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Authors

  1. Messina, Mark PhD, MS
  2. Venter, Carina PhD, RD

Abstract

Substantial numbers of children and adults report having immunoglobulin E-mediated food allergies. However, generating accurate food allergy prevalence data is difficult. Self-reported data can overestimate prevalence when compared with prevalence estimates established by more rigorous methods. As of 2004, in the United States, the Food Allergen Labeling and Consumer Protection Act mandated that the label should declare the source of the food if the product contains that food or a protein-containing ingredient from that food (not all proteins in a major food allergen cause allergic reactions) in the manner described by the law. The 8 major food allergens are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, and soybeans, commonly referred to as the "Big 8." These 8 allergens are thought to account for 90% of the food allergy reactions. Recently published large surveys of Americans and Canadian adults and children provide considerable insight into the prevalence of allergy for the major allergens. These data indicate that there is a large variation in prevalence among the Big 8. The prevalence of soy beans allergy is lower than the prevalence reported for each of the other 7 major allergens, which has been used to argue that soy could be removed from the Big 8 without risking harm to the public. However, the momentum appears to be in favor of expanding the Big 8. The US Food and Drug Administration is evaluating classification of sesame seed as a major allergen; it is already classified as a major allergen in Canada, Australia, and Europe. Europe classifies 14 foods as major allergens. There may be some advantage to standardizing major allergen lists globally, although it may be equally important to acknowledge differences in priority allergens based on cultural and dietary preferences. It is incumbent upon health professionals to help their patients and clients identify foods to which they are allergic and aid in planning diets that are nutritionally adequate despite elimination of these foods.