Quebec waiter arrested for serving food and causing anaphylactic shock in customer

Melissa Fundira for the CBC – Quebec waiter arrested after seafood puts allergic customer in coma

Canuel had left his EpiPen in his car.

He was hospitalized at the intensive care unit of the Centre hospitalier universitaire de Sherbrooke, where he was treated for a severe allergic reaction.

He says he also suffered a cardiac arrest the following day and was in a coma for several days.

“I almost died,” he said.

I’m not blaming Canuel one bit, but I can certainly understand how after carrying around an EpiPen for a long time, you can end up thinking it’s generally not needed. And seconds count when you have a reaction.

Also see Jonathan Montpetit’s article on the charges and legal side of things – Fish served to a customer nearly kills him – is that a crime?:

In order to convict the waiter, the Crown would have to establish that he displayed extreme carelessness toward the client’s safety, said one criminal defence lawyer.

“Criminal negligence requires a reckless disregard for human life,” Eric Sutton told CBC’s Radio Noon. “It’s not enough to be negligent or careless. You need more than that.”

Sutton is unconvinced the Crown will pursue a case against the waiter.

Allergies are certainly misunderstood by many people.

 

On deliciousness

David Chang at Wired – The Unified Theory of Deliciousness:

Joshua told me he wanted to make a version of a Bolognese, the Italian meat sauce. I told him that was fine, but he had to use only Korean ingredients. I often set these kinds of limitations, because I’m a big believer that creativity comes from working within constraints.

Anyway, that meant he would have to find a way of re-creating the sweetness, umami, and pungency of Bolognese without the onions, celery, carrot, tomato paste, or white wine. He ended up using scallions, red chiles, ground pork, and fermented bean paste. Instead of using milk to provide that silky mouthfeel, I encouraged him to add in some whipped tofu. And rather than pasta or gnocchi, he served it with rice cakes that looked like gnocchi. We called it Spicy Pork Sausage & Rice Cakes, and when most people taste it, it reminds them—even on a subconscious level—of a spicier version of Bolognese.

I often find that with our food constraints, much of what we cook tastes the same, and very familiar. This is good in one sense, since by now we know what our son likes and dislikes and can guess whether he’ll like the food or not. But it’s bad in another sense, where I feel that we’re limiting him and not presenting a wider range of flavours and textures the we want him to experience.

Chang’s attempts at recreating familiar foods with different ingredients shows that in some instances he can re-imagine familiar dishes using unfamiliar ingredients. We are trying to do that every time we make a new dish, having to replace ingredients with others that are safe. Unfortunately it’s only too easy to fall back on the tried and true recipes. Time is the overriding constraint.

Gluten free diets aren’t quite what most people think they are

Norelle R. Reilly recently published an article in the Journal of Pediatrics – The Gluten-Free Diet: Recognizing Fact, Fiction and Fad:

Gluten-free packaged foods frequently contain a greater density of fat and sugar than their gluten-containing counterparts. Increased fat and calorie intake have been identified in individuals after a GFD. Obesity, overweight, and new-onset insulin resistance and metabolic syndrome have been identified after initiation of a GFD. A GFD also may lead to deficiencies in B vitamins, folate, and iron, given a lack of nutrient fortification of many gluten-free products.

Uh-oh. Not good for those people who are gluten-free for non-celiac reasons.

There is emerging evidence that those consuming gluten-free products without sufficient diversity may be at greater risk of exposure to certain toxins than those on an unrestricted diet. Arsenic is frequently present in inorganic form in rice, a concern for those on a GFD given that rice is a common ingredient in gluten-free processed foods.

A constant worry for us, since much of our diet is rice-based. Maybe 80% or so.

There also are noteworthy non-nutritional implications of a GFD. Worldwide, those purchasing gluten-free products will encounter far greater food costs than gluten containing competitors. Social isolation and inconvenience have been reported by children with CD requiring a GFD, and some with CD report a deterioration in their quality of life while on a GFD, linked in many cases to the diet itself.

We are lucky to be able to afford the time and expense of making much of our food from scratch in order to keep it as safe as we can from allergens. But it’s another worry for us in the future as our son grows up.

Food fraud

Natalie Whittle at the Financial Times – The fight against food fraud:

“We picked up reports of people getting ill from eating cumin in Canada. They were getting ill from anaphylactic shock from eating curries.” The cumin had been cut with peanut shells. Small retail businesses selling spices in larger quantities may buy direct from their countries of origin — which provides another opening for organised criminals to penetrate supply chains that are not as heavily regulated, says Elliott.

I had previously thought that the cumin incident was due to poor packaging, storage conditions or some other mishandling of the food. I hadn’t thought that it could be due to fraud. This is unsettling.

Allergen labeling on food products

Ishani Nath at Allergic Living – Precautionary Allergy Labels Cause Widespread Confusion, Researchers Find:

The survey results, presented at the AAAAI allergists’ conference on March 5, reveal that: 40 percent of consumers avoiding one or more allergens bought foods “manufactured in a facility that also processes allergens,” but only 12 percent bought foods with a “may contain” label. Beyond buying habits, the researchers also found a lack of awareness of labeling rules: 45 percent of respondents didn’t know that precautionary warnings are not required by law.

Those 1-800 phone numbers on the package? Call them and ask these two questions about the product:

  • Is the product manufactured on the same process line that produces other products that use the allergens?
  • Is the product manufactured in a facility that also processes the allergens?

Most reputable food manufacturers will have information on this.

Calcium and milk/dairy allergy

A few more thoughts on yesterday’s post on calcium:

  • While I admit that dairy seems to be some of the most calcium-rich foods, why is dairy pushed so much in the dietary guidelines?
  • Is it a political issue? (i.e., through industry lobbying, economic issues, or something else?)
  • Many people are lactose intolerant (especially many people with non-european backgrounds) so why is milk/dairy listed in such a large amount of foods in many countries’ food guides?
  • While the vitamin D/calcium relationship is well known, does the type of calcium-rich food also matter? Is the calcium from dairy better or worse than from other foods?

Nutrition with food allergies and sensitivities – Calcium

See previous… Nutrition with food allergies and sensitivities

(Update: please also see my further thoughts on this issue here.)

Calcium intake in our diet is a major concern of ours since most of the dietary guidelines push a form of dairy as the primary source of calcium. However, the dietary guidelines do not provide a sufficient variety of foods for those of us with food allergies. Witness Appendix 11 of the recently updated USDA dietary guidelines, published late last year, on the Food Sources of Calcium. I’ve highlighted in pink the foods that we cannot consume.

Appendix 11. Food Sources of Calcium - 2015-2020 Dietary Guidelines - health.gov cropped highlighted
(Click on the picture to enlarge)

That leaves us with the following 5 items from the list, with my comments following each item:

  • Fortified ready-to-eat cereals – many of which we cannot eat due to our wheat, peanut and treenut, and dairy allergies
  • Orange juice, calcium fortified – we would have to purchase this, as whole oranges are not at the top of this list
  • Sardines, canned in oil, drained – okay; though some are packed in soy oil, and so we tend to stay away from these products
  • Mustard spinach (tendergreen), raw – I don’t see this in our grocery stores
  • Rice drink – this is suitable; however, many rice drink producers also manufacture almond and/or soy drinks on the same production line, and so we tend to stay away from these products

There are some good resources out there that list calcium-rich foods to incorporate into your diet:

National Institute of Health – Calcium in Diet
National Osteoporosis Foundation – A Guide to Calcium-Rich Food
Dietitians of Canada –Food Sources of Calcium

Also, the USDA provides a great food-nutrient database from which you can search based on nutrient, categories of food, and even through some popular processed foods (Click on Nutrients List in the header).

Here’s a search based on Fruits, legumes and vegetables. (A lot of it is soy-based, which we can’t have, but we can’t remove soy from the search results.)

Nutrition with food allergies and sensitivities

While our son has the majority of the allergies and food sensitivities, we are still nursing him and thus his mother also has to stay away from the many of the same foods. I have no food restrictions, but we plan and cook our meals as a family and we want the food at our table to be all-inclusive. Thus in the interest of creating a safe food space for our son, we’ve decided to restrict our foods within the home such that all (or almost all) of the food we eat is safe and healthy for everyone to eat.

With the food restrictions, we have constantly been concerned with nutrition – how do we ensure that we are all getting a nutritious diet? One guidance document is Canada’s Food Guide published by Health Canada.

Overall the guide seems to be quite reasonable – focus on vegetables, fruit and grain products, some milk and alternatives, and some meat. Limit your oils and fats. However, looking at the page on serving size examples, a lot of it is restricted for us. What I see is illustrated below.

GFAF Canada Food Guide Suggested Foods Serving Restricted

I know that this figure is an example of serving size, and not an example of the foods that are possible in that category. But when I look at that, I see limitations and not possibilities, and it’s very disheartening. What I want to find are possibilities for new or different recipes and foods that we may enjoy, and be healthful.

For example, Dairy and Alternatives is a category unto itself in Canada’s Food Guide; however, with our restriction on soy and milk, what can we do? I think calcium and vitamin D are the main nutrients being promoted with dairy, but how can we get that otherwise? What about grain? Our diet is mainly rice since bulgur and quinoa is difficult to source without contamination.

Over the next few weeks, I hope to explore this more and try to answer some questions we have about nutrition and health in light of our food restrictions. I will also look into food guides around the world to see what they have to say about it.

Children of asian descent born in Australia have higher rates of allergy

Murdoch Childrens Research Institute – Migration clue to nut allergy:

Professor Allen said the results suggest that removing children from the Asian environment, or conversely exposing them to environmental risk factors in our Western environment- such as diet changes, microbial and UV exposure- uncovers a genetically-determined risk of food allergy in children of Asian descent.

Professor Allen echoed this sentiment for children raised in rural areas.

Interesting.

Food Recalls

In light of yesterday’s post, here are screenshots of the current food recalls taken from the respective Canadian and US agencies:

CFIA Food Recalls - 2016 02 10
CFIA Food Recalls – 2016 02 10
FDA Food Recalls - 2016 02 10
FDA Food Recalls – 2016 02 10

Undeclared egg, mustard, wheat, sesame, fish, milk, peanuts, sulfites, almonds and pistachios. All in the past month. Not to mention the salmonella, listeria, and E. coli occurrences.

Scary.

Canadian Food Inspection Agency
US Food and Drug Administration