Professor Clare Mills
Food allergies present everyday problems for allergic consumers and food companies alike. Sometimes it seems we simply have to come to terms with these problems and manage them on a daily basis. However, revolutionary scientific work is being carried out behind the scenes that aims to help food companies radically improve their management of allergens with the ultimate aim of protecting consumers at risk.
This article is intended to summarise some of those projects.
Data collected by the EU-funded EuroPrevall project – which looked at the patterns and prevalence of food allergies across Europe and beyond – are now being utilised in a global, EU-funded venture called iFAAM*. The intention is to develop evidence-based approaches to improve the control of allergens by the food industry and also help patients cope better.
Briefly, the aims of iFAAM are:
The project’s partners also hope to obtain the scientific evidence necessary to provide recommendations on the introduction of allergenic foods into infants’ diets in order to prevent the development of food allergies later in their lives.
Most allergen exposures occur in one of two ways: either the consumer makes a mistake and eats a food they should avoid; or a manufacturer or other food supplier fails to manage allergen handling properly and a food expected not to contain an allergen contains enough to trigger an allergic reaction.
There are many anecdotal reports of how people with allergies experience reactions in the community but until now, a systematic approach to studying them has not been widely undertaken.
Working with patient organisations such as the Anaphylaxis Campaign, DAAB in Germany and Anaphylaxis Ireland, iFAAM is systematically collecting details on the reactions experienced by allergic patients in Ireland (AlleRisc) and the UK (AlleRic). Where possible food samples have been collected and analysed for the presence of undeclared allergens. The study is due to be completed in the coming months and is now being rolled out to other European countries such as Germany.
iFAAM acknowledges that in practice it is not possible to exclude allergens completely from foods otherwise free from a particular allergenic ingredient when shared facilities and processing lines are used. As a result allergen management strategies need to focus on how much residual allergenic ingredient can be tolerated in such foods. An excellent body of research on how much of an allergenic food is required to cause a reaction is now available for foods such as peanut. These data are being used to build population-level dose distribution models which can predict the dose at which, for example, five per cent of the allergic population (known as the ED 05) might react. The ED05 level of allergen is thought to combine a good level of patient safety.
The ED05 level is being verified in the iFAAM project for three allergenic foods: hazelnut, egg and milk. Using a study design implemented to validate the ED05 values for peanut, patients are given the allergenic food in a single portion of chocolate dessert. Data from these studies are encouraging and promise to provide a means of validating any dose level chosen that is considered generally safe for the food allergic population.
The amount of allergen eaten by a person with a food allergy is not the only factor that can impact on severity of the reaction. Through a set of integrated studies the iFAAM project is seeking to investigate how the food matrix and medication, such as antacids, may alter a patient’s reactivity to foods through clinical studies undertaken in Switzerland (Zurich), Spain (Madrid) and the UK (London and Manchester). These data will be used to assess whether these factors do indeed need to be taken into consideration in the risk assessment process and contribute to identifying safe allergen doses.
In the iFAAM project analytical tools are being developed for allergen analysis which target biologically relevant molecules known to cause allergic reactions, using foods with a defined allergenic activity. Ensuring such “clinical relevance” will aid interpretation of test results which play such a critical role in food allergen management and help to support food allergic consumers to avoid problem foods. It will also help to provide analysts with much-needed quality control samples which have the potential to be developed into properly-validated reference materials in the future.
The methods include tests suitable for in-factory analysis (e.g. immuno-based) and confirmatory in-laboratory tests (e.g. mass spectrometry-based) for peanut, hazelnut, walnut, egg and milk.
Processing-induced changes to allergens (for example, heat-induced chemical modifications) and the food matrix may alter the allergenicity of food proteins. It can also modify the effectiveness of extraction and detection methods used for allergen determination. These factors are being taken into account in iFAAM so that the analytical methods being developed are robust and suitable for use in a number of different food matrices such as chocolate and baked goods such as cookies.
As part of this activity an inter-laboratory comparison of both immunoassay and mass spectrometry methods is being undertaken, involving analytical laboratories from Europe, the USA, Australia and Japan. This initiative is also supporting the harmonisation of reporting units, since allergen risk assessment is undertaken using a measure of protein – the component in foods that causes allergies – rather than on a commodity basis.
The project involves a comprehensive risk analysis of food production, which takes into account all the components in the food supply chain from the raw materials to the finished products, and including manufacturing and processing steps.
In order to take account of variations in portion size, the iFAAM risk assessment builds on food consumption data collected from individual allergic consumers.
The project leaders hope that knowledge gained from this part of iFAAM’s work will lead to a transparent way forward for the application of precautionary allergen labels and will seek to ensure phrases on labels clearly communicate the level of risk that low levels of allergens may pose to consumers.
*iFAAM stands for the Integrated Approaches to Food Allergen and Allergy Risk Management. The €9million project involves the world’s leading experts in the UK, Europe, Australia and US. Together they mark the biggest study of food allergy in the world. The project leader is Professor Clare Mills, of the Institute of Inflammation and Repair and Manchester Institute of Biotechnology, Manchester Academic Health Science Centre, University of Manchester.
Methods for managing allergens in food production: advances from the global iFAAM project. E. N. Clare Mills1, K. Beyer2, L. K. Poulsen3, S. Taylor4, S. Baumgartner5, R.W.R. Crevel6, S. Schnadt7, R van Ree8
1Institute of Inflammation and Repair and Manchester Institute of Biotechnology, Manchester Academic Health Science Centre, University of Manchester, 131 Princess Street, Manchester M1 7DN, UK; 2University Children’s Hospital Charité of Humboldt University, Berlin, Germany; 3Allergy Clinic, Copenhagen University Hospital, Gentofte, Denmark; 4Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, USA; 5 Universität für bodenkultur, Vienna, Austria; 6SEAC, Unilever Colworth, Sharnbrook, UK; 7Deutscher Allergie- und Asthmabund, Mönchengladbach, Germany; 8Academic Medical Centre, Amsterdam, The Netherlands.
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