Food allergy articles
Article pagesBecause there is no "cure" for food allergies other than strict avoidance of an offending food, one of the biggest problems those with food allergies face is verifying whether a forbidden product is contained in a particular food. For example, in Sampson's study, all six deaths occurred because either the child or the parent was unaware the food contained a substance to which the child was allergic. Munoz-Furlong says the Nutrition Labeling and Education Act, which requires more complete food labeling, should greatly help people with food allergies to avoid dangerous foods.
"The new labeling changes will make it easier for the consumer to readily identify things they could be allergic to," says Linda Tollefson, D.V.M., chief of the epidemiology branch at FDA's Center for Food Safety and Applied Nutrition. "Before this law was passed, true allergens were required to be on the label, but the exceptions were standardized foods, which will now have to list all ingredients."
According to Elizabeth J. Campbell, director of the center's division of programs and enforcement policy, the principle underlying standardized foods originally was that people basically knew what was in various foods.
"Originally, food standards were adopted to ensure uniformity. If you saw a product labeled mayonnaise, food standardization meant it had to be mayonnaise. People used to know what was in mayonnaise; nowadays they have to be told that mayonnaise contains both eggs and oil," Campbell says. "Years ago, when the law was first written to provide for standards of identity for certain foods, it only required that optional ingredients be declared. The new law stipulates that all ingredients in standardized foods must be declared." (See "Ingredient labeling: What's in a Food?" in the April 1993 FDA Consumer.)
Campbell believes that once the labeling is in place, consumers will have the information they need to make correct food choices. "In most cases, ingredients have to be labeled simply because they are ingredients, not because they are unsafe," she stresses. "For those with food allergies, I think it is more of a patient education problem."
Food additives, such as sulfites and certain colors, can also cause problems for people sensitive to them. (See "A Fresh Look at Food Preservatives" in the October 1993 FDA Consumer and "From Shampoo to Cereal: Seeing to the Safety of Color Additives" in the December 1993 FDA Consumer.)
"If you have a food allergy, you really have to alter your life," Tollefson says. "You have to really read labels, and really be careful about what you eat."
Steve Taylor, Ph.D., a professor and head of Department of Food Science and Technology at the University of Nebraska in Lincoln, says the biggest problem for people with food allergies is restaurant food. Historically, restaurants have been regulated by local heath departments and have not had to label foods.
"For many restaurants, labeling of food products they serve would cause horrendous problems...what about chalkboard menus? How would you include all the ingredients? Enforcement would be a nightmare," he admits.
But steps are being taken to better educate restaurant employees. The Food Allergy Network and The American Academy of Allergy and Immunology, along with the National Restaurant Association, recently produced a pamphlet on food allergies, which has been distributed to 30,000 members of the association. The brochure explains what restaurants can do to help customers who need to avoid certain foods, defines anaphylaxis, and advises employees on what to do if food allergy incidents occur.
John A. Anderson, M.D., director of the Allergy and Immunology Training Program at Henry Ford Hospital in Detroit, says changes in food habits may be responsible for the feeling some physicians have that food allergies may be on the rise.
"You could make a case for the fact that we are introducing peanuts, in the form of peanut butter, to people at a very young age, which would affect the prevalence rate for people who are sensitive to that allergen," he notes. "In Japan, where they use more soy, there is a higher prevalence of soy allergy. My feeling is that as soy, a cheap protein supplement, is put in a lot of commercial foods you will see an increase in the rate sensitivity worldwide."
Metcalfe say that if food allergies are rising, it is due to more common use of foods that tend to be allergenic. He cites milk as a source of protein supplement in many prepared foods, and points out that people are eating more exotic seafood and more fish.
"But it's important to remember that the majority of people with true food allergies are allergic to three or fewer foods," Metcalfe says. Other than advising anyone with a known or suspected severe food allergy to carry and know how to self-administer epinephrine, there is no treatment for food allergy other than to eliminate the offending food. But Metcalfe is optimistic about the future.
"I don't think it is likely a drug will be found to prevent food allergies. But I do think within 10 years we will see allergy shots available for some of the more common food allergies, because we are learning to identify and purify food allergens. I think we will see some development of immunotherapy for food allergies," he says.
