PEDIATRIC FOOD ALLERGIES: PITFALLS IN CURRENT FOOD LABELING REGULATIONS

FCAAIA Notes: Food allergy has significant impact on quality of life for patients and their families.  I work hard to have my patients live entirely normal lives with the exception of avoiding the offending foods.  Be vigilant and diligent about reading labels and asking servers, but go out to eat.  Go to parties and ball games.  Enjoy all the social activities you would if you didn’t have food allergy.

While the Food and Drug Administration requires that food manufactures clearly identify the presence of common food allergens in the product on their labels (milk, egg, wheat soy, peanut, tree nuts, fish, shellfish, and sesame), many companies place various “disclaimers” on their labels.  Statements such as, “May contain….”, Processed on…..”, and “Packaged in….” have no legal definition and (in my opinion) are their lawyers talking. I translate these statements to mean, “In the highly unlikely event there is a minute amount of cross contamination in our building and you have a reaction, it is not our fault.” One of the biggest effects of these disclaimers is that they instill even more fear in many patients, further diminishing quality of life.

(Source: https://www.medscape.com/viewarticle/890667?nlid=121212_3821&src=WNL_mdplsfeat_180313_mscpedit_aimm&uac=112079PK&spon=38&impID=1580373&faf=1 March 13, 2018For Medscape articles: User name: FCAAIA, Password: Allergies)

Abstract

Increased awareness about the impact of food allergies on quality of life issues in pediatrics is critical. To create a safe environment for the pediatric food allergic population, parents, healthcare professionals, caregivers, and food handlers must remain informed about current federal food labeling regulations and proposed policies. They must understand the complexities pertaining to the interpretation of food labels, improperly or incompletely labeled foods, and the pitfalls with vague precautionary statements, such as “may contain,” to decrease accidental ingestions, and thus, allergic reactions in the pediatric population.

Introduction

Currently, research estimates that over 8% of children in the United States have food allergies.

That number continues to rise, but the reasons why remain a mystery. Food-induced anaphylaxis is the most frequent type of anaphylactic reaction among children and is reportedly responsible for over 30,000 emergency department visits and approximately 150 deaths per year in the United States alone. However, recent studies report that emergency department visits and hospital admissions for food-induced anaphylaxis among children has more than doubled since 2006, suggesting that the burden of food allergy is much larger than previously reported.

Additionally, at present, there is no cure for food allergies, so management is key. Management primarily consists of identification and strict avoidance of allergenic foods, and prompt recognition of symptoms that lead to anaphylaxis.

The daily strain and fastidiousness of food allergy management and the constant fear of accidental exposure is a heavy burden to bear for individuals with food allergies, and their family members and caregivers. Daily activities are impacted by issues, such as label reading of commercial products; concerns for cross-contamination of foodstuffs in various settings; and exposures that may occur in school, childcare, and social situations. For instance, because food is involved in most school and social activities, children with food allergies may feel singled out or be the target of bullying. For example, one out of four parents avoid letting their child go to camp, and one out of 10 parents avoid letting their child attend birthday parties or play at a friend’s house .In addition, 31.5% of children are bullied specifically because of their food allergy. Bullying consists mostly of threats with food and verbal teasing, but it provokes unneeded stress and anxiety for children, and on occasion, places them in dangerous situations.

Additionally, typical activities, such as grocery shopping and meal preparation, are time-consuming and emotionally taxing on parents and caregivers. Parents may feel unfairly labeled as neurotic and overprotective of their food-allergic child when they engage in efforts to prevent their child’s exposure to food allergens. For example, unless children bring their “safe” foods with them to outside events, parents are relying on others to have sufficient knowledge of label reading and cross-contamination issues, and to provide a safe diet. Unfortunately, parental concerns and increased stress are warranted because most deaths from anaphylaxis due to food allergy occur outside the home. Consequently, increasing public knowledge and awareness may help alleviate some social and health issues children with allergies and their families and caregivers face daily.

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