F O O D A L L E R G I E S can now eat milk products like icecream and cooked scrambled egg; and the dustmites in her living environment are controlled by regular cleaning. She still has moderate asthma but almost no eczema, and is still highly allergic to peanuts, although she can almost predict a bad reaction at least 10 minutes before it hits. Her specialist is making noises about desensitising her to peanuts, but she’s decided not to. She’s not good around almonds and cashews either, but she says exposure can generally be controlled. Her boyfriend looks at me with astonishment if I offer him something with peanuts as an ingredient…and that reassures me that others are now able to keep her safe when I’m not there. My shoulders have been lifted as she’s grown, but I still hate hearing her cough and cry. It reminds me of the past. We have no idea where her allergies originated, although my mum is a chronic asthmatic and my husband had it as a child. My father, from good Taranaki dairy farm stock, can remember hives developing down his legs after consuming the daily compulsory warm milk at school, although he says any dairy allergy in those days would have been ignored by parents ignorant of the concept. What I do know is that we’d never seen anything like her reactions before, nor heard of anyone with them when she was born. When we talked to people about it (or if they saw her having a reaction), they were generally incredulous and just couldn’t believe her story. It’s like having a ticking time bomb inside your body that reacts to things so ordinary, so completely benign, that it’s hard to comprehend. That’s why food labelling and sourcing is so vitally important to those mums and dads following in our wake with allergic children. Being allergic doesn’t just mean a sore stomach or bad taste in the mouth. For children like my daughter, it means suffering and potential death. I’m proud of my girl. All through this, she has been nothing but brave and stoic, wearing her Medic Alert bracelet and keeping herself safe. She would sometimes cry for things she couldn’t have, but not for long. Her sunny personality always overcame the cloudy moments. She’s now a young woman with flawless skin and a positive outlook on life. And she deserves it. FOOD ALLERGIES… Food allergy has become increasing prevalent. In the recent well-conducted Healthnuts study from Melbourne, up to 10 per cent of one-year-old children were shown to have a food allergy. Our own 2009 pilot study suggested food allergy was likely to be a significant problem for New Zealand infants. The reasons for the increased incidence of food allergy are unknown. There is also evidence egg and milk allergy may be persisting longer than previously thought. There is thus an increasing cohort of young adults who have food allergy. Currently the mainstay of managing food allergy is avoidance. Food desensitisation/ tolerisation is not part of routine clinical practice in New Zealand today, making avoidance of allergenic foods the joint responsibility of the manufacturer, the patient and the regulatory authority. The Food Standards Authority of Australia and New Zealand (FSANZ) regulates labelling of food products including allergen declarations in this country. There is a mandatory requirement for the presence of major allergens including eggs, milk, soy, wheat, peanuts, tree nuts, sesame, shellfish and fish to be declared on labels. Molluscs may also be labelled in the future, and noncompliance can result in product withdrawal and other legal consequences for the manufacturer. Defensive food labelling is consequently a major problem for consumers who are allergic to foods. Many products state ‘may contain traces of…’ or ‘manufactured in a factory which processes …’ This can severely reduce consumer choice, and can add to the anxiety faced by food allergic patients or parents. In some cases, these labels may be inserted in lieu of thorough cleaning of equipment to reduce the cost of manufacture. There are often situations where a food which previously did not contain such a label now 14 JUNE 2016 • Foods causing IgE-mediated food allergy in New Zealand are milk (dairy), eggs, peanuts, wheat, soy, tree-nuts, fish and shellfish. • Milk, eggs and peanuts are the most common causes of food allergies in NZ children • Rates of food allergy globally have risen significantly in the last decade, some dramatically • Food allergy affects up to 10% of infants in New Zealand • Most children will outgrow their food allergies although peanuts, tree-nuts, fish and shellfish tend to persist for life • Non IgE-mediated forms of food allergy such as Eosinophilic Oesophagitis are also known to be increasing; as well as allergies to fruit and vegetables related to pollen allergy • Food-allergic patients often have or develop other allergies as well, such as to pollens and house dust-mites • Up to 5% of the population overall are likely to have a food allergy. WHAT DO MANUFACTURERS NEED TO DO? FACT FILE By Dr Rohan Ameratunga
1-48 FT June16
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