When someone has a food allergy, they must completely avoid eating the food(s) to which they are allergic. Accidental ingestion can cause an allergic reaction, including severe and life-threatening reactions for some people. Communication with food handlers, knowledge of ingredient lists, and reading labels of packaged foods are all necessary components of successful allergen avoidance.
Reading labels can be tricky and ingredient lists can change suddenly without warning. It is recommended that people with food allergies read all labels prior to eating products, including those they have safely eaten before. This becomes particularly important during trick-or-treating and other holiday gatherings where many potentially unsafe options may increase risk for accidental ingestion.
Since 2006, the Food Allergy Labeling and Consumer Protection Act (FALCPA) requires all packaged foods in the United States to clearly state if they contain the most common food allergens: peanut, tree nuts, cow’s milk, egg, wheat, soybean, fish, and shellfish. This does not apply to fresh foods, foods regulated by the USDA (meat, poultry, eggs), or food sold by street vendors, food trucks, or packaged for resale by restaurants.
What about other food allergies? While the top eight foods mentioned above account for more than 90 percent of food allergies, many people are allergic to other foods, such as sesame, mustard, or fruits/vegetables. Unfortunately, the FDA does not mandate that any other foods be clearly listed on packaging.
What should I do if I’m allergic to a non-top eight food? It can be helpful to contact manufacturers directly to inquire about ingredient lists, especially if labels are difficult to understand, or include terms such as ‘natural flavorings’. Be extra careful with products containing spices or flavorings.
What about cross contact? FALCPA does not mandate that companies list any potential cross contact during production on their labels. Many companies place a ‘may contain’ or ‘processed on shared equipment’ label on their products. However, these labels are voluntary, unregulated, and there is no product testing to see if allergen is present and in what amount. Currently, these labels offer little insight in regards to how much/if any allergen is present. This can be challenging and highly restrictive when trying to identify safe foods.
What about oils derived from nuts or seeds? FALCPA does not apply to any highly refined oils, including peanut or other nuts. Clinical studies have shown these highly refined oils to contain little, if any allergen, and generally be safe for consumption by nut allergic individuals. Caution with any ‘cold-pressed’ oil as this can pose risk. Questions surrounding this should definitely be discussed with your personal allergist.
Practice, practice, practice. Reading labels can be daunting at first, especially for those newly diagnosed with food allergies. It helps to learn as much as you can about your specific food allergies and various ways they may be listed on products. If you’re ever unsure, it’s best to avoid buying or eating. With a little practice, you’ll soon become a food allergy detective!
Anyone with food allergies should have a detailed discussion with their personal allergist to help them understand what foods to avoid and risks from cross-contact or other exposures. This post may be helpful in raising awareness or generating new questions to ask your doctor, but should not be used as someone’s only resource on this topic.
For more information on Nationwide Children’s Hospital’s Allergy and Immunology Services, click here.