Food labeling issues for severe food allergic patients

Abstract

Food allergy carries high importance and responsibility, affecting an estimated 220 million people worldwide. It is a frequent cause of food-induced anaphylaxis, a life-threatening condition requiring a toll of about one death per 50 million people a year worldwide. In order to help patients to identify allergenic foods and thus avoid anaphylactic reactions, 66 countries over the 5 continents require by law that allergenic ingredients must be declared when used in prepackaged foods. Unfortunately, the mandatory allergen list is not uniform, but varies among different countries. The widespread adoption of Precautionary Allergen Labeling (PAL) results in a proliferation of unregulated PALs with different informative statements. In this situation, the need of a scientific consensus on the definition of food allergy and the identification of a tolerable risk with routinely used detection assays, considering not only the eliciting dose but also the food source, is urgent. The aim of this manuscript is: 1) to draw a picture of the global situation in terms of PALs, and 2) to highlight new approaches that could aid in tackling the problem of regulating the labeling of allergens. These include the Voluntary Incidental Trace Allergen Labelling (VITAL) system, which intersects reference doses and labelling decisions, and a direct quantification of trace amounts of allergens at lower limit of detection (LOD) levels in the food itself through proteomics. We here highlight how, although with some limitations, the steady advances in proteomic approaches possess higher sensitivity than the recommended VITAL reference doses, allowing the identification of allergens at much lower LOD levels than VITAL. Considering that each assay used to detect allergen in food products carries method-specific issues, a more comprehensive and harmonized approach implementing both quantitative and qualitative methods could help overcoming the risk stratification approach and the overuse of PALs, offering promise as the field moves forward towards improving consumers’ quality of life.

Effects of fucoidans and alginates from Sargassum graminifolium on allergic symptoms and intestinal microbiota in mice with OVA-induced food allergy

“…1 It is estimated that food allergy, which usually occurs in infants and children, affects 2%-10% of the population of the world and could be life-threatening in severe cases. 2 Most food allergies are mediated by IgE on mast cells or basophils, which cross-link with allergens to cause the release of allergenic mediators. 3 In the investigation of allergens that caused food allergy, it was found that the most common food allergy reactions were caused by protein foods such as milk and eggs.…”

Hepatoprotective Effects of Rosmarinic Acid on Ovalbumin-Induced Intestinal Food Allergy Mouse Model

“…Food allergy (FA) is an adverse immune reaction to certain foods containing allergens. The adverse health effects of food allergy involve a serious of symptoms ranging from mild irritations to life-threatening anaphylaxis, which may affect 2–10% of the population worldwide [ 1 ]. Due to the increasing prevalence and life-threatening potential, it has become one of the growing health problems around the world [ 2 ].…”

Cow's milk and egg protein threshold dose distributions in children tolerant to beef, baked milk, and baked egg

“…15,16 To this end, data from cohorts of subjects assessed in oral food challenges (OFCs) are used to calculate eliciting doses (EDs) and to specify the relation between EDs and symptoms. 17,18 Based on such thresholds, the Voluntary Incidental Trace Allergen Labelling (VITAL), a scheme developed by the Australian and New Zealand food industries, established reference doses of 0.2 mg total protein (Eliciting Dose 01) for milk and egg, 16,19 and an Eliciting Dose 05 between 0.5 and 2.4 mg protein for both foods. 16,20,21 Such thresholds have been calculated on populations of patients allergic to both raw and baked foods.…”