Food labeling and the epidemiology of food allergy

May 4, 2008

Recently, the number of patients with food allergies is reported to be on the increase. In addition to the well established food allergens of egg, cows milk, wheat, and nuts seafoods, vegetables and fruits have joined the list of the most common allergens. Clinical symptoms of food allergy take various forms, and can include atopic dermatitis, asthma, anaphylaxis and sometimes death.

Recently, the number of patients with food allergies is reported to be on the increase. In addition to the well established food allergens of egg, cows milk, wheat, and nuts seafoods, vegetables and fruits have joined the list of the most common allergens. Clinical symptoms of food allergy take various forms, and can include atopic dermatitis, asthma, anaphylaxis and sometimes death.

In a discussion about nutrition strategies for preventing allergies in the first year of life, John A kerner, Stanford University Medical Center, Palo Alto, CA, noted that breast feeding significantly decreased atopic dermatitis(AD) in infants with a risk for AD. Exclusive breast milk for at least 4 months may prevent or delay AD. In addition, infants who breastfeed have a higher percentage of bifidobacteria and intestinal microflora that promote anti-allergic processes. Children with decreased bifidobacteria are more likely to develop allergic disease.

For those not choosing breastfeeding, formulas with hydrolysed casein and hydrolysed whey supplemented with probiotics, showed a marked reduction in the incidence of atopic dermatitis. Probiotics appear to suppress allergic immune responsiveness and improve the integrity of the gut barrier. Supplementation may be an alternative to breast milk in the prevention of allergies in children at risk. Kerner added that there is a 1.9 times risk of developing allergies using standard formulas.

Dr Kerner noted that pediatricians should think about AD even if there is no family history. More than 50% of children at risk develop AD even if there is no family history.

Speakers from Japan and Korea discussed the clinical symptoms of food allergy in their respective countries. Although food allergens may be similar to the US, there are differences in the epidemiology of food allergy in these countries. Yukoh Aihara, (Yokohama City University Medical Center, Japan), Atsuo Urisu, Fujita Health University, Japan and Yukoh Aihara, (Yokohama City University Medical Center, Japan), and Kangmo Ahn,(Sungkyunkwan University, Korea) presented studies on food allergies in children and the mandatory use of labeling of food allergies in both Japan and Korea.

Dr Aihara discussed the symptom of food-dependent exercise induced anaphylaxis in Japan. Children with severe allergies who eat an allergic food and exercise, even moderately have shown to develop uriticaria, dyspnea and anaphylaxis. He called for increasing public awareness of this indication and the need for more research to improve diagnosis of allergies in children.

Dr Urisu suggested that there has been a reduction in the number of food allergy reports with increased awareness of food allergies listed on labels,. In particular, in Japan, notice of allergens in food are mandated to be placed on labels. The mandated allergens include eggs, cows milk, wheat, buckwheat, peanuts, shrimp, lobster, and crab.

Dr Ahn noted that food labeling of allergens in Korea is mandated as well. From 1995 to 2005 there has been an increase in the number of food allergies reported in children in the first five years of life. He added that a survey found that most people were not reading the food label, and this may have an affect on avoidance of eating foods that cause allergies.

Japan and Korea have more foods listed as allergens on food labels than the US. Monitoring of the food labeling system seems to vary greatly in use of detection methods, documenting and validating methods among countries.