Food Allergy Prevalence

The number of people affected by food allergies has grown steadily in recent years and, according to more recent statistics, continues to rise. It is estimated that 2-4% of adults and 4-7% of children are affected by food allergies.

What is a food allergy?

The causes of a food allergy are versatile and multifunctional.

In general, the immune system shows a misdirected immune response to actually harmless substances (proteins) of a food. The immunological reactions are based on the activity of allergen specific antibodies of the immunoglobulin class E (IgE). After a primary sensitization with  the allergenic food IgE can be found onmast cells and basophils.  Renewed contact with certain proteins of the allergenic food, signal molecules (histamine and others) are released and trigger typical (food) allergic symptoms. Symptoms can show up in different areas, for example: Skin, gastrointestinal tract, respiratory tract, cardiovascular system.

 Due to the lack of treatment strategies, the only momentary recommended and routinely used "therapy" is the strict avoidance of the allergenic food. The avoid of allergic substances is difficult to perform, because even smallest amounts can trigger allergic reactions.

 The European Union responded to the problem of increasing numbers of food allergies by issuing a regulation in  form of Regulation (EU) No. 1169/2011.  According to this regulation certain substances or products causing allergies must be labeled on the package of the food.

VITAL - („Voluntary Incidental Trace Allergen Labelling“)

In the production of food, unintentional ingestion of allergenic substances through so-called cross-contamination ("cross contacts") can occur. This can be caused by insufficient cleaning of the production lines or by the use of the same production lines for allergen-containing food and food without allergens. As a precautionary measure and for reasons of product liability, manufacturers declare a warning on the food label, e.g. "may contain" or "contains traces of ...". In this context, It should be noted that the use of the word 'trace' in the warning is no longer recommended because it implies a small quantity. However, this term is not precisely defined. Studies have shown that there is generally no correlation between the formulation and the amount of allergen carried over.

Overall, it can be said that the increasing use of various warnings further restricts the choice of food for allergy sufferers.

This website provides a general introduction to the VITAL concept. Further information can be found at https://vital.allergenbureau.net/vital-program/ and the following links:

Overview of the development of the VITAL concepts and the current VITAL 3.0

In 2007, various international food manufacturers and the Australian Food and Grocery Council (AFGC) developed the so-called VITAL concept ("Voluntary Incidental Trace Allergen Labelling"). The VITAL concept was a standardised procedure for the detection and declaration of unintentional traces of allergens in foodstuffs on the basis of threshold values.

In 2012, a revision of the VITAL concept initiated by the Allergen Bureau was published. This version, VITAL 2.0, was based on a comprehensive evaluation of the available scientific data on food allergies by the VITAL Scientific Expert Panel (VSEP). By adapting VITAL 2.0 to the current state of science, it has become a globally respected tool for allergen management and risk assessment in the food industry.

On 28 October 2019, the concept was updated from version VITAL 2.0 to the current version VITAL 3.0.

As before, the update is based on the findings of VSEP. For VITAL 3.0, a new mathematical model (stacked model averaging program) was used to calculate the reference doses. This model includes 5 different statistical calculation models and allows the derivation of the reference doses. This and the additional evaluation and consideration of scientific data acquired in the past years (since 2011) resulted in partially deviating reference doses, which are now updated in VITAL 3.0 to the latest scientific level. Also new is the fact that the reference doses for all parameters have now been consistently indicated on the basis of ED01.

In its current version, it enables a clear and uniform declaration of possible traces of allergens in food. The most important changes of VITAL 3.0 compared to its predecessor VITAL 2.0 are shown in the following table.

Table 1
The following table gives an overview of the previous reference doses according to VITAL 2.0 and the future reference doses according to VITAL 3.0.

Table of Summary of changes to Reference Doses in VITAL Online
Allergen Reference Dose (mg protein) Comment
  VITAL 2.0 VITAL 3.0  
Reference Dose has decreased
Cereals containing
gluten
1.0 0.7 Labelling outcomes
may have shifted
from Action Level 1
to Action Level 2 -
check for affected
recipes.

Soy 1.0 0.5
Sesam 0.2 0.1
Lupin 4.0 2.6
Cashew & Pistachio 0.1 0.05
Pecan & Walnut 0.1 0.03
Reference Dose has increased
Egg 0.03 0.2 Labelling outcomes
may have shifted
from Action Level 2
to Action Level 1.
Milk 0.1 0.2
Fish 0.1 1.3
Crustacea 10 25
New Reference Dose
Celery/Celeriac None 0.05  
Reference Dose in unchanged
Peanuts 0.2 0.2  
almonds, Brazil nuts,
Hazelnuts, Macadamia
0.1 0.1
Mustard 0.05 0.05

 

Action Levels

Already with VITAL 2.0, the originally existing three-stage VITAL grid with threshold values for Action Levels 1-3 was abolished. Instead, an interactive grid was introduced, which determines variable action levels for the various allergens based on the respective reference dose and the product-specific reference quantity. The reference dose indicates the total amount (in mg) of protein in an allergenic food, which only highly sensitized allergy sufferers (1%) react to (see Table 2). It can be assumed that this group of people aren't using food via prepackaged products, so that all relevant persons are protected.

The reference quantity or portion size is defined as the maximum quantity of a product typically consumed. The food manufacturer is responsible for determining this size for the respective product.

The previously available Action Level, which in case of high cross contamination allowed the declaration as an ingredient ("Contains XY"), no longer exists. Here the responsibility of the manufacturer is appealed to minimize the risk accordingly.

Table 2
Overview of VITAL 3.0 reference doses with conversion to exemplary total foodstuffs:

Allergenic food Reference dose Reference dose
based on the protein [mg]
Protein content [%] 1 Conversion to total foodstuff
Peanut 0,2 27 Roasted peanut 0,7 mg
Milk 0,2 36 Skimmed milk powder 0,6 mg
Egg 0,2 46 Dried whole egg 0,4
Walnut/Pecan 0,03 8 Walnut 0,2 mg/ Pecan 0,3 mg
Pistachio/Cashew 0,05 18 Roasted pistachio 0,3 mg/ Cashew 0,3 mg
Almond, Brazil nut Hazelnut, Macadamia nut
(remaining nuts)
0,1 16 Hazelnut 0,6 mg
Soy 0,5 40 Soy flour 1,3 mg
Cereals containing gluten 0,7 10 Wheat flour (Type 405) 7,0 mg
Fish 1,3 21 Salmon fish cooked 6,2 mg
Mustard

0,05

23 Mustard powder 0,2 mg
Lupine 2,6 40 Lupine flour
Sesame 0,1 21 Sesame 0,5 mg
Crustacea 25 19 Shrimp cooked 132 mg
Celery 0,05 17 Celeriac dried 0,3 mg


Gluten

Since, in addition to the gluten fraction, the other proteins from cereals can also be relevant for allergy sufferers, the Vital Concept not only takes the presence of gluten into account, but also uses the total amount of protein present in the cereal to determine the portion size-related limit values. The action level for this varies depending on the portion size, as for the other allergens, but is capped at 20 ppm in order not to conflict with the legal requirements regarding the labelling of gluten-free products.

 

Your Vital Trainer

Dr. Martin Röder 

 
 Certificate Martin Roeder  

 

Source:
Berechnung des Proteingehalt erfolgte nach BLS; https://www.blsdb.de/ und https://www.naehrwertrechner.de/

 

Allergen Analysis in Food, Swabs and Rinse Water

The sensitivity of allergen detection methods depends on the matrix and the allergenic food to be detected. We provide more detailed information on the potential applications of the different detection methods with respect to the relevant allergenic food and matrix in individual consultations. Some cases may require a combination of detection methods.

Immunological allergen detection by means of ELISA

Immunological protein detection methods, so-called Enzyme-Linked Immunosorbent Assays (ELISA) are solid phase coupled antibody tests. The allergenic food is detected with specific monoclonal or polyclonal antibodies. The limit of detection is matrix-dependent between 0.5-1 mg/kg of allergenic food (ca. 0.1-1 mg/kg potentially allergenic protein).

Molecular biological allergen detection using real-time PCR

The molecular biological detection methods used for allergen detection involve the polymerase chain reaction (PCR). The allergenic food is detected based on amplification of a specific DNA fragment. The limit of detection is matrix-dependent between 2-20 mg/kg of allergenic food.

Available methods of detection

At ifp, the allergens listed below are detected by means of the following methods:

1 immunologically (ELISA, Lateral Flow); 2 molecular biologically (real-time PCR); 3 enzymatically; 4 distillation/titration

Tree nuts1, 2

  • Almond
  • Brazil nut
  • Cashew
  • Hazelnut
  • Macadamia
  • Pecan nut
  • Pistachio
  • Walnut

Legumes1, 2

  • Lupin
  • Peanut
  • Soy

Animal allergens

  • Egg1
    • Lysozyme (in wine analysis)
    • Ovalbumin (in wine analysis)
    • Whole egg
  • Milk
    • β-Lactoglobulin1
    • Casein1
    • Whole milk1
    • Lactose3
  • Seafood
    • Fish2
    • Crustaceans1, 2
    • Molluscs2

Cereal

  • Gluten1
  • Barley2
  • Oat2
  • Rye2
  • Wheat2
  • Soft wheat2

Spices/others

  • Celery2
  • Mustard1, 2
  • Sesame1, 2
  • Sulphite4

 

VITAL 2.0

Incidental contamination with allergenic substances as a result of "cross-contact" is a frequent issue in food-processing plants. Potential causes include the use of contaminated raw ingredients as well as allergenic substances carried over in the production process, e. g. due to insufficient cleaning procedures or when a joint production line is used for foods containing allergens and for allergen-free foods. As a precautionary measure and for product liability reasons, food manufacturers label their foods with declarations such as "may contain" or "contains traces of". The increasing use of such declarations, however, restricts the choice of foods for allergy sufferers.

Below you will find a general introduction to the VITAL concept. For more information, please see http://www.allergenbureau.net/vital/vital/ or the following links:

Voluntary declaration

In 2007, several international food producers and the Australian Food and Grocery Council (AFGC) developed the VITAL concept ("Voluntary Incidental Trace Allergen Labelling"). This concept is a standardised approach for the detection and threshold-based declaration of inadvertent traces of allergens in foodstuffs. The concept is already being applied by several food manufacturers in Australia.

A revised VITAL concept - commissioned by the Allergen Bureau - has been published in 2012. The new version, VITAL 2.0, is based on the VITAL Scientific Expert Panel’s (VSEP) comprehensive assessment of the latest scientific data on food allergies. Updates to the state-of the art are intended to substantiate the significance of the tool for allergen management and risk assessment in the food industry. The tool was introduced in 2007. A number of renowned companies in Australia and New Zealand are already using it to help them label possible allergen traces in foods clearly and consistently.

The most important changes published before this final launch are summarised below.

Action Levels

The three-stage VITAL grid with threshold values for Action Levels 1 – 3 that has been existing so far has been abolished. Instead, an interactive grid was introduced. It determines variable Action Levels for the different allergens based on the respective reference dose and the product-specific reference amount. The reference dose specifies the total amount (in mg) of protein from an allergenic food, below which only extremely sensitive allergic persons (1 – 5 %) will experience an adverse reaction (see table). The reference amount or serving size is defined as the maximum amount of a product that is consumed in a typical eating occasion. It is the food manufacturer’s task to define this amount for each relevant product.

Along with this, there will no longer be an Action Level that triggers ingredient labelling (“Contains XY”) – in the event of heavy cross-contaminations, manufacturers are encouraged to assume responsibility and minimise the risk accordingly.

Click on the image below to view the list of VITAL reference doses:

VITAL EN

Gluten

As allergy sufferers may be affected not only by the gluten fraction but also by the other cereal-derived proteins, the Vital concept takes into account not only the presence of gluten but also the total protein quantity present in the cereal when determining the portion size limit values. While the relevant action level varies - as in the case of the other allergens - depending on the portion size, they are capped at 20 ppm to avoid conflict with the statutory requirements for the marking of gluten-free products.

 

Your Vital 2.0 Trainer

Dr. Martin Röder 

 Dr. Wolfgang Weber

 Certificate Martin Roeder  Certificate Wolfgang Weber

List of Allergenic Ingredients That Must Be Labelled

The Food Information Regulation (Regulation [EC] No. 1169/2011) regulates the labelling of allergens.

Annex II of the LMIV lists the substances or products that cause allergies or intolerances and are therefore subject to labelling. These are:

  • Cereals containing gluten (i. e. wheat, rye, barley, oats, spelt, kamut or their hybridised strains)and products thereof
  • Crustaceans and products thereof
  • Eggs and products thereof
  • Fish and products thereof
  • Peanuts and products thereof
  • Sojabeans and products thereof
  • Milk and products thereof (including lactose)
  • Nuts i.e. almond,(Amygdalus communis L.), hazelnut (Corylus avellana), walnut (Juglans regia), cashew (Anacardium occidentale), Pecan nut (Carya illinoiesis), brazil nut (Bertholletia excelsa), pistachio nut (Pistacia vera), macadamia nut und Queensland nut (Macadamia ternifolia) and products thereof
  • Celery and products thereof
  • Mustard and products thereof
  • Sesame seeds and products thereof
  • Sulphur dioxide and sulphites at concentrations of more than 10 mg/kg or 10 mg/l, expressed as SO2
  • Lupine and products thereof
  • Molluscs and products thereof