Allergy-Mgmnt-art - 12/29/16

"Feast Allergy Management in the SCA" by Baron Drake Morgan, OL.

NOTE: See also the files: ingred-lists-msg, Fd-Service-MA-art, feast-serving-msg, Food-Safety-art, Fst-Managemnt-art, Medievl-Feasts-art, Servng-Roylty-art.

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NOTICE -

This article was submitted to me by the author for inclusion in this set of files, called Stefan's Florilegium. 

These files are available on the Internet at: http://www.florilegium.org

Copyright to the contents of this file remains with the author or translator.

While the author will likely give permission for this work to be reprinted in SCA type publications, please check with the author first or check for any permissions granted at the end of this file.

Thank you,
Mark S. Harris...AKA:..Stefan li Rous
stefan at florilegium.org
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NOTE: This was originally written for feasts in the Kingdom of Lochac and some of the reservation procedures are likely to be different in other kingdoms.

Feast Allergy Management in the SCA
by Baron Drake Morgan

Introduction and Forward
by Anne de Tournai, OP

Allergy management is becoming an ever increasing issue for kitchen stewards and you need to have strategies about how you are going to deal with allergies and the people who may have them.

At the outset of this event, you set outlines for what dietary issues you would and wouldn’t cater for. However, things will come up that you haven’t thought about (or even heard that it’s an issue for someone) and you should consider those bookings on a case by case basis. I’ve mentioned before that respectful dialogue between people who are attending and people who are cooking is very important. You are a volunteer as well but you have signed up for the job. You have a responsibility to be courteous and professional not matter how frustrated you might be.

Unlike dining at a restaurant, eating at a SCA event is less in the control of the guest with food allergies. Kitchen stewards (and event stewards) must be aware that they are dealing with a “captive audience”—while food allergic patrons at restaurants can choose to go elsewhere, food allergic guests at events may not have this option.  In a sense many important “screening” steps and decisions may be taken out of the control of food allergic guests, including not having the opportunity to assess the food allergy knowledge and policies of the catering hall. This can cause stress and tension (nothing like being accidentally poisoned) for the guests particularly if they are newly diagnosed with food issues. It’s not an excuse for rudeness but it does explain some of the concerns your attendees might have.

Another complicating factor in easily communicating allergy needs is the scale of the meal or meals being prepared and served. Many menu items served at events are pre-prepared or at least “prepped” prior to the arrival of the guests. In other words, many foods are handled or prepared without being able to prevent cross contact (a common cause of allergic reactions).

Safety depends on effective communication and partnering between the event steward, the kitchen team and guests. To ensure we all have fun, event stewards need to ask if there are attendees with food allergies and provide those food allergic attendees with opportunities to notify them of any special accommodations. This early communication can help the steward and you plan for safe alternatives when possible. It also gives guests time to work through acceptable and safe alternatives.

It is your role as the steward to respectfully decline to feed someone if you cannot do it safely. This is particularly important for any guest who allergy will result in anaphylaxis (an acute, potentially life threatening allergic reaction).

Key Safe Food Handling Practices to Prevent Triggering a Food Allergy Reaction

1. Listen carefully when someone indicates in their booking that they have a food allergy.

2. Explain to the person what you know to be true about the food being served. Don't be afraid to say you don't know.

3. Check ingredient labels on food packages for allergens every time--food products may change.

4. Do not serve a food to a person with a professed allergy if you can't guarantee it will be allergen free, or offer the person with an allergy an off board price.

5. Disclose ingredients used to prepare dishes.
A. Avoid using "secret" ingredients. Always indicate whether key allergens are included in the recipe or may have come in contact with the food you are preparing or serving.

6. Prevent cross contact between allergen-containing and allergen-free foods.

1. Keep even a trace amount, part, or product of an allergenic food (e.g., peanut, peanut butter, peanut oil) from coming in contact with an allergen-free food or allergen-free food or surface (e.g., counter, bowl, spoon, boards, and knives).

2. Cross contact measures are not the same as cross contamination measures used to prevent foodborne illness. That is, while many foodborne diseases can be prevented by cooking foods thoroughly, cooking a food containing an allergen will not make the food safe to eat by someone allergic to it.

3. Wash your hands, workspace, utensils, and pans, and make sure dishes are allergen-free before preparing foods. Where possible, prepare allergen free foods before general foods to reduce the chance of contamination.

4. Thoroughly clean-up workspace after use.

Additional precautions for kitchen stewards include:

Letting all members of the team know what allergies you are catering for. I maintain an allergy register for bookings, this allow me and my team to know what we’re dealing with and who we need to look out for. 

Offering a wide variety of food to accommodate a range of allergies and restrictions. You may wish to choose to provide simple options that can be made from scratch for specific guests. (All hail the spinach and herb omelette  -can rescue you in a range of situations).

Having a full list of ingredients for your menu available. Provide it to any diner declaring an allergy or food intolerance in advance of the event. Baron Drake’s Allergy matrix is a great quick reference guide for showing exactly what dishes are and aren’t safe to eat for individual allergy types. (See Appendices)

Asking your bookings with dietary requirements to come and say hi at the kitchen. This is good for two reasons (it allows you to know exactly who they are) and it also gives them a sense of comfort if you demonstrate good allergen food handling practices.

Informing your servers who are working the event of any specific allergies so that there can be separate meals or offerings prepared in advance. Provide them with copies of the allergy matrix and ingredients list so they can answer any questions from guests.

Directly communicating any concerns, strategies, etc., well in advance of the event to all your team members (i.e. if you need a clean, separate work space in the kitchen to prepare certain meals/foods).

Reiterating and repeating concerns at every step of the planning process and in every communication.

All kitchen staff, which includes front of the house, back of the house, management, etc., must have understand the protocols for dealing with food allergy. This should include communication, label reading, knowledge of hidden ingredients, prevention of cross contact and/or cleaning techniques and processes for promptly dealing with allergic and other medical emergencies. Our goal is to have fun and make this safe for ourselves and other attendees. Proper awareness will ensure this is happening.

Developing a Menu

First stage of allergy management is to actually get an idea on your menu.  Start with a decent medieval manuscript and work forward from there with your redactions.  You want to be keeping allergies in mind when developing a menu.  Don’t be scared to bring in an import (like a 16th c French dish in a 16th c Italian menu if it greatly assists with diversity of ingredients. 
With a menu, you are looking for diversity in lots of areas.

Diversity in cooking style, no point having all baked dishes if you only have one tiny oven or all boiled dishes if you have one small 4-hob stove. Diversity in Meat/Vegetable.  And importantly, diversity in ingredients that may cause an allergy. 

Common allergies found are:

•	Seafood and Shellfish
•	Nuts
•	Dairy / Lactose
•	Meat protein
•	Gluten / Wheat/ Grains
•	Specific Spices
•	Eggs
 
Try to avoid a menu that has one of these in most of your dishes.  This is also true even if that allergy type isn’t booked. You can have a last-minute allergy booking that can cause you to scramble to change recipes or dishes or entire menus.  An example was a feast where I had a lot of gluten-free bookings. So all the stews and sauces were thickened with Almond meal.  A last minute serious tree nut allergy declaration threatened to de-rail the whole feast.  It was carefully managed and there was no issue but sometimes it can lead to issues.

Identify Ingredients & Generate Shopping list

After developing a menu, you’ll have a list of ingredients and amounts (hopefully) for a shopping list.  With compound ingredients like ready made stocks and spice mixtures, break down and sort your ingredient list by recipe into a spreadsheet vertically. Be mindful of unusual ingredients like Textured Vegetable Protein that is often Soy based and glucose, which is often derived from Wheat.

Know your Ingredients!

Issues around Shopping

Shopping can always been an area fraught with issues.  There are usually two main issues and that's of an unexpected substitution by the manufacturer and another cook assisting.

With the manufacturer, sometimes the recipe is changed so it always pays to check the ingredient list on the packet each time and not to rely on historical knowledge of ingredients.

The other issue is substitution by other cooks.  Often when organizing feasts it's commonplace for cooks to farm out recipes for pre-cooking (especially baked goods like biscuits, and things easily frozen like stews and stocks).  This is a good thing as it reduces the workload of the kitchen crew on the day.  However, there is always the risk that a substituted ingredient could trigger an allergy. Strategies that can assist with this are:

•	Delivering all the ingredients personally to the cook rather than letting them shop themselves and getting reimbursed on receipts.

•	Clearly stating what the current allergy list to the pre-prep cook.

•	Clearly stating that you will require a full ingredient list from the pre-prep cook to ensure that you can update your allergy matrix properly.

•	Clearly communicating with your pre-prep cook about the dangers of cross-contact.

Identifying Allergies - Levels of Allergies

•	Allergy – a medical condition that means eating a food will have severe physical impact. Person must not eat this ingredient (e.g. Nut Allergy)

•	Intolerance – some discomfort if this ingredient is eaten. Person should avoid eating this food.

•	Lifestyle – person has chosen not to eat a range of foods due to a belief.

•	Preference – person does not like this food, or chooses not to eat it. Preferences should not be accepted by the Bookings person and added as an allergy/intolerance.
 
Put these allergies into the same spreadsheet, horizontally.  Group allergies where applicable.  Sometimes it’s beneficial to break apart wheat vs say gluten allergies, sometimes you can keep things like dairy and lactose together.

Difference between an Allergy and an Intolerance

An allergy to food is caused by an abnormal immune response. The signs and symptoms of a food allergy may be mild, severe, and even life-threatening or fatal. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives; all the way up to trouble breathing, a severe drop in blood pressure. This typically occurs within minutes to several hours of exposure, and when severe, it is known as Anaphylaxis.  People  with known Anaphylactic reactions usually carry an epi-pen or similar device with them.   Immunoglobulin E (IgE) reacts with food particles, binding to them, then histamine is release, causing the symptoms.

Food intolerance's come in a few forms:

•	An absence of specific chemicals or enzymes needed to digest a food substance.

•	Food intolerance reactions can occur to naturally occurring chemicals in foods. Salicylates and amines are known to do this.

•	A non-allergic food hypersensitivity is an abnormal physiological response. It can be difficult to determine the poorly tolerated substance as reactions can be delayed, dose-dependent, and a particular reaction-causing compound may be found in many foods.[4]

•	Gastro-intestinal reactions due to malabsorption or other GI Tract abnormalities can be food based.

•	Immunological responses, mediated by non-IgE immunoglobulins, occasionally happen where the immune system recognizes a particular food as a foreign body.  My partner once developed a food poisoning that was actually caused by an allergy to the virus particles in the food.

•	Psychological reactions can involve a manifestation of symptoms caused not by food itself but by emotions associated with food. These symptoms do not occur when the food is given in an unrecognizable form.  I personally have these reactions to Avocado, Tomatoes, and Animal Brains.

Identifying Allergies - Bookings

Ensure your bookings officer is intelligent and well versed in Allergy Management.  You need them to accurately define allergies, and to avoid putting down food dislikes.  It’s important to understand the allergies booked, go back to the Bookings officer if the booking is unclear.  I had one allergy to ‘sulphur’ which I challenged because if they were allergic to sulphur as an element, they’d be dead.  On further enquiry, the person was allergic to ‘sulphites’ which are a common preservative in drinks, wine, and dried fruits.

Identify Compounded Ingredients 
(like pre-prepared pastries, stock cubes, etc.)

Sneaky foods!  Some foods are very sneaky and you always need to be vigilant for unexpected ingredients.  Examples I’ve come across are:

•	Spices in stock cubes

•	Soy in various forms and guises

•	Fish collagen in commercial royal icing

•	Wine can contain seafood or egg products used as clarifying agents

•	Preservatives such as Sulphites

•	Sometimes E numbers are quoted but not names, causing you to look up what is in the ingredients.  Often people will declare an allergy but not give you the E Numbers.  A great guide to E Numbers is here: 
https://en.wikipedia.org/wiki/E_number (https://en.wikipedia.org/wiki/E_number)
 
Often people are allergic to anions/cations rather than whole molecules. People who are allergic to sulphites are not allergic to one but often a whole family such as:
E221 Sodium sulphite, E222 Sodium bisulphite, E223 Sodium metabisulphite,E224 Potassium metabisulphite, E225, Potassium sulphite, E226 Calcium sulphite, E227 Calcium hydrogen sulphite,  E228 Potassium hydrogen sulphite.

Generate Matrix

Generate the matrix by corresponding and cross checking the vertical vs the horizontal. Trim the ingredient list afterwards for clarity. One line for one dish, one column for one allergy.

Optional extras:

•	Have an ingredient list in the right-most column

•	Have some simple codes.  I mostly use (X – Forbidden, O – Allergy free option available, W – Warning, may have issues, P – have a small portion), and only use the P option for diabetics when the savory dish contains a small amount of sugar or carbs.

Examine weights/amounts of food – Are you feeding your allergy people enough?

•	Have the % of grams for each dish towards the final food amount.  Tally that up for each person with an allergy.  Attempt to be able to feed each allergy at least 66% of the weight of the food per person.

•	If you can't aim for 66% try the following:

•	Special dishes for that allergy group (ie. bake 12 pies, have 1 with gluten free pastry)

•	Add the allergen late if you can after separating out a portion.  This works well for allergen containing stew thickeners.

•	Exclude an ingredient or substitute if appropriate.  Don’t risk the integrity or taste of a dish on behalf on one person with an allergy.

Allergy Management Concepts to Evaluate For Each Dish

Late additions

•	Reserve a portion, put it to one side. Keep hot if possible.

•	Where possible, add a spice late.

•	If thickening stews with an allergen, add it last after reserving.

•	Salads – season or dress at the last minute.

Exclusion of ingredient

•	Sometimes an ingredient can be excluded.

•	Exclusions are best done on an individual basis.

•	Try to avoid widespread exclusions that can affect an entire feast.

•	Salt and Pepper,

•	Cooking the entire feast Gluten Free because of one allergy in a hundred bookings.

Exclusion of eater

As a last resort, exclude that dish from being eaten from that person. Ensure they get a little bit more of the dishes they can eat.

Exclusion from menu

As an extreme resort if you cannot get enough dishes for that person then consider offering them an off-board price and allow them to bring their own food.

Server Education

The kitchen crew is only one part of the equation when it comes to management of Allergies for SCA feasts.  Often you may have a good handle on your Allergies but it's very important to educate your servers on what is contained in the dish and what potential allergens it contains.

Cross-Contact in the Kitchen, not the same as Cross-Contamination

With feasts you will need to have a discussion about cross-contact with both your servers (for cross contact) and your kitchen staff, for Cross-contamination. Even though food allergies are commonly understood, the term cross-contact is fairly new. You may know the term and how to safely prepare an allergen-free meal, but this term is still not universally understood.  Cross-contamination is preventing foods from being contaminated by biological contaminates (such as bacteria). Once you know the difference it will be easier to discuss. 

Cross-contamination is a common factor in the cause of foodborne illness. Microorganisms such as bacteria and viruses from different sources can contaminate foods during preparation and storage. Proper cooking of the contaminated food in most cases will reduce or eliminate the chances of a foodborne illness.

Cross-contact occurs when an allergen is inadvertently transferred from a food containing an allergen to a food that does not contain the allergen. Cooking does not reduce or eliminate the chances of a person with a food allergy having a reaction to the food eaten.

It is your responsibility to ensure that servers and cooks know the difference.
 
Examples of Cross-Contact and How to Avoid It:

Say a knife that has been used to spread peanut butter is only wiped off before being used to spread normal butter. There could be enough peanut protein remaining on the knife to cause a reaction in a person who has a peanut allergy. All equipment and utensils must be cleaned with hot, soapy water before being used to prepare allergen-free food. Even a trace of food on a spoon or spatula that is invisible to us can cause an allergic reaction.

Areas of specific concern:

•	Tasting spoons moving from one dish to another

•	Tea towels used in hot food carrying can dip in the food and cross-contact

•	Breadboards/Chopping Boards.  People are often mindful of cross-contamination risks but not the cross-contact risks which are just as bad.
 
Strategies to avoid Cross-contact:

•	Ensure everybody understands the concepts of cross-contact.

•	Do you have a separate area to prepare foods for special allergies?

•	Do you have separate cutting boards and utensils to prepare any special dishes?

•	Do you use a shared cooking area for different dishes where cross-contact might occur.  Such as a roaster full of Beef and Pork if someone has a pork allergy.  Rapidly boiling and spitting pots can cross-contact.

•	Who will be preparing that allergy meal? Have someone you trust specialise in it.

•	Labeling and/or Delivering. Food should be either well labeled on a buffet table or if servers are delivering plates, the allergy portion should be delivered separately

•	Be mindful of cross-contact on platters if multiple foods are placed on the same platter, cross-contact issues might occur. 

Please note that the authors retain copyright on their original material but that permission to copy and print are granted on the condition that proper credit is given to the authors/editors.  Likewise, permission is granted for use of the recipes in this website with proper credit given — in both practical and written works — as long as they are not being sold or profit being made from their use.  
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Copyright 2016 by Craig Jones, Brigid Costello. <drakey at internode.on.net>. Permission is granted for republication in SCA-related publications, provided the author is credited.  Addresses change, but a reasonable attempt should be made to ensure that the author is notified of the publication and if possible receives a copy.

If this article is reprinted in a publication, please place a notice in the publication that you found this article in the Florilegium. I would also appreciate an email to myself, so that I can track which articles are being reprinted. Thanks. -Stefan.

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