Fending Off Food Allergies

In a perfect world, preventing food-allergy attacks would be as easy as knowing which foods you're allergic to and simply avoiding them.

But in the real world, it's not quite so easy. No matter how careful people are about trying to avoid foods that give them adverse reactions, they're still susceptible because of everything from uninformed waiters to improperly labeled foods.

Those are the conclusions of several studies on food allergies presented at the recent annual meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI) in New Orleans.

Among the studies was research showing that allergy sufferers and dining establishments must often take equal blame for exposure to allergens.

In looking at 706 people who'd had at least one allergic reaction associated with restaurant dining, the researchers found that in half the cases, the food item was "hidden" in sauces, dressings or egg rolls.

Yet in only 38 percent of the cases did the allergy sufferers themselves warn the establishment of the extent of their allergies.

"People would, for instance, ask, 'Does this dessert have nuts in it?' And the waiter might say, 'No,'" says Dr. Scott Sicherer, an assistant professor of pediatrics at the Jaffe Food Allergy Institute in the Mount Sinai School of Medicine.

"But the customer wouldn't have indicated that the reason they're asking is because they might be deadly allergic to it. The waiter may, meanwhile, just think they're asking to find out how many calories are in it," he adds.

The highest number of exposures to allergens (19 percent) occurred at Asian restaurants. Other establishments with high rates included ice cream shops (14 percent) and bakery/doughnut shops (13 percent).

In 18 percent of the allergic episodes, the problems were caused by "cross-contamination," in which ice cream equipment and cooking/serving supplies were used to handle different foods.

Sicherer says that's because those establishments tend to use a lot of nut products. "For instance, in an ice cream shop, you can have someone come in and order vanilla, but the person behind the counter will use a scoop that has some rocky road left over on [it]."

Sicherer says the findings should be a wake-up call to allergy sufferers about the risks of eating out, but they don't necessarily mean the sufferers can't dine out at all.

"The bottom line is that, for people who suffer from food allergies -- over 3 million Americans -- restaurants pose a particular problem. But if they really want to eat out, the main thing we suggest is that they have strong communication with the correct people at the restaurant," Sicherer says.

"And it's important to remember that it may not be the waiter they need to talk to. It may be the chef, or some other staff member who has more to do with food preparation," he adds.

Likewise, food establishments need to train staffers to be more aware of the seriousness of food allergies and the ways cross-contamination can occur, Sicherer says.

But even retreating to in-home dining holds risks for food-allergy sufferers, according to another of Sicherer's studies.

He evaluated 221 calls to the Food Allergy and Anaphylaxis Network Institute's hotline and found that more than half the callers were concerned by unlabeled ingredients.

Other labeling problems reported to the hotline included ingredient changes in new versions of old products (46 calls), incorrect contents in a package (15 calls), and foreign-language labels with incorrect ingredients listed in English (three calls).

Sicherer and his colleagues on the study called for stricter labeling practices as well as increased awareness and education for patients to remedy the problem.

Late last month, the food industry announced new guidelines for simplifying the language on food-product labels. It also plans to identify more thoroughly the ingredients that could cause food allergies.

"These guidelines will make life a lot easier and take the mystery out of label reading," says Anne Munoz-Furlong, founder of the Food Allergy Anaphylaxis Network (FAAN).

FAAN and more than 18 food companies worked together to produce the voluntary guidelines, which clarify how to best warn consumers with food allergies on choosing their foods.

Visit the American Academy of Allergy, Asthma and Immunology for additional information.

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