A food allergy is an immune reaction that occurs shortly after eating a specific food. Even a small amount of the allergy-causing food might cause symptoms such as bloating, hives, and enlarged airways. A food allergy can cause severe symptoms or even a life-threatening reaction called anaphylaxis in some people. Food allergies are becoming more common in both adults and children. In recent years, the incidence of peanut allergy has risen rapidly, with the likelihood of a fourfold increase in the next few years. The severity of allergic illness appears to be growing as well, as reported and seen by an increase in anaphylaxis hospitalisations.
A variety of formerly uncommon severe, life-threatening allergies are becoming more widespread, such as kiwifruit allergy in young children. There is no cure or preventative therapy for food allergies at this time. As a result, therapy entails avoiding the involved food through elimination diets and addressing symptoms caused by accidental consumption through treatment programmes aimed at reducing morbidity and death while improving quality of life. Food allergy patients have a low risk of morbidity and a very low chance of death, and on the other hand, they have been shown to negatively impact a child’s and family’s daily existence and quality of life, as well as mental states like anxiety and melancholy.
Scenario in India
India’s cuisine is as diverse as its inhabitants, with regional and sub-regional cuisines and eating patterns. Food allergies are common among Indians, and they include of prawns, legumes, eggplant, pollen-food, milk, maize, wheat, egg, soybean, fish, peanuts, and so on. Food allergies have been discovered to be more common in children than in adults. According to researchers, a health and food sensitivity specialist, there have been 100 to 200 deaths in India owing to food allergies, 30,000 emergency cases, and up to 3 million cases of peanut allergy. Food allergies affect around 2.5 percent of the world population, with occurrences ranging from 1 percent to 10%. Food allergies may be caused by lifestyle changes, lack of sleep, pollution, poorly labelled packaged food, additives, preservatives in food, and the consumption of packaged goods without inspecting the components in India.
An allergic response to a specific food is known as a food allergy. Hives, enlarged airways, digestive difficulties, and other signs and symptoms may be triggered by the allergy-causing food. Other signs and symptoms include tingling or stinging in the mouth, hives, itching or eczema, and swelling of the lips, cheeks, throat, tongue, or other body regions. Some patients experience severe allergic responses, such as anaphylaxis, which is a life-threatening condition that can lead to coma or death if not treated promptly. Runny nose, hoarse voice, dizziness, loss of consciousness, constricted and tightened airways, fast pulse, swelling throat restricting breathing, shock, and significant drop in blood pressure are all signs of anaphylaxis.
Impact on Foods due to Processing
Foods can undergo many non-enzymatic biochemical processes as a result of thermal processing such as frying, roasting, curing, and different forms of heating. The Maillard reaction, which is one of the key processes that happens during heating or browning of meals, is responsible for the browning of many foods (e.g., roasting, frying, and curing) and is important in the development of flavour and colour in foods like peanuts and tree nuts during roasting, as well as in the enhancement of flavours in beverages like beer and coffee. It is a process in which amino groups of proteins are modified via non-enzymatic condensation with reducing sugars, and can be compared to caramelisation.
Food allergens are proteins, and millions of metabolic processes can influence them. As a result, food processing can alter the allergenic or immunogenic potential of foods, resulting in differences in the protein encountered by serum IgE, T cells, and other immune cells. The fact that milk or egg is baked into a muffin causes a less severe allergic reaction in milk or egg allergy people than drinking milk or eating a fried or boiled egg is an excellent example of this discovery. This is significant because it has been demonstrated that desensitising allergic individuals to milk or egg with baked products is more safe (with a lower risk of severe reactions) than with raw or standard egg or milk consumption. However, it is important to note that this approach is not safe or effective for all egg or milk allergic individuals, as immune responses among allergic individuals can vary significantly based on different degrees of food processing, the altitude, and other factors.
Each method can have a distinct impact on the allergenic potential of certain foods. While roasting or frying peanuts increases IgE identification of peanut allergens, boiling and high pressure treatment can reduce the allergenic potential of peanuts. When allergic people ate soaked pistachios instead of raw pistachios, their symptoms have been found in dramatically decreased manner.
The FSSAI has now compelled food business operators (FBOs) to give allergy information in the label of food package, if specific foods or substances are used during the manufacturing of the product, such as peanuts, tree nuts, gluten-containing cereals, soybeans, milk, egg, fish, and so on. Even when substances contained in the meal might cause cross-contamination, the Regulations require a separate allergy warning. However, for oils produced from allergy-causing components and even raw agricultural commodities, allergen data are not necessary. While the option for allergy information is new to the labelling requirements, there were previously provisions in the labelling standards that provided for warnings if specific components were used in the manufacturing of food. For example, in packages containing low gluten food, it is needed to include a declaration that the item contains low gluten, as well as a warning on the label that this may offer a danger to persons with celiac disease. Aside from the general labelling area, the Food Safety and Standards (Fortification of Foods) Regulations, 2018(the Fortification Regulations) requires that warnings be provided if food is fortified with iron.
Furthermore, for items covered by the Food Safety and Standards (Health Supplements, Nutraceuticals, Food for Special Dietary Use, Food for Special Medical Purpose, Functional Food, and Novel Food) Regulations, 2016, any contraindication must be listed on the label (the Nutraceuticals Regulations). These warnings, however, were restricted to a specific food category and were not precisely tied to the possibility of components to induce food allergies in general. Furthermore, the majority of the components that currently qualify for allergy information under the Regulations were not taken into account for these contraindication warnings. As a result, the previous regime and rules requiring particular warnings on some food packages were unable to achieve the benefits that an allergy statement might bring.
The choice to offer precise allergy information appears to be in line with European and US labelling guidelines. This was a much-anticipated addition, as peanuts, tree nuts, wheat, milk, eggs, fish, and soybeans are responsible for 90% of food allergies, according to the National Health Portal. If FBOs wish to use any of the aforementioned food products as ingredients, they must give allergy information on the label, according to the new rule. As a result, the new Regulations are likely to provide some relief to people who are allergic.
The FSSAI has placed most of the country’s major food chains, under the labelling regime. The Regulations state that Food Business Operators covered by a central licence (usually when operating in multiple states) or with outlets in 10 or more locations must now disclose calorific value in kcal per serving against food products displayed on menu cards, boards, or booklets. They must also clearly and prominently show the following information: “An average active adult requires 2000 kcal energy per day, however calorific demands may vary.”The goal is to educate people about the types of food they may purchase online, as well as the nutritional and allergy content. People should be aware of what they are consuming. They have labels on packaged food, but they don’t have labels on prepared dishes like dal makhani or butter chicken. Consumers will be more aware of the need of eating well as a result of menu labelling for prepared foods. It will assist consumers in making rapid and well-informed diet selections. Regulation 5(3) of the FSS Labelling and Display, Regulations 2020 mandates that food service establishments offer nutritional information. The same guideline, however, allows for a 25 percent variance in nutritional declarations to be accepted.
It is evident that food allergies clearly have a significant psychological impact on children, adolescents, and their families and continual attention is required to avoid allergens and the daily management of food allergies, in particular, has an influence on everyday family activities and social occasions. Food allergies tend to have a significant negative impact on various areas of life viz emotional, physical functioning and certain patient and caregiver categories appear to be the most affected.
Note: Opinions expressed in this article are based on review of scientific research carried out by scholars, organisations like FAO, WHO, UN, and has nothing to do with the organisation the writer works for.
The writer is Advisor, (SSD), Food and Consumer Affairs, Government of Madhya Pradesh, AIGGPA, Bhopal. [email protected]