The importance of research to support food hypersensitive consumers

For the last 20 years, the Food Standards Agency (FSA) has placed science at the centre of its work to protect public health. A key part of this effort has involved using research to help us tackle food safety issues.

So how do we do this in practical terms? In some areas of food safety there already exists a wealth of scientific evidence that we can rely on to inform our guidance and policies.

However, in other areas, such as with food allergies or intolerances, there is far less available knowledge, and it is here that the FSA’s research work is even more important.

It’s ultimately through commissioning targeted research in this area that we will inform and direct the work of the Food Hypersensitivity (FHS) Programme in its ambition to provide sound guidance to those with food allergies or intolerances and reduce the burden on hypersensitive individuals.

Research into allergens

Since 1994, the FSA has invested more than £20 million into in excess of 60 different research projects on food hypersensitivity as part of the Food Allergy and Intolerance Research (FAIR) Programme.

This work has had a significant impact on our understanding of food allergy and intolerance and placed the FSA at the forefront of world leading research on food hypersensitivities.

Some of the key, groundbreaking findings include identifying the skin as a probable route of exposure to food allergens, which can lead to increased allergen sensitivity; and that exercise and stress can reduce the amount of peanut allergen required to trigger an allergic reaction.

The research has also found early introduction of allergenic food into the diets of infant at around four to six months of age may reduce the risk of developing food allergy to those foods, especially in infants at high risk (eg, with existing eczema).

Food anaphylaxis in the UK

Just last month a new FSA-funded project looked at the hospital admissions and related fatalities for food-induced anaphylaxis from 1998 to 2018 in the UK.

The study, conducted by scientists from Imperial College London UK was published in the British Medical Journal (BMJ) and is the first output from a wider FSA-funded study.

Accurate analysis of the data is crucial to better understanding who is most at risk of severe allergic reactions, what food allergen most commonly causes them, and the circumstances or influences that cause severe or life-threatening reactions to food.

The outputs from this wider FSA study will be able to help consumers make informed decisions about how to better manage their allergies and help healthcare providers identify those most at risk, to reduce the likelihood of fatal outcomes.

Milk, not nuts, is the biggest cause

One example of how this data can help change our perceptions about allergies comes from looking at what causes hospitalisations.

Perhaps surprisingly, the study shows that milk and not (tree) nuts is the biggest cause of fatal reactions.

A total of 66 deaths were reported in children from 1998-2018. Fourteen percent of these were caused by peanuts, nine percent by tree nuts and 26 percent by cow’s milk.

One factor could be the increased awareness among food businesses and the general public about the allergy risk that peanuts and tree nuts present instead of cow’s milk. Another factor could be that cow’s milk is protein-rich, widely present in the western diet, and can be present in many forms, which results in an increased chance of exposure.

Cow’s milk is the main culprit when it comes to fatal allergic reactions

How data informs our work

The study confirms the reports that food-related hospital admissions for anaphylaxis are on the rise, with a threefold increase from 1998 to 2018. It also shows that the greatest increase was among young people under 15 years old and even more so for those under five.

While the case fatality rate (fatalities as a percentage of hospital admissions) more than halved from 0.7-0.3 percent for food-induced anaphylaxis during the same period, it also identified there were 152 fatalities in the 10-year period studied.

The highest fatality rate was observed during teenage years but remained raised throughout adulthood. This research is not just useful to know, it informs who the FSA needs to communicate with and how we do it.

Just last month we launched a new Instagram and Tik Tok social media campaign called #SpeakUpForAllergies to help encourage young adults to speak up about their food allergies every time they order a takeaway.

Further studies into food anaphylaxis in the UK

The team at Imperial College is now looking to expand on these findings by investigating why some people may be more susceptible to severe allergic reactions than others.

But this FSA-funded research is just part of the wider work being carried out to further increase and improve our understanding of food hypersensitivity.

Other research work includes developing ‘allergen reference materials’, which will improve the accuracy of allergen analysis so that businesses can validate their allergen management controls. A pilot project is also aiming to develop a food allergen data management system to aid small and medium sized businesses.

We are also expanding our consumer research work to understand more about food hypersensitive consumers and their behaviours, as well as the burden caused by living with food hypersensitivities and the day-to-day management of these conditions.

And, in addition to all of this, we are also working with our independent Science Council to evaluate the existing FSA Research Programme in food hypersensitivity as we help to identify priorities for future research and look ahead to anticipate future challenges.