This is known as an allergic reaction. During an allergic reaction, the white blood cells send chemical messages around the body, jolting every part of the immune system into action. Common cells of the immune system are called mast cells. These are mostly found in the airways of the lungs, the eyes, nose, and throat. They hold antibodies on their surface. When an allergen is detected, these cells release chemicals which enlarge the blood vessels, contract the muscles in the lung airways, and trigger the production of mucus to defend the body.

These rapid changes can cause swelling and soreness, which in turn causes coughing, a runny nose, and itching in the mouth. It can also involve the skin causing rashes and itching.

Anaphylaxis

This is the most severe level of allergic reaction. Any food can cause anaphylaxis, but the most common are included in the main 14 allergens list. The main difference between mild allergies and anaphylaxis is the amount of chemicals that are released by the mast cells. Blood pressure drops and can cause a collapse of the circulatory system, which carries blood to vital organs of the body. There are a wide range of reactions that can occur during anaphylactic shock, but low blood pressure and shortness of breath are the characterizing features.

As well as food items, latex gloves can also induce anaphylactic shock for those allergic to latex and have the ability to contaminate products. This is something not often thought about during kitchen cross-contamination, since they are used in almost every professional kitchen.

What causes a reaction to be more severe or react faster?

Certain factors can dramatically increase sensitivity to allergic reactions such as:

• Alcohol
• Exercise
• The amount of allergen in the body
• Stress

Immediate Treatment

Adrenaline is usually carried in the form of an EpiPen, which, when injected into the thigh, contracts the blood vessels and reverses the swelling in the lungs to prevent choking and other life-threatening events in the body for long enough to obtain medical help. If you think someone is having an anaphylactic reaction you should call 999 immediately.

Milk

On an ingredients list, milk is the allergen stated for any form of dairy product, such as cheese, yogurt, butter, and cream. All animal milk and associated products fall into this category also, as the protein casein is responsible for most reactions. Some products that contain casein need to be classified on a menu as containing the milk allergen:

• Casein
• Whey
• Rennet
• Artificial butter flavours
• Some caramels
• Chocolate
• Nougat
• Tuna
• Margarine
• Margarine

Some kitchen products are safe for people with milk allergies but are sometimes confused because the names may suggest some forms of dairy products:

• Calcium lactate
• Calcium stearoyl lactylate
• Cocoa butter, cream of tartar, sodium lactate, sodium stearoyl lactylate.

Lupin

Lupin is a less well-known allergen. It is a small yellow seed which is traditionally eaten as a snack food in the Mediterranean and Latin America. It can also be used in flour production. There are similarities between Lupin and peanut allergies, so this should be a consideration when advising customers on menu choices. Pay special attention to nut mixes or pre-bought baked goods, which may contain Lupin seeds or products. Always check your flours for Lupin, even though most producers have already faded out the use of Lupin in their flours.

Sulphur dioxide.

Sulphur dioxide, or E220/E228 is found in products that contain or have contained alcohol, such as wine or vinegars since it is a by-product of fermentation and is also used in the preservation of dried fruits. Sulphur dioxide is produced naturally during wine and beer production and is often added to wine to stop it fermenting in the bottle. For dried fruits, they stop discoloration and discourage the growth of bacteria.
Products containing Sulphur Dioxide

• Pickled products and vinegars
• Wine and beer
• Dried fruit
• Sauces containing vinegar.

Eggs

Egg allergies usually apply to hen’s eggs but can also include other species of birds. Eggs are one of the tricky allergens to keep track of since they creep into products that you don’t necessarily expect or think about. They’re used as stabilizers, thickeners, and emulsifiers, and it is vital that you check everything you use for egg traces, even if it seems unlikely.

Common Sources of Egg

• Artificial and natural flavours
• Canned soup
• Salad dressings
• Meat products such as burgers and meatballs
• Marshmallows
• Nougat
• Buttercream.

Soy

Soybeans are part of the legume family, the same as peas and peanuts, although despite the prevalence of peanut allergies. this does not mean you’re more likely to be allergic to soy. Only an estimated 0.3% of the European population suffer an allergy to soy. Anaphylactic shock is very rare with soy allergies. Other symptoms are as per other allergens. Many people with a soy allergy can tolerate small amounts of soy protein since the typical dose to start an allergic reaction is 90 to 100 times the dosage of other allergens.

However, it can be the most difficult to avoid as it is found commonly in a wide variety of foods:

• Condiments like Worcestershire sauce, mayonnaise and soy sauce
• Tamari – a soy sauce substitute without wheat
• Natural artificial flavours
• Natural artificial flavours
• Meat substitutes
• Fillers in processed meats such as chicken nuggets
• Soy oil in margarine
• E322 – Soy oil found in sweets
• Frozen meals
• Most Asian foods
• Some cereals
• Some peanut butter
• Some ice creams
• Miso
• Tofu
• Edamame.

Soy Lecithin

Soy lecithin is one of the most common food additives on the market. It is a food stabilizer and emulsifier in many food products and also features in supplements and health foods. Oil is extracted from raw soybeans and then separated to isolate the lecithin.
A common question asked is, does it contain soy? The simple answer would be yes since it is a by-product of soy. However, it only contains trace levels of soy proteins and it is widely accepted that this trace amount is not enough to provoke an allergic reaction in most people with an allergy to soy. Since allergens are found in the proteins of a product, which are almost all removed in the manufacturing process, many nutritionists and allergists don’t advise their patients to avoid soy lecithin, even when it’s listed as a food ingredient. This depends on the severity of the allergy and always check with your doctor.

Pollen Food Syndrome

One common form of the soy allergy is pollen food syndrome, also called secondary allergy. This is common in people that are allergic to birch, hazel, or alder pollen. The proteins are similar to the soy proteins, therefore, the antibodies for those allergens can attack the soy proteins and trigger an allergic reaction. A soy allergy can be caused, not only by eating soy but also breathing in soy particles in large amounts which can cause the body to produce antibodies. This is most common in food industry workers who have to handle or process soybeans or soy flour products. Soy is one of the most common allergies in young children, but in most cases, this subsides by the age of 10.

Gluten

Gluten is not technically an allergen since the reactions experienced are not usually allergic reactions but a range of different gluten/wheat triggered conditions. So it’s still included on allergen lists to make customers aware of its presence in food.

Gluten allergies and intolerances are something that cause huge problems in restaurants, although neither actually exist. Most restaurants experience gluten-free customers each day and gluten free can range from a customer avoiding gluten for their diet to a customer avoiding high levels of gluten due to coeliac disease. It is important that we make no assumptions when it comes to these customers. A lot of these special requests will be preference or diet related. However, taking insufficient care could result in symptoms such as nausea, mouth ulcers, and anaemia and coeliac.

Different types of gluten conditions:

• Coeliac disease
• Non-coeliac gluten sensitivity
• Dermatitis herpetiformis
• Wheat allergy

Wheat Allergy

Let’s address the only true allergy in this list first. Wheat contains gluten. However, people with a wheat allergy will be able to consume things like rye, barley, and oats which also contain gluten as long as they avoid wheat specifically. This is because the allergic reaction is caused by the wheat proteins and not the gluten. Wheat must be declared in food packaging by law. However, wheat, barley, and rye can often be labelled simply as ‘contains gluten’ so always check for which grain this refers to.

Types of Wheat and its Forms

Wheat is classified as all cereals of the tritium species, which include:

• Spelt
• Kamut
• Bran
• Wheat bran
• Wheat gluten
• Wheat germ
• Cereal binder
• Cereal protein
• Couscous
• Farina
• Wheat flour
• Wheat starch
• Rusk
• Semolina
• Semolina
• Durum wheat
• Semolina
• Durum wheat
• Starch
• Modified starch
• Hydrolysed starch
• Food starch
• Edible starch
• Vegetable protein
• Vegetable starch
• Vegetable gum

Monosodium glutamate (MSG) can also be derived from wheat. However, the production process breaks down the proteins enough to a form that is unlikely to cause reactions unless the individual has an extreme case of wheat allergy.

Products that Contain Wheat

• Artificial cream
• Ketchup
• Pâté
• Baked beans
• Curry powder
• Curry powder
• Fruit pie fillings
• Haggis
• Malt vinegar (malt is a by-product of grains which potentially contains wheat)
• Muesli
• Muesli
• Processed cheese
• Suet.

Coconut and nutmeg

Despite being called nuts, coconut and nutmeg are not related to nuts or peanuts. A reaction to either is very unlikely, however, it still may be a problem for a small number of individuals.

Nut Essence

Most essences are safe to use since they contain none of the proteins that cause reactions, however, always check the brand you’re using.

Disaronno and Other Alcohols

Although it can’t be stated, not every liqueur is nut-free. Disaronno is specifically a brand that uses apricot kernels to impart the distinctive almond flavour, so it is nut-free.

Sesame

Individuals that are allergic to sesame must avoid it completely, both cooked and uncooked. It is slightly less common than some other allergies but still remains a substantial risk to the customers that are affected. Sesame oil made from cold-pressing is one of the few oils that is not refined. This oil will contain large amounts of the protein responsible for allergic reactions. Sesame seeds are also a common cause of cross-contamination since they are so small.

Unrefined foods that contain sesame:

• Raw sesame in bread, biscuits and crackers
• Salad dressings
• Pre-brought marinades and sauces
• Hummus
• Tahini
• Halva.

Fish

This refers to any finned fish, not shellfish crustaceans or molluscs. The allergens in fish can cause extreme allergic reactions, including anaphylaxis. Even trace amounts can cause strong reactions. More than half of people who are allergic to one type of fish are allergic to others, so never assume with the customer if they have only specified an allergy to one type of fish.
Other Sources of Fish Allergens:

• Some barbecue sauces
• Caesar dressings
• Worcester sauce

Fish allergy is sometimes confused with iodine allergy because fish is known to contain iodine, but this isn’t what triggers the reaction. Parvalbumin in the muscle tissue and bones is believed to be responsible along with collagen and gelatine in the skin of the fish.

Celery

Apart from peanuts, celery appears to be the second-most dangerous allergen for causing fatal anaphylactic shock. Cooking does not remove or destroy the allergen from either the stalk, fruit or seeds. The highest allergen content comes from the seeds which can easily become a contaminant due to their size. Celeriac (celery root) has the second-highest allergen content and is largely dangerous since the connection between celery and celeriac can sometimes be missed. The stalks have the least amount of allergen, however, it’s still highly dangerous and potentially life-threatening for a customer with celery allergy.

Celery is possibly the hardest allergen to track since it is used as a base or flavouring for thousands of products. Always check your spice mixes and bases for celery products. Be aware that even though one brand of product may be celery-free, the same product from another brand may use different ingredients.

Mustard

Mustard is normally thought of as the spreadable, jarred condiment, however, we sometimes forget that it’s made from mustard seeds and it is these that contain the most allergen. Mustard seeds are used in pickles and can be found in products such as gherkins, pickled onions, and spice mixes. Mustard may also be present in some flours, crackers and various condiments. The dose of mustard needed to cause reaction is very small since the concentration of seeds in spreadable mustard is so high. This means that even a trace amount could cause severe reactions.

Grapeseed and Canola Oil

Grapeseed oil/canola is a major source of vegetable oil and is related to mustard. Although, it is worth noting the hidden allergen, canola oil, is considered safe due to the fact it is so highly refined. It is also worth noting that it is very common for someone with a mustard allergy to be allergic to other products in the Brassica family such as broccoli, cabbage, brussel sprouts, turnips, and cauliflower.

Semi-Vegetarian/Flexitarian

A semi-vegetarian does not have any specific diet restrictions. However, their diets consist mostly of vegetables and grains, with reduced intake of fish, poultry, or red meat.

Ovo-vegetarian

Ovo-vegetarians follow a vegetarian diet but do not include dairy products like standard vegetarians. This can be for health or moral reasons. It depends on the individual. Dairy does not just include cow’s milk but the milk of any animal. Ovo-vegetarians can eat eggs as part of their diet.

Lacto-Vegetarian

Lacto-vegetarians’ practices match that of vegetarians. However, they also exclude eggs, as well as meat products. Lacto-vegetarians are still free to consume dairy products.

Pescatarian

This diet excludes any meat. Pescatarians add seafood to a vegetarian diet, which leaves out only meat and poultry products.

Pollotarian

A pollotarian excludes only red meat from the individual’s diet. Most pollotarians are phasing out meat in stages, on the way to becoming a full vegetarian. This timing can be flexible when it comes to fish. That can vary depending on the reasons of the individual.

Vegans

Vegans do not consume any products which are the results of animal exploitation or cruelty. This extends not only to food but also to areas like clothes and cosmetics. Honey is a product also avoided in a vegan diet, but is sometimes overlooked.

Paleo

Paleo diets are short for Paleolithic, referring to the Paleolithic era, in which our ancestors were still hunter-gatherers. People who follow a Paleolithic diet stick to natural products like nuts, vegetables, and seeds, as well as grass-fed meat. Rules for this diet do also depend on the individual. However, the main parts will always consist of natural products available in the era of cavemen. This diet is also known as the hunter-gatherer diet or caveman diet. Followers of the paleo diet believe that our modern diets put a strain on our digestive system, and that eating as per our ancestors is better for the body, since the way our bodies work has only shifted slightly since that era.

Please remember that, even though thorough washing and sanitisation will help prevent contamination, cooking allergens at high heat, temperature, will not kill them. Allergens do not react in the same way as bacteria.

Five, staff allergies,. It’s worth noting that not just customers are at risk from reactions to allergens. Allergic reactions from staff are often overlooked, and it’s important to offer the support needed to avoid these products. It is also advisable to have a plan/ procedure in place in case of allergic reactions of staff members.