Customers who ask you for allergen information may have very different conditions. Understanding the difference helps you take every request seriously.
Food allergy
An allergy is a reaction of the immune system against a protein in a food that is normally harmless. It can occur with very small amounts, sometimes within minutes.
Symptoms can include:
- skin: itching, hives (urticaria), redness, swelling of the lips, face or eyelids;
- mouth and throat: itching, tingling, swelling of the tongue or throat;
- digestive: nausea, vomiting, abdominal pain, diarrhoea;
- respiratory: coughing, wheezing, shortness of breath, congestion;
- general: dizziness, fainting, drop in blood pressure.
What protects a person with an allergy is avoiding the food: there is no way to "make it safe" by cooking it. If a customer says "I'm allergic", always take it seriously.
Anaphylaxis
Anaphylaxis is a severe, fast-onset allergic reaction that affects several organs at once. It can be life-threatening.
Warning signs:
- difficulty breathing or noisy breathing;
- swelling of the tongue, throat or face;
- dizziness, pallor, feeling faint;
- hives all over the body together with other symptoms;
- repeated vomiting together with other symptoms.
What to do:
- Call 112 straight away.
- Tell your manager.
- Ask whether the person has an adrenaline auto-injector (many people with severe allergies carry one) and help them use it if they cannot, following their instructions.
- Keep the person lying down with their legs raised if they feel dizzy; if they have trouble breathing, let them stay sitting up. Do not leave them alone.
- Do not give them anything to eat or drink.
- When the emergency services arrive, tell them what the person has eaten and what ingredients the dish contained.
A reaction can improve and then get worse again a few hours later. So even if they seem better, a person with anaphylaxis must be seen by a medical service.
Food intolerance
An intolerance is not caused by the immune system. It is usually a problem of digestion or metabolism. The symptoms are mainly digestive (wind, pain, diarrhoea) and are almost never life-threatening. Sometimes a small amount is tolerated.
The best-known example is lactose intolerance: the body does not have enough lactase to digest the sugar in milk. A customer with lactose intolerance may need to avoid milk or choose "lactose-free" products. Be careful: lactose is the sugar in milk, but a milk allergy is different: it is a reaction to milk proteins, and lactose-free milk is not suitable for those people.
Coeliac disease
Coeliac disease is a permanent autoimmune disease. In people with coeliac disease, gluten damages the gut. They need a gluten-free diet for life, and for them traces matter: a little flour in the fryer oil, on a board or on a spoon is enough. Implementing Regulation (EU) No 828/2014 governs the claims "gluten-free" (up to 20 mg/kg of gluten) and "very low gluten".
Why does the difference matter?
- For allergy, coeliac disease and intolerances, the customer expects what you serve not to contain what they avoid.
- Even if the severity is not the same, never play a request down. Some people do not say what condition they have, and your answer has to hold for everyone.
- Give only facts you are sure of: if you do not know whether a dish contains something, do not state that it does or does not.
Key points
- Allergy is an immune reaction and can be severe. Intolerance is digestive, and coeliac disease is a lifelong autoimmune disease.
- Anaphylaxis: call 112, help with the adrenaline if they carry it, do not leave them alone.
- Lactose-free milk is not safe for a milk allergy.
- Take every request seriously.