An Update on Food Allergen Management and Global Labeling Regulations A Thesis SUBMITTED TO THE FACULTY OF UNIVERSITY OF MINNESOTA BY Xinyu Diao IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE Advisor: David Smith, Ph.D. Aug 2017 © {Xinyu Diao} {2017} Acknowledgements I would like to thank my advisor Dr. David Smith for his guidance and support throughout my Master’s program. With his advice to join the program, my wonderful journey at the University of Minnesota began. His tremendous support and encouragement motivates me to always dream big. I would like to also thank Dr. Jollen Feritg, Dr. Len Marquart and Dr. Adam Rothman for being willing to take their valuable time to serve as my committee members. I am grateful to many people whose professional advice is invaluable over the course of this project. I would like to take this opportunity to show appreciation for Dr. Gerald W. Fry for being a role model for me as having lifetime enthusiasm for the field you study. I wouldn’t be where I am now without the support of my friends. My MGC (Graduate Student Club) friends who came all around the world triggered my initial interest to investigate a topic which has been concerned in a worldwide framework. Finally, I would like to give my most sincere gratitude to my family, who provide me such a precious experience of studying abroad and receiving superior education. Thank you for your personal sacrifices and tremendous support when I am far away from home. i Dedication I dedicate this thesis to my father, Hongquan Diao and my mother, Jun Liu for their unconditional love and support. ii Abstract Food allergy is a growing concern worldwide, it has profound effects on the individual’s quality of life, as well as a country’s economy. There is an increasing recognition of food allergy pathogenesis, diagnostic methods and treatment therapies in recent years. Currently, food allergen management has been gradually established in different settings in order to reduce the occurrence of life-threatening food allergy reactions although the best practice to prevent food allergy is still strict avoidance. Food allergen labeling has proven to be an effective way to prevent accidentally access to potentially hazardous residues of the allergen for allergic consumers, however, inconsistency across countries regarding food allergen labeling legislation poses inconvenience in international food trade. Therefore, 3 topics will be discussed in this thesis (1) the current understanding of food allergy; (2) food allergen management in the industry, schools, restaurants and during/after pregnancy; (3) the status of food allergen labeling legislation around the world, including 164 countries which are current WTO members (till August 2017), an inventory was assembled and analyzed, future needs were identified by comparison. iii Table of Contents Chapter 1 Food Allergy Review ...........................................................................................1 Food allergy definition .............................................................................................................................. 1 Food allergen classifications .................................................................................................................. 4 Food allergy features ................................................................................................................................. 6 High resistance to food processing ...................................................................................................... 6 Cross-reactivity ............................................................................................................................................ 7 Minimum eliciting dose and severity .................................................................................................. 7 Epidemiological information ............................................................................................................... 10 Prevalence .................................................................................................................................................... 10 Highly risk population ............................................................................................................................ 12 Sensitization mechanism ............................................................................................................... 13 Symptoms ................................................................................................................................................... 16 Diagnosis ..................................................................................................................................................... 19 Treatment ................................................................................................................................................... 22 New food allergenicity evaluation ..................................................................................................... 27 Chapter 2 Food Allergen Management ........................................................................... 28 Food allergen analytical methods ..................................................................................................... 28 Food allergen management in the industry .................................................................................. 30 Food allergen management in the restaurant .............................................................................. 36 Food allergen management in the school ....................................................................................... 40 Maternity management ......................................................................................................................... 42 Chapter 3 Food Allergen Labeling around the World ................................................ 43 iv Methodology: the search process ...................................................................................................... 44 The Codex Alimentarius .......................................................................................................................... 45 Overview of national regulations ...................................................................................................... 46 Summary ...................................................................................................................................................... 46 African Region ............................................................................................................................................ 48 Americas Region ........................................................................................................................................ 48 East Asia region ......................................................................................................................................... 51 Europe region ............................................................................................................................................. 51 Eastern Mediterranean Region ........................................................................................................... 53 Western Pacific Region ........................................................................................................................... 53 Discussion ................................................................................................................................................... 58 What are “common allergens” ............................................................................................................ 60 Whether the food allergen labeling voluntary or mandatory ............................................... 68 Types of foodstuffs covered by food allergen labeling regulations ..................................... 69 Exemption and addition ......................................................................................................................... 70 Ways indicating food allergens .......................................................................................................... 72 Hidden ingredients and Precautionary allergen labeling ....................................................... 73 Conclusion .................................................................................................................................... 78 Reference ...................................................................................................................................... 79 Appendices ................................................................................................................................... 96 Appendix 1. WHO Reginal Map ............................................................................................................ 96 Appendix 2. Member States ................................................................................................................... 97 Appendix 3. Different methods of showing allergens on the labels.......................................... 98 Appendix 4. Allergy Advisory Labelling Decision Tree assessment .......................................100 v List of Tables Table 1-1 Types of hypersensitivity .................................................................................................... 2 Table 1-2 Different symptoms of food allergy .............................................................................