Report outlines strategy to improve food allergy safety in US

The Committee on Food Allergies concluded that the actual prevalence of food allergies is unknown due to misinterpretation of symptoms and lack of simple diagnostic tests.
The Committee on Food Allergies concluded that the actual prevalence of food allergies is unknown due to misinterpretation of symptoms and lack of simple diagnostic tests.

A new report has outlined steps needed to address public health concerns regarding food allergy safety.

The prevalence of food allergies is unknown, and most studies likely overestimate the rate, according to the report from the National Academies of Sciences, Engineering, and Medicine.  In addition, the report found that healthcare providers and the public frequently misinterpret a food allergy and its symptoms, cannot differentiate a food allergy from other immune and gastrointestinal diseases, and are unsure of proper management and preventive approaches.

“To prioritize food allergy as a public health concern and ensure that adequate resources are directed at the issue, the extent of the problem must first be defined,” said Virginia Stallings, MD, MS, chair of the Committee on Food Allergies, director of the Nutrition Center at the Children's Hospital of Philadelphia, and professor of pediatrics at the Perelman School of Medicine, University of Pennsylvania.

“Concerted efforts by early care and education systems, schools, and universities, food establishments, the travel industry, and the healthcare system are necessary to bring about a safe environment for those with food allergies. Many policies, practices, and behaviors could be changed in the short term to substantially improve food safety, which would enhance the health and quality of life for individuals with this chronic disease and save lives.”

The committee has recommended the following steps to promote food allergy safety:

  • Use proper diagnostic methods and provide evidence-based health care. Because there is no simple, accurate test for diagnosing food allergy, the skin prick test as well as an oral food challenge would better confirm diagnosis than the skin prick test alone.

  • Identify evidence-based prevention approaches, such as introducing allergenic foods (peanut products, egg, dairy, and wheat) when an infant is developmentally ready, about 6 months of age.

  • Improve education and training for healthcare providers, patients and their caregivers, the food industry, and the general public. 

    • Medical school and residency and fellowship programs should include training in the management of food allergy and anaphylaxis.

    • Organizations that provide emergency training to first responders and the public, such as the American Red Cross, should include food allergy and anaphylaxis emergency management in their curricula.

    • Food industry leaders should work to integrate food allergy training into existing general food safety and customer service training for employees at all levels and stages in the food industry. 

  • Implement improved policies and practices to prevent the occurrence of severe reactions.

    • The FDA and the US Department of Agriculture should work cooperatively to replace the precautionary allergen labeling system for low-level allergen contaminants with a new risk-based labeling approach.

    • The priority list of allergens should be based on evidence of regional preferences and severity of food allergies.

    • The FDA, CDC, and Federal Aviation Administration should convene a special task force that includes participants from the medical community, food companies, and advocacy stakeholder groups to establish and implement policy guidelines.

  • Expand research programs in areas such as diagnosis and prognosis, mechanisms, risk determinants, and management. 

Reference

  1. Stallings VA, Allen K, Burks W, et al. True prevalence of food allergies unknown due to misinterpretation of symptoms and lack of simple diagnostic tests; new report outlines steps to address public health concerns of food allergy safety. National Academies. 30 November 2016. http://bit.ly/2gaVSt8
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