Food preparation – some enjoy it, others despise it! Whether you are a fan or not, everyone can appreciate that cooking is more than an act of food preparation… it is an art form, science, a passion and a challenge.
Food as it not only provides essential nourishment to protect from illness but can also be the cause of illness if not stored, prepared, cooked and served correctly. Chefs, cooks and kitchen staff have an exceptional responsibility which often get overlooked! They need ensure that food is not only appealing to the eye and delicious to eat, but also nutritionally adequate and safe to consume. Due to the rise in prevalence of food allergies and intolerances, food service staff are now having to navigate this high-risk platform in addition to managing food hygiene and mealtime enjoyment. A challenge? Definitely! Unachievable? Absolutely not.
Let’s investigate some guidelines, standards and tools that can help food service staff successfully plan, develop and provide safe and nutritious meals to children and residents with food allergies.
Navigating food allergies in menu planning
Food allergen management in food service can be daunting, however there are many tools and resources available that can help navigate this. The key principle for food allergy management is to ensure nutritional adequacy with appropriate meal choices that include substitutions or alternatives rather than exclusion of the allergen as this can result in inadequate nutrition content of that meal.
The National Allergy Strategy have developed the Food Allergen Management in Foodservice best practice guidelines which combine all the overarching standards and practices under the food standards code (FSANZ). These guidelines overlook all stages of meal preparation and service, from admission to service.
STEP 1: NOTIFICATION:
Screening for allergens on admission
Allergen statements listed and displayed on dietary care plans, menus and/or electronic menu management software systems
Chefs, Dietitians and other food service staff notified of the allergen etc.
STEP 2: SOURCING:
Food contractors/contracts supply allergen declaration and product information forms for all products
Products are checked for ingredients and allergens on receival
STEP 3: SEGREGATION:
Allergy meals are covered and stored separately until delivered to the resident
Cleaning and hygiene practices as per allergy standards (e.g., may use separate utensils, a separate workbench or separate serving equipment (e.g., red plates for allergies))
Meals prepared in isolation to other food (e.g., allergy meals may be cooked and served first, before the regular menu items)
STEP 4: SERVICE:
The meal is checked as per the menu card and child or resident’s identifiers (eg. name, photo, DOB, room number, allergies etc.)
Delivered covered and in a way that minimises cross contamination risk (eg. on the top shelf of the meal service trolley)
Staff assisting with meals comply with personal hygiene practices
STEP 5: SUPPORTS:
Standardised recipes which identify allergens and ingredients of concern
Menu or recipe substitutions are checked with a Dietitian prior to service to ensure nutritional adequacy and safety
Ongoing training in food allergy and awareness for all staff (clinical, food service and admission)
What role does a Dietitian play in menu planning?
Dietitians can help food service staff by applying Dietitians Australia (DA) recommendations and practices to the Child Care centre or Aged Care home menus and offering suitable alternatives. This focuses on individual key nutrients that are often compromised by removing allergens whilst assuring that adequate choice, serving size, frequency and nutrient targets are met.
For example – yoghurt when there’s a cow’s milk allergy. A Dietitian can help recommend an allergen free alternative and ensure the product is calcium fortified and similar in protein and energy to the standard yoghurt and offered in a similar portion size to meet nutrient targets.
Meeting a child’s nutrition requirements with allergies in childcare
Well-nourished children have everything they need to grow, learn and thrive. A childcare centre provides roughly 50% of a child’s protein, energy and micronutrient needs daily. When planning a menu, this can easily be quantified by using the five food groups. During a day at childcare, children will receive approximately:
2 serves of Grain (cereal) foods
1-1.5 Serves of vegetables, legumes, beans
1 serve of fruit
2 serves of milk, yoghurt, cheese and alternatives
1 serve of lean meat, poultry, fish or vegetarian alternatives
Nuts are the most common allergen that has a blanket ban at many childcare centres. Other less common allergens such as wheat, dairy or egg often won’t be banned or taken off the menu completely. Instead, a care plan or action plan will be put in place for the child with an allergen.
Our Dietitians can assist childcare centres to ensure there are no traces of nuts on their menu to meet the blanket ban. As well as ensure individual children are getting adequate nutrition whilst managing their allergies.
Meeting a resident’s nutrition requirements with allergies in aged care
In Aged Care, majority if not 100% of a resident’s intake is provided by the Aged Care home so Dietitians ensure the menus are developed to provide adequate amounts of each food group as per the Australian Guide to Healthy Eating as per the resident’s age group.
Dietitians Australia have also developed a Food Allergy and Intolerance Menu Assessment Tool. This is based off the Menu Audit Tool for Aged Care Homes to ensure menus can be planned with nutritional adequacy, choice and safety, to meet aged care quality standards.
Our Dietitians ensure that there is adequate choice for residents (eg. hot meals offered at least twice per day) and that the key nutrients in Aged Care (calcium, protein, fibre, iron and energy) are not compromised by removing allergens.
Summary
Although challenging, managing food allergies in foodservice can be successful! Educating food service staff and families on safe ways to manage allergies is important. For more information or personalised support, speak with an Accredited Practising Dietitian (like us!).
By Lauren Goffredo and Simone Cammarere, Accredited Practising Dietitians for OSCAR Care Group