Precautionary allergen labeling: Current communication problems and potential for future improvements

While there are EU laws for priority allergenic ingredients information on food product packaging, there is no legislation about Precautionary Allergen Labelling (PAL) for unintended allergen presence (UAP). As a result, PAL is used in different ways by different manufacturers and retailers, which hampers consumers’ interpretation of the information in the PAL. Previous research has focused on the forms of PAL that are used and on the way they are interpreted and used by consumers. This study adds the perspective of producers, retailers and branch organizations. Thirteen interviews with QA- and QC-professionals were conducted to find out more about the reasoning behind their PAL-use and to find out how PAL could be optimized. Results show that harmonization is needed, on different levels: in the way information on UAP is shared between parties involved in the food chain; in the way PAL is presented and phrased; and in the rules and regulations on PAL. More research is needed on possible ways to share (updates on) information on UAP with consumers

Precautionary allergen labeling: Current communication problems and potential for future improvements

While there are EU laws for priority allergenic ingredients information on food product packaging, there is no legislation about Precautionary Allergen Labelling (PAL) for unintended allergen presence (UAP). As a result, PAL is used in different ways by different manufacturers and retailers, which hampers consumers’ interpretation of the information in the PAL. Previous research has focused on the forms of PAL that are used and on the way they are interpreted and used by consumers. This study adds the perspective of producers, retailers and branch organizations. Thirteen interviews with QA- and QC-professionals were conducted to find out more about the reasoning behind their PAL-use and to find out how PAL could be optimized. Results show that harmonization is needed, on different levels: in the way information on UAP is shared between parties involved in the food chain; in the way PAL is presented and phrased; and in the rules and regulations on PAL. More research is needed on possible ways to share (updates on) information on UAP with consumers

Potential cofactors in accidental food allergic reactions are frequently present but may not influence severity and occurrence

Background: Cofactors, such as physical exercise and alcohol intake, might be associated with the severity or occurrence of food allergic reactions. Objective: To gain insight into the frequency of presence of potential cofactors in accidental food allergic reactions in adults and to what extent these factors influence the severity and occurrence of allergic reactions. Methods: A prospective cohort study was conducted, with a 1-year follow-up in adult patients with a physician-diagnosed food allergy. Patients were required to fill in a questionnaire after every accidental allergic reactions to food over a 1-year period. The primary outcome measure was the frequency that potential cofactors were present in these allergic reactions. Results: A total of 157 patients were included, of which 46% reported a total of 153 reactions during a 1-year follow-up period. In 74% of the reactions, ≥1 potential cofactor was reported to be present: tiredness (38%), alcohol intake (16%), stress (14%), symptoms of pollinosis (16%), symptoms of asthma (9%), sickness/flu (3%), physical exercise (3%) and use of analgesics (2%). More than one potential cofactor was reported in almost half of all reactions (47%). There was no significant difference in the presence of these factors between mild, moderate and severe reactions (P = 0.522). In the total study population, 9% of the patients used medication that might act as cofactor (antacids, angiotensin receptor blockers [ARBs], beta blockers and angiotensin-converting enzyme inhibitors [ACEIs]) on a daily basis, which however did not influence the occurrence of reactions. Furthermore, 38% daily used allergy-suppressing medication. Conclusions: Although factors suggested to be cofactors were frequently present during accidental food allergic reactions, we found no evidence for an association between the potential cofactors examined and reaction severity, in a population where most reactions were of mild to moderate severity

Allergen risk assessment: Food intake levels of the general population represent those of food allergic patients

Unintentional intake of allergens through food products poses a daily risk for allergic patients. Models estimating the risk of reactions mostly use intake data from general population surveys. Our study evaluates the comparability of food intake levels in the general population to those in the food allergic population. Data were collected by a 24-h recall method on 2 non-consecutive days in 38 cow's milk and/or hen's egg and 35 peanut and/or tree nut allergic adult patients. All products were assigned to food groups previously developed for allergen risk assessment. Food intake distributions from the allergic populations and a matched sample from the Dutch National Food Consumption Survey were compared, and risk assessments were performed. Food intake data was obtained for 92% of the food groups. Comparison of the intake showed no statistically significant differences between either of the two allergic populations and the general population. Consequently, only small variations in estimated risks were found, that would not result in different risk management decisions. In conclusion, food intake data from the general population can be used for food allergen risk assessment and will not lead to a relevant under- or overestimation of the risk for the food allergic population

Poor understanding of allergen labelling by allergic and non‐allergic consumers

Background: Understanding consumers’ interpretation of allergy information is crucial for effective food safety policies. We evaluated consumer understanding of allergy information on foods in controlled, experimental studies. Method: Using 18 packaged foods, we evaluated consumer understanding of information about allergens in two experiments: First, a comparison of foods with no stated allergen versus allergen as a stated ingredient versus a precautionary allergen label (PAL); second, a comparison of three common variants of PAL. In each experiment, consumers with and without self-reported food allergy were asked to estimate the risk of allergic reaction and to rate the comprehensibility of the allergen information. In the second experiment, consumers were also asked which form of PAL they preferred. Results: Risk of reaction was assessed as high and low for foods with the allergen stated as ingredient, or without any mention of allergen. However, risk assessment for PAL varied and was judged as higher by non-allergic than allergic participants (82% vs. 58%, p <.001). Understanding of risk associated with PAL also varied by health literacy (p <.001). Both allergic and non-allergic consumers judged all forms of allergy information to be unclear, especially products with no allergy information for non-allergic consumers. Products with a ‘Produced in a Factory’ PAL were perceived as less risky than ‘May contain’ or ‘Traces of’ PALs (p <.001), less than 40% of participants judged PAL information to be comprehensible, and participants preferred ‘May contain’ over the other PALs. Conclusion: Both allergic and non-allergic consumers find allergen information difficult to interpret on packaged foods and misunderstand PAL, incorrectly distinguishing different risk levels for different PAL wording. Clearer allergy information guidelines are called for, and the use of only one PAL wording is recommended