Aarthi JanakiRaman, Research Director, Chemicals and Advanced Materials at TechVision, sheds light on food allergies and considers if this is an epidemic in the making
Food allergies have been rapidly increasing during the last five years, leading to various governmental and non-profit agencies comparing it to epidemics. While there are various causes of allergic reactions to people (adults and children alike), recent statistics showcase that food allergies are the leading cause of allergic reactions compared to others such as hay fever, insect allergies, etc. It has become a public issue with research from the Food Allergy Patient and Family Registry (AAFA) in the year 2019 showcasing that around 32 million Americans have some type of food allergy. CDC statistics state that in the U.S. alone, around 5 million children younger than eighteen develop allergies in a year; this translates to one in thirteen children having some form of food allergy.
The situation is similar in Europe and the UK. NHS statistics showcase a doubling of the number of people who are hospitalised as a result of allergic reactions in the last five years. The Food Standards Agency estimates that over 2 million people in the UK have some form of food allergy. The situation is similar across the world, with a rise in food allergies reported in countries like Australia, Southeast Asia, etc. in the last five years leading to increasing economic burden due to cost of treatments, missed time towards work, etc. Apart from the economic burden, food allergies adversely impact an individual’s quality of life.
It is evident that food allergies are on the rise, even though the exact reason is still not apparent. Various hypotheses have been put forward to explain the rise of food allergies. Classic theories such as “hygiene hypothesis,” debates related to continued exposure to microbiome, etc., exposure to potential known allergic foods at a very young age and its effects on the occurrence of food allergies are still underway. There has also been research on the effect of the COVID-19 pandemic on food allergies. While there is scientific evidence that suggests that there is a direct correlation between COVID-19 and food allergies or any allergies for that matter, The European Academy of Allergy and Clinical Immunology (EAACI) has advised caution as the occurrence of allergies can result in worsening of potential asthma attacks (a common result of allergic reactions), which is a risk factor in severe COVID-19 infection.
“The Food Standards Agency estimates that over 2 million people in the UK have some form of food allergy.”
One of the aspects that make food an allergy difficult to manage is that there is still not much data about the reasons for its increasing incidence, especially amongst children. Food allergies often manifest as various symptoms in the skin, GI tract and respiratory tract with severe allergic reactions leading to anaphylactic shocks. A myriad of symptoms makes it difficult to track, especially in a classroom or public setup, making information dissemination critical to proper and timely management as studies have shown that around 15% to 18% of school-aged children having food allergies has experienced an allergic reaction in school. Psychological studies have also shown that children with allergies tend to be more prone to social and emotional issues.
Critical role of federal agencies in managing food allergies
This makes the role of public agencies and governmental authorities vital to properly track, monitor, prevent and treat food allergies, especially amongst children. Governmental agencies such as the U.K’s Food Standards Agency (FSA), European Food Safety Authority (EFSA) and U.S. Food and Drug Administration (FDA) are particularly active in addressing the challenges related to food allergies. The CDC along with the U.S. Department of Education and other federal agencies have developed voluntary guidelines for managing allergies in schools and early care and education programs in line with the requirements suggested by the U.S. FDA’s Food Safety Modernization Act, 2011. The FSA has identified the list of 14 most common foods that contribute to allergies. The FDA has passed down various laws and standards that cut across most of the food industry value chain aimed at the prevention and reduction of food allergies.
“Most of the management protocols are targeted towards food avoidance rather than establishing the relationship between allergens to physiochemical changes.”
Focus on prevention of food allergies: FDA
The FDA is active in enforcing regulations and policies to help reduce the incidence of food allergies. Regulations that require F&B companies to list the ingredients on food labels to more specific food labelling requirements for products that contain known allergens are mandated by the agency through the FALCPA (Food Allergen Labeling and Consumer Protection Act) of 2004. It also identified a list of eight ingredients, which include milk, eggs, fish, shellfish, soy, tree nuts such as almonds and walnuts, peanuts, etc. as the most common food allergens. The U.S. FDA, like many of the European countries’ food safety agencies also provide guidance to stakeholders within the food industry value chain and consumers alike to identify, assess and manage food allergens. The agency is also instrumental in ensuring compliance to standards lied down in the FSMA and FALCPA acts; The rising incidence of food allergies and the rising number of food recalls due to errors in labelling, etc. has resulted in the ramping up of FDA’s allergen enforcement program that conducts food inspections, devise protocols to prevent cross-contamination, conducts food safety tests, monitors information dissemination, evaluates consumer complaints to improve product safety, etc. The 2021 Food Allergy Safety, Treatment, Education, and Research (FASTER) Act, which was signed as law has identified sesame as the ninth major food allergen and will need to reflect in food labelling by 1st January 2023. The law also will track the economic burden of food allergies; collect information on the incidence of food allergies, etc. to name a select few.
What next?
Despite steady research advances being made in identifying various food allergies and measures taken by federal agencies, there is still a gap with regards to early-stage detection of allergens and the development of treatment regimens. Another challenge is the availability of analytical tests with rapid turnaround of results and can also detect multiple allergens. There is also a need for continuous research to advance the effective management of food allergies as there is still no viable cure for it. It can only be prevented and various therapeutic protocols are centred on the management of the same. Most of the management protocols are targeted towards food avoidance rather than establishing the relationship between allergens to physiochemical changes.
Studies related to effective nutrient management and the role of physiological effects due to food allergies are still not sufficiently explored. Research advances in these issues can help in addressing challenges related to food allergies and help its effective management and develop treatment protocols. While treatment regimens such as immunotherapies are available, there are still in pre-clinical to early clinical stages, making them a long way to commercialisation. Further, holistic research can also help in devising regulations and policies for better management of food allergies, thereby reducing the economic burden for governments and individuals alike.
