❓Often people ask me what they should do when they see a "𝘮𝘢𝘺 𝘤𝘰𝘯𝘵𝘢𝘪𝘯" label.
⁉️My first question to them is, how many variations of that wording have they seen?
✅In a study done many years ago, the researchers found over 20 different ways of writing an allergy warning in food.
▶️They asked people how they would act, depending on what was written, and the variability was incredible.
𝐒𝐨 𝐭𝐡𝐚𝐭 𝐲𝐨𝐮 𝐤𝐧𝐨𝐰, 𝐚𝐥𝐥 𝐯𝐚𝐫𝐢𝐚𝐭𝐢𝐨𝐧𝐬 𝐦𝐞𝐚𝐧 𝐞𝐱𝐚𝐜𝐭𝐥𝐲 𝐭𝐡𝐞 𝐬𝐚𝐦𝐞.
✅Several other studies went to see what was the actual variation of allergen concentration.
✳What did they find?
➡️In products with a warning, 6.5 to 93% contained an allergen.
➡️In products without a warning, 11 to 53% contained an allergen.
⚠️In reality, there is still a significant risk of a not labelled food, to contain a substantial amount of allergens.
❓But why is it that the food industry has this massive variability in warnings they use and still have so much potential cross-contamination of allergens?
❌The problem tracks back to political parties, the way they are funded or the individual politician's financial interest.
❗What I am saying might be controversial, but let's look at what is known.
⚠️Most of you have never heard of the "𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘍𝘰𝘰𝘥 𝘍𝘰𝘳𝘶𝘮".
🔻This is the most powerful lobby within the 𝘌𝘜 – the 𝐟𝐨𝐨𝐝 𝐢𝐧𝐝𝐮𝐬𝐭𝐫𝐲 𝐥𝐨𝐛𝐛𝐲.
🔻They have offices inside the 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘗𝘢𝘳𝘭𝘪𝘢𝘮𝘦𝘯𝘵 and manage to block all resolutions that can lead to improvement of food quality when this affects the profit the food industry has.
🔻It is easy to see what they have done so far, as most are widely published. (the list is far too long for me to place it here).
⚠️In the 𝘜𝘚𝘈 alone, in the 2014 elections, the food industry donated $𝟏𝟕𝐌, in total, to both parties.
❇This comes to the 𝐏'𝐬 I have spoken about before.
Those, also called 𝐄𝐃'𝐬 (𝘌𝘭𝘪𝘤𝘪𝘵𝘪𝘯𝘨 𝘋𝘰𝘴𝘦), look into the dose needed to cause an allergic reaction and the percentage of allergic people who will react.
✅So a 𝐏𝟏 or 𝐄𝐃𝟏 means that the potential cross-contamination in a particular food will lead to 1% or fewer allergic people reacting to that food.
✴The best collaboration done so far is the one between the food industry in Australia, the Government and Allergy Organizations.
(see the attached table to see the ED for the 14 main allergens)
⛔Such an agreement does not exist in the 𝘌𝘜 at present.
✴The hope for the 𝘜𝘒, at the moment, is that the so called "𝐍𝐚𝐭𝐚𝐬𝐡𝐚'𝐬 𝐋𝐚𝐰" will lead to a change in this practice.
▶️But we need to go deeper than simple labelling, look into manufacturing practices, and avoid allergens altogether.
A US study suggests that, though camps will accept 🧒 children with allergies, most are not prepared to act if something happens as often they don’t have or request individualized action plans.
🏕It seemed camps that had faced anaphylactic events in previous years were better trained and able to recognize it than others who didn’t.
Despite that, one-third of camp leaders did not think most staff would be able to act appropriately.
Though this study was not done in the UK, I would suggest👫 parents need to be aware of the possibility of the same happening in summer camps here or any other country where they might send their children to.
⚠️The main lessons to take from this study are:
🔹️Enquire if the staff at the summer camp is trained to deal with allergic conditions, mainly anaphylaxis.
🔹️See what policies and emergency measures they have in place, e.g. contacts for local ambulance service, GP or Hospital.
🔹️Provide action plans specifically for your child. If you don’t have one, ask your Paediatric Allergist to provide a BSACI action plan.
🔹️See if your child’s medication did not expire and take them to the camp, in a clearly marked container, potentially with a photo of your child outside it.
🔹️You don’t stand to lose anything by asking if the food your child is allergic to is excluded from the camp, and other children cannot bring it with them there.
🏫As more and more nurseries/schools are becoming nuts free, it would not be a bad idea for summer camps to follow suit.
(Many Summer Camps Unprepared for Allergic Campers - Medscape - Dec 10, 2019)
🤧 It is a reaction from our immune system to something we got in contact with that the immune system did not recognize as "safe".
This can happen to a multitude of substances, with the best known being 🥘foods, 🐈pet dander, pollen, house dust mites, 🐝bee or wasp venom. But chemicals can also lead to those reactions.
The substance that causes such a reaction is called an "allergen".
Allergens can be found all around us.
In 🥘food, 🍵drinks, environment, being them airborne (which can be either 💦droplets or minuscule solids) or solids we get in contact with.
The primary reaction that will happen is the immune system trying to destroy that "invader" (allergen), and for that, it uses a significant amount of the immune mediators.
The outcome is an allergic reaction that can come in all sorts of presentations and severity.
Saying that not all allergens we get in contact with will make our immune system react.
Some are relatively harmless, depending on each individual's immune system and, often, prior exposure to that substance.
What are the most common allergens in children?
🔸️ Tree nuts
How does it affect 👶children:
🔸️Increased risk of developing allergies if one/both 👫parents are atopic
🔸️33% with moderate/severe eczema may present with a food allergy
🔸️There is a close relationship between asthma, 👃allergic rhinitis and food allergy in school-age
🔸️Food allergy is associated with severe asthma
The outcome of the allergies depends on the food the child is allergic to.
🔸️ Milk and egg - usually resolved by teenage years
🔸️ Wheat and soy - those are transient allergies of childhood
🔸️ Peanut and tree nut - typically starts in childhood and only 20% resolve
🔸️ Fish - it is often lifelong
Milk, soy, egg and wheat - are the most common foods involved in non-IgE mediated food allergy.
Dr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health.