Canteen Manager Training Part 2

Special Dietary and Cultural needs

Page last updated: 09 October 2013

In this topic we will give a brief overview of allergies, food intolerances and sensitivities, as well as cultural and religious considerations.

Special Dietary Needs

Food Allergies

  • An immune response to protein found in common foods
  • Any amount will cause a reaction
  • Reaction usually occurs within 30 minutes and can be life threatening (anaphylaxis)
  • Epi-pen and action plan signed by doctor
  • Strict avoidance is extermely important

Food intolerance

  • Sensitivity to the chemicals found in food
  • Naturally occurring or added in manufacturing
  • Small amounts may be tolerated
  • Reaction can take several days to appear
  • Diet modified to keep intake below threshold tolerated

The term 'allergy' is often misused to describe everything from a headache through to tummy bloating, and you may have the impression that every second child you meet is allergic.

True food allergy is a serious life-threatening condition. Some people are allergic to the protein found in common foods. Their immune system mistakenly detects the protein as a ‘foreign’ substance and mounts an attack, very similar to when you get a cold. The runny nose, aches and pains, watery eyes etc. are your body trying to get rid of the ‘foreign’ bacteria. When your body has killed off enough bacteria the reaction stops and you start to feel better.

With food allergy, however, the immune system does not know when to stop and so the reaction keeps going and can be life threatening. This is called an anaphylactic reaction. The response is usually within 30 minutes of exposure to the allergen, either by eating or (in some people) by touching the food containing the protein. Children at risk of anaphylaxis will probably have an Epi-pen (adrenaline) and an action plan detailing the procedure to take if exposure to the allergen occurs. The action plan is usually placed in prominent positions around the school. Strict avoidance of the protein is necessary. Further information on action plans can be obtained from the Australasian Society of Clinical Immunology and Allergy (ASCIA) website. Details are in the Guidelines for healthy foods and drinks supplied in school canteens on page 42.

Food intolerance, on the other hand, is a sensitivity to the chemicals found in food. These chemicals can be naturally occurring or be added by manufacturers. The one you might be most familiar with is MSG (monosodium glutamate), also represented by the number 621 on food packaging labels. This chemical occurs naturally in certain foods such as aged cheese and mushrooms or it can be added during processing to enhance flavour in savoury snack foods, such as flavoured crisps and two-minute noodles. Unlike food allergy, if an individual is sensitive, the reaction may take several days to appear. Not all chemicals are a problem for sensitive people. Small amounts may be tolerated without inducing symptoms.

A table detailing the additives most likely to cause a problem in sensitive individuals has been included in the Guidelines for healthy foods and drinks supplied in school canteens on page 43.

Emphasise that not all chemicals will be a problem to all people with sensitivities and only a small proportion of the population is sensitive to food chemicals.

Most common food (protein) allergens:
  • Peanuts(1 in 50 children)
  • Tree nuts (for example: cashews, walnuts)
  • Shellfish and fish
  • Milk
  • Eggs
  • Sesame
  • Soy
  • Wheat
This slide details the most common food allergens. Most children tend to grow out of egg and milk allergies, but allergies to nuts and seafood generally persist for life.

Egg allergy is the most common (and also the one most likely to be outgrown). The number of children with milk, egg and seafood allergy has remained steady. However, peanut allergies (which are the second most common food allergy) have increased by 50% between 2003 and 2006. Approximately 1 in 50 children has a peanut allergy. The Royal Prince Alfred Hospital Allergy Unit reports that allergy to other nuts, such as cashews, are also on the increase. Your school may have a policy regarding nuts and the use of products containing nuts (or any other food allergen if there is a child enrolled at your school with a diagnosed allergy). You need to be aware of your school’s food policy and remove foods from your school menu if necessary.

Allergens must be declared on a food label. Further information is available from Food Standards Australia (FSANZ), The Royal Prince Alfred Hospital Allergy Unit and ASCIA.

Website addresses are provided in the Guidelines for healthy foods and drinks supplied in school canteens on page 42 and also in the Participant’s Workbook on page 18.

Coeliac disease - gluten intolerance
1 in 100 people
Products containing wheat, oats, rye, barley and triticale
Damages the lining of the gut
Impairs ability to absorb nutrients
Cross-contamination
Strict avoidance is extermely important

Lactose intolerance
The 'sugar' found in milk
Lack of the enzymen 'lactase'
Small amounts may be tolerated
5% Caucasian and up to 75% non-Caucasian living in Australia
Diet modified to keep intake below threshold tolerated

Other ‘intolerances’ you may be aware of are Coeliac disease and lactose intolerance.

Coeliac disease affects approximately 1 in 100 people. In coeliac disease the individual is intolerant to the protein ’gluten’ found in products containing wheat, oats, rye, barley and triticale. This is different to a wheat protein allergy. Even small amounts of gluten may cause damage to the gut and impair the person’s ability to absorb nutrients. Cross-contamination is of particular concern in coeliac disease. Simply using gluten-free bread is not enough. The ideal is to use separate utensils and work spaces to prepare food that is to be eaten by someone with coeliac disease. Oats do not naturally contain gluten, however, in Australia they are likely to be contaminated with gluten.

Strict avoidance is extremely important.

Lactose intolerance is often confused with milk protein allergy. Lactose is the sugar found in milk. Lactose is digested by the enzyme lactase and the amount of this enzyme present differs from person to person. Lactose intolerance is quite common among people from Asia, Africa, the Middle East and some Mediterranean countries, as well as among Indigenous Australians. Up to 5% of Caucasians and up to 75% of non-Caucasians living in Australia are lactose intolerant.
Small amounts may be tolerated.

Further information and website contacts are provided in the Guidelines for healthy foods and drinks supplied in school canteens on page 42.

Special Dietary Needs - Role of the school canteen

Reference; Participant‘s Workbook p.17/ Trainer’s Manual p.24

Group discussion: Role of the school canteen with regards to special dietary needs
Discuss as a large group what participants think the role of the school canteen is in regards to special dietary needs.

Be aware of and adhere to any school policies.
For example, remove products containing nuts.

You may choose to stock certain foods if practical and if there is sufficient demand.
For example, use soy milk as an alternative to regular milk.

There is no clear role of the canteen or the canteen manager beyond these steps.

Reference; Participant‘s Workbook p.17 / Trainer’s Manual p.24

Group discussion: Acknowledging cultural differences
How many different cultures are represented at your school?

How does your canteen menu cater for different cultures and cuisines?
Halal meats, vegetarian options, ethnic dishes (e.g. sushi, stir-fry, pastas, curry) – pictures on slide are sushi, couscous and naan bread.

Why should we do this?
To address the cultural needs of specific groups in the school community.
To expose students to a variety of cuisines.

Maintain level of interaction with the group and explore more cultures. Where did the traditions come from? What are the expectations of other cultures?

Examples:
Asian cuisine varies from country to country. Think how different Japanese, Chinese and Thai foods are. In general, most Asian cuisines are based around rice and/or noodles, with vegetable dishes and smaller amounts of meat. They often use soy-based products such as tofu (soy bean curd - wet) and tempeh (fermented soy bean - dry).
Indian (cook with a lot of herbs, spices and chillies).
Middle Eastern – again there is large variability from country to country but there are a number of similarities. Some commonly used ingredients include olives and olive oil, pitas (flat breads), honey, sesame seeds, sumac (lemon flavoured spice), chickpeas, mint and parsley.
Southern European – olives and olive oil, pasta in southern Italy, tomatoes, rice (Greece, risotto, Spain, paella), meat (lamb and goat) generally well cooked, fish and seafood.

Lead a discussion or conversation on different menu items influenced by religion.
Hindu – regard the cow as sacred; eating beef is a sin.Devout Hindus observe a lacto-vegetarian diet, meaning no meat and no eggs.

Judaism – food has to be prepared to kosher guidelines.

Orthodox Jews follow the teachings of the Torah. This states that all edible animals must satisfy two conditions:
1. They must chew their cud (regurgitated food).
2. They must have cloven feet (split hoof).

Pigs have cloven feet but do not chew the cud and so are forbidden.Meat and dairy products must not be prepared together.

Muslims – Meat must be slaughtered in the Halal (to the law) manner.

Muslims also exclude the following Haram (not to the law) foods from their diet. Pig meat, birds of prey, wild animals, crustaceans, molluscs blood /blood products, aggressive fish, fish without scales.

Buddhist – Mostly vegetarian, though Buddhists may eat meat if it has not been killed for them specifically.

Christians – For the most part do not let their beliefs shape their eating habits.
Lent –The 40 days prior to Easter. Until 1967, every Friday meant fish for dinner for Roman Catholics because it was deemed to be a day of sacrifice. Fish rather than meat was to be served as the main meal of the day. Many Roman Catholics still observe this on every Friday during Lent.