menu and their process in the kitchen step by step to ensure that – even if they don’t have broad food allergy knowledge – they will be able to make safe meals for our kids. Our epinephrine is always with us!
Do you think the general public will ever have a thorough understanding and respect for the serious nature of food allergies?
I hope they never have to – because that would mean a cure is found before broad public acceptance has a chance to take place! But realistically – because unfortunately we have to accept the fact that a cure is nowhere in sight – yes, I do think the general public will eventually have a healthy respect for the seriousness of food allergies, if not a broad understanding. Let’s face it, most people in their 40’s and younger today probably know someone with food allergies. And for the younger cohort in particular, once they actually get to know someone with food allergies, they tend to be compassionate and accept the seriousness of food allergies. Further, recognize the surge in food allergies that has taken place in our kids over the past 20 years. Logic would suggest that almost all people 20 years old or younger have grown up with or gotten to know friends with food allergies. Our kids are more accepting than our older generations; thus, I think the trend is our friend and broader acceptance is taking place every day.
What do you see as the biggest obstacle to widespread respect and understanding of food allergies?
Time. The younger generation gets it, and each day they become a larger part of the population. The older generations are also coming into contact with food-allergic individuals more and more each day, with many of them accepting it as well. I’ve seen the acceptance improve dramatically over my family’s 19 year journey. It will continue.
What advice can you give to parents of a child with newly diagnosed food allergies?
Do your best not to panic by recognizing that millions and millions of parents have been in your shoes. Yes, this can be terrifying – we all love our kids more than ourselves – and it can feel overwhelming, but as you start this journey you’ll soon learn that it’s manageable, even if not always (or ever!) comfortable. Each step has it’s challenges – shopping for safe food, eating food made by a family member or friend, dining out, starting your child in school, going on vacation, having your kids eat out with friends, eventually going to college, etc. – but you take each of these steps one at a time. Support groups like Kids With Food Allergies Foundation (www.kidswithfoodallergies.org) can be a big help in the beginning, as can local support groups, and online forums. Of course, finding friends and acquaintances who have been down this path can be extremely helpful as well. Realize too that, as you proceed down this path, you need to teach your kids all along the way, preparing them for their ultimate independence. Of course, rule #1? Never find yourself without epinephrine nearby.
What do you see in the future for AllergyEats?
For now, our focus continues to be on attracting new visitors to our app and website, and building our database of ratings. A lot of people in this world aren’t online raters in general (I’m one of them), but we have to impress upon these individuals that our food allergy community is all in this together and that each new rating someone adds on AllergyEats makes the app and website even more valuable for future food-allergic diners. (And yes, I AM a rater on AllergyEats, of course.) Like many other small businesses in the food allergy space, we’re also trying to execute a business model that can generate a profit (or at least breakeven) since we’re not a non-profit and can’t attract grants and funds in the same way. If we’re successful in doing so, the opportunity for AllergyEats to expand both vertically and horizontally is awesome. Our platform lends itself to many, many other options.
I am so grateful that Paul has developed this site to help us find allergy friendly dining spots. Please check out the site! Click Here for AllergyEats website
This is from our newsletter in July 2012. Author, John Grisham, shared his story with Allergic Living about his long journey to identify his beef allergy which was brought on by a tick bite! (known as Alpha-gal Red Meat Allergy caused by tick bites)
John Grisham was experiencing reactions, some at night, feeling like his skin was on fire and welts that would swell and itch. Trying to find out what was causing it was a long ordeal. He consulted a doctor and kept a journal of everything he ate for months and discovered the cause of his reaction. It was meat (beef, pork and other mammals meat). He later learned that the cause of his allergy was linked to a Tick Bite and his farm in Virginia is located in an area known to have lots of ticks.
What makes this hard to diagnose is that the symptoms often start over four hours after the meat has been ingested. University of Virginia researchers were the first to document this type of allergy. UVA’s world renowned Allergist, Dr Thomas Platts-Mills also developed a meat allergy after being bitten by a tick.
Click on the links below to read John Grisham’s incredible story about his journey to diagnosis and learn why he now eats a lot of chicken.
Interview on Alpha-Gal Red Meat Allergy Caused by Tick Bites
Celiac Disease, Food Allergies, Autism, Gluten Intolerance 