Headlines about a 26-year-old woman with a nut allergy recently dying from eating Nutella at a Tel Aviv restaurant have been a popular topic of conversation over the past couple of weeks in Israel.
Chen Efrat’s death has been a stark reminder to Israelis of the gravity — and sometimes, fatal nature — of food allergies. Health authorities have begun to raise awarenessof the prevalence of food allergies and to try to get people to take the issue more seriously. Efrat had reportedly asked the restaurant’s waitress repeatedly to check whether the chocolate spread in the Belgian waffle desert she had ordered was Nutella or not, and she was assured that it was not — when, in fact, it was. After being rushed to a hospital, she died several days later. Her parents have just filed a NIS 5.5 million suit against the restaurant.
Increasing allergy awareness is not an easy task in a country where Bamba, corn puffs covered in peanut butter (the product is 49% peanuts), are fed to almost all babies as soon as they can chew. However, Israel’s Ministry of Health has already made progress in terms of food labeling. Currently, labeling regulations require that products list allergy-triggering ingredients such as milk, nuts, soy, eggs, sesame and gluten after the words “contains” or “may contain.” Since Efrat’s death, it was announced that steps are now being taken by the government to move toward even clearer and more noticeable allergy warnings similar to those used in Europe, the U.S. and Australia.
There are no plans at this time for the Ministry of Health to require restaurants to list allergy-inducing ingredients on their menus, but there is talk of producing a guide for food allergy sufferers to non-packaged foods (such as those purchased in restaurants, cafes and open-air markets).
Among Israelis, there are differing opinions about how specific and far-reaching food-allergies regulations and protocols should be. Jen Maidenberg, an American immigrant to Israel with one child allergic to nuts and another allergic to sesame, wrote in a blog post for the Jerusalem Post last week that food labeling in Israel needs to be accurate and differentiate between “contains” and “prepared on equipment with.” She wrote that currently, “manufacturers slap everything with a ‘May contain traces of nuts, sesame, or gluten’ label in order to avoid liability issues, leaving our food allergic children with no true concept of what they can and cannot eat from the packaged food selection.”
Maidenberg also wrote that her children do not go anywhere without their EpiPen, but that, unfortunately, she continues to find a lackadaisical attitude among teachers and counselors and that schools are not staffed with people trained to help administer the life-saving medication, if needed. Last week, an Israeli food allergies advocacy and education non-profit organization called Yahel called for the inclusion of EpiPens in all first aid kits in public places, especially restaurants.
While Israel may not be as advanced as other countries in terms of food allergy awareness, many here point out that things have come a long way, and that for some food allergy sufferers, living in Israel is actually an advantage. Ancil Zeitak is an older adult who developed a serious allergy to the milk protein about 20 years ago. He finds it generally easy to avoid milk due to the almost universal awareness here of the rules of kashrut that separate milk and meat (he looks for pareve labels). When he doesn’t buy kosher products or eat in kosher establishments, his rule of thumb is “If it looks white, don’t eat it.”
Melissa Ser, who directs the Ramah Jerusalem Day Camp, says that she perceives a greater awareness among younger generations. “But members of older generations think they can just give kids food without first asking about allergies or checking with parents,” she pointed out.
Ser’s impression, based on her personal experience working with kids, is that there seems — at least anecdotally — to be a lower per capita rate of food allergies in Israel as compared to America. She thinks it might be attributable to parents’ exposing their children to all foods, including ones known to cause allergies, from a very young age.
Aviad Stier, a father with young children in Herzliya, has found the Ministry of Health’s pediatric guidelines in this regard confusing. When his five-year-old son was born, he was told to wait until the baby was six months old to expose him to some foods, and until a year for others. But when his daughter was born a few years later, he was instructed to give her everything from the moment she began eating solids at around four months (with the exception of honey).
He’s grateful that, so far, his kids are allergy-free, and he hopes they stay that way.