Food Hypersensitivity Food Allergy And IntolerAnce nuts gluten milk shellfish eggs celery Food Hypersensitivity Food Allergy And IntolerAnce In 2004, the European Food Safety Authority (EFSA) estimated that food allergies and intolerances occurred in approximately 1-3% of the EU population and in about 4-6% of children. Though it is generally accepted that the incidence of food allergies and intolerance in industrialised nations appears to be increasing, determining precise numbers is difficult due to relatively mild symptoms in some cases and the unreliability of self diagnosis. fish gluten milk crustaceans This information leaflet is designed to answer many of the questions people may have in regard to food allergies and intolerances, collectively known as food hypersensitivities. • Food is one of a number of • Changes to your diet should only allergy triggers (pollen, dust, be undertaken on the advice of animal dander, latex). a dietitian. • A food allergy differs from • Products containing any of food intolerance in the type the 14 food allergens as an of reaction by the body. ingredient must declare that allergen on the label. • Symptoms and their onset can vary with the trigger and the • Allergens can be declared in the individual’s sensitivity. list of ingredients or elsewhere on the packaging. • People can experience nce hypersensitive responses to • Current legislation does A more than one type of food. not require low levels of contaminating food allergens to nd Intoler • Some foods can trigger both an be included on the food label. A allergic reaction and intolerance, e.g. milk. • Current legislation does not require food sold loose or by Food Allergy • Processing a food, e.g. cooking, catering establishments to 1 may or may not alter its carry an allergen label. ty I v I t allergenicity. I • Precautionary labels (‘may • Avoidance is currently the only contain’) are voluntarily applied way of managing a food allergy by food businesses. or intolerance. Food Hypersens • Diagnosis of a food allergy or intolerance should involve medical consultation. termInology SymptomS the distinction between a food allergy and depending on the food involved and the intolerance is not defined in legislation. sensitivity of individuals, symptoms though interpretations can vary, experts associated with food allergy or intolerance in the field consider a food allergy to be a can appear immediately (within minutes) hypersensitive reaction to a food that is or take several hours or days to manifest. mediated by the immune system, particularly symptoms can range from mild irritation involving Ige antibodies, e.g. reactions to severe or life threatening anaphylaxis to milk, peanut, soya, eggs, but also non and may affect the skin, oral cavity, Ige antibodies (gluten hypersensitivity gastrointestinal tract, respiratory or coeliac disease). An adverse reaction tract or the eyes. Because many of the that does not involve the immune system symptoms associated with food allergy directly is considered food intolerance, or intolerance can have unrelated e.g. reactions to sulphites, lactose. triggers, medical advice should be sought before taking remedial action. nce A HypersensItIve reActIon to Food nd Intoler A Food Food Allergy Food Allergy Food Allergy 2 IntolerAnce ty I v I t I Immune Immune non-Immune response (Ige) response (non -Ige) response Food Hypersens metABolIc pHArmAcologIcAl otHer Because many of the symptoms associated with food allergy or intolerance can have unrelated triggers, medical advice should be sought before taking remedial action. almonds AnAphylAxIS Food Allergy And IntolerAnce In chIldhood Anaphylaxis is a rapid and potentially life-threatening allergic reaction caused Food allergy and intolerance can appear by exposure to allergens including certain early in life as a child is gradually introduced foods. symptoms experienced during to new foods such as cows’ milk, egg, soy and anaphylactic reactions to foods such as fish.t he hypersensitive reaction to food peanut can begin in the mouth and throat experienced by many children recedes over within minutes of ingestion and quickly time as tolerance is developed. However, progress to affect the pharynx, skin, the proportion of children who develop respiratory tract and cardiovascular system, tolerance to some allergens, such as peanut, either individually or in combination. people is relatively low. currently, the only way of susceptible to anaphylactic reactions managing food allergies or intolerances need to carry life saving adrenaline in case is by eliminating the offending food or of emergency. staff in catering facilities ingredient from the diet, but this should such as restaurants or takeaways and only be undertaken under the guidance in schools or other institutions should of a dietitian to minimise the impact on be aware of susceptible individuals and a child’s growth and development. nce have appropriate training to be able A to provide assistance if required. nd Intoler medIcAl dIAgnoSIS IS ImportAnt A medical consultation is recommended when a person believes that they or Food Allergy Food Allergy someone in their care are suffering from 3 a food allergy or intolerance. Accurate ty I v diagnosis is particularly important for I t I children or where the symptoms cause severe or persistent discomfort. Incorrect diagnosis can result in the actual cause of a health problem being overlooked and Food Hypersens in unnecessary dietary restrictions. peanuts cashew nuts almonds coelIAc dISease Gluten is a water-insoluble Hypersensitivity to gluten (coeliac disease) is a genetically determined disorder that mixture of proteins that can is estimated to affect 0.5-1% of the Irish damage the mucosa of the population and for which gluten avoidance is the only treatment. gluten is a water- small intestines in people insoluble mixture of proteins that can with the coeliac condition and damage the mucosa of the small intestines in people with the coeliac condition and is defined in EU legislation is defined in eu legislation as “a protein fraction from wheat, rye, barley, oats or as “a protein fraction from their crossbred varieties and derivatives wheat, rye, barley, oats or thereof”. under eu food law, foods containing gluten at less than 20mg/kg can be labelled their crossbred varieties as ‘gluten-free’ while those processed and derivatives thereof”. specifically to reduce gluten levels to between 20 and 100mg/kg can be labelled nce A as ‘very low gluten’. coeliacs can avail of naturally-occurring gluten-free cereals such as rice, maize and sorghum. guidance nd Intoler A note 24, published by the Food safety Authority of Ireland (FsAI) in 2010, provides information on best practice to avoid cross- Food Allergy Food Allergy contamination during the manufacture of 4 ‘gluten-free’ or ’very low gluten’ foods. ty I v Ingredients containing gluten are specifically I t I prohibited in the manufacture of infant formula and follow-on formula. In addition, processed cereal-based foods and baby foods intended for infants and young Food Hypersens children under 6 months of age should indicate the presence or absence of gluten. milk cereals wheat gluten shellfish containing oats mAnAgement oF A Food Allergy Some FoodS cAn cAuSe both An or IntolerAnce Allergy And IntolerAnce research suggests that in some cases, certain foods can be responsible for both tolerance may be built up by a gradual an allergic reaction and intolerance, e.g. exposure to an allergenic food. However, milk proteins can cause an allergic response the only way of successfully managing a in some people, while a reduced ability to food allergy or intolerance is to eliminate metabolise lactose, the primary sugar in the offending food or food ingredient from cow’s milk, is called lactose intolerance. the diet, but this should only be done in consultation with a dietitian. AllergenS trIgger AllergIc reActIonS most allergenic foods contain one or more allergenic proteins (allergens) that trigger an allergic reaction in susceptible individuals. nce some allergenic proteins are sensitive to A processes such as cooking, though this is not a reliable safeguard as with peanuts where nd Intoler boiling can reduce or eliminate the allergenic A potential but roasting does not. most allergenic proteins resist degradation in the harsh environment of the human stomach, Food Allergy Food Allergy a characteristic used to screen new food 5 ingredients for their allergenic potential. ty I v I t I Food Hypersens milk shellfish eggs Food Allergen lAbellIng Following are the 14 food allergens many foods and food ingredients can trigger which require specific allergen an allergic reaction or intolerance, but labelling under Directive 2000/13/EC only 14 require specific allergen labelling as amended: under eu law. Food allergens must be 1. Cereals containing gluten (i.e. wheat, declared on the packaging, e.g. in the list rye, barley, oats, spelt, kamut or their of ingredients, if there is one. Alcoholic hybridised strains) and products thereof, beverages (>1.2% by volume of alcohol) do except: not require ingredient labelling but must still indicate the use of food allergens on a) Wheat-based glucose syrups the label. certain derivatives of known food including dextrose; allergens are exempt from food allergen b) Wheat-based maltodextrins; labelling because the protein components known to elicit the allergic response c) Glucose syrups based on barley; have been removed during processing. d) Cereals for making distillates or ethyl alcohol