Gluten Free Lunches

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Gluten Free Diets in School Meal Programs
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Introduction

• Estimated that 17 of children less than 18 years
  of age have some type of developmental disability
  (NFSMI 2006 report)
• 3-4 million Americans have a developmental
  disability and another 3 million have milder
  forms of cognitive disorders or mental
  retardation (ADA 2004)

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Disabilities

• Disability- defined as a person who has physical
  or mental impairment which substantially limits
  one or more of the major life activities.
• These may include

Heart Disease Metabolic Diseases Severe Food
Allergies Cancer Specific Learning Disabilities
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Federal Mandates

• Today three federal legislative acts mandate that
  school food service will serve children with
  special dietary needs.

• Rehabilitation Act 1973
• Individuals with Disabilities Education Act- IDEA
• Americans with Disabilities Act (ADA)

Children and adolescents served under this law
have health problems that require nutrition
intervention and benefit greatly by modification
of school meals.
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Special Diet Process

• Physicians Statement for Children with
  Disabilities USDA regulations 7 CFR Part 15b
  require substitutions or modifications in school
  meals for children whose disabilities restrict
  their diets.
• The physicians statement must include

• The childs disability
• An explanation of why the disability restricts
  the childs diet
• The major life activity affected by the
  disability
• The food or foods to be omitted from the childs
  diet, and the food or choice of foods that must
  be substituted.

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Special Diet Process

• Medical Statement for Children with Special
  Dietary Needs
• Each special dietary request must be supported
  by a statement, which explains the food
  substitution that is requested

• An identification of the medical or other special
  dietary condition which restricts the childs
  diet
• The food or foods to be omitted from the childs
  diet
• The food or choice of foods to be substituted

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Example Physicians Statement
Date_____ To Whom It May Concern Jimmy
Jones has been diagnosed with Celiac Disease.
This is a condition in which the body cannot
properly digest the protein gluten that is found
in many grain products. It damages the small
intestine and interferes with absorption of
nutrients from food. Consuming gluten can result
in seizures, chronic diarrhea, abdominal bloating
and pain, fatigue, osteoporosis, nutritional
deficiencies, and other symptoms. The only
treatment for celiac disease is to follow a
gluten-free diet. A gluten-free diet involves
removing wheat, rye, oats, and barley from any
foods eaten. Meat, fish, rice, and fruit in their
original states as well as specialty gluten-free
products do not contain gluten. I would ask that
you please accommodate this students needs at
school. Signed ____________________________
John Smith M.D.
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Gluten Free Diet

• Any of the following words on food labels usually
  means that a grain containing gluten has been
  used

Stabilizer Starch Flavoring Emulsifier Food
Starch Vegetable Gum
Hydrolyzed Vegetable Protein Flour or Cereal
products Vegetable Protein Malt or Malt
Flavoring Modified Starch or Modified
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Gluten Containing Foods

• Foods made from wheat, rye, or barley

• Bread
• Pasta
• Breading
• Pizza Crust
• Crackers
• Cookies
• Cake
• Muffins

• Salad Dressing
• Sauces/Gravies
• Imitation Bacon or Seafood
• Luncheon and processed meats
• Malt or Malt Flavoring
• Marinades
• Soy Sauce
• Soups

• Lipstick
• Stamps
• Lotions
• Shampoo

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Most Important Concept

• READ FOOD LABELS!!!!!!

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School Nutrition Responsibilities

• Staff will prepare nutritious food substitutions
  or modifications as requested
• Staff may not revise or change medical order
• Staff will maintain good record keeping on a
  yearly basis

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School Nutrition Responsibilities

• Staff will offer special meals at no additional
  cost
• Staff will work closely with other district
  professionals- school nurse, teachers, parents,
  etc.
• Staff will be educated about diet modifications
  and cross contamination

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Other Responsibilities

• Train foodservice employees- MSNA workshops and
  training sessions
• Increase staff awareness
• Increase student awareness in the classroom and
  cafeteria environment

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Gluten Free Lunches in Rochester

• 1st gluten free menu was created in 2004
• The traditional menu was modified two days a week
  to provide a gluten-free diet.

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Lunch menus today

• Over 20 children in the Rochester area require
  gluten free menus
• Over 12 different menu items are offered per
  month
• All items mirror the traditional school lunch
  menu
• All gluten free items are purchased locally
  through the Gluten Free Cupboard, the Bread
  Baker, or Hy-Vee grocery stores.

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Traditional vs. Gluten Free Menu
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Traditional vs. Gluten Free Menu
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Public Awareness
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Our Inspiration

• Hey Sherri, little Kimberly is so grateful.
  After I served her on Tuesday she just kept
  telling me how good it was. Then I saw her in gym
  class on Wednesday and she ran over to me and
  hugged my leg. She looked up at me and said I
  get to eat your lunch tomorrow!! and she smiled
  at me, like I was a goddess or something! It
  really made me feel great.

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Our Inspiration

• Our son Brandon will be attending John Adams
  this upcoming school year in 6th grade. He has
  Celiac Disease. During his elementary schooling
  at Washington he brought lunch to school each
  day. However, from our experience with our older
  son and his friends, very few kids bring lunch in
  middle school.
• Therefore, we want to explore the
  possibilities of having his needs supported
  through SNS. Please let me know what we need to
  do or information we need to provide to make this
  
• happen. Thanks in advance!

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Awareness of this disease is spreading as the
diagnosis of celiac disease is on the rise.
Grocery stores are becoming more helpful and more
aware.
More good news!
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Public Awareness
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Feedback

• Thanks for everything you have done for me so
  far. I really appreciate what you have done for
  me and it is so much easier than bringing my own
  lunch.
• Brandon
• Here is Brandon's menu for the month of April.
  Thank you so much for making this a wonderful
  experience for Brandon. He has really enjoyed
  being able to eat at school with his friends. We
  wouldn't have been able to do it without you!!
• Thanks again.
• Brandons Mom

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Feedback

• Thanks so much for setting up the gluten-free
  lunches for my son. Over the weekend, I visited
  friends and family in Wisconsin including a
  school social worker from Wausau and a teacher
  from Sun Prairie.  They were astounded and
  impressed by your gluten-free lunch program.  I
  know we are very lucky!

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Any Questions?