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Eating with the enemy: in recent years the prevalence and awareness of food allergies has been on the rise.

Imagine if simply snacking on some milk and cookies, or eating a peanut butter and jelly sandwich or picking on a shrimp cocktail appetizer left you sweating and short of breath, or sprinting for the nearest bathroom. Unfortunately, that's reality for people with food allergies.

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About 11 million Americans suffer from one or more food allergies and about 200 die every year from food allergy-related reaction. This means that one in 25 people in the U.S. are unable to consume a range of basic, familiar ingredients without triggering serious, sometimes lethal immune responses.

The seriousness of food allergies has even prompted federal government agencies to act. In fact, in August 2004 President Bush signed the Food Allergen Labeling and Consumer Protection Act (S.741). The new law, effective January 1, 2006, requires food manufacturers to clearly state if a product contains any of the eight major food allergens.

As the pharmaceutical industry continues to focus research efforts geared toward lessening allergic reactions, the natural products industry is offering consumers alternatives to avoid allergens altogether.

Food Allergy Primer

According to The Food Allergy & Anaphylaxis Network, Fairfax, VA, 90% of allergic reactions in the U.S. are caused by eight items: milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat. As common as food allergies are, many people who claim to have an allergy in fact suffer from what is more properly termed food sensitivity or intolerance.

True food allergies, as opposed to food intolerance, involve the immune system and occur when the body mistakenly interprets something in a food or a food ingredient--usually a protein--as an invader and produces antibodies to fight it. With repeated exposure to the offending protein, the body continues to mount its defense so that, finally, the allergenic food triggers the release of histamine and other powerful chemicals in the body. These are the components of the body's defense that cause food allergy symptoms.

Food allergy symptoms can range from mild--itchy mouth, tongue, vomiting, diarrhea, hives--to severe--anaphylactic shock, cardiac arrest. Anaphylaxis is an infrequent, yet potentially fatal response to an allergen and involves several different body systems resulting in a collection of symptoms instead of the usual one or two seen with a typical food allergy. Difficulty breathing, throat constriction, decreased blood pressure and unconsciousness may occur almost simultaneously.

Discussing in further detail the difference between food allergies and intolerances was Cindy Kaplan, director of marketing, Enjoy Life Foods, Chicago, IL. "A food allergy occurs when a specific food that is eaten affects the immune system, which triggers the body to make an antibody called IgE to fight it," she explained "The symptoms can hit right away or they can hit a couple of hours later, and range in severity depending upon the sensitivity of the person. Food intolerance occurs when eating a certain food triggers a negative reaction from the body but the immune system is not affected in the same way and symptoms can actually take up to three days to occur making it much more difficult to diagnose."

Analyzing the Food Allergy & Intolerance Product Market

A new report titled, "The U.S. Market for Food Allergy and Food Intolerance Products," published by Packaged Facts, New York, NY, says the U.S. market for food allergy and intolerance products has nearly doubled since 1999, growing from $947 million in retail sales to over $1.8 billion in 2003. The market has sustained an annual growth rate of more than 15% during this period, with overall sales climbing over 17% in 2003 alone. Based largely on the increasing prevalence and growing consumer awareness of food allergies and intolerance, improvements in non-allergenic ingredients and flavor profiles, and positive effects of national allergy-related legislation, Packaged Facts projects that market sales will reach nearly $4 billion by 2008.

Broken down into four categories representing the total U.S. retail sales of food allergy and intolerance products between 1999 and 2003, dairy and dairy-alternative products grew from 68% to 70% of total sales; baked goods, flour and pasta grew from almost 16% to 19% of total sales; peanut and tree nut alternatives decreased from 13% to 8% of total sales; and lastly, infant formula and baby food decreased from 4% to 3% of total sales.

The growth of the allergen-free market over the past several years can in part be attributed to an increase in awareness toward the consumption of natural and organic food products, according to Franco Spanzione, CEO, Fortitude Foods Corporation, Coral Gables, FL. In addition, he said, "The low carb craze, Atkins in particular, lifted the veil from consumers, allowing them to see healthier, alternative options to mainstream food choices."

Susan Walters-Flood, president, Nu-World Amaranth, Inc., Naperville, IL, agreed that the low-carb trend helped pave the way for increased awareness at the consumer level. However, she said the allergen- and gluten-free markets are not a passing fad. "The allergen- and gluten-free markets are rooted in serving consumers with medical needs," she offered. "Fortunately or unfortunately, depending on whose perspective you look at, that need is growing and creating a greater demand for allergen- and gluten-free products, which means these markets are here to stay."

Understanding Celiac Disease

Celiac disease, an autoimmune condition triggered by gluten, which is the protein found in certain grains, has caused rising concern over the past several years. Also known as gluten intolerance, celiac disease occurs in the lower intestine and at present there is no cure or treatment options other than adherence to a gluten-free diet. It is a genetic disorder in which consumption of gluten from wheat, as well as related grains such as rye, barley and oats, damages the lining of the small intestine, preventing absorption of essential nutrients. While wheat and soy allergies can be outgrown, celiac disease is a lifelong condition.

Celiac disease has been around for years, but it was not until a significant study was published in 2003 titled, "Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States," that it began to gain serious attention from the medical community.

Until this study was published, physicians in the U.S. were taught that celiac disease was a very rare disorder, according to Enjoy Life Foods' Ms. Kaplan. "The reason for this is because when an individual with celiac disease eats gluten, the gluten damages the lining of the small intestine and would therefore be classified by the medical community as a gastrointestinal disorder," she said. "However, the study showed that as many as one in 150 Americans may suffer from celiac disease. Then in 2004 the National Institutes of Health (NIH), Bethesda, MD, released new statistics that showed at least 1%, or about three million Americans, have the disease. Other estimates place the figure as high as one in 133 Americans."

Ms. Kaplan continued, "Only a portion of those that have the disease are currently diagnosed," she said. "However, because these studies have been released in very credible publications, medical practitioners are reading them and starting to look for and diagnose more accurately the disease. In addition, consumer publications are putting out more information about celiac disease so the general public is becoming more educated as well."

A Gluten-Free Future

According to "Food Allergies and the Consumer in the U.S.," a new report published by Mintel, Chicago, IL, gluten-free products captured approximately $450 million in retail sales last year. In addition, the gluten-free sector experienced approximately 34% growth in just two years (2002-2004). While the increasing numbers of people being diagnosed with celiac disease is contributing to the boom of gluten-free products, there are several other factors involved in the market's rapid growth.

Nu-World Amaranth's Ms. Walters said that one of the key factors adding to the growth of allergen-free products has been the population's overexposure to commoditized ingredients like wheat and soy, which are hidden in many food items. "Sometimes when our bodies are overexposed to something it rebels, and a growing number of people can't deal with consuming such high levels of certain ingredients," she said. "For example, some people in the past who avoided wheat and turned to soy products as an alternative are slowly finding that soy can also be a common allergen, which has caused them to turn toward other ingredients, including those that are gluten-free, that offer great nutrition."

Advances in food science have also helped push the category forward according to Enjoy Life Foods' Ms. Kaplan, who said great strides have been taken not only in terms of the taste and texture of gluten-free products, but also in their quality. "In the past, the reputation of gluten-free foods was that they were bland, dry and 'crumbly' because part of gluten's function as a food ingredient is to hold things together," she said. "Food science has come a long way to present other grains that can bring gluten-free foods more richness, moisture and texture."

Grabbing crossover mainstream food consumers in search of healthier food options is another factor that has helped contribute to the market's growth, according to Fortitude's Mr. Spanzione. "Of the users of gluten-free products, about 70% suffer from food allergies or intolerances, while the remaining 30% are searching for alternatives to wheat, soy and gluten," he said. "Anecdotal evidence suggests that when people discard wheat and gluten from their diet they feel better immediately, reporting increased levels of alterness and the ability to sleep better. Too many people are overeating and being weighed down by gluten without even knowing it."

RELATED ARTICLE: This article in a nutshell:

* A food allergy primer

* Examining the overall market for food allergy and intolerance products

* Understanding celiac disease

* Taking a closer look at the gluten-free market boom

* FDA's new food labeling law

RELATED ARTICLE: How Food Allergies Affect Children

According to the Packaged Facts report, the biggest factor driving increased sales in the market for food allergy products is the rise in food allergies in children, among whom as many as 8% may have one or more food allergies. In many cases, responses to a child's allergies result not only in a change in diet for the affected individual, but also a shift in the entire family's diet. When this is taken into consideration, this means the number of people actually afflicted with food allergies is only a small percentage of the growing market for allergy foods, the report said.

Infant Formula Alternatives

Many times when a child is given an initial cow's milk formula, the child exhibits some kind of reaction, such as spitting up, according to Tom Ryan, vice president professional services, PBM Products, Gordonsville, VA. "That's not to say that all children who spit up are allergic to cow's milk because it is fairly common for infants to do this, but the best thing to do is get a healthcare professional to ascertain the situation," he said. "Breast-feeding is by far the best way to feed a child because it eliminates the problem of allergies altogether. However, there will always be a segment of the population that needs formula. Currently an estimated 25% of formula-fed infants in the U.S. use soy-based formulas either because of lactose intolerance or allergies."

PBM Products recently launched Bright Beginnings Soy Pediatric Drink, the first soy-based pediatric drink for children one to 10 years of age. The drink provides 100% of the RDAs for protein, vitamins and minerals. "The reason we came up with this product was because we felt there was a hole in the market," said Mr. Ryan. "After the age of one, when babies normally stop breast-feeding, there was no soy-based product for kids requiring a product of this nature. Without any alternatives to cow's milk formulas, kids were forced to take supplemental hypoallergenic formulas, such as Alimentum, which utilize predigested cow's milk proteins and are expensive."

Fighting Infant Allergies with Probiotics

As societies in the developed world become cleaner, the incidence of food allergies is increasing. This phenomenon is known as the "hygiene hypothesis." "The theory says that the cleaner we become, the more allergy issues we will face," said Rosemary Young, RN, MS, pediatric gastroenterology clinical nurse specialist, University of Nebraska, Omaha, NE. "Living in an increasingly anti-bacterial environment is messing up our immune systems in terms of what they've been used to. From an evolutionary standpoint we've gone from being born on farms to sterile hospitals. Children in underdeveloped parts of the world are faced with so many bacteria, viruses and parasites that the immune system is so active and allergies don't exist in large part. Furthermore, children who attend day care have less allergies because they're exposed to more bacteria in that environment."

Such theory has led to the practice of exposing babies to healthy probiotic bacteria in an effort to strengthen their immune systems to ward off food allergies. "Recent studies coming out of Europe have highlighted the potential probiotics might play in warding off cow's milk allergies in babies," said Ms. Young. "In the studies Lactobacillus GG (LGG) was given to babies who exhibited allergic reactions, which manifested themselves in the form of eczema on the skin. It is not known how a cow's milk allergy elicits an allergic reaction on the skin instead of in the gut, but there is no doubt that they are connected. Study results demonstrated that the probiotic LGG was almost as effective as giving the baby predigested formulas."

At the moment, Ms. Young said there is at least one, maybe two formulas on the market in Europe that contain probiotic bacteria. "The Europeans are way ahead of the U.S. in the probiotic arena," she said. "Because of regulations, companies in the U.S. are not allowed to include probiotics in infant formulas, however, many formula companies are working on approval." So far, she said there have been several panels conducted with FDA about the issue of putting probiotics in infant formula.--T.W.

RELATED ARTICLE: Did you know?

A recent survey of healthcare practitioners in the U.S. conducted by Enjoy Life Foods, Chicago, IL, revealed an increase in the number of patients affected by food allergies and intolerances. The participating healthcare practitioners included nutritionists, nurses and doctors representing 52,190 total patients. Of the healthcare practitioners surveyed:

* 67% said they had seen an increase in food allergies in their practice over the past three years. The most common food allergies reported, in order from most to least prevalent, were dairy, peanuts, wheat, fish/shellfish, soy, eggs, tree nuts and sesame seeds;

* An average of 24% of their patients have diagnosed food allergies;

* 79% reported an increase in food intolerances over the past three years. The most common food intolerances reported, in order from most to least prevalent, were dairy, wheat/gluten, casein, citrus, peanuts, soy, sugar, yeast and corn;

* 67% said they had seen an increase in celiac disease, an autoimmune disease triggered by a complete intolerance to gluten, in the past two years.

By Tim Wright

Associate Editor
COPYRIGHT 2005 Rodman Publications, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
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Title Annotation:Food Allergen Labeling and Consumer Protection Act
Author:Wright, Tim
Publication:Nutraceuticals World
Geographic Code:1USA
Date:Apr 1, 2005
Words:2492
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