Viewpoint: School nutrition director on why foodservice pros should learn about the red meat allergy aka Alpha Gal Syndrome, sooner rather than later

Amanda Warren

Oligosaccharide Galactose-α-1,3-Galactose, aka Alpha Gal. It sounds a little like a new sci-fi superhero, right? Unfortunately, it’s real science that is perplexing the medical world and I guarantee it’s coming shortly to shake the foodservice industry.  

What is Alpha Gal? 

First, a little background on Alpha Gal. It’s a sugar molecule residing naturally, without complication, in the cells of mammals, except primates and humans. However, if this benign confectionary particle happens to come into contact with a bloodthirsty ectoparasite, like the Lone Star Tick, then Alpha Gal can be unwittingly transformed into a deadly human offender and subsequently induce in humans Alpha Gal Syndrome or the “Red Meat Allergy.”

To further illustrate, Lone Star Ticks usually prefer the finer fare of human hosts, but they’re also opportunists and will feed on any mammal they can cling to, like a deer. During feeding, the tick pulls the AG carbohydrate from the host’s blood and retains it in its saliva. When the Lone Star tick does finally catch a human host and is able to take a bite, it injects the AG into the human's blood. Since AG is not organic to humans, our body senses “fight,” so antibodies are created and an immune response is activated. Consequently, now anytime AG is introduced into the human; for example, by eating prime rib, the body has an immune reaction, better known as a food allergy.    

It happened to me

Right now, according to data, nearly 1 million people in the US are affected; and I am one of them. I have Alpha Gal Syndrome. Due to successive tick bites, I became allergic to all mammalian meats; developed a secondary allergy to milk, cheeses, animal byproducts and carrageenan; and as a cherry on top, have airborne lipid and particle reactivity. 

I have over 25 years of food industry experience and currently work as a school nutrition director. Alpha Gal Syndrome not only upended my personal food world, it also changed the scope of how I work and brought to mind thoughtful concerns around allergy management, food labeling and our food system. 

My epi-pen is on hand at all times, as anaphylaxis is a real risk. My symptoms ranged from hives, rashes and swelling to severe GI distress, joint pain, and chronic fatigue. My symptoms however won’t necessarily mirror someone else's. 

What does this mean for foodservice operators?

While most food industry workers are no strangers to food allergies, this emerging vulnerability is breaking all the rules. This condition is atypical in nature, in that it presents differently in each affected person with varying degrees of reaction, from mild to severe. It also has a latent reaction time, 2-10 hours, making it sometimes difficult to connect back to the food that was consumed. Alcohol and exercise are cofactors that can trigger a reaction more quickly. This little tick and its carbohydrate companion are wreaking havoc across the globe, and with lengthier, warmer seasons in our future, cases will only continue to rise. 

I believe the implications of this anomaly are far reaching, especially in the food industry, and we need to get in front of it now. 

Allergy management in food service operations is always tricky and Alpha Gal Allergy is risky. How do you mitigate airborne lipid reactions in an establishment that cooks a variety of meats and cheeses? How do you assure a patron that her “safe” chicken hasn't been processed with a mammalian byproduct during the plumping process? What about kids who rely on school meals? How do you guarantee the safety of that child when cross-contamination is a high probability without a completely sterile environment in which to prepare and contain each meal.  

Do we just turn away this growing consumer market? Do we create Alpha Gal friendly eating environments? How do we support employees in our food business with this condition?

Through my research, and talking to others impacted by this, I'm finding many people simply stop going out to eat (I have) due to the complex nature of their condition and not wanting to burden staff with bizarre requests. On a school nutrition Facebook forum, where I asked about accommodating kids with AG, I found that kids with higher level reactivity simply weren't participating in school meals, with some even being segregated during mealtimes. This is certainly a reduction in quality of life, but is there really anything the food industry can do about it? Listen to two Alpha Gal awareness advocates speak to their experience. 

“Dining out with Alpha Gal syndrome is complicated because it isn’t just removing one clear ingredient. Many of us have to avoid consuming the obvious mammal meats, but also dairy, meat byproducts, and other ingredients that contain the alpha-gal epitope such as Carrageenan. We also have to consider cross-contamination and fume reactions. Many people with alpha-gal can’t even eat at places where food containing mammal is being prepared. It’s imperative to communicate this clearly to waitstaff and food preparers, which is one of the reasons we created our Stick It To The Ticket notepads. We’re always so grateful to the servers and chefs who are patient and understanding as we’re trying to enjoy dining out while safely navigating the experience."

—Candice Matthis & Debbie Nichols, Two Alpha Gals www.twoalphagals.com

Aside from considering how to provide a better dining experience, another important way to improve quality of life for those afflicted with AG is through honest and transparent food labeling. When individuals and food professionals have a clear understanding of the ingredients labeled, then more informed, safe choices can be made. Processors and manufacturers should be required to label all processing agents, animal byproducts, stabilizers, and “natural ingredients” clearly, and by a standard, recognizable name.  

For example, this fish has been processed with carrageenan, not just “color added.” Carrageenan is a red algae that contains the Alpha Gal epitope and not only is it causing severe allergic reactions among the Alpha Gal community, it’s an additive in many of our “safe food products,” like almond milk and vegan cheeses. It is simply unfair to become sick from a food you’ve been told is safe, but more so, it’s also unethical for an allergen not to be labeled.  

The Cornucopia Institute recently issued a proxy letter asking Costco to take carrageenan out of their organic products. Food service operators and industry partners can impact change too, by demanding, on behalf of their patrons, consumer-safe products, clean label foods, and honest labeling. They can purchase from local trusted sources and they can also research and develop a food allergy plan for their establishment, to include continuous training, full recipe and ingredient list copies and first aid training, to include responding to anaphylaxis. Food manufacturers and producers can demand integrity in their operations and take toxic ingredients out of our food. FDA should  “beef up” better oversight and back legislation to protect consumers.  

Undoubtedly, Alpha Gal Syndrome gives us much to ponder. I’ve only scratched the surface here, but want to leave with one final statistic: Farmers, hunters, and forest workers are two times more likely to contract Alpha Gal. If the most intimate source of our food supply chain, our producers and land tenders, become sick and can no longer do this work, who will? What about our underserved populations, like migrant farmers? They already face barriers, like language and access to quality medical care. If they get sick, how do they know where to go to seek help and how do they pay for it? What about farming communities that are isolated? How do they become informed about this new tick borne condition, so they can prevent or at least recognize symptoms and seek care. In my own farm-to-school initiative, I buy local and partner with farmers on nutrition education; I need my friends to stay well. This is where the agriculture industry needs to step up. 

Photo: Amanda Warren, foodservice director at Staunton (Va.) schools, is working to raise awareness on this emerging food allergy that makes red meat dangerous.

The research on Alpha Gal is bare. The outreach and public awareness is minimal. Funding is scarce. The USDA should be leading out loud on this and flowing support down. State Departments of Agriculture and local extension offices should be filling in information dissemination gaps, providing affordable blood tests and affordable non-toxic tick prevention. These agencies should also be partnering with other support agencies like public health and education departments and other healthcare networks. Research, task forces, support groups, etc. don’t affect change if the work stays in a bubble. I implore this to become a widespread community conversation, with all of us at the table. I ask my fellow foodies, colleagues, restaurateurs, chefs and industry partners to take heed, to speak out, to demand better and to spread the word, like our lives depend on it. Check out these resources for more info.