and common names for labelling, so for instance ingredients such as casein, whey, and lactose should be declared with a reference to milk in which they are found. Similarly, milk should be referred to as an ingredient in unfamiliar cheeses such as mascarpone, or brands like Quark.
Although manufacturers are required to reduce or eliminate cross contamination with allergens that are not the intentional ingredients of a food, there are no legal controls governing cross contamination in the manufacturing. You may find "may contain nuts" or "manufactured in a factory that also produces nuts" on the label but this information is voluntary.
Packaged food can still be risky. It may be old stock from before the new regulations were in force, or be mislabelled, or have been unpacked to serve loose and become contaminated. It may also have been refined and come into contact with potential allergens during the process. Currently, non-allergenic ingredients derived from an allergen don't have to be declared. If you can refine peanut oil in a way that removes the allergenic proteins, or can produce from wheat glucose a syrup that no longer contains gluten or other wheat proteins, these derivative products don't have to be labelled as allergens.
Standardized labelling that is clear, prominent, and unambiguous would be a great start. At the moment, inconsistencies and different terms across food brands and countries are confusing. Studies in America have shown that in some cases fewer than 10 per cent of children with milk allergies were able to correctly identify products containing milk. This is a risky state of affairs.
Plain language on labels. One manufacturer's view of plain language may not be another's and neither may correspond with yours. You may know that Cantal and Parmesan are cheese and that if listed as an ingredient the product must contain dairy -but is it obvious to everyone? It remains essential to teach children with food problems all the possible terms that might be used (see pp.40-42).
Improved procedures to avoid cross contamination in factories and a more considered use of "may contain traces of..." on labels. Nut trace contamination warnings are contentious because the suspicion is that manufacturers are simply covering themselves. Consumers need proper information: if the tiniest trace of a substance can cause a serious reaction, then people need to know that there is a trace risk. The more products without nuts as an ingredient that carry warnings, the less credible the warnings become. Credibility has been shown to be at its lowest amongst nut-allergic teenagers and children -the most at-risk group.
Feeding people with food sensitivities need not be expensive as long as you use a little foresight and planning. Specialist foods such as gluten-free pastas and bread and cake mixes are often obtainable on prescription. Egg-replacer and non-dairy infant formulas are sometimes available through hospitals or pharmacies. Ask your allergy specialist for more information.
> Various manufacturers, particularly of gluten-free foods, will send free samples. Contact suppliers directly or via allergy organizations and trade shows.
> Research supermarket prices before you buy because some supermarkets hike up the prices. The internet is invaluable for comparing prices.
> Buy specialist store cupboard staples in bulk from a wholesaler. Find them via the internet or ask your local health food store for help.
> Some GPs will prescribe egg-replacer and gluten-free products if they are a medical necessity.
> Fresh fruit and vegetables are likely to form the major part of your diet, but they don't have to be prepackaged in plastic in a supermarket. Check out your local fruit and vegetable shops and market stalls, which often sell bruised and slightly damaged produce for less.
> Start growing your own food to guarantee your food is allergen and additive free. Plant window sill herbs or a tomato plant in a pot. Enthusiastic gardeners could share a vegetable plot or allotment.
> Shop via mail order and the internet, especially for allergy-friendly foods and free-from ranges. They cut costs by not having shop premises and should pass some savings on to you. (See Resources pp.218-19).
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