Dietary Restrictions

Question 1

immune response; when the immune system overreacts to a harmless food ______

Answer 1

Food Allergy
Protein

Question 2

In food allergies, _______ in food bind to specific ____________ made by the immune system, which triggers immune defenses that leads to a reaction.

Can occur in response to ANY FOOD.
Even the smallest amount of food can cause a reaction – no amount is safe to eat
There is NO CURE.

Answer 2

proteins
IgE antibodies

Question 3

Experimental treatments and ongoing research for food allergies include _______ and ________

Food allergy reactions are unpredictable because ________.

Answer 3

biologics
OIT (oral immunotherapy)

The way your body reacts to a food allergen one time might not be the same the next time.

Question 4

_______________: digestive system reaction, not an immune response, non-life threatening

Answer 4

Food Intolerance

Question 5

Millions of people have food allergies.
_______ adults and ______ children have a food allergy.

_____ is the most common food allergen in babies and young children.

A food allergy can develop at any age, even to a food that has not previously caused a reaction.
Children can outgrow a food allergy over time – common with _______________
Harder to outgrow: ________________

Answer 5

1 in 10
1 in 13

Milk

milk, egg, soy, wheat
peanut, tree nuts, fish, shellfish

Question 6

mild symptoms of food allergies

Answer 6

itchy/runny nose
itchy mouth
hives
sneezing
itching
nasusea

Question 7

severe symptoms of food allergies

Answer 7

anaphylaxis

• swelling of lips/tongue/throat
• trouble swallowing
• shortness of breath
• drop in BP
• turning blue
• loss of consciousness
• chest pain
• weak pulse

Question 8

______ is the only medication that can reverse anaphylaxis

Answer 8

epinephrine

Question 9

______ ….

Provides guidance to the food industry, consumers, stakeholders on best ways to manage allergens in food.

Conducts inspections and samplings to check that major food allergens are properly labeled on products.

Makes sure food facilities have controls to prevent cross-contact.

Makes sure labeling controls in place to prevent undeclared allergens during manufacturing and packaging.

Answer 9

FDA

Question 10

Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA)

Identified ______ foods as major food allergens: _______
nuts, peanuts, wheat, soybeans

Account for ___% of food allergies and serious allergic reactions in the US

Answer 10

8
milk, eggs, fish, shellfish, treenuts, peanuts, wheat, soybeans

90%

Question 11

The FDA enforces this in most packaged food products, including ___________

This does not include…
- _____________ ( US Department of Agriculture)
- _________ (Alcohol and Tobacco Tax and Trade Bureau)
- _________ commodities
- _______
- ___________
- most foods sold at retail/food service establishments that are _________________

Answer 11

dietary supplements

meat, poultry, and egg products
alcoholic beverages
raw agricultural
drugs
cosmetics
not pre-packaged with a label

Question 12

FALCPA-regulated allergens can be called out in one of three ways :
1.________________
2. Using the word “________” followed by the name of the major food allergen
3. In the____________, when the ingredient is a less common form of the allergen

Answer 12

In the ingredient list - using the allergen’s common name
Contains
ingredient list in parentheses

Question 13

For tree nuts, fish and crustacean shellfish - the _________ must be listed (almond, tuna, crab)

Manufacturers must list an FALCPA-regulated allergen, regardless of the amount.

Phrases like “________” are not regulated – might be made in facilities where the allergens are present.

Always contact the manufacturer if you are unsure.

Answer 13

specific type

peanut-free

Question 14

______ is the 9th most common food allergen
- increased worldwide over the past two decades

Answer 14

Sesame

Question 15

Sesame declared as the 9th major food allergen by the ________________ Act.

Answer 15

Food Allergy Safety, Treatment, Education, and Research (FASTER) Act

Question 16

Sesame recognized by the US - signed April 23, ____

Became effective on January 1, ______
- Labeling was not required until then

Products manufactured ________ may still contain unlabeled sesame and will remain on store
shelves until replaced by new inventory.

Used in many different cuisines and dishes, as well as snacks, dips, baked goods, soups, etc.

Answer 16

2021
2023

prior to 2023

Question 17

Gluten in proteins found in _____________

Celiac disease: gluten-containing foods trigger an immune response that attacks and damages ________
- May limit the ability to absorb nutrients
- Can lead to _______________

Increased risk for potentially serious health problems - intestinal cancers, autoimmune diseases

Answer 17

wheat, rye and barley

the lining of the small intestine
iron deficiency anemia, osteoporosis, malnutrition

Question 18

August 2, ______: FDA issued a final rule defining “gluten-free” for food labeling.

August 12, _____: FDA issued a final rule to establish compliance requirements for fermented and
hydrolyzed foods, or foods that contain fermented or hydrolyzed ingredients, bearing the “gluten-
free” claim.

Answer 18

2013
2020

Question 19

“Gluten-free” requirements:

Presence of gluten <____ppm

an ingredient that is any type of wheat, rye, barley, or crossbreeds of these

an ingredient derived from these grains and that has not been __________ to remove gluten

an ingredient derived from these grains that has been processed to remove gluten, if the food contained ____ or more ppm gluten

Foods that are inherently gluten-free can also be labeled “gluten-free” if any gluten that came in contact with the food is <_______ ppm.

Answer 19

20 ppm

processed
20
20

Question 20

Vegetarian

Religious, personal, health, environmental, ethical reasons

__________________: Eliminates meat, fish poultry; allows eggs and dairy

________________: Eliminates meat, fish, poultry, eggs; allows dairy

________________: Eliminates meat, fish, poultry, dairy; allows eggs

Answer 20

Lacto-ovo-vegetarian diet
Lacto-vegetarian diet
Ovo-vegetarian diet

Question 21

Vegan

Religious, personal, health, environmental, ethical reasons

Plant-based - all __________________

Answer 21

animal and animal-derived foods are avoided

Question 22

Kosher

Foods that comply with dietary guidelines in traditional
______ law.

3 categories: ________

Determines which foods may be consumed and how they
must be ________________

Guidelines regarding how meat should be ___________prior to consumption

Limits specific ________

Answer 22

Jewish
meat, dairy, pareve
produced, processed, and prepared
slaughtered
food pairings

Question 23

Halal

Foods permitted under________ law defined by the religious text of ______.

Processed, made, produced, manufactured and stored using utensils, equipment/machinery that has been ___________

Halal – lawful
_______ – prohibited

Guidelines regarding how meat should be _________prior to consumption

Answer 23

Islamic
Islam

cleansed according to Islamic law
Haram

slaughtered

Question 24

Current Allergen Testing Methods

Answer 24

Oral Food Challenge
Blood Test
Skin Prick Test
Food Elimination Diet

Question 25

Start with small amounts of the food and gradually have larger amounts while being observed under __________

Answer 25

Oral Food Challenge
Medical supervision

Question 26

Blood Test

Measures the presence of __________ to specific foods.

Answer 26

IgE antibodies

Question 27

Skin Prick Test

Use to measure the presence of __________
for the suspect food blood tests

Positive tests ________________

Answer 27

IgE antibodies
alone aren’t enough for confirmation

Question 28

Can be helpful when used along with skin and blood tests

Answer 28

Food Elimination Diet

Question 29

______________ : two or more foods come in contact with each other

• Hands/Gloves
• Clothing
• Equipment and utensils – grill, slicer, fryer, oven, etc.
• Air
• Allergens cannot be removed through _________.

Answer 29

Cross-contact

cooking

Question 30

______________: transfer of bacteria from one substance to another; can cause foodborne illness

Proper cooking may reduce/eliminate this

Answer 30

Cross-contamination

Question 31

Purchasing and Receiving

• Designated receivers and our Director of Purchasing are responsible for food delivery __________.
• Inspect all labels and dates when received.
• Alert if any product _____________ were made.
• Alert and set aside any ________ packaging or incorrect items.
• Packaged food labels should be read every time that food is purchased.
• Ingredients and manufacturing processes can change without warning – Important to make a habit of carefully reading ___________.

Answer 31

accuracy
substitutions

damaged

labels each time

Question 32

Cleaning

• Important to keep _______ clean.
• _______ alone will not remove allergens!
• Cleaning with _________ thoroughly is necessary to remove allergens.
• After washing, rinse with clean water and air dry.
• ____________ can aerosolize allergens
• buckets of sanitizing solution should be used.

Answer 32

stations

Sanitizing
soap and water

Spray bottles

Question 33

Food Preparation

• Following recipes exactly is important
• __________ must know if substitutions were made!

Answer 33

Chefs and managers

Question 34

Educating Food Service Staff

• ________ trainings for all chefs, managers and hourly employees.
• Establish ________ at each dining location.
• At CMU Chartwells, this is the location manager and the Executive Chef.
• All questions are directed to the ______
• Explain everything known about the menu item and provide __________ to the customer for them to make a decision about what is safest for them individually.
• Continuously train staff on how to handle students with food allergies.
• Never answer questions about allergens or ingredients in the food…. always get a ____________________

Answer 34

Yearly
Allergen Ambassadors

Allergen Ambassador (or the Dietitian)
packaging/labels

manager, Executive Chef or the Dietitian.

Question 35

Serving Customers with Food Allergies

• ________ and change ________
• Make sure the _______ is clean.
• Use clean _______
• Use designated _______ kits for making separate meals for students with food allergies when available.
• Use clean _________
• If a mistake is made when making the order, you must ___________!

Answer 35

Wash hands
gloves
area
utensils
purple
service ware
start over

Question 36

• ________allergen testing and reporting to Kitchens

Answer 36

Monthly

Question 37

Chartwells Allergen Management

Three approaches to Food Allergen Management:
- All accounts need to meet the minimum requirements, but many provide more aggressive measures.

1. ___________: “Don’t Be Shy, Self-Identify”
2. ____________ (formerly G8)
3. _____________
   - Not recommended due to supply chain variance
   - Available at certain campuses where contractually required; must have designated RD for upkeep and to manage very closely
   - Utilize Campus RD and Allergen Ambassadors for answering questions and providing all necessary details for food products and production when needed

Answer 37

Self-Identification
Delicious Without Stations
Allergen Labeling

Question 38

Avoiding Gluten areas can be provided

• Risk for ________

Answer 38

cross-contact

Question 39

Delicious Without Stations

• Offered at some Chartwells campuses.
• ________
• Provides menu options that are prepared without the 9 major allergens and gluten.
• Minimally processed meals, made from single-source ingredients without hidden additives or seasonings.
• Trained staff.
• Dedicated station, preparation space, equipment, storage and utensils.
• Accidental cross-contact can occur due to open kitchen.

Answer 39

Flourish

Question 40

Nourish Station

Allergen-friendly kitchen, featuring a menu prepared without ___________________

Menu items: salads, sandwiches, and hot entrees, variety of vegan offerings.

All food is prepared and sealed in a dedicated kitchen by food service staff who are trained and highly knowledgeable about food allergens and preventing cross-contact.

Maintaining a safe space includes:
- Designated lab coats, shoe coverings and hair coverings - Proper Personal hygiene
- No personal items or food in the kitchen

Answer 40

gluten, wheat, milk, egg, soy, fish, shellfish, peanuts, and most tree nuts (except coconut)

Question 41

Students, faculty, and staff use Grubhub to place
orders.

Nourish grab-and-go items are available in a separate cooler with a designated_________.

All Nourish products are stored in a separate space and items received for Nourish are immediately separated and delivered to designated spaces.

Also makes sure no substitutions were sent.

Answer 41

microwave

Question 42

Kitchens with Confidence

• Independent ______________ entity that helps dining facilities of all kinds become safer for diners with food allergies.
• Experts in food allergies, intolerances, sensitivities, and celiac disease and on how to keep kitchens and manufacturing facilities safe.
• Nourish has a __________ & ___________

Answer 42

accreditation/certification

Yearly Audit
Monthly Allergen Testing and Reporting

Question 43

Student Responsibilities

• Encourage all students to __________ and keep in regular contact with dining services.
• Wear/carry an____________, wallet card or phone case in case of a severe reaction.
• Always carry _______/rescue medications.
• Have Campus Police as a saved contact.
• Notify RAs, roommates and friends of what to do in an emergency situation.
• Reach out to dining team and Health Services for guidance with dining on campus
• Disclose allergen each time and ask to speak with a Chef or Manager – they will provide __________ and
  verify information about the food and _______methods.

Answer 43

register their allergy
identification tag
EpiPen
food labels
preparation