Food-Allergic Consumer’s Perspective on Ingredient Labeling Anne Munoz-Furlong FAAN.
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Transcript of Food-Allergic Consumer’s Perspective on Ingredient Labeling Anne Munoz-Furlong FAAN.
Food-Allergic Consumer’s Perspective on
Ingredient Labeling Anne Munoz-Furlong
FAAN
Objectives
Profile of the food-allergic consumer
Discuss food allergy labeling information
Provide consumer’s perspective on
threshold levels
FAAN
Non-profit organization, established in ’91Over 27,000 membersMission is:
To increase public awareness, to provide advocacy and education, and to advance research on behalf of all those affected by food allergy and anaphylaxis.
Profile of Food-Allergic Consumer
Affects approximately 4% of U.S. population or 11 million Americans
Fish and shellfish allergy 2.3% or
6.5 million
Peanut and tree nut allergy 1.1% or 3 million people
Fish and Shellfish Allergy
Shellfish allergy:• 2% of the population
• Shrimp, crab, lobster, clam
Fish allergy:• .4% of the population
• Salmon, tuna, catfish, cod
Tree Nut Allergy
Tree nuts are not related to peanutsTree nut allergy affects 1.5 million
AmericansMost common causes of tree nut allergy:
• Walnut, cashew, almond, pecan
What does it mean to have food allergies?
Vigilant label reading for foods, bath products, pet foods, medications--everything
Trace amounts can cause a reactionJust one little bite can hurtEpinephrine is the only medication to
stop a severe reaction
Profile of Food-Allergic Consumer
There is no cure, strict avoidance is key Food allergies impact
• Decisions about• Food shopping• Cooking• Dining out • Socializing• Schools and child care• Travel• Vacation
• Family relationships
Food Allergy Impact on Quality of Life
Families with a food-allergic child scored lower than
the general population on scales of general health,
emotional health and family activities
Reduction in score for general health influenced by
associated chronic disorders (i.e. asthma, eczema)
Families with children with > 2 food allergies scored
lower for 9/12 scales compared to those with 1-2
allergies
Impact on Quality of Life
Sicherer, Noone, Munoz-Furlong Ann Allergy Asthma Immunol 2001
50
5560
6570
7580
8590
Score
General health
Emotional stress
Family activities
Label reading
Reading Food Ingredient Statements
Food-allergic consumers must live in a black and white world: if you are allergic, you don’t eat the product
If the allergen is listed on the label or the product says, “Contains allergen”, they avoid it
They expect ingredient labels to be consistent and reliable
The same product with different information causes confusion, frustration, and concern
Reading Food Ingredient Statements
Challenge: Patients are told to strictly avoid the allergen—
zero tolerance
They are not aware of the scientific names for these foods
It’s more than just the patient’s family who is reading labels on their behalf
Allergens appear in unexpected places
Common Foods In Unexpected Places
Egg Tree Nut Milk Peanuts Fish
•Tartar sauce
•Sorbet
•Pizza
•Mustard
•Barbecue flavor potato crisps
•Shampoo
•Walnut in pasta, pie crusts, frozen lasagna, blue cheese dressing
•Pistachio, pine nuts, or walnuts in pesto sauce
•Almond in soap
•Chicken flavor rice mix
•Barbecue flavor potato crisps
•Hamburger
•Coffee whiteners
•Non-dairy products •Hot dogs
•French fries
•Bath soap
•Turkey Stew
•Veg. w/hot oil
•Sweet Potato puree
•Pesto sauce
•Egg rolls
•Enchilada sauce
•Brown gravy
•Basting sauce
•Barbeque sauce
•Caesar Salad dressing
•Worcestershire sauce
•Imitation shellfish
Soy & Wheat•Roast Beef
•Canned tuna
Interpretation of Food Labelsby Parents of Food Allergic Children
0 20 40 60 80 100
Egg
Wheat
Peanut
Soy
Milk
Percent Perfect Score
Joshi, Mofidi, Sicherer JACI 2002
Allergen Advisory Statements Problem
• No guidelines or standards for use
• Can’t educate consumers about what they mean
Proliferation of “may contain” precautionary allergen labeling has further restricted their diet• Northern Virginia grocery store
• Products from cookies, crackers, candy, and bakery
• 28 different versions of “may contain” type statements
Allergen Advisory Statements
Current Environment
• Some physicians advise their patients to ignore precautionary labeling
• Some companies tell consumers the statement is on the package only for legal purposes
• Advisory statements for peanut only
• Consumers confused and frustrated
• Risk taking behavior, particularly teens
Consumer BehaviorFAAN Labeling Study
Would Never purchase a product that says:
Contains Allergen 99% May contain Allergen 95%May Contain Traces of Allergen 91% Manuf. on Shared Equipment … 91% Manuf. on a Line … 91% Manuf. in a Facility … Uses 76% Packaged in a Facility … 74%
Thresholds from the Consumer’s Perspective
Physician advice--strict avoidance or a reaction may occur
Consumers believe:• threshold levels will put their child at risk
• threshold levels are the industry’s way to avoid appropriate cleaning and labeling
Thresholds from the Consumer’s Perspective: Catch 22
Labeling for all allergen levels may lead to:• further restricted diets
• increased frustration and risk taking
• undermine the integrity of the ingredient label
• potentially more allergic reactions and
• an increase in doctor or hospital visits
Thresholds from the Consumer’s Perspective: Catch 22
Example:One FAAN member of a soy-allergic child who had safely eaten soy lecithin in the past, gave a packaged product to the child.
Afterward, she read the label “Contains Soy”, and screamed “it now contains soy!”
Child had itching, hives , rash, feeling of impending doom. Mom administered medication –reaction or panic attack?
We should not subject consumers to this type of stress
Thresholds from the Consumer’s Perspective
Education is keyOutreach needed for:
• physicians and registered dietitians
• patients and their families
• food industry
Summary
Consumers want as many food choices as safely possible
Consumers need:
• to understand the information on the ingredient statement
• to trust that the information is complete and reliable
• minimal number of precautionary/Allergen Advisory statements used and guidance from industry regarding their meaning
Conclusion
Current labeling and manufacturing practices present enormous challenges to food-allergic individuals
The bottom line is
We must protect the integrity of the ingredient information because the food-
allergic consumer depends on this information to avoid an allergic reaction and to maintain their health and safety