FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1966694952> ?p ?o ?g. }

• W1966694952 endingPage "922" @default.
• W1966694952 startingPage "920" @default.
• W1966694952 abstract "Issues regarding food manufacturing and labeling continue to be a major source of frustration and, unfortunately, risk for people with food allergy. Although it would seem that specific avoidance diets should be rather simple and straightforward, nothing could be further from the truth. Food-allergic patients must overcome significant obstacles on a day-to-day basis, including difficulties with the interpretation of food labels and never-ending concerns about improperly or incompletely labeled foods. This issue of the Journal contains 2 timely and informative articles on these subjects. In one article, Joshi and colleagues1Joshi P Mofidi S Sicherer SH Interpretation of commercial food ingredient labels by parents of food-allergic children.J Allergy Clin Immunol. 2002; 109: 1019-1021Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar report on a study in which they evaluated the ability of parents of food-allergic children to accurately read labels for the presence of 1 or more major food allergens.1Joshi P Mofidi S Sicherer SH Interpretation of commercial food ingredient labels by parents of food-allergic children.J Allergy Clin Immunol. 2002; 109: 1019-1021Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar Realizing how poorly written labels are with respect to most common allergens, particularly as a result of the use of complex and ambiguous terms, one might have predicted that the results would be poor. In fact, they were absolutely dismal. This outcome is even more distressing given the fact that these were parents who had children with established food allergy and who presumably thus had experience in the interpretation of food labels. In fact, approximately one half of the families had previously seen a dietician and/or had been seen in the food allergy referral center that conducted the study. Accurate interpretation of the food labels ranged from just 7% for milk to 22% for soy, 54% for peanut, 88% for wheat, and 93% for wheat. Although some of these errors might be considered minor and might not have led to clinical reactions—such as the presence of the abbreviation DE (for Dairy Equipment ) on the label of a product that was otherwise milk-free—others would have caused significant exposures with potentially severe reactions. In addition, it is important to note that some of the errors would have led to an unnecessary restriction of the child's diet, such as the avoidance of soybean oil in a child with soy allergy. These results are especially troubling inasmuch as they are likely to reflect an overestimation of the actual ability of allergic consumers to read a label, in that these families had had more education on food allergy than most. Moreover, they had more time to study the labels in the setting of this study than would be typical of a hurried trip to the grocery store. In the second study, Vierk and colleagues, from the Center for Food Safety and Applied Nutrition of the US Food and Drug Administration (FDA), report on the recalls that occurred in 1999 for foods containing undeclared allergen(s).2Vierk K Falci K Wolyniak C Klontz KC Recalls of foods containing undeclared allergens reported to the US Food and Drug Administration, fiscal year 1999.J Allergy Clin Immunol. 2002; 109: 1022-1026Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar Of 659 food products recalled, 236 were recalled because they contained 1 or more undeclared allergens. These recalls involved from fewer than 200 to as many as 100,000 packages of the recalled food. The major reasons for the recalls were (1) ingredient statement omissions or errors and (2) contamination of products by undeclared allergens through equipment cross-contact. Of note, most of these recalls were initiated by consumers who identified the undeclared allergen, and in 34 instances allergic reactions were reported by the consumer who identified the problem food. In many ways, this information is of much greater concern than that presented in the first article. The issue of label interpretation is significant, and misinterpretation is undoubtedly a common cause of accidental allergic reactions; however, it is at least theoretically possible to teach patients to read and accurately interpret even the most confusing label. The issues that are highlighted by the second study are not necessarily surmountable even with education and constant vigilance; the labels on these foods were not just hard to interpret—they were wrong! Unfortunately, though the number of food recalls for undeclared allergen rose dramatically during the 1990s, the numbers presented in the article by Vierk et al are still likely to be a significant underestimate of the true problem. First, the mislabeled food had to be identified. In most cases, this meant either that it caused an allergic reaction or that its presence was obvious by sight or by taste. Second, only the 8 most common food allergens were included. Although it is appropriate to focus on these most common allergens, there are many allergens that are less common but just as important for patients who are allergic to those foods. Third, such FDA recalls are entirely voluntary; there might have been many, many more potential recalls that never occurred. The true magnitude of this problem is indeed hard to estimate. The FDA recently provided results of a series of inspections that were conducted in partnership with the Departments of Agriculture of Minnesota and Wisconsin.3Food allergen partnershipFood Safety and Applied Nutrition, Office of Scientific Analysis and Support.www.cfsan.fda.gov/~dms/alrgpart.htmlDate: January 2001Google Scholar Eighty-five facilities, specifically including bakeries and candy and ice cream manufacturing facilities, were inspected. When labels were studied for accuracy by comparison of raw ingredients with finished product labels, 25% of the establishments were found to have omitted raw ingredients, including peanuts and tree nuts, from the final labels. Some firms had procedures in place to verify label accuracy, and 15% even of those were found to have label discrepancies. When product samples were analyzed for egg and peanut allergens through use of highly sensitive immunoassays, 25% of the 73 products analyzed for peanut and 10% of the 45 products analyzed for egg tested positive for residual allergen. Of the companies that did not have procedures in place to verify label accuracy, 38% in Minnesota and 64% in Wisconsin were found to have undeclared egg and/or peanut allergens in their products. Although these data are striking and suggest that the presence of undeclared allergens is rampant, they still do not provide information as to the magnitude of the problem from a clinical standpoint. Allergic reactions have been documented to occur as a result of the presence of undeclared food allergens,2Vierk K Falci K Wolyniak C Klontz KC Recalls of foods containing undeclared allergens reported to the US Food and Drug Administration, fiscal year 1999.J Allergy Clin Immunol. 2002; 109: 1022-1026Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar, 4Gern JE Yang E Evrard HM Sampson HA Allergic reactions to milk-contaminated “nondairy” products.N Engl J Med. 1991; 324: 976-979Crossref PubMed Scopus (142) Google Scholar, 5Jones RT Squillace DL Yunginger JW Anaphylaxis in a milk-allergic child after ingestion of milk-contaminated kosher-pareve-labeled “dairy-free” dessert.Ann Allergy. 1992; 68: 223-227PubMed Google Scholar, 6Kemp SF Lockey RF Peanut anaphylaxis from food cross-contamination.JAMA. 1996; 275: 1636-1637Crossref PubMed Scopus (25) Google Scholar, 7McKenna C Klontz KC Systemic allergic reaction following ingestion of undeclared peanut flour in a peanut-sensitive woman.Ann Allergy Asthma Immunol. 1997; 79: 234-236Abstract Full Text PDF PubMed Scopus (27) Google Scholar, 8Altschul AS Scherrer DL Munoz-Furlong A Sicherer SH Manufacturing and labeling issues for commercial products: relevance to food allergy [letter].J Allergy Clin Immunol. 2001; 108: 468Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar yet it is likely that much of this exposure is below the threshold of response for most patients. It would seem that our offices and emergency rooms would be full of patients with inexplicable allergic reactions if this were a major clinical problem. On the other hand, it is certainly possible that patients do regularly experience mild or more subtle reactions, such as abdominal pain or exacerbations of atopic dermatitis, from these low-level exposures. Hopefully, answers to the questions raised by these considerations will become more clear once we are able to establish accurate information on the threshold doses that will cause an allergic reaction for each major allergen.9Taylor SL Hefle SL Bindslev-Jensen C Bock SA Burks Jr, AW Christie L et al.Factors affecting the determination of threshold doses for allergenic foods: how much is too much?.J Allergy Clin Immunol. 2002; 109: 24-30Abstract Full Text Full Text PDF PubMed Scopus (314) Google Scholar This is an area of active research, and it should be possible at least to determine levels below which the vast majority of allergic people will not react. However, it is also important to recognize that even that information will not provide a completely clear picture. In addition to the rare patients who might react at levels below a proposed threshold, there are significant issues regarding the effects of low-level exposure on allergic sensitization and the natural history of food allergy. For example, could it be that the apparently rising prevalence of peanut allergy is due in part to an increased exposure to peanut early in life from the unknowing use of contaminated foods? And could it also be that some children have more persistent food allergy because of chronic exposure from inaccurately labeled food products? These questions will be even harder to answer. It should be noted that these issues are not unique to the United States and that we are far better off than most of the rest of the world in this regard.10Schappi GF Konrad V Imhof D Etter R Wuthrich B. Hidden peanut allergens detected in various foods: findings and legal measures.Allergy. 2001; 56: 1216-1220Crossref PubMed Scopus (49) Google Scholar, 11Eigenmann PA Food allergy: a long way to safe processed foods.Allergy. 2001; 56: 1112-1113Crossref PubMed Scopus (25) Google Scholar In the greater part of Europe, an ingredient does not even have to appear on a label if it constitutes less than 25% of the product. It has been proposed that this level be dropped to 5%; that would be an improvement, but it would barely make a difference for the food-allergic consumer. Under those guidelines, it would seem almost impossible for someone with food allergy to eat anything without first calling the food product's manufacturer to ensure its safety. What, then, can and should be done? For our patients with food allergy, education remains the key. Until labeling for food allergens is made clearer and more straightforward, it is essential that all patients with food allergy be provided with the resources to accurately interpret food labels as well as to make informed decisions about restaurants and other food sources. It is in fact likely that restaurants, bakeries, and other eating establishments present far greater risks for mislabeled or contaminated food than do food manufacturers. Because of these inevitable pitfalls, it is also essential that education be directed toward the emergency treatment of food-allergic reactions in the event of accidental exposure. Several recommendations appear obvious. Immediate efforts should be directed toward the creation of clear, unambiguous labeling for food allergens. Simple terms should be used to identify major food allergens in an ingredient list, and the presence of an allergen should be clearly stated on the product label. For example, there is no good reason that not all foods containing milk protein have the word milk on their labels; the consumer should not have to search for (and know the meaning of) a word such as casein , whey , or lactoglobulin . If an allergen is contained in a spice or natural flavoring, this should also be clearly stated. Precautionary statements that include such a term as “May contain” or “Processed in the same facility as” should be used only when appropriate; they should not be used as blanket statements to replace good manufacturing practices. These efforts are all reasonable and could be implemented in short order with appropriate guidance from the FDA. However, even when these labeling issues have been resolved, issues of contamination and incomplete or inaccurate labeling will still need to be addressed. Some companies have spent the time and money to make their foods safe, and they can serve as models for others. The operative word, however, is money . All of these measures are costly and will most likely not be embraced by the average food manufacturer. It will therefore be necessary for the FDA to implement a more formal system to help ensure food safety for the allergic consumer. This will have to include specific guidelines for food labeling and manufacturing as well as a system of formal inspections involving use of the assays that are now available to meas-ure the major food allergens. Similar recommendations are in fact proposed in the article by Vierk and colleagues, who work for the FDA.2Vierk K Falci K Wolyniak C Klontz KC Recalls of foods containing undeclared allergens reported to the US Food and Drug Administration, fiscal year 1999.J Allergy Clin Immunol. 2002; 109: 1022-1026Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar Fortunately, there really does seem to be much more interest and movement at the FDA with regard to food allergens than there ever has been before.12Falci KJ Gombas KL Elliot EL Food allergen awareness: an FDA priority.www.cfsan.fda.gov/~dms/alrgawar.htmlDate: February 27 2002Google Scholar It is worth noting, however, that recommendations very much like these were proposed in a similar editorial a full 10 years ago.13Hamburger RN Misleading hazardous food labels.Ann Allergy. 1992; 68: 200-201PubMed Google Scholar It is now time to gather all available resources and work together to make certain that another 10 years does not pass without significant progress on these critically important issues." @default.
• W1966694952 created "2016-06-24" @default.
• W1966694952 creator A5045041188 @default.
• W1966694952 date "2002-06-01" @default.
• W1966694952 modified "2023-10-11" @default.
• W1966694952 title "Food manufacturing and the allergic consumer: Accidents waiting to happen" @default.
• W1966694952 cites W1965654503 @default.
• W1966694952 cites W1997487122 @default.
• W1966694952 cites W2019456683 @default.
• W1966694952 cites W2019743243 @default.
• W1966694952 cites W2033149064 @default.
• W1966694952 cites W2052022547 @default.
• W1966694952 cites W2052338519 @default.
• W1966694952 cites W2056147729 @default.
• W1966694952 cites W2318101790 @default.
• W1966694952 doi "https://doi.org/10.1067/mai.2002.124889" @default.
• W1966694952 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/12063518" @default.
• W1966694952 hasPublicationYear "2002" @default.
• W1966694952 type Work @default.
• W1966694952 sameAs 1966694952 @default.
• W1966694952 citedByCount "21" @default.
• W1966694952 countsByYear W19666949522014 @default.
• W1966694952 crossrefType "journal-article" @default.
• W1966694952 hasAuthorship W1966694952A5045041188 @default.
• W1966694952 hasBestOaLocation W19666949521 @default.
• W1966694952 hasConcept C144133560 @default.
• W1966694952 hasConceptScore W1966694952C144133560 @default.
• W1966694952 hasIssue "6" @default.
• W1966694952 hasLocation W19666949521 @default.
• W1966694952 hasLocation W19666949522 @default.
• W1966694952 hasOpenAccess W1966694952 @default.
• W1966694952 hasPrimaryLocation W19666949521 @default.
• W1966694952 hasRelatedWork W1491839574 @default.
• W1966694952 hasRelatedWork W2011945577 @default.
• W1966694952 hasRelatedWork W2596173151 @default.
• W1966694952 hasRelatedWork W2624733068 @default.
• W1966694952 hasRelatedWork W2765153054 @default.
• W1966694952 hasRelatedWork W2931838652 @default.
• W1966694952 hasRelatedWork W3080576469 @default.
• W1966694952 hasRelatedWork W3168296622 @default.
• W1966694952 hasRelatedWork W4231340554 @default.
• W1966694952 hasRelatedWork W2051331738 @default.
• W1966694952 hasVolume "109" @default.
• W1966694952 isParatext "false" @default.
• W1966694952 isRetracted "false" @default.
• W1966694952 magId "1966694952" @default.
• W1966694952 workType "article" @default.