The Food Information Regulations 2014 require food businesses to provide accurate and verifiable information for 14 allergens used as an intentionally ingredient in food and drink. This can be communicated verbally or written to the consumer.
Celery (stalk) and celeriac (root) is common food allergy in France, Switzerland and Germany39. Celery is used as ingredient in stocks, spice mixes and sauces. People are more likely to be allergic to celeriac than the stalk40. Symptoms range from mild to severe and cause photosensitivity in some people. Most severe reactions occur after consuming raw celery39.
Cereals containing gluten
Cereals containing gluten must be declared as an intentionally allergenic ingredient by law and includes wheat, rye, barley and oats.
Wheat allergy is more common in children than adults and most will outgrow it before 12 years of age33. Symptoms usually occur when food is eaten, but sometimes a reaction can be triggered by touching or inhaling wheat34. These symptoms range from mild to severe with most reactions affecting the skin34. For some people the symptoms of wheat allergy only happen when they exercise within a few hours after consuming wheat33,34 This rare condition is usually life threatening. Wheat dependent exercise-induced anaphylaxis (WDEIA) can occur within minutes or hours after consuming wheat34.
Egg allergy is more common in children and often occurs in the first year of life, but most will outgrow it before adulthood19,20. People with an egg allergy may also have an allergic reaction to other types of eggs, such as duck, quail and goose. Egg white contains the main egg allergens20. Cooked egg may not necessarily cause a reaction and research reports 80% of people can tolerate egg baked in a cake19.
Symptoms range from mild to severe. Eczema is a common food allergy associated with eggs 19. Vapours produced from cooked eggs may also induce respiratory problems when inhaled by people with a high sensitivity19.
The prevalence of a fish allergy is most common in adults and in countries where fish is the main part of the diet. An allergic reaction to fish can develop at any point in a person’s life, but usually occurs in childhoold25,26. Cross reactivity may significantly increase sensitivities to more than one type of fish. Exposure to vapours produced by cooking fish or contaminated oil previously used to cook fish can cause an allergic reaction25,27.
Symptoms can range from mild, moderate or severe. People with asthma are more susceptible to severe reactions25. Signs and symptoms of fish allergy may not necessary be an allergic reaction. Scombroid toxic poisoning may occur in certain fish (e.g. tuna) that has not been stored or handled under correct time and temperature controls. Histamine produced during decomposition can mimic an allergic reaction
Lupin is a garden flower and its seeds have been used as an official food ingredient in the UK since 199637. Cases of food allergy are rare as lupin flour is more widely used in Europe. Lupin can be found in a wide range of products including bread, cakes and pasta. Reports also estimate around 50% of people with a peanut allergy can react to lupin37. Symptoms range from mild to severe and can include anaphylaxis37.
Cow’s milk is a common food allergy in children, but most (90%) will outgrow the allergy by the age of three18. People are usually allergic to one or more proteins found in milk. Sheep and goats’ milk may not be a suitable substitute because the proteins in them are very similar to cow’s milk.
It is rare for children to develop allergic reactions to cow’s milk after the first year of life with most symptoms occurring before 6 months of age18. Children with a milk allergy will have two or more symptoms18. Most (50-70%) will have reactions affecting the skin, followed by gastrointestinal (50 -60%) and respiratory problems (20-30%)18. Life-threatening and severe reactions can occur in 10% of children18.
Mustard belongs to the Brassica family. The seeds are used to make mustard and the stem and leaves of some varieties are used as vegetable and salad leaf37. Cross reactivity to other foods is rare. Food allergy to mustard is uncommon in the UK, but more prevalent in mainland Europe. In France, mustard affects more than 10% of those with a food allergy37. Symptoms range from mild to severe. There have been no reported fatalities linked to mustard allergy37.
Peanut is a legume and botanically related to other foods such as peas, beans, and lentils22. People with peanut allergy may also be allergic to tree nuts, sesame seeds and lupin22. The highest rates of peanut allergy are in UK, Australia and USA, and Canada21. Peanut allergy affects 2% (1 in 50) children in the UK22 and 1 in 5 will never outgrow their sensitivity.
Symptoms can range to mild to severe and repeated exposure may increase severity. A reaction may occur in minutes or in some cases up to one-hour later23. People with asthma are at particular risk. Peanuts are implicated in most food allergy fatalities.
The prevalence of sesame allergy in the population can vary from country to country with the highest rate in Australia (8.5%)35. People with sesame allergy may also react to other seeds, nuts, rye and kiwi 35.
Symptoms of sesame food allergy usually occur immediately or up to an hour later. Most people will only have mild reactions such as a rash, swelling and gastrointestinal problems (vomiting and diarrhoea). Severe respiratory reactions can occur in children with poorly controlled asthma36.
Shellfish (Molluscs and Crustaceans)
Shellfish is divided into two distinct groups: molluscs and crustaceans. Molluscs include bivalves (e.g. mussels), Cephalopods (e.g. squid) and Gastropods (e.g. periwinkles and snails). Most people (60%) experience a food allergy to shellfish as adults with prawns, crab and lobster causing the majority of reactions. Cross reactivity may cause people to react to more than one crustacean and even molluscs28. Reports estimate that 75% of individuals may be allergic to more than one crustacean28. Cooking does not destroy allergens present in crustaceans and molluscs.
Symptoms range from mild to severe and may occur when shellfish is ingested, handled or when vapours produced during cooking are inhaled. A perceived allergic reaction may be due to other factors. The ingestion cod worm (Anisakis) found in marine fish and shellfish can cause an allergic reaction in a small number of people29 and the consumption of bivalves contaminated with poisonous aquatic biotoxins can result in gastrointestinal symptoms.
Soya is a derivative of the soya bean and categorised as a legume. The bean is also known as Edamame when sold fresh or frozen. Food allergy to soya is rare compared to other allergens and more common in children (4 in 100030) and nearly 70% will outgrow sensitivity by 10 years of age30. Soya is widely used in processed foods with up to 60% containing soya30. People may unintentionally ingest soya products in a ‘hidden form’32. Soya can be found in lecithin (E322), gum and albumin 31,32. Ten percent of children who are allergic to milk may also be allergic to soya31.
An allergic reaction to soya can happen when consumed or through inhaling dust particles containing soya31. Symptoms in most people are mild and reports of anaphylaxis are rare. Soya allergy is more severe in those with asthma.
Sulphites are preservatives used in food and drink to improve colour, enhance flavour and extend shelf-life. They can also occur naturally in some foods containing yeast. There is legal requirement to declare sulphur dioxide or sulphites at levels above 10mg per kg and 10mg per litre. Sulphites can be found in wine, dried fruit, peeled potatoes, meat and fresh or frozen prawns.
Food allergy to sulphites is rare but can cause symptoms (e.g. difficulty breathing) similar to an allergic reaction in people with asthma38. Sulphites in food react with acid in the stomach and create sulphur dioxide gas which irritates the airways 38.
Tree nuts are a common food allergy in children and adults. Sensitivity to tree nuts usually occurs before 5 years of age but can also develop in older children and adults24. Nuts in the tree nut family include: almonds, brazil nuts, cashews, hazelnuts, macadamia, pecan, pistachios, walnuts and shea nuts24. The most common tree nuts to cause an allergic reaction are walnuts and cashew nuts. Some foods are mistaken as a tree nut when in fact they are actually an aquatic vegetable (water chestnut), fruit (butternut squash) or seed (coconut). An allergy to one tree nut does necessarily means a person is sensitive to all tree nuts. Cross reactivity can also the risk of sesame allergy24. Most reactions are mild, but they can also be moderate or severe. Symptoms happen with minutes or delayed for up to two hours24.
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18. Anaphylaxis (2018). Immediate onset cow’s milk allergy in children (IgE allergy). [Online]. Available at: https://www.anaphylaxis.org.uk/knowledgebase/immediate-onset-cows-milk-allergy-in-children-ige-allergy-the-key-facts/
19. Anaphylaxis UK (2018). Milk Allergy. [Online]. Available at: https://www.anaphylaxis.org.uk/wp-content/uploads/2016/06/Egg-2016-V5-with-Info-Std-Logo.pdf
20. Manchester University (2018) Milk and Egg. [Online]. Available at: http://research.bmh.manchester.ac.uk/foodallergens/allergycause/milkandegg/
21. Crevel and Madsen (2014) Risk Management for Food Allergy. Elsevier. London UK
22. Anaphylaxis (2018). Peanut allergy and tree nut allergy – the facts [Online]. Available at: https://www.anaphylaxis.org.uk/wp-content/uploads/2018/06/Peanut-2018-V4-Website.pdf
23. Allergy UK (2018). Peanuts [Online]. Available at: https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/36-types-of-food-allergy#download_access
24. Allergy UK (2018). Tree nut allergy [Online]. Available at:https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/36-types-of-food-allergy#download_access
25. Allergy UK (2018). Fish. [Online]. Available at: https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/36-types-of-food-allergy#download_access
26. Anaphylaxis UK (2016). Allergy to Fish: The Facts [Online]. Available at: https://www.anaphylaxis.org.uk/wp-content/uploads/2015/06/Fish-V10a-formatted-with-footer-correction-1.pdf
27. Manchester University (2018). Fish. [Online]. Available at: http://research.bmh.manchester.ac.uk/foodallergens/allergycause/fish/
28. Manchester University (2018). Shellfish [Online]. Available at: http://research.bmh.manchester.ac.uk/foodallergens/allergycause/shellfish/
29. Anaphylaxis UK (2016). Shellfish Allergy: The Facts. [Online]. Available at: https://www.anaphylaxis.org.uk/wp-content/uploads/2015/06/Shellfish-V11-formatted.pdf
30. Allergy UK (2018). Soya. [Online]. Available at: https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/36-types-of-food-allergy#download_access
31. Allergy Northwest NHS (2018). SOYA BEAN ALLERGY. [Online]. Available at: https://allergynorthwest.nhs.uk/resources/allergy-leaflets/soyabean-allergy/
32. Anaphylaxis UK (2016). Soya Allergy: The Facts [Online]. Available at: https://www.anaphylaxis.org.uk/wp-content/uploads/2015/06/Soya-Allergy-Factsheet-v10-food-labelling-update-new-logo.pdf
33. American College of Allergy, Asthma & Immunology (2016). Wheat Allergy. [Online]. Available at: https://acaai.org/allergies/types/food-allergies/types-food-allergy/wheat-gluten-allergy
34. Manchester University (2018). Cereals. [Online]. Available at: http://research.bmh.manchester.ac.uk/foodallergens/allergycause/cereals/
35. Manchester University (2018). Sesame. [Online]. Available at: http://research.bmh.manchester.ac.uk/informall/allergenic-food/?FoodId=49
36. Allergy Northwest NHS (2016). Sesame Seed Allergy. [Online]. Available at: https://allergynorthwest.nhs.uk/resources/allergy-leaflets/sesame-seed-allergy/
37. Manchester University (2018). Celery. [ Online]. Available at: http://research.bmh.manchester.ac.uk/informall/allergenic-food/?FoodId=56
38. Allergy UK (2018). Celery. [Online]. Available at: https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/36-types-of-food-allergy#download_access
39. Anaphylaxis UK (2014). Celery Allergy: The Facts. [Online]. Available at: https://www.anaphylaxis.org.uk/wp-content/uploads/2015/06/Celery-version-9-formatted-with-changes-to-terminology-re-pollen-food.pdf
40. Safefood (2018). Celery. [Online]. Available at: https://www.safefood.eu/Allergens/Food-Types/Celery.aspx