Just about every day in my practice I discuss with my patients how to avoid the foods to which they're allergic. We discuss reading ingredient labeling on packaged foods. Since 2004, the U.S. Food Allergen Labeling and Consumer Protection Act of 2004 requires clear labeling of major food allergens on packaged food products.
This frequently leads my patients to ask the question, "What about when the packing says the food is processed in the same facility or on the same equipment?" The answer isn’t completely clear, but as an allergist, I have to treat food allergy in terms of black and white – either I tell my patients to avoid a food at all cost, or eat as much as they want. I know that the truth isn't black and white, however. Most people with food allergies can tolerate a small amount of the food to which they're allergic – but if they reach their "threshold dose", they can experience an allergic reaction.
Recent studies have sought to determine how much food allergen is present in foods that are labeled as being processed in the same facility or on the same equipment as the food that needs to be avoided.
Milk Allergen Labeling
A study published in 2010 found that milk allergen was found in 60% of foods being labeled as "may contain" milk, 33% of foods being labeled as "processed on the same equipment" as foods containing milk, and almost 29% of foods being labeled as "processed in the same facility" as foods containing milk. While most of these foods contained very small amounts of milk allergen, which would cause a reaction in only people with a severe milk allergy, other foods contained higher amounts that may cause a reaction in less severely allergic people. The highest risk food for containing large amounts of milk allergen was dark chocolate candy, with nearly 78% of samples containing a significant amount of milk allergen.Therefore, people with severe milk allergy should avoid foods labeled with the above-mentioned precautions, especially foods containing dark chocolate.
Peanut Allergen Labeling
A study published in 2007 sought to determine the amount of peanut allergen in foods labeled as being processed in the same facility or on the same equipment as peanuts. In this study, approximately 7% of packaged foods had detectable peanut protein, most of which had very small amounts of peanut allergen unlikely to cause an allergic reaction. However, some of the foods, especially the candy/confectionery and nutrition/meal bar categories, had enough peanut allergen to cause an allergic reaction in people with a severe peanut allergy. Therefore, people with severe peanut allergy should avoid foods labeled with the precautions as outlined above, particularly candy and energy-type nutrition bars.Even when food allergen avoidance is followed, it is common for accidental exposure to occur. For this reason, it's always a good idea to be prepared to treat an allergic reaction, such as having an injectable form of epinephrine (Epi-Pen) available.
Source:
Crotty MP, Taylor SL. Risks Associated with Foods Having Advisory Milk Labeling. J Allergy Clin Immunol. 2010;125:935-7.
Hefle SL, Furlong SL, Furlong TJ, Niemann L, Lemon-Mule H, Sicherer S, Taylor SL. Consumer Attitudes and Risks Associated with Packaged Foods Having Advisory Labeling Regarding the Presence of Peanuts. J Allergy Clin Immunol. 2007;120:171-6.
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