1. 1 FOOD ALLERGIES 2211 Steven C Seideman Extension Food Processing Specialist Cooperative Extension Service University of Arkansas

2. 2 ACKNOWLEDGEMENT Parts of this series were taken from a presentation by Dr Steven Taylor, PhD, Professor and Head of Food Science and Technology at the University of Nebraska- Lincoln at the 2003 Ozark Food Processors Association meeting, March 2003. Parts of this series were taken from a presentation by Dr Steven Taylor, PhD, Professor and Head of Food Science and Technology at the University of Nebraska- Lincoln at the 2003 Ozark Food Processors Association meeting, March 2003.

3. 3 Photo courtesy of National Restaurant Assoc

4. 4 Photo courtesy of USDA

5. 5 Food Sensitivities FOOD INTOLERANCE FOOD INTOLERANCE FOOD ALLERGY FOOD ALLERGY

6. 6 FOOD INTOLERANCE A response to a food other than a true protein reaction. A response to a food other than a true protein reaction. EXAMPLE; Lactose intolerance; EXAMPLE; Lactose intolerance; *Mother Nature’s method of weaning where the carbohydrate in milk (lactose) is not readily digested by the offspring. *Mother Nature’s method of weaning where the carbohydrate in milk (lactose) is not readily digested by the offspring. *Generally starts in people in their 30s &40s. *Generally starts in people in their 30s &40s.

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8. 8 FOOD ALLERGIES True food allergies are the body’s rejection of a foreign protein. True food allergies are the body’s rejection of a foreign protein. There almost has to be a protein involved. There almost has to be a protein involved. Hay fever in humans is a true allergy caused by protein-containing pollen and animal hair and feathers.. Hay fever in humans is a true allergy caused by protein-containing pollen and animal hair and feathers..

9. 9 HAY FEVER Certain cells around the eyes and sinuses perceive the protein from certain tree and plant pollen, animal hair, feathers, and possible other natural occurring proteins as foreign. Certain cells around the eyes and sinuses perceive the protein from certain tree and plant pollen, animal hair, feathers, and possible other natural occurring proteins as foreign. The body’s defense mechanism is set in motion to remove the protein from entering the body. Tears form around the eyes and sneezing to blow out the foreign protein are examples. The body’s defense mechanism is set in motion to remove the protein from entering the body. Tears form around the eyes and sneezing to blow out the foreign protein are examples.

10. 10 Mechanisms of Mediator Release

11. 11 PREVALENCE Between 2-2.5% of the U.S. population (or 6-7 million Americans) have food allergies.

12. 12 Typical Symptoms of Food Allergies Gastrointestinal Gastrointestinal *Nausea *Nausea *Vomiting *Vomiting *Abdominal pain *Abdominal pain *Diarrhea *Diarrhea Systemic Systemic *Anaphylactic shock *Anaphylactic shock Cutaneous *Urticaria *Angioderma *Atropic dermatitis Respiratory *Rhinitis *Laryngeal edema *Asthma

13. 13 90% Peanut Tree nuts Milk Egg Soy Fish Shellfish Wheat 10% Hundred s of others Food Allergies Prevalence Food Allergies Prevalence

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17. 17 Other Foods There are 160+ other foods that can cause allergic reactions. There are 160+ other foods that can cause allergic reactions. Strawberries- the protein in the seed. Strawberries- the protein in the seed.

18. 18 ANAPHYLACTIC SHOCK All the previous symptoms of food allergies such as nausea, vomiting, rhinitus etc are discomforting but not “life threatening”. All the previous symptoms of food allergies such as nausea, vomiting, rhinitus etc are discomforting but not “life threatening”. Anaphylactic shock is life threatening. Anaphylactic shock is life threatening. *Can be caused by food proteins *Can be caused by food proteins

19. 19 Anaphylaxis Defined as a hypersensitivity to a foreign substance, especially in animals, induced by a small preliminary or sensitizing injection of the substance. Defined as a hypersensitivity to a foreign substance, especially in animals, induced by a small preliminary or sensitizing injection of the substance. A generalized shock reaction. A generalized shock reaction. Can have multiple organ failures. Can have multiple organ failures. Can have many symptoms including severe loss of blood pressure and cardiac arrhythmia. Can have many symptoms including severe loss of blood pressure and cardiac arrhythmia. If not treated immediately, can be fatal. If not treated immediately, can be fatal.

20. 20 Food-Induced Anaphylaxis is Not a Rare Occurrence Researchers estimate 29,000 emergency room visits and 150-200 deaths per year due to food-induced anaphylaxis(U.S.) Researchers estimate 29,000 emergency room visits and 150-200 deaths per year due to food-induced anaphylaxis(U.S.)  Bock et al. J. Allergy Clin. Immunol. 2001;107:191-193. Danish study: 5% fatality rate Danish study: 5% fatality rate  Sorensen et al. Allergy 1989;44:28-29. 1 in 800,000 chance of dying from a food-allergic reaction (Hugh Sampson, Mt. Sinai Medical Center, FAAN Conference, 6/8/02) 1 in 800,000 chance of dying from a food-allergic reaction (Hugh Sampson, Mt. Sinai Medical Center, FAAN Conference, 6/8/02)

21. 21 TREATMENT FOR TRUE FOOD ALLERGIES Specific avoidance diets. Specific avoidance diets. *People have to learn what they are *People have to learn what they are allergic to. allergic to. *What is their tolerance level? (milligrams, *What is their tolerance level? (milligrams, ppm)-No peanuts on airlines anymore. ppm)-No peanuts on airlines anymore. *What is in the food as an ingredient in trace *What is in the food as an ingredient in trace amounts? amounts?

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23. 23 Ingredients Derived from Commonly Allergic Sources Edible oils Edible oils Hydrolyzed proteins Hydrolyzed proteins Lecithin Lecithin Flavors Flavors Lactose Lactose Starch Starch Gelatin Lysozyme Lactoferrin Soy Sauce Worchester Sauce Fermented ingredients.

24. 24 LABELING Best solution for people with food allergies is knowledge via labeling. Best solution for people with food allergies is knowledge via labeling. Major challenge to food industry is to label products with increased emphasis on source of additives. Major challenge to food industry is to label products with increased emphasis on source of additives. *Old method “hydrolyzed protein” *Old method “hydrolyzed protein” *New method “hydrolyzed protein derived *New method “hydrolyzed protein derived from wheat”. from wheat”.

25. 25 Approaches to Precautionary Labeling  “may contain….”  “may contain the occasional nut”  “may contain nut traces”  “not suitable for nut allergy sufferers”  “contains ….traces”

26. 26 Approaches to Precautionary Labeling  “contains traces of …”  “contains one or more of the following ingredients:…”  “on rare occasions this product contains traces of….”  manufactured on the same equipment as….”  manufactured in the same facility as….”

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28. 28 A hamburger Extender

29. 29 Hamburger Buns

30. 30 A packaged of Glazed Walnuts

31. 31 LABELING CHALLENGES Industry concern over increase in lawsuits. Industry concern over increase in lawsuits. Hard to pin down where trace amounts can come from. They can come from other processed ingredients or contact surfaces in a plant. This is a major challenge to the food industry since the tolerance levels are so small. Hard to pin down where trace amounts can come from. They can come from other processed ingredients or contact surfaces in a plant. This is a major challenge to the food industry since the tolerance levels are so small.

32. 32 Photo courtesy of National Restaurant Assoc.

33. 33 Current Status of Food Allergen Issue Recalls are increasing Recalls are increasing Recalls primarily involve smaller companies. Recalls primarily involve smaller companies. Surveys show that 25% of products in certain categories contained undeclared major allergens (peanut, egg, casein) Surveys show that 25% of products in certain categories contained undeclared major allergens (peanut, egg, casein) FDA beginning to do inspections for allergen control. FDA beginning to do inspections for allergen control. USDA is also emphasizing allergen control. USDA is also emphasizing allergen control. Still cannot test for some unlabeled food allergens (fish, crustacea, soybean, some tree nuts) Still cannot test for some unlabeled food allergens (fish, crustacea, soybean, some tree nuts)

34. 34 U.S. FDA Food Allergen Recalls 1988-2001

35. 35 FSIS/ USDA Food Allergen Recalls 1999-2003

36. 36 New Drug to Mitigate Peanut Allergy Researchers at National Jewish Medical & Research Center and Mount Sinai School of Medicine tested TNX-901 on peanut allergy sufferers. Researchers at National Jewish Medical & Research Center and Mount Sinai School of Medicine tested TNX-901 on peanut allergy sufferers. After 4 weeks on the treatment, people with an allergic response to peanuts were 15 times more tolerant to peanut flour. After 4 weeks on the treatment, people with an allergic response to peanuts were 15 times more tolerant to peanut flour.

37. 37 CONCLUSIONS An issue of growing concern An issue that is here to stay An issue that has increasing international aspects An issue that can be controlled

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