(Editor’s Note: This is an online-only article attributed to the October/November 2018 issue.)
Most food allergies develop in children around 6 years of age, says Clifford W. Bassett, MD, FACAAI, FAAAAI, a New York City doctor who specializes in the evaluation and management of allergic disorders affecting children and adults. As many as 7 percent of American children have some allergy to food or ingredients in food.
However, most outgrow these food allergies. Only about 2 percent of American adults suffer from food allergies, with the most common allergies in adults caused by eating peanuts, tree nuts, fish, and shellfish. Skin and blood tests can help determine if someone has a food allergy. If a child is tested and it reveals a food allergy is present, the child should be tested again after a few years. There is a 60 percent chance that the allergy has been lost.
What Causes a Food Allergy?
According to Dr. Bassett, food allergies are caused by allergen-antibody interactions. Simply put, this means that a food allergy occurs when the body’s immune system views a specific food or food ingredient as harmful and reacts by causing symptoms. These reactions may be mild to severe—even deadly—and can include any of the following:
- Skin rash, itching, and hives (the most common signs of a reaction);
- Swelling of the lips, tongue, or throat;
- A variety of respiratory problems;
- Stomach pain and vomiting; and
- A general “getting sick” feeling (for instance, when someone believes they are coming down with the flu).
Reaction severity can depend on the amount of food the person has eaten containing the allergen, what other types of food eaten at the same time, and whether alcohol was consumed while eating. Some consumers are so sensitive to food allergens, even if they inhale air that encounters the allergen, such as peanuts served on an airplane, they can react.
Food allergies can be inherited. Some consumers have a strong predisposition to food allergies because it runs in their family. In addition, environmental factors can also produce food allergies; long-term exposure to tobacco smoke, pesticides, even stress can contribute to different types of allergic reactions.
It is believed that eight kinds of foods are responsible for more than 90 percent of all food allergies in children. These are milk, eggs, peanuts (which has increased significantly in the past decade), tree nuts (almonds, Brazil nuts, cashews, chestnuts, macadamia nuts, pecans, pistachios, walnuts, and others), fish, shellfish, soy, and wheat.
There also appears to be the so-called “families of foods” that cause allergies. For instance, if a child is allergic to almonds or pecans, there is an excellent chance that the child is also allergic to peanut butter, peanut oil, and many if not most of the other tree nuts mentioned above. These families of foods can be very broad; a child with an egg allergy may also be at higher risk for having a peanut allergy.
Preventing Allergic Reactions
How should a person experiencing a food allergy reaction be treated? If the response is acute and the person is taken to an emergency room, an injection of epinephrine (adrenaline) is usually given. This can help decrease the allergic reaction, however, epinephrine has its own side effects, some of which can be severe.
There are also some prescription drugs that can help treat people and minimize reactions to food allergies. However, these may not work for everyone. Ultimately, the best treatment is avoidance: Those who have a known food allergy are advised to avoid foods and food ingredients that cause the reactions, and this is where proper food labeling comes into play.
The food industry has a significant role to play to protect the consumer from allergic reactions. Some may believe this has already been accomplished with the U.S. Food Labeling and Consumer Protection Act that requires food manufacturers and processors to identify major allergens. These include wheat, eggs, milk, peanuts, fish, shellfish, soy, and tree nuts.
However, what if a consumer purchases food items that contain ingredients other than those mentioned? Does that mean they are safe from allergic reactions? Not necessarily.
Manufacturers may voluntary place a cautionary statement on a food product label that the food item “may contain” a specific allergen, was “manufactured in a facility” that produces foods containing certain allergens, or was manufactured or processed on “shared equipment” with foods containing allergens. According to a November 2016 study, published in the Journal of Allergy and Clinical Immunology: In Practice, these cautionary terms cause a lot of confusion for consumers. As many as 40 percent of the 6,600 consumers surveyed who either have a known food allergy, have a child with an allergy, or care for a child who has a food allergy are still purchasing foods that might cause an allergic reaction even with these cautions printed on the label.
The study found the most misunderstood food labels are those that say “may contain” or are “manufactured on shared equipment.” Nearly half of the respondents believed these statements were required by law, which they are not, and a third thought they were based on amounts of an allergen, which is also not true. Whatever the belief or thinking, the study concluded that many consumers don’t take them seriously enough to not purchase a food item.
Eliminating the Confusion
This is an opportunity for the food industry to take its own steps to end this confusion, help prevent allergic reactions to foods, and keep consumers healthy. To do this, more advanced menu management systems are needed that are designed to not only accurately detect whether allergens are present in foods, but to also evaluate more than 120 other nutritional metrics and claims, such as fat content, calories, vitamins, sodium, sugar, and gluten.
Menu management systems are designed to help food service providers create and manage food recipes. They do this by analyzing the ingredients and the nutrients in the recipes. While variations of menu management systems have been around for about 20 years, the newer and more advanced systems take things several steps further.
Cloud-based systems allow new food regulations or recipe changes that are impacting a chain of restaurants or food producing facilities to be communicated to all locations simultaneously. Further, the corresponding labels for these food items can be changed at the same time.
More advanced systems can also help recipe managers reformulate recipes to eliminate foods and food ingredients that might contain allergens or adjust salt, sugar, or fat content with changes reflected on the label. Determining serving portion costs and suggesting portion pricing is also possible.
In much of North America today, we are in what could be called a “deregulatory” environment. This does not mean that industries no longer need to be concerned about specific regulations they were required to follow in the past. Instead, it means industry has been handed an opportunity; the food industry can take steps on its own, independent of government measures, to ensure American consumers are clear about what is in the foods they select and which allergens may be present, as well as all the other nutritional information.
While some industry regulations may be passé, when it comes to food allergens and the food prepared for consumers, transparency is here to stay.
Carte is category manager of food safety at DayMark Safety Systems. Reach her at firstname.lastname@example.org.