FCS8781 Decoding Food Labels: Tools for People with Food Allergies1 Amy H. Simonne and Elizabeth A. Gollub2 Background on the food label. Similarly, soy protein may be used for flavoring and listed on the label as natural flavoring. True food allergies are immune-mediated systemic allergic reactions to certain foods. According to the Food and Drug The Food Allergen Labeling and Consumer Protection Act Administration (FDA), true food allergies affect less than (FALCPA), which took effect on January 1, 2006, requires 2% of the adult population and 2-8% of children. However, food manufacturers to use common names to identify the impact of true allergies can be quite severe. Most child- major allergens. However, many consumers continue hood food allergies are found in young infants and children to have problems understanding complicated labeling under 3 years old. Food allergies have a genetic component information. and may be more common among those with asthma. The goal of this publication is to provide information to Reactions to a food allergen can range from uncomfortable help consumers understand ingredient statements on skin irritations to gastrointestinal distress to respiratory food packages so they can avoid foods and food products involvement to life-threatening anaphylaxis—a systemic al- that might contain specific allergens. It also differentiates lergic reaction that generally involves several of these areas between allergies and intolerances, and discusses the as well as the cardiovascular system. The number of people potential for cross-contamination of foods both in and with food allergies appears to be increasing, especially away from the home. among children. To keep pace with this trend, there is an increasing need for preemptive food selection strategies. Food Allergy vs. Food Intolerances Currently, an individual with a food allergy must learn to vs. Histamine Sensitivity read labels carefully and critically. This is because a food Most people experience an adverse reaction to some food at allergen may take on an unfamiliar name when used for some point in their life. This does not necessarily mean that processing purposes. For example, if eggs, one of the most the individual is allergic to that food. Food intolerances, allergenic foods, are used as a binder to retain water in a including sensitivity to elevated levels of histamine in foods, food product, the term binder, rather than egg, will appear 1. This document is FCS8781, one of a series of the Department of Family, Youth and Community Sciences, Florida Cooperative Extension Service, Institute of Food and Agricultural Sciences, University of Florida. First published November 2004. Revised November 2007. Reviewed November 2010. Visit the EDIS website at http://edis.ifas.ufl.edu. 2. Amy Simonne, PhD, associate professor and extension specialist, and Elizabeth A. Gollub, PhD, MPH., RD., former OPS professional, Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL 32611. Disclaimer: Not all foods and potential allergens have been included in this handout. Check with your physician or specialist to make sure you have a complete, individualized list. If you are in doubt regarding food label information or product ingredients, contact the food manufacturer. Any use of trade names in this publication is solely for the purpose of providing specific information. The Institute of Food and Agricultural Sciences (IFAS) is an Equal Opportunity Institution authorized to provide research, educational information and other services only to individuals and institutions that function with non-discrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, marital status, national origin, political opinions or affiliations. U.S. Department of Agriculture, Cooperative Extension Service, University of Florida, IFAS, Florida A&M University Cooperative Extension Program, and Boards of County Commissioners Cooperating. Millie Ferrer-Chancy, Interim Dean can produce a response similar to an allergic reaction. digest the offending food. This is usually because of a Adverse reactions and suspected allergens can be identified chemical deficiency (e.g., an enzyme deficiency). through a detailed history and specific allergy testing by a physician or qualified specialist (to exclude other causes). An individual with food intolerance can generally consume a small amount of the offending food without experiencing The difference between a food allergy and a food intoler- symptoms. However, the specific amount may be different ance is how the body handles the offending food. In for each individual. Intolerances, unlike allergies, seem to the case of an allergy, the immune system recognizes a intensify with age. chemical in the food (usually a protein) as an allergen, and produces antibodies against it. Histamine sensitivity may be considered a type of food intolerance. Because histamine is a primary mediator of an A response to an allergen may manifest as: allergic response in the body, consumption of histamine can elicit a similar response. Histamine toxicity is most • Swelling of the lips frequently associated with the consumption of spoiled fish, but has also been associated with aged cheeses and red • Stomach cramps, vomiting, diarrhea wines. Elevated levels of histamine occur naturally in these foods. • Hives, rashes, eczema • Wheezing or breathing problems Decoding Allergens in Foods Eggs • Severely reduced blood pressure If you are allergic to egg protein, you should avoid any Most common allergens are found in the following food product with the word egg on the label. You should also groups: avoid products with the following terms on their labels: Albumin Lysozyme 1. Cow’s milk (especially among children) Binder Ovalbumin Coagulant Ovomuci 2. Wheat (especially among children) Emulsifier Ovomucoid Obulin/ovaglobulin Ovovitellin 3. Soy (especially among children) Ecithin Vitellin Levetin Simplesse 4. Eggs Simplesse™ is a fat substitute made from egg 5. Peanuts white and milk protein. 6. Tree nuts Types of foods that are likely to contain egg protein include: Baked goods and Marshmallows 7. Fish packaged mixes Creamy fillings and Processed meat 8. Shellfish sauces products Breakfast cereals Pastas /egg 9. Food additives (not true allergens, but capable of causing noodles reaction or illness specific to a given person) Malted drinks and Salad dressings mixes /mayonnaise In most cases, children will outgrow their allergies to milk, Pancakes and waffles Soups wheat, soy, and eggs, but not to peanuts. Adults do not Marzipan* Meringue usually grow out of their allergies. Custard Pudding *Marzipan might be made with egg whites Food intolerance is more common than a true allergy and does not involve the immune system. Intolerance is a metabolic problem in which the body cannot adequately 2 Milk Flour – bleached, unbleached, white, Milk and milk proteins are also found in a variety of MSG whole-wheat, all- processed foods. Individuals with milk protein allergies (monosodium purpose, enriched, should avoid all types of milk, ice cream, yogurt and cheese, glutamate) including vegetarian cheese. Allergic individuals should graham, durum, high- avoid foods with the terms butter, cream, casein, caseinate, gluten, high-protein Vegetable whey, or emulsifier on the labels. Additional labeling terms Cornstarch indicating the presence of milk proteins in a food product starch/gum Gelatinized include: Farina starch Caramel color or flavoring Lactose Semolina Spelt* High protein flavor Natural flavoring Hydrolyzed vegetable Kamut* Lactalbumin/lactalbumin Solids protein phosphate Modified food starch Triticale* Lactoglobulin Simplesse* Miso** Malt TM *Simplesse is a fat substitute made from egg *Spelt and kamut are both relatives of wheat; white and milk protein triticale is a wheat/rye hybrid. These grains are gaining popularity as wheat substitutes. Types of foods that are likely to contain milk protein Spelt-, kamut-, and triticale-containing include: products are marketed primarily through health/natural food stores. Custard, puddings, **Fermented soy product with up to 50% Battered foods sherbet wheat Baked goods and mixes Imitation sour cream Instant mashed Types of foods that are likely to contain wheat proteins Breakfast cereals potatoes include: Chocolate Margarine Ale/beer/wine/bourbon/ Gravy Cream sauces, soups Sausages whiskey and mixes Baked goods and mixes-- Ice cream and cones Gravies and mixes Sweets/candies including barley Ghee* products *Ghee is clarified butter and is frequently used Battered or breaded Malts and flavorings in Indian cuisine. foods Breakfast cereals Pasta/egg noodles Candy/chocolate Soup and soup Wheat mixes Individuals who are allergic to wheat proteins should avoid Processed meats Soy sauce any product that contains the term wheat, bulgur, couscous, Coffee substitutes Pretzels, chips, bran, gluten, bread crumbs, or hydrolyzed wheat proteins on crackers the label. 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