Future Trends of Food Allergies

Research in food allergies has been rapidly expanding in recent years with the recognition that the prevalence and severity of food allergies is increasing. Research is progressing on multiple fronts. From the clinical perspective, research will continue on the prevalence of food allergies including:

  • Specific food allergies
  • Improved diagnostic methods, particularly focusing on strategies that circumvent the need for DBPCFC in all cases.
  • An improved understanding of the role of delayed hypersensitivity reactions in food allergy
  • And better treatment options for food allergy, ranging from anti-IgE therapy to vaccines to ‘cure’ allergies to probiotic approaches that will aid in the prevention of food allergies in infants.

However, perhaps the most important research will be to better define threshold doses. While this is clinical research, there is currently no more important research than this for the food industry. How much is too much?

That is a critical question that will drive food industry labeling and sanitation (and other allergen control) strategies as well as improved clinical approaches oriented toward the needs of individual patients.

From the food industry perspective, research should also continue on assessment of the potential allergenicity of ingredients derived from allergenic sources and on the effectiveness of various sanitation practices. How clean is clean enough?

That question is also related to the threshold issue and cannot effectively be answered until more data are available on minimal eliciting doses. From an analytical perspective, more research is needed to develop methods for the detection of residues of allergenic foods that are not commercially available yet.

Such analytical methods will provide important tools for the food industry and for regulatory agencies. With respect to regulatory agencies, the detection of allergenic food residues can be of tremendous assistance in their role as protectors of the health of food-allergic consumers.

Obviously, these methods will be important quality assurance tools for the food industry because they will allow the validation of sanitation practices on shared equipment. Shared equipment is an economic necessity in the food industry and is common in a wide variety of food industry sectors (e.g. ice cream, confectionary, bakery, pasta).

Proper sanitation of that shared equipment is critical to mitigation of potential allergen hazards, and analytical tools will facilitate the validation of sanitation practices. Clearly, analytical methods must be specific, allowing the detection of an allergenic food in the presence of others, and must be appropriately sensitive.

The ideal range of sensitivity of the methods should be driven by knowledge of minimal eliciting doses. The goal should be to protect allergic consumers while allowing them the greatest variety of foods in their diets rather than the detection of miniscule levels of allergenic food residues that have no adverse health consequences on even the most sensitive individuals.

The latest clinical information on food allergies is often available from medical societies such as the American Academy of Allergy, Asthma and Immunology and the European Academy of Allergy and Clinical Immunology. Consumer groups can be sought out for information from the consumers’ perspective. But some care must be taken to assure the accuracy of this information.

Consumer groups do not exist in all countries. The Food Allergy and Anaphylaxis Network in the US, the Anaphylaxis Campaign in the UK, Nederlands Anafylaxis Network in the Netherlands, Anaphylaxis Australia, Allergy New Zealand, and Association Quebecoise des Allergies Alimentaires in Quebec Province of Canada serve as examples of such consumer groups.

Regulatory agencies should be consulted for information on labeling and other regulations that may exist in various locales to protect food-allergic consumers. Regulations vary greatly from one country to another. The Codex Alimentarius Commission and its Committee on Food Labeling are a good source for general guidance.

For regulations specific to individual countries, the websites of the countries of interest should be examined – for Europe, the European Food Safety Authority would be the most appropriate agency. Specific advice can also be sought from various research groups including the University of Nebraska (Lincoln, Nebraska, USA) Food Allergy Research and Resource Program.