Food-labeling issues for severe food-allergic consumers

Abstract

Purpose of reviewFood label represent the primary and only source of information before consuming a food product. Deputy government agencies on five continents require allergenic ingredients to be declared when used in prepackaged foods to assist patients in identifying allergenic foods and to help them to choose wisely. Unfortunately, the mandatory allergen list and legislation regarding food labels and reference doses is not uniform and varies by country. This may add difficulties to food-allergic patients, especially those with severe food allergy. Recent findingsA new definition of food allergy severity (the DEFASE grid, developed by the World Allergy Organization), aims to assist clinicians in the identification of the at-risk patients. The FASTER ACT and Natasha's Laws has made important improvements such as the entry of sesame as a major allergen in the United States, and increased evidence of allergens on the food label within prepackaged for direct sale (PPDS) in the UK. The recent introduction of Vital 3.0 brought important new features such as an updated reference doses for many foods. SummaryCurrently, there are still considerable differences regarding food labels in different countries. Growing public and scientific attention to the problem promises to increase the food safety for allergens. Among the next improvements, we expect a reconsideration of the food reference doses, a harmonization of the food oral challenge process, and the promulgation of regulatory rules for the precautionary labeling.

Botanical Impurities in the Supply Chain: A New Allergenic Risk Exacerbated by Geopolitical Challenges

“…However, the use of precautionary allergen labeling (PAL) introduces a new layer of complexity. While regulations like Article 36(3)(a) of Regulation (EU) 1169/2011 provide a legal foundation for voluntary information on allergen impurities, the lack of standardized guidelines raises concerns about potential overlabeling [ 60 ]. Different nations adopt varied approaches, with some prohibiting PAL, others requiring labeling of unintended allergen presence, and some proposing reference doses for allergy management.…”

“…Lastly, specific hygiene and traceability requirements are established for food redistribution activities, ensuring food safety even in charitable endeavors [ 57 , 59 ]. Labelling is an issue of relevance to consumers with food allergies with regard to processed or pre-packaged foods, as accidental ingestion of allergens in pre-packaged processed foods, due to labelling ambiguities, is a modifiable risk factor [ 60 ]. In the European Union, until 2005, legislators allowed composite ingredients to be listed on labels if not in excess of 25 per cent of the whole product.…”

“…This clause was eliminated in 2005, following the review of a labelling directive issued in September 2001 [ 62 ]. Twelve food items are now required by law to appear on the label: cereals containing gluten, crustaceans, eggs, fish, peanuts, soy, milk, nuts, mustard, sesame seeds, celery, and sulfites > 10 mg/kg [ 60 , 63 , 64 ]. A similar legislation is in effect in the US.…”

“…In particular, the risk that unfamiliar names can hide allergenic foods is now addressed, For example, terms like “starch” will be substituted with more specific labels such as “corn starch” or “wheat starch,” and “Lysozyme” will be replaced with descriptors like “lysozyme, containing egg”, and so on [ 67 ]. On both sides of the Atlantic, the regulatory problem is now the opposite concern—whether too many foods containing trace amounts of these allergenic foods are being precautionary “overlabeled” and whether this would then potentially restrict potentially safe food choices for allergic consumers [ 60 ]. Actually, the use of precautionary allergen labeling (PAL) falls into a legislative grey area, often being unregulated and non-standardized, with no clear guidelines on when to use or not use it.…”

Reactivity to allergenic food contaminants: A study on products on the market

“…As PAL poses several problems to allergic consumers, [5][6][7][8] the international authorities together with the scientific community are attempting to discipline this matter. In 2019, the FAO/WHO Codex Committee on Food Labelling asked for scientific advice aimed to develop guidance on the use of PAL.…”