Food Intolerances & Food Services: Providing Choice at Community Meals

Written by Holly Heximer & Marilee Pumple, UBC Dietetics Students

According to the Disability Alliance of BC, 50% of Canadian Food Bank users report having a disability, which can include digestion challenges such as celiac diseaseBread & Cheese.jpg or sensitivity to wheat. Across Vancouver, many people depend on food banks and community food services, yet are faced with the harsh reality that they cannot digest all of the foods available in these programs.

People on a limited income affected by chronic conditions or food intolerances must sometimes choose between going hungry or eating foods that make them feel ill.  Without access to acceptable foods, they risk becoming increasingly malnourished. How can food providers create a safe and inclusive environment for people requiring a special diet?

Celiac Disease Requires a Special Diet

Celiac Disease is an autoimmune disorder affecting the small intestine.  When an individual with this disorder consumes gluten, their nutrient absorption capabilities decline and they experience uncomfortable symptoms like bloating, pain, rashes and irritability. Gluten is a protein found in wheat, barley and rye, and is an ingredient in many processed foods, providing texture, chewiness and elasticity. The Canadian Celiac Association estimates that 1 in 133 Canadians are affected by celiac disease. The only treatment for people living with celiac disease is to follow a strict gluten-free diet. Similarly, some people who are not true celiac feel better when not eating wheat, and thus try to avoid it.

Reliance on Food Services

Individuals with dietary restrictions like wheat sensitivity often face a lack of choice when accessing charitable food programs as items commonly served often contain wheat or gluten. Gluten-free specialty foods are typically more expensive and are donated less often. Naturally gluten-free foods such as potatoes, beans, rice, corn, meats, fruits and vegetables can provide plenty of nutrients for a person avoiding gluten. However, these items are not always available.

10th Church Community Meal

The opportunity to speak with individuals facing ongoing health challenges arose while visiting a community meal at 10th Church. One guest shared her experience of living with a wheat allergy.  She suggested volunteers at food programs be receptive to guests inquiring about ingredients or allowing them to disclose their diet restrictions at the start of the meal. There may be a misconception that when a guest inquires about ingredients or preparation methods that they are being picky or rude. However, providers should be empathetic to clients who must ask questions necessary to follow through with diet restrictions.

For people coping with a health condition, it may be challenging to disclose personal information regarding dietary restrictions. A person with a special diet may fear that if there is no alternative, they may not be able to eat at all. Individuals often choose to remain silent about their restrictions and risk their health just to ensure they get something to eat. A separate menu for guests with special diets may not be practical, as it may single out individuals for receiving special treatment. Instead of isolating guests during their dining experience, having similar menu items without common allergens, such as wheat-containing gravies or sauces, may allow for these guests to enjoy their meal while not compromising their health.

As more people become diagnosed with allergies and chronic conditions, food providers may have to rethink their methods for providing food. Although it may not be feasible to accommodate everyone, focusing on client concerns will ensure a more inclusive and safe dining experience.

Recommendations to Food Providers 

  • Provide space for guests to ‘check in’ with staff before the meal is served where they may privately share any allergies or food restrictions.
  • Provide a display board featuring menu items with a common allergens disclaimer (eg. nuts, shellfish, wheat, soy, etc.) so that guests may avoid a certain food without the need for full disclosure.
  • For donations, immediately separate donated gluten-free foods from other items. When sorting foods, scan labels and mark foods that may contain hidden sources of gluten such as sauces or soups. Use separate food hampers or storage for those requiring a special diet. Look for these words on ingredient labels: malt, spelt, wheat, gluten, semolina, kamut or barley.
  • Avoid contamination of gluten-free foods by preparing meals on a clean work surface. Prepare gluten-free foods before other foods, to avoid trace contamination. Ensure each dish has its own utensils when serving food.
  • Label dishes at buffet or family-style community events. List ingredients so that celiac individuals can identify which dishes are safe to eat.
  • Plan meals with a variety of foods.  If the main course has pasta and cheese, for example, choose a dessert without wheat or dairy.
  • Ensure staff and volunteers are trained with safe food handling practices, demonstrate empathy and help clients with food intolerances in a respectful manner.

For more information on celiac disease and a gluten free diet, visit the Canadian Celiac Association.

Holly Heximer is entering her 4th year in the UBC Dietetics program. After graduating she plans to work rurally as a clinical or community dietitian.

Marilee Pumple is a 4th year student at UBC, also studying to become a Registered Dietitian. She is passionate about health, wellness and overall care for others.  She has a particular interest in food literacy and gerontology.

2 thoughts on “Food Intolerances & Food Services: Providing Choice at Community Meals

  1. Karen G says:

    Further ideas from another reader who lives with Celiac Disease and occasionally relies on community food programs:

    “Avoid wheat in stews, soups, gravies. As a matter of routine, always substitute other ingredients such as corn starch, tapioca, etc. That’s an easy fix. Use oatmeal in meat patties, meat loaf and so on. Use recipes for corn bread that never include wheat flour.

    Also, it would be helpful if all volunteers understand that for those with allergies or intolerance or celiac disease, they should not have to, year after year, explain their issue and risk being treated rudely or unfairly. It is never satisfactory that they should eat 50% of what others receive. If there are seconds, they may receive another 50%, that is, still half of what others eat. Most volunteers should understand that an extra scoop or two of something else can make up for skipping of dishes with wheat and copious amounts of bread. Unfortunately, not all volunteers understand this math so it often comes across that the person has to beg and gets indignant when regularly refused by the high turnover of volunteers, or even by regular volunteers who are told to deny every request for ‘more’. Treating the person as if they are greedy is a poor solution that may not be the intended result.

    Lastly, it would be awesome if there were always a choice between a sugary dessert and fresh fruit, such as apples and oranges, uncut. This can help address diabetes as well as having something to take home. Most people don’t have the time and/or health to attend these dinners as a lifestyle choice. As people age, or health turns, as more of these places shut down, seasonally, occasionally or permanently, there are few choices left. Many of us eat once a day due to increasing poverty. For that reason it would be great to continue having substantial amounts of nutritionally balanced complete meals on a reliable basis. It is only a minority of people who can get to daily meals. And, of course, those without kitchens, and the homeless, spend a lot of hours and days trying to survive or even get ahead so it is helpful that such charities honour them by at least once a day helping them to get a little more than enough fuel to help them bear the increasing poverty, abuse and neglect of all vulnerable people in BC.”

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s