Legumes as hidden ingredients require improved labelling and educational strategies
Published: November 05, 2020
Allergen labelling requirements vary between countries. Legumes, including chickpea, pea, lentil, and lupine, are not priority allergens in the US and Canada and as such, do not always have to be labelled, thus making them hidden allergens. As a result of their increasing use in food products as well as the gaining popularity of plant-based diets, these legumes also have the potential to become important allergens.
A scoping review published by The Journal of Allergy and Clinical Immunology: In Practice was conducted by Hildebrand et al. The purpose of the review was to summarize what is known about chickpea, pea, lentil, and lupine food allergy in the clinical context with specific interest in prevalence, burden, labelling information, and education strategies. To be included in the study, articles had to be peer-reviewed primary clinical-based studies. Eligible articles reported on both legume food allergies and 1 or more of the following: prevalence, burden, labelling information, and education strategies.
Following screening, there were 47 relevant articles that underwent data extraction. Of the included articles, 38.3% were published in the last 5 years with 63.8% published in the last decade suggesting that legume allergies have become a recent topic of interest. Most studies (68.1%) were conducted in Europe where food allergy labeling regulations are more extensive, including lupine. However, all North American studies (7 of 7) included in this review were performed in the last 7 years, suggesting that legume allergy may be of increasing importance in North America. All 47 articles focused on prevalence with lentil being most commonly analyzed (46.8%). The prevalence of legume allergy ranged from 0.5% in studies analyzing the cause of food-induced anaphylaxis to 39.6% in patients with known food hypersensitivity to any food allergen. Four studies (8.5%) compared food allergy prevalence based on geographic location with rates of sensitization found to be higher in regions known to incorporate legumes into the diet more often. With regards to burden, only 5 studies were found, while no articles on education or labelling needs surrounding legume allergy were identified. In addition, only 25.5% of included studies had a prospective design, highlighting a major knowledge gap in this area. This review provides a comprehensive overview of the prevalence of non-priority legume food allergy. As such, it highlights the need for additional areas of research and discussions with public health and the food service industry centred around labelling and education.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.