Food allergies are increasingly becoming an important public health concern globally with a growing number of consumers being reported to suffer from the condition. Estimates indicate that up to 10% of population are affected with food allergies and the most serious cases are accounted by a narrow list of foods like peanut, tree nuts, fish, shellfish, egg, milk, wheat and soy. The lack of awareness on the type of allergies a consumer experiences and the confusion between food allergies and food intolerances further poses a challenge in addressing the problem.
Food intolerances are non-immune reactions 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. Whereas food allergies are adverse health effects arising from a specific immune response on exposure to naturally occurring protein. Allergic symptoms can include any combination of local oral, dermatological, gastrointestinal and respiratory symptoms & also death in severe cases; and a trace amount of protein can trigger different symptoms in affected individuals. The manifestation of food allergy is influenced by genetics (G), environment (E), and G x E interactions and the risk factors contributing to food allergy include genetics, sex, race / ethnicity. For instance, peanut allergies are very common in the Western countries, but relatively rare in Asia. Some food allergies like milk, egg, wheat and soy may be outgrown in childhood; while some allergies like peanut, tree nut, fish, and shellfish persist throughout life.
The pathophysiological differences between food allergy and food intolerance result in different diagnostic strategies and therapeutic options. Identifying a true food allergy that a consumer experiences is critical for recommending avoidance of a particular food/ ingredient that triggers the adverse reaction. The ability to avoid allergic food depends on factors outside the control of the individuals and the food manufacturers and food handlers have a greater responsibility in this. Proper labeling of food products is required for consumers to avoid specific allergens. Food manufacturers must have accurate information about their ingredients & sources and also understand their processing conditions that 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 untrained workers can be lethal for consumers.
With increasing public safety concerns, food allergen management is becoming very important in food industry globally and several national regulators address this through specific regulations for food industry. However, the allergen labeling requirements or the list of allergens to be declared varies across the countries. There is also lack of information on allergen sensitivity in local populations and/or lack of in-country studies to identify specific allergens/ allergies prevalent in a country. While most countries with allergen regulations stipulate the declaration for 8 common allergenic foods as per the CODEX standards for general labelling, the list of allergens is extended in countries like Australia, Canada & EU. This lack of uniformity can impact cross-border trade and food exporting units should be aware of these differences and should address specific allergen labelling requirements of the importing countries.
The data on probable food allergies among general population in India is very limited and India does not have allergen labelling regulation in place as of now. However, the draft Food Safety and Standards (Labelling and Display) Regulations, 2018 includes the provision for labelling of food allergens and hopefully the final regulations get notified soon. There is a need to create awareness among the consumers about the distinction between food allergies and intolerances that are often confused by individuals. The food business operators and food handlers should also be trained on allergens, their health implications and allergen management to ensure safe food for everyone.
Dr. K.V. Satyanarayana
Author is Associate Vice President at Sathguru Management Consultants and leads the Food Processing and Retail practice. He is also an FSPCA Trainer of Trainer for Preventive Controls of Human Foods. He can be reached at email@example.com
First Published in: IndiFoodBev magazine (Dec 2019- Jan 2020)