FoodAllergic Consumers Perspective on Ingredient Labeling

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Food-Allergic Consumers Perspective on
Ingredient Labeling

• Anne Munoz-Furlong
• FAAN

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Objectives

• Profile of the food-allergic consumer
• Discuss food allergy labeling information
• Provide consumers perspective on threshold levels

3
FAAN

• Non-profit organization, established in 91
• Over 27,000 members
• Mission is
• To increase public awareness, to provide
  advocacy and education, and to advance research
  on behalf of all those affected by food allergy
  and anaphylaxis.

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Profile of Food-Allergic Consumer

• Affects approximately 4 of U.S. population or 11
  million Americans
  
• Fish and shellfish allergy 2.3 or
• 6.5 million
• Peanut and tree nut allergy 1.1 or 3 million
  people

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Fish and Shellfish Allergy

• Shellfish allergy
• 2 of the population
• Shrimp, crab, lobster, clam
• Fish allergy
• .4 of the population
• Salmon, tuna, catfish, cod

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Tree Nut Allergy

• Tree nuts are not related to peanuts
• Tree nut allergy affects 1.5 million Americans
• Most common causes of tree nut allergy
• Walnut, cashew, almond, pecan

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What does it mean to have food allergies?

• Vigilant label reading for foods, bath products,
  pet foods, medications--everything
  
• Trace amounts can cause a reaction
• Just one little bite can hurt
• Epinephrine is the only medication to stop a
  severe reaction
  

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Profile of Food-Allergic Consumer

• There is no cure, strict avoidance is key
• Food allergies impact
• Decisions about
• Food shopping
• Cooking
• Dining out
• Socializing
• Schools and child care
• Travel
• Vacation
• Family relationships

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Food Allergy Impact on Quality of Life

• Families with a food-allergic child scored lower
  than the general population on scales of general
  health, emotional health and family activities
  
• Reduction in score for general health influenced
  by associated chronic disorders (i.e. asthma,
  eczema)
  
• Families with children with 2 food allergies
  scored lower for 9/12 scales compared to those
  with 1-2 allergies
  

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Impact on Quality of Life
Sicherer, Noone, Munoz-Furlong Ann Allergy Asthma
Immunol 2001
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Label reading
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Reading Food Ingredient Statements

• Food-allergic consumers must live in a black and
  white world if you are allergic, you dont eat
  the product
  
• If the allergen is listed on the label or the
  product says, Contains allergen, they avoid it
  
• They expect ingredient labels to be consistent
  and reliable
  
• The same product with different information
  causes confusion, frustration, and concern
  

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Reading Food Ingredient Statements

• Challenge
• Patients are told to strictly avoid the
  allergenzero tolerance
  
• They are not aware of the scientific names for
  these foods
  
• Its more than just the patients family who is
  reading labels on their behalf
  
• Allergens appear in unexpected places

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Common Foods In Unexpected Places
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Interpretation of Food Labelsby Parents of Food
Allergic Children
Joshi, Mofidi, Sicherer JACI 2002
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Allergen Advisory Statements

• Problem
• No guidelines or standards for use
• Cant educate consumers about what they mean
• Proliferation of may contain precautionary
  allergen labeling has further restricted their
  diet
  
• Northern Virginia grocery store
• Products from cookies, crackers, candy, and
  bakery
  
• 28 different versions of may contain type
  statements

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Allergen Advisory Statements

• Current Environment
• Some physicians advise their patients to ignore
  precautionary labeling
  
• Some companies tell consumers the statement is on
  the package only for legal purposes
  
• Advisory statements for peanut only
• Consumers confused and frustrated
• Risk taking behavior, particularly teens

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Consumer BehaviorFAAN Labeling Study

• Would Never purchase a product that says
• Contains Allergen 99
• May contain Allergen 95
• May Contain Traces of Allergen 91
• Manuf. on Shared Equipment 91
• Manuf. on a Line 91
• Manuf. in a Facility Uses 76
• Packaged in a Facility 74

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Thresholds from the Consumers Perspective

• Physician advice--strict avoidance or a reaction
  may occur
  
• Consumers believe
• threshold levels will put their child at risk
• threshold levels are the industrys way to avoid
  appropriate cleaning and labeling
  

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Thresholds from the Consumers Perspective
Catch 22

• Labeling for all allergen levels may lead to
• further restricted diets
• increased frustration and risk taking
• undermine the integrity of the ingredient label
• potentially more allergic reactions and
• an increase in doctor or hospital visits

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Thresholds from the Consumers Perspective
Catch 22

• Example
• One FAAN member of a soy-allergic child who had
  safely eaten soy lecithin in the past, gave a
  packaged product to the child.
  
• Afterward, she read the label Contains Soy,
  and screamed it now contains soy!
  
• Child had itching, hives , rash, feeling of
  impending doom. Mom administered medication
  reaction or panic attack?
  
• We should not subject consumers to this type of
  stress
  

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Thresholds from the Consumers Perspective

• Education is key
• Outreach needed for
• physicians and registered dietitians
• patients and their families
• food industry

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Summary

• Consumers want as many food choices as safely
  possible
  
• Consumers need
• to understand the information on the ingredient
  statement
  
• to trust that the information is complete and
  reliable
  
• minimal number of precautionary/Allergen Advisory
  statements used and guidance from industry
  regarding their meaning
  

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Conclusion

• Current labeling and manufacturing practices
  present enormous challenges to food-allergic
  individuals

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The bottom line is

• We must protect the integrity of the
  ingredient information because the food-allergic
  consumer depends on this information to avoid an
  allergic reaction and to maintain their health
  and safety