SELECTED ARTICLES FROM THE RECENT LITERATURE 2004

12/27/04

How much of a food is allergenic?

Summary
Background – There has been an increasing awareness of food allergy (FA) and the need to alert the public about “hidden” food components in processed/prepared foods that are not always apparent to the user of such products. But to what extent should every component in the processed food be listed on the label?

Findings – This subject was discussed in an editorial by Bjorkstein of the Karolinska Institute in Sweden . He pointed out that such decisions about food component labeling are not always easy to make. On the one hand, trace amounts of a highly allergenic food may very occasionally elicit a severe allergic reaction in an individual highly allergic to that food allergen. At the same time, most people allergic to that food may readily tolerate such trace amounts. Should “excessive” restriction of allergenic foods be carried out with implications for the quality of life? Bjorkstein discussed an article in the same issue of Clinical and Experimental Allergy in which a committee of experts in FA came up with a consensus statement describing the minimum dose of several highly allergenic foods which have elicited reactions in double-blind, placebo-controlled food challenge tests. Not surprisingly, this minimum dose varied considerably among the different foods tested. Bjorkstein concluded that some compromises would likely be needed.

Reference
Clin Exp Allergy 2004;34:6734-75

Editor's Comments
There is considerable interest in and confusion about the subject of FA. As pointed out in this editorial, true immune based FA represents only a minority of the adverse reactions following food ingestion that are called “allergic reactions” by the lay public. The understandable movement for better labeling of food contents in prepared food products may result in elimination of trace amounts of food allergens that are well below the dose required to elicit an allergic reaction in most FA patients. Some compromise may be needed.

 

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