FOOD AND

nuts

eggs

celery Food Hypersensitivity AND INTOLERANCE

In 2014, the European Authority (EFSA) estimated that food and intolerances occurred in approximately 3% of adults and 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.

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 .

• Food is one of a number of • Changes to your should only allergy triggers (, , be undertaken in consultation animal dander, ) with suitably qualified experts

• A food allergy differs from • EU food law identifies 14 in the type specific food that must of reaction by the body be declared when they are used to produce or prepare • Symptoms and their onset can vary with the trigger and the • The requirement to declare/ individual’s sensitivity label food allergens does not apply when they are present • People can experience at low levels due to cross- hypersensitive responses to contamination more than one type of food or food ingredient • For pre-packed food, allergens must be declared in the list of • Some foods can trigger both an ingredients or elsewhere on the allergic reaction and intolerance, packaging where there is no

e.g. milk, ingredient list AND INTOLERANCE FOOD ALLERGY 1 • Processing a food, e.g. cooking • information for non- may or may not alter its prepacked foods in Ireland must allergenicity be provided in written format

• Avoidance is currently the only • Precautionary labels

way of managing a food allergy (‘may contain’) are voluntarily FOOD HYPERSENSITIVITY or intolerance applied by food businesses

• 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 , particularly Symptoms can range from mild involving IgE (e.g. reactions to to severe or life threatening , soya and eggs), cellular mechanisms and may affect the , oral cavity, or both. In addition, autoimmune adverse , or reactions to food (e.g. coeliac ) the eyes. Because many of the symptoms occur when the immune system reacts associated with food allergy or intolerance abnormally to the of a food or can have unrelated triggers, medical advice food component. An adverse reaction should be sought before taking remedial that does not involve the immune system action such as dietary alteration. directly is considered food intolerance, e.g. reactions to sulphites, lactose.

ADVERSE REACTIONS TO FOOD

Food Allergy Food Intolerance (Immune mediated) (Not-immune mediated)

FOOD ALLERGY AND INTOLERANCE FOOD ALLERGY IgE-mediated Enzymatic 2 (e.g. ) (e.g. )

Cell-mediated Pharmacological (e.g. scombroid poisoning) IgE- and cell- mediated (e.g. ) Other and unknown triggers FOOD HYPERSENSITIVITY

Autoimmune disorder (e.g. )

Adverse reactions to food (adapted from EFSA Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes, 2014).

Because many of the symptoms associated with food allergy or intolerance can have unrelated triggers, medical advice should be sought before taking remedial action such as dietary alteration. ANAPHYLAXIS IS IMPORTANT Anaphylaxis is a rapid and potentially Medical consultation is recommended life-threatening allergic reaction caused when a person believes that they or by exposure to allergens including certain someone in their care are suffering from foods. Symptoms experienced during a food allergy or intolerance. Accurate anaphylactic reactions to foods such as diagnosis is particularly important for peanut can begin in the mouth and throat children or where the symptoms cause within minutes of ingestion and quickly severe or persistent discomfort. Incorrect progress to affect the , skin, diagnosis can result in the actual cause respiratory tract and cardiovascular system, of a health problem being overlooked and either individually or in combination. People in unnecessary dietary restrictions. susceptible to anaphylactic reactions need to carry life-saving auto- FOOD ALLERGY AND INTOLERANCE injector devices in case of emergency. Staff IN CHILDHOOD in catering facilities such as restaurants or takeaways and in schools or other Food allergy and intolerance can appear institutions should be aware of susceptible early in life as a child is gradually introduced individuals and have appropriate training to to new foods such as cows’ milk, egg, soy and be able to provide assistance if required. fish. The hypersensitive reaction to food experienced by many children recedes over time as tolerance is developed. However, the proportion of children who develop tolerance to some allergens, such as peanut is relatively low. Currently, the only way of FOOD ALLERGY AND INTOLERANCE FOOD ALLERGY managing food allergies or intolerances 3 is by eliminating the offending food or ingredient from the diet, but this should only be undertaken under the guidance of suitably qualified experts to minimise the impact on a child’s growth and development. FOOD HYPERSENSITIVITY

almonds

nuts ALLERGENS TRIGGER ALLERGIC COELIAC DISEASE REACTIONS Hypersensitivity to gluten (coeliac disease) Most allergenic foods contain one or is a genetically de