Understanding how consumers with food allergies make decisions based on precautionary labelling

Galvin, Audrey Dunn; Roberts, Graham; Regent, Lynne; Austin, Moira; Kenna, Fiona; Schnadt, Sabine; Sanchez-Sanz, Angel; Hernández, Pilar González; Hjorth, Bettina; Fernández‐Rivas, Montserrat; Taylor, Steve L.; Baumert, Joseph L.; Sheikh, Aziz; Astley, Siân; Crevel, René; Mills, Clare

doi:10.1111/cea.13479

Cited by 41 publications

(35 citation statements)

References 37 publications

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“…The iFAAM PAL survey was developed for adults and parents of children with food allergy . The aim was to help us to understand more about how those living with food allergy assess risk when making decisions based on PAL (‘may contain’), attitudes to current labelling practice and to the potential use of quantitative risk assessment in manufacturing.…”

Section: A New Approach To Precautionary Allergen Labelling: the Patimentioning

confidence: 99%

Evidence‐based approaches to the application of precautionary allergen labelling: Report from two iFAAM workshops

Galvin

Roberts

Schnadt³

et al. 2019

Clin Experimental Allergy

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Food allergy is a major public health concern with avoidance of the trigger food(s) being central to management by the patient. Food information legislation mandates the declaration of allergenic ingredients; however, the labelling of the unintentional presence of allergens is less defined. Precautionary allergen labelling (PAL) was introduced by the food industry to help manage and communicate the risk of reaction from the unintended presence of allergens in foods. In its current form, PAL is counterproductive for consumers with food allergies as there is no standardized approach to applying PAL. Foods with a PAL often do not contain the identified food allergen while some products without a PAL contain quantities of common food allergens that are capable of inducing an allergic reaction. Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM) was an EU‐funded project that aimed to improve the management of food allergens by the food industry for the benefit of people with food allergies. Within iFAAM, a clinically validated tiered risk assessment approach for food allergens was developed. Two cross‐stakeholder iFAAM workshops were held on 13‐14 December 2016 and 19‐20 April 2018. One of the objectives of these workshops was to develop a proposal to make PAL effective for consumers. This paper describes the outcomes from these workshops. This provides the basis for the development of more informative and transparent labelling that will ultimately improve management and well‐being in consumers with food allergy.

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Section: A New Approach To Precautionary Allergen Labelling: the Patimentioning

confidence: 99%

Evidence‐based approaches to the application of precautionary allergen labelling: Report from two iFAAM workshops

Galvin

Roberts

Schnadt³

et al. 2019

Clin Experimental Allergy

Self Cite

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“…Quality of life (QOL) is impaired in patients with peanut allergy due to dietary restrictions and hypervigilance, 2 especially with foods that have not been introduced yet and during social activities. In addition, peanut‐allergic children and their families are confronted to foods with precautionary allergen labels (PAL) on packaged products such as “may contain traces of peanuts” or “may contain peanuts,” which are confusing and can increase anxiety of parents and children 3,4 . These PALs are used inconsistently by the food industry and do not always reflect actual risk to the allergic patient 4‐6 .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, peanut‐allergic children and their families are confronted to foods with precautionary allergen labels (PAL) on packaged products such as “may contain traces of peanuts” or “may contain peanuts,” which are confusing and can increase anxiety of parents and children 3,4 . These PALs are used inconsistently by the food industry and do not always reflect actual risk to the allergic patient 4‐6 . To further complicate matters, PAL laws vary from one country to another.…”

Section: Introductionmentioning

confidence: 99%

Can my child with IgE‐mediated peanut allergy introduce foods labeled with “may contain traces”?

Graham

Caubet

Eigenmann

2020

Pediatric Allergy Immunology

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Peanut IgE‐mediated food allergy is one of the most common food allergies in children with a prevalence that has increased in the past decades in Westernized countries. Peanut allergies can trigger severe reactions and usually persist over time. Peanut‐allergic children and their families are often confronted to processed foods with precautionary allergen labeling (PAL) such as “may contain traces of peanuts,” which are frequently used by the food industry. Patients are generally confused as to whether eating such foods entails a risk of allergic reaction, which can ultimately lead to dietary restrictions and decreased quality of life. Thus, guidance toward eviction of foods with PALs such as “may contain traces of peanuts” is a recurring problem that peanut‐allergic patients address during pediatric allergy consultations with varying attitudes among allergists. Many studies have evaluated peanut contamination in foods with PALs, with generally less than 10% of foods containing detectable levels of peanuts, albeit heterogeneous amounts, with in rare occasions levels that could trigger allergic reactions in certain patients. The risk of reacting to foods with traces varies significantly with threshold, with patients with the lowest reaction thresholds at highest risk, and a dramatic reduction of risk as threshold increases. Thus, risk stratification based on individual reaction threshold may help stratify patients’ risk of reacting to foods with PAL. In clinical practice, a single‐dose 30 mg peanut protein oral food challenge may be an option to stratify peanut‐allergic patients’ risk when introducing foods with PAL, as illustrated by three clinical cases.

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“…The United Kingdom [ 10 ], Canada [ 11 ], Australia and New Zealand [ 12 ] and the European Union [ 13 ], have detailed guidelines to support those living with food allergy. In many of these regions, allergy-related food recalls remain high [ 14 ], as many as 30% of products have undergone risk assessment screening, yet carry no precautionary allergen labelling (PAL) [ 15 ], and consumers remain unclear about PAL [ 14 , 16 ]. Yet, while patients’ voices are critical in food allergy research [ 17 ], little is known about how those directly affected by food allergy perceive current guidelines and gaps.…”

Section: Introductionmentioning

confidence: 99%

“I want to really crack this nut”: an analysis of parent-perceived policy needs surrounding food allergy

et al. 2020

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Background: In Canada, anaphylaxis-level food allergy constitutes a legal disability. Yet, no nationwide policies exist to support families. We sought to understand what parents of children with food allergy perceive as the most pressing food allergy-related policy concerns in Canada. Methods: Between March-June 2019, we interviewed 23 families whose food allergic children (N = 28mean age 7.9 years) attending an allergy clinic in Winnipeg, Canada. Interviews were audio-recorded, transcribed and analyzed using content analysis. Results: Over 40% of children had multiple food allergies, representing most of Health Canada's priority allergens. We identified four themes: (1) High prevalence. High priority?. (2) Food labels can be misleading, (3) Costs and creative ideas, and (4) Do we have to just deal with the status quo around allergies? Conclusion: Food allergy ought to be a national policy priority, to improve the process for precautionary labelling, to improve funding, educational tools access to care, and knowledge of current allergy guidelines.

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Understanding how consumers with food allergies make decisions based on precautionary labelling

Cited by 41 publications

References 37 publications

Evidence‐based approaches to the application of precautionary allergen labelling: Report from two iFAAM workshops

Evidence‐based approaches to the application of precautionary allergen labelling: Report from two iFAAM workshops

Can my child with IgE‐mediated peanut allergy introduce foods labeled with “may contain traces”?

“I want to really crack this nut”: an analysis of parent-perceived policy needs surrounding food allergy

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