What They Are, What They Do and How We Can Prevent Injury?

“Allergy is the most common chronic disease in Europe” (EAACI, 2016)

The increasing prevalence of food allergies worldwide means more people than ever are affected by allergies to food. It is predicted that by 2025, half of the entire EU population will be affected by chronic allergic diseases, the UK alone has an estimated 2 million people suffering from a diagnosed food allergy – one of the highest rates of allergic conditions in the world.

Unfortunately, I fall into this statistic, as 5 years ago I was diagnosed with a severe tree nut allergy. Luckily, I’ve only ever had mild reactions and while these are frightening and painful they haven’t yet required hospitalisation. However, there is the potential that only a small quantity of food containing nuts could cause anaphylaxis, a sudden and life-threatening allergic reaction.

What are food allergies?

The immune system plays a key role in the development of allergic reactions. Our immune system is vital in protecting us from colds, flu and harmful bacteria. We potentially come into contact with millions of harmful pathogens everyday, but thanks to our adaptive and complex immune system, we rarely get sick. To protect us, antibodies are produced by our immune system, these proteins circulate in the blood and help the removal of substances which have invaded our body. There are 5 different classes of antibodies –Immunoglobulin- IgM, IgG, IgD, IgA and IgE, each with a specific function to fight invasion! The complex part our immune system plays also means there are multiple areas where it can malfunction, for example over reaction to seemingly innocent compounds – it’s this over reaction which results in allergic reaction.

Allergy is “disease following a response by the immune system to an otherwise innocuous antigen”.

When the immune system reacts to an allergen it produces IgE antibodies. These IgE antibodies, originally evolved to fight parasites, recognise the allergen when it is encountered again and mediate the chain reaction of an allergic response, eventually leading to the mass release of histamine, responsible for anaphylaxis.

It’s possible for any food to cause an allergic reaction – there are actually over 170 different foods which have been identified as allergenic, however, only a few cause the majority of clinically diagnosed allergies. In the UK, there is mandatory labelling for the top 14 allergens:

  • Milk
  • Eggs
  • Soya
  • Lupin
  • Sesame
  • Cereals containing gluten
  • Fish
  • Crustaceans
  • Molluscs
  • Mustard
  • Peanuts
  • Nuts
  • Celery
  • Sulphur dioxide

What does Anaphylaxis look like?

The Anaphylaxis Campaign describe anaphylaxis as any of the following symptoms:

  • A dramatic fall in blood pressure, called anaphylactic shock, causing the person to become weak and floppy. This may lead to collapse, unconsciousness and, on rare occasions, death.
  • Sense of something terrible happening
  • Widespread flushing of the skin
  • Hives (also called nettle rash or urticaria) 
  • Swelling of the skin anywhere on the body
  • Swelling of the lips
  • Abdominal pain, nausea and vomiting

For those at risk of anaphylaxis, a pre-loaded auto-injector (also called epipen) is prescribed. These pens contain adrenaline and are injected straight into the side of the thigh to increase blood pressure and reverse anaphylaxis. If administered in time, epipens can prevent the serious consequences of allergic reaction, however, they are not always successful.

Management of Food Allergies.

It is well known there is no cure as yet for allergies, instead, the only successful way to manage a food allergy is complete avoidance of all foods containing the allergen. This means supermarket visits turn into lengthy trips spent scrutinising every product label, checking every ingredient and searching for that dreaded “may contain” statement. Generally ‘safer’ food is more expensive as most supermarket brands have allergen disclaimers. Label scrutiny doesn’t just stop with food, you also have to check cosmetics to avoid products which contain nut oils such as face cream that contains almond or shampoo with macadamia. 

Eating out in restaurants are anxiety inducing events involving a complete investigation of the menu – and what feels like – interrogation of servers!

With increased media coverage of allergy “horror stories”, general awareness is on the rise. Cases such as Natasha Ednan-Laperouse who went into anaphylaxis and sadly died after eating a poorly labelled sandwich and Amy May Shead who was left brain damaged after consuming just one bite of a meal in Budapest, which sent her into anaphylaxis. This was despite informing the chef three times she had a severe nut allergy and being assured by staff that the meal was safe.

While these stories are devastating to read they have inspired change in the food industry. Following Natasha’s death, her parents founded Natasha’s Foundation and have already had great success with “Natasha’s Law” – requiring food pre-packed for sale (such as coffee shop sandwiches) to list all allergens on the packaging.

Allergen Regulations and how Nutraceuticals safeguards its customers

It is compulsory for all allergenic ingredients to be listed on product labelling, these include the top 14 allergens listed above. This also includes products which may not intentionally contain allergens – such as those with “may contain” status – which may have been contaminated through manufacturing processes. Nutraceuticals only supply ingredients with a known allergen status, reviewed and approved by our experienced Quality Team as part of our manufacturer risk assessment.

We have a stringent allergen control policy in place, supported by our allergen risk assessment, to ensure the products provided by Nutraceuticals are safe for all consumers, including those who have food allergies. Our team carefully controls the sourcing, handling and storage of allergenic products and all colleagues follow rigorous procedures to prevent cross-contamination at every step of the supply chain. This includes ingredient composition checks, dedicated segregated allergen storage areas and the implementation of approved and researched cleaning processes to eliminate all traces of allergen.

As an additional safety measure, we undertake random allergen testing at external UKAS accredited laboratories to guarantee the allergen status of our products.

I certainly feel safe in my working environment.

As a company, we recognised the potential for contamination where mushroom powders and extracts are concerned as some sites were using peanut shells as the growing medium. Therefore as well as randomly testing all materials, we routinely test anything falling into the mushroom/fungi family, something we highlighted last year. You can read that blog here.

Anaphylaxis week

Rebecca Spicer is an Analytical Scientist at Nutraceuticals Group.