Determining allergen protein equivalents in a variety of retail foods

Published: October 27, 202

Food products contain proteins from a variety of ingredients, but product labels provide insufficient information to accurately assess food allergen protein content. In a study published in this issue of The Journal of Allergy and Clinical Immunology: In Practice, Groetch and colleagues developed a systematic approach to estimate the allergen protein content of a variety of retail foods for 7 of the most common food allergens.

The authors created a multi-step process using information from product food labels, nutrient databases, independent weighing and measuring of foods, and information provided by manufacturers to more accurately estimate the allergen protein content of multiple retail foods for each of seven allergens. The resulting library includes educational material and details the allergen protein content of a variety of commonly available retail foods including peanut, milk, egg, wheat, cashew, hazelnut, and walnut. The information was used to support participants in a clinical research trial who transitioned to retail foods after treatment with omalizumab or omalizumab facilitated oral immunotherapy using doses determined by oral food challenge.

For example, if it was determined that a study participant could safely eat 1000mg peanut protein, participants were given the option of consuming 1 teaspoon of peanut flour, 1 teaspoon of peanut butter, 4 ½ whole peanuts, 7 peanut M&Ms or 12 Reese’s Pieces. Similarly, if a participant could safely eat 1000mg of milk protein, they could choose from 2 tablespoons of liquid milk or yogurt, ½ tablespoon of powdered milk,1/6th of a mozzarella cheese stick, ¼ cup ice cream,1 tablespoon of cream cheese, and even 1 ½ tablespoons of milk chocolate chips. Specific brands were recommended, and label reading education was provided. The ability to allow participants to safely choose from a variety of common food options may help increase compliance and help participants achieve their daily intake goals.

Oral immunotherapy has become more common in clinical practice with the availability of an FDA approved therapy. However, a recent study found that more than 90% of patients treated with this approved therapy chose to transition to common retail food products after reaching their maintenance dose for a variety of reasons including taste aversion and convenience. The work by Groetch et al, highlights the need and provides a method to more accurately estimate food allergen protein content of retail foods.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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