Looking beyond “the Big 14”
Because EU law has given special status to 14 named allergens, it may be overlooked that there are other food allergens “just below the surface”. Some of these may increase in prevalence as time goes on and you may already be affected by these allergens or indeed others not listed here.
Allergy to kiwifruit is becoming remarkably common as a cause of severe reactions, particularly in children.
The kiwifruit was introduced in the UK late 1960s. Consumption increased steadily and by the 1980s emerging allergy cases were seen, mainly in adults and mainly involving oral symptoms. By the 1990s more severe cases were becoming common in children and infants.
Kiwifruit may be high on the list of contenders for joining the “Big 14”.
Sesame is already on the EU list of 14, but allergy clinics report allergies to other seeds as well, including poppy, sunflower, pumpkin, melon and pine nuts. We notice that a widening number of seeds are being used in baked goods. By law, businesses selling loose foods are required to have robust information systems in place in respect of the 14 named allergens; we believe it is good practice to record information on other allergens, such as seeds, so that this information is available to customers on request.
Any food containing protein has the capability to cause an allergic reaction and legumes are no exception. Those well documented in the medical literature include green peas, chick peas, lentils and kidney beans. Our helpline takes regular calls from people enquiring about allergy to specific legumes.We believe green peas to be a particular issue as pea protein can turn up where customers may not expect it. In 2010 the son of a Campaign member suffered a moderately severe reaction to a sorbet – not realising it contained pea protein, to which he is allergic. Pea protein has been noticed in a wide range of foods including meat, fish, baked goods, soups, sauces, cereals and snacks. It can be found in some health foods, those marketed as “ideal for vegans”, bodybuilding and sports supplements and products free from gluten.
A condition known as pollen food syndrome is seen frequently in allergy clinics. This occurs when people who are already allergic to pollens, and suffer from hay fever,
experience allergic symptoms when they eat certain raw fruits or vegetables. This is due to the similarities between the proteins in pollen and those present in the fruits and vegetables. Symptoms are usually mild.
Less commonly, people allergic to fruit have a different, more serious type of allergy where anaphylaxis is a possibility. Medical advice is required in all cases where fruit causes adverse symptoms.
Allergy to buckwheat is believed to be an uncommon problem in the UK but the reason for its rarity could simply be because it is infrequently eaten. In Japan, where its use as a food is much more common, it is a major trigger of severe reactions and its labelling is mandatory. If its popularity were to increase in the UK we would almost certainly see a rise in allergy. As buckwheat is not a true cereal, it is sometimes marketed for people who cannot eat wheat.
Is allergy to fenugreek a ‘hidden’ problem? A Norwegian allergy register recorded 15 peanut-allergic patients reacting to curry – which often contains fenugreek (a legume). Doctors studied cross-reactivity using serum from a peanut-allergic patient. The serum was positive for fenugreek. Two grains on the patient’s lip caused an immediate allergic reaction. This poses the question: Could some reactions to curry be caused by fenugreek – and not peanut as sometimes supposed?
An American lobbying group has been campaigning for more than a decade to have Quorn (which contains mycoprotein) accepted as a major food allergen. In 2003 the Center for Science in the Public Interest (CSPI), a consumer advocacy organisation based in Washington DC, said it had received 597 reports of adverse reactions through a website and by mail, many of them coming from the UK.
However our membership database records only one person stating they are allergic to Quorn. Our helpline only very rarely receives calls on this subject. So what is really going on?
In January 2011 Marlow Foods, the company that makes Quorn, convened a one-off independent expert panel in London to discuss consumer reports of adverse reactions to mycoprotein. Panel members comprised respected international experts including Prof. Steve Taylor, director of the Food Allergy Research and Resource Program in Nebraska, USA. The panel established that many of the symptoms attributed to Quorn are likely to have a trigger other than true allergy. The panel concluded:
The number of reported adverse reactions to mycoprotein is very low and it is likely that most of these incidents relate to the high fibre content. Mycoprotein provides around 5.5g of dietary fibre in 100g of Quorn mince or pieces. The Panel hypothesised that, in certain individuals or under certain conditions, consuming mycoprotein could speed up the normal transit of foods from the small to the large intestine. This could, in turn, cause the fibre in mycoprotein to be fermented very rapidly in the large intestine, leading to symptoms of gastro-intestinal distress of the type reported by some consumers. The small numbers of consumers at risk from this type of gut response may have an imbalance in their normal gut bacteria, an unusual dietary intake of fibre (too low or too high) or may suffer from irritable bowel syndrome.
Food with exercise
In the allergy community, there is an increasing awareness of food-dependent, exercise induced anaphylaxis (FDEIA) and it is sensible for food company staff to be aware of this condition when receiving reports of allergic reactions from customers. FDEIA occurs when a food is eaten before exercise. Ingesting the food itself does not cause a problem. Wheat is often the culprit food, but others including shellfish are sometimes implicated. Sometimes the link with exercise is missed and FDEIA is diagnosed as idiopathic (of unknown cause). We believe many people with this condition are unaware of the important link that their allergy symptoms have with exercise.