Food allergies are becoming an important public health concern globally with a growing number of consumers reportedly suffering from this condition. Up to 10% of the population are estimated to be affected by food allergies with the most serious cases caused by a narrow list of foods like peanuts, tree nuts, fish, shellfish, egg, milk, wheat, and soy. The lack of awareness on the type of allergies consumers experience and the confusion between food allergies and food intolerance poses a further challenge in addressing the problem.
Food intolerance versus food allergy
Food intolerance is a non-immune reaction that may include metabolic, toxic or pharmacologic mechanisms. For example, lactose intolerance is caused by a deficiency of lactase enzyme in affected individuals that leads to an intolerance to milk containing lactose. In contrast, food allergies are adverse health effects arising from a specific immune response on exposure to a naturally occurring protein.
Allergic symptoms can include any combination of local oral, dermatological, gastrointestinal and respiratory symptoms and also death in severe cases. Moreover, a trace amount of protein can trigger differing symptoms in affected individuals. The manifestation of a food allergy is influenced by genetics (G), environment (E), and G x E interactions while risk factors contributing to food allergy include genetics, sex, race or ethnicity. For instance, peanut allergies are very common in Western countries, but relatively rare in Asia. Some food allergies like milk, egg, wheat, and soy may be outgrown in childhood; while others such as peanut, tree nut, fish, and shellfish allergies persist throughout life.
Proper labeling of ingredients
The pathophysiological differences between food allergy and food intolerance result in divergent diagnostic strategies and therapeutic options. Identifying a true food allergy that consumers experience is critical for recommending avoidance of a particular food or ingredient that triggers the adverse reaction.
The ability to avoid allergic food depends on factors outside the control of individuals. Therefore a greater responsibility devolves on food manufacturers and food handlers such as the proper labeling of food products to help consumers avoid specific allergens.
Food manufacturers must have accurate information about their ingredients, sources and also understand their processing conditions, which may potentially lead to allergen cross-contact. The results of allergen mislabeling, allergen cross-contact due to poor implementation of Good Manufacturing Practices (GMPs) and the use of untrained workers can be lethal for consumers.
Food allergens demand awareness
With increasing public safety concerns, food allergen management is gaining its very necessary importance in the global food industry and several national regulators address it through specific regulations for the food industry. However, the allergen labeling requirements or the list of allergens to be declared still varies across countries. There is also a lack of information on allergen sensitivity in local populations and often, a lack of in-country studies to identify specific allergens or allergies prevalent in a country.
Most countries with allergen regulations do stipulate the declaration for 8 common allergenic foods such as milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybean as per the CODEX standards for general labeling. While this list of allergens is extended in Australia, Canada, and the European Union, the lack of uniformity can impact cross-border trade. Moreover, food exporters should be aware of these differences and address the specific allergen labeling requirements of the importing countries.
The India case – awaiting regulation
In India, the data on probable food allergies among the general population is very limited and the country does not have an allergen labeling regulation in place currently. However, the draft Food Safety and Standards (Labeling and Display) Regulations, 2018 includes a provision for labeling of food allergens, and hopefully, the final regulations will be soon notified. There is a need to create awareness among consumers of the distinction between food allergies and intolerance that are often a source of confusion for consumers. The food business operators and food handlers also need to be trained on allergens, their health implications and allergen management to ensure safe food for everyone.
Source: K V Satyanarayana is associate vice president at Sathguru Management Consultants and leads its food processing and retail practice. He is also Food Safety Preventive Controls Alliance Trainer for Preventive Controls of Human Foods