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Criteria to determine food allergen priority.

The emergent health issue of food allergens presents an important challenge to the food industry. More than 170 foods have been reported in the scientific literature as causing allergic reactions. Clearly, it would be impossible to deal with the presence of trace amounts of all these in the context of food labeling. If the decision to classify major allergens is based solely on the knowledge and experience of allergists and food scientists in the field, without scientifically defined criteria, it is likely to lead to a proliferation of lists. Such practices may lead to an unnecessary elimination of foods containing important nutrients. This paper defines food allergy, food intolerance, and food anaphylaxis and identifies criteria for classifying food allergens associated with frequent allergic reactions. A practical list of food allergens that may result in potentially life-threatening allergic reactions is provided. A mechanism-based (i.e., immunoglobulin E mediated), acute life-threatening anaphylaxis that is standardized and measurable and reflects the severity of health risk is proposed as the principal inclusion criterion for food allergen labeling. Where available, prevalence in the population and threshold levels of allergens should be used as an additional guide to identify possible future labeling needs.

Allergens↗

Nutritional claims for functional foods and supplements.

Food labels are an important educational tool to assist consumers in making healthy food choices. In addition to mandatory nutritional labeling information, manufacturers have a variety of options on the food/supplement packages to communicate the nutrition/health benefits of their products. This paper describes the different types of claims that can be made for foods and supplements.

Dietary Supplements↗

Intrinsic labelling of different foods with stable isotope of zinc (67Zn) for use in bioavailability studies.

Intrinsically-labelled foods are required to validate extrinsic-labelling techniques used to study the bioavailability of trace elements. Wheat (Triticum aestivum), peas (Pisum sativum), goat's milk, human milk, eggs and chicken meat were selected for intrinsic-labelling studies with 67Zn. Peas were grown hydroponically in enriched nutrient solution and wheat was grown in sand and watered with enriched nutrient solution. Some of the wheat plants were also given stem injections of 67Zn solution. Eggs and chicken meat were prepared by administering 67Zn intravenously to chickens, and human milk was collected after an oral dose of 67Zn in a cola drink. All the foods investigated were sufficiently enriched with 67Zn for Zn absorption studies except wheat prepared by the sand and water-culture method.

Animals↗

[The national survey of immediate type of food allergy].

BACKGROUND: The actual conditions regarding immediate type food allergy have not been fully understood. Appropriate countermeasures have not been taken so far. The objective of our research is to identify the actual conditions of immediate type food allergy in Japan for the purpose of contributing to future practices. SUBJECT: We conducted a survey on the patients in collaboration with 2689 domestic hospitals which have pediatrics and more than 100 beds. We focused on these cases who presented with symptoms of allergy within 60 minutes of the intake of any offending food. RESULT: 60.4% of collaborators returned the questionnaire. We investigated 1420 cases in 498 hospitals. Average age of cases was 6.7+/-13.1 (Mean+/-SD). Ages not more than 8 years-old comprised 80.1% of the whole population. The most common offending foods were eggs, milk products, wheat, buckwheat, fish and fruits. In addition, offending foods varied depending on age. The clinical symptoms appeared at 24.2 minutes+/-19.4 minutes (Mean+/-SD) after the intake of offending foods. The most common clinical symptom was observed on the skin and respiratory organs. CONCLUSION: Based on the results of this study, the Ministry of Health, Labor and Welfare amended the ministerial ordinance concerning the allergy food labeling system. Five major offending foods (eggs, milk, wheat, buckwheat, and peanuts) were designated as ingredients to be specified on the label.

Adolescent↗

[The importance of dietary sodium: the time has come for a public health intervention].

In recent years, many studies have been published regarding the link between sodium intake and high blood pressure. Canadian, American and WHO Guidelines on the treatment of hypertension all indicate salt reduction as an efficient non-pharmacologic recommendation. However, due to the lack of clear and specific Canadian legislation on food labelling, consumers are not able to make informed choices of food products on the basis of salt content. The time has come for public health experts to join this debate.

Canada↗

The new nutrition facts label in the print media: a content analysis.

A content analysis was conducted to evaluate the coverage of the new food labels in the print media from December 1, 1992, to August 30, 1993. We used newspaper, magazine, and health newsletter indexes to identify 59 newspaper articles, 16 magazine articles, and 7 health newsletter articles for examination. Articles were evaluated by four trained coders using a pretested coding form addressing 35 aspects of the nutrition label coverage. Twenty percent of articles were double-coded with at least 80% coder reliability. Analysis of the data indicated that health newsletters covered the topic in the most detail, followed by magazines and then newspapers. Ten of 59 (17%) newspaper articles named and defined the term percent daily value, whereas 6 of 7 (86%) health newsletter articles and 9 of 16 (56%) magazine articles provided this information. Analysis of quotes in the articles indicated that more than half of the quotes were from government and industry officials. In contrast, quotes from college and university faculty represented only 5% of total quotes and quotes from dietitians represented less than 8% of total quotes. Coders identified several errors resulting from oversimplification of complex concepts. These findings suggest that dietitians need to increase their exposure with the media and help the media translate complex nutrition labeling information to the public.

Food Labeling↗

Health and safety issues pertaining to genetically modified foods.

Genetic modification involves the insertion of genes from other organisms (within or between species) into host cells to select for desirable qualities. Potential benefits of GM foods include increased nutritional value; reduced allergenicity; pest and disease-resistance; and enhanced processing value. Possible detrimental outcomes include producing foods with novel toxins, allergens or reduced nutritional value, and development of antibiotic resistance or herbicide-resistant weeds. Benefits to individuals or populations need to be weighed against adverse health and environmental risks, and may differ between developing and Westernised countries. Whether testing and monitoring should exceed requirements for conventional foods is under debate. While not necessarily scientifically justifiable, consumer concerns have resulted in Australian and New Zealand requirements to label foods containing GM-produced proteins. Dissatisfied consumer advocacy groups are calling for all foods involving GM technology to be labelled, irrelevant of whether the final product contains novel protein. Goals to improve the quantity, quality and safety of foods are laudable; however, the primary aim of the bio-food industry is financial gain. GM foods may be as safe as conventional foods but public distrust runs high. It is important that discussion is informed by science and that claims of both benefits and risks are evidence-based, to ensure that the process is driven neither by the vested interest of the bio-technical multinational companies on the one hand, nor ill-informed public fears on the other.

Attitude to Health↗

Nutrition function, health and related claims on packaged Australian food products--prevalence and compliance with regulations.

Australia and New Zealand are currently reviewing the regulations governing nutrition function, health and related claims on foods. Health claims currently are not permitted on food labels, with one exception. The aim of this study was to describe the use of such claims on packaged food for sale in Australia (excluding nutrient content claims) prior to any changes to the regulations, and measure compliance with existing regulations. A survey was conducted of the labelling of 7850 products (including multiple pack sizes of individual foods) in 47 different food categories on sale in New South Wales in 2003. A total of 2098 nutrition function, health or related claims and 12 therapeutic claims were recorded. Fourteen percent of products carried some sort of claim. If nutrient function and general health maintenance claims are excluded, 8.1% of products carried a health or related claim. Using the claims categorisation proposed by Food Standards Australia New Zealand for a new standard on claims, general-level claims were found on 9.8% of products and high-level and therapeutic claims (illegal at the time) on 1.2%. The food categories with the highest proportion of products carrying claims were sports drinks (92%), energy drinks (84%), sports bars (57%) and breakfast cereals (54%). 118 high-level and therapeutic claims did not conform to current food standards and there were many general-level claims for ingredient benefits that were unlikely to be able to be scientifically substantiated. The results of this survey suggest that more than 5% of claims were not complying with the current regulations and that the standards were not being fully enforced. To be effective, the new standard will need to be accompanied by clear guidelines for manufacturers on requirements for substantiating claims. Comprehensive education and enforcement frameworks also will be needed, to reduce the number of illegal or apparently unsubstantiated claims.

Australia↗

Sulfites--a food and drug administration review of recalls and reported adverse events.

Sulfite-sensitive individuals can experience adverse reactions after consuming foods containing sulfiting agents (sulfites), and some of these reactions may be severe. In the 1980s and 1990s, the U.S. Food and Drug Administration (FDA) acted to reduce the likelihood that sulfite-sensitive individuals would unknowingly consume foods containing sulfites. The FDA prohibited the use of sulfites on fruits and vegetables (except potatoes) to be served or presented fresh to the public and required that the presence of detectable levels of sulfites be declared on food labels, even when these sulfites are used as a processing aid or are a component of another ingredient in the food. In the present study, data from FDA recall records and adverse event reports were used to examine the current status of problems of sensitivity to sulfites in foods. From 1996 through 1999, the FDA processed a total of 59 recalls of foods containing undeclared sulfites; these 59 recalls involved 93 different food products. Fifty (55%) of the recalled products were classified as class I, a designation indicating that a consumer reasonably could have ingested > or = 10 mg of undeclared sulfites on a single occasion, a level that could potentially cause a serious adverse reaction in a susceptible person. From 1996 through mid-1999, the FDA received a total of 34 reports of adverse reactions allegedly due to eating foods containing undeclared sulfites. The average of 10 reports per year, although derived from a passive surveillance system, was lower than the average of 111 reports per year that the FDA received from 1980 to 1987, a decrease that may have resulted in part from FDA regulatory action.

Allergens↗

Configural displays can improve nutrition-related. decisions: an application of the proximity compatibility principle.

The nutrition label format currently used by consumers to make dietary-related decisions presents significant information-processing demands for integration-based decisions; however, those demands were not considered as primary factors when the format was adopted. Labels designed in accordance with known principles of cognitive psychology might enhance the kind of decision making that food labeling was intended to facilitate. Three experiments were designed on the basis of the proximity compatibility principle (PCP) to investigate the relationship between nutrition label format and decision making; the experiments involved two types of integration decisions and one type of filtering decision. Based on the PCP, decision performance was measured to test the overall hypothesis that matched task-display tandems would result in better decision performance than would mismatched tandems. In each experiment, a statistically significant increase in mean decision performance was found when the display design was cognitively matched to the demands of the task. Combined, the results from all three experiments support the general hypothesis that task-display matching is a design principle that may enhance the utility of nutrition labeling in nutrition-related decision making. Actual or potential applications of this research include developing robust display solutions that aid in less effortful assimilation of nutrition-related information for consumers.

Adult↗

Patients' understanding and use of snack food package nutrition labels.

PURPOSE: Little information exists on how patients in medical practice use food package nutrition labels. We theorized that patients in a general medical practice might not make the distinction between serving size and total package nutrition information, and this might lead to obesity. METHODS: Ninety patients between ages of 18 and 65 attending the St. Francis/University of Tennessee Family Practice Center were interviewed to determine whether they could calculate the total calories in sample snack food packages that contained more than one serving. RESULTS: Ninety percent of our patient sample correctly identified the number of calories per individual serving, but only 37% were able to recognize that the sample packages contained multiple servings. Confusion between calories per serving size and total calories per package was correlated with lower educational levels (P =.011) and with the presence of cardiovascular heart disease in our patient sample. CONCLUSIONS: Our patients tended to think of a multiple serving package as one serving. They underestimated and under-reported caloric intake from snack food sources. We conclude that snack food labels as actually used by patients do not lead to informed dietary choices. These findings could impact our understanding and management of the obesity epidemic in the United States.

Adolescent↗

[Development and application for approval of "Foods for Specified Health Use"].

As a result of the aging population in Japan, physiologically functional foods, which were first introduced by the project supported by the Ministry of Education of Japan, are expected to play an important role in body defence, prevention and recovery of life-style related diseases. The scientific studies concerning the relationship between food components and health promoted the Ministry of Health and Welfare to establish the system for the food labelling which was used for a "Foods for Specified Health Use" (FOSHU) in 1991. Concerning FOSHU, the terminology, the regulatory provisions, the required criteria for application, the system of approval and the labelling of approval products are summerized in this article. The procedure from application to approval is examplified by Heme-iron beverage for iron deficiency anemia. This product contains heme-iron-enriched amino acid chains which maintain the good absorption of heme-iron from hemoglobin. The health claim approved for this product is "suitable for those who suffer from a mildly anemic condition which may require an iron supplement".

Anemia↗

Dietary fiber: the influence of definition on analysis and regulation.

Since 1953 when the term "dietary fiber" was coined, there has been concern about accurately defining this macronutrient component of the human diet. Proper and adequate analytical methodology and food labeling regulations are dependent upon an accurate definition. Health impact studies also depend upon an accurate and meaningful definition along with relevant methodology to provide data of adequate quality for epidemiological and clinical studies. The scientific communities associated with dietary fiber within AOAC INTERNATIONAL have been the leaders in bringing consensus to the dietary fiber definition and method validation for over a quarter of a century. The consensus definition and subsequent methodology have served as the base for regulations worldwide with regard to dietary fiber labeling and health claims. Recently, there has been renewed interest in reviewing the dietary fiber definition and updating it if the review indicates such a need. The American Association of Cereal Chemists completed an effort that provides a continuum for the historical scientific and regulatory efforts while allowing for inclusion of future discoveries into a framework based upon the knowledge gained in the past. Such a definition will provide for transparent and workable regulations with regard to dietary fiber, and will allow the dietary fiber scientific community of AOAC to validate relevant methods. The Food Nutrition Board of the Institute of Medicine of the National Academies has published a set of definitions disconnected from the historical scientific base that do not provide a relevant basis for either adequate methodology, health studies or workable regulations.

Animals↗

Dietary fiber decreases the metabolizable energy content and nutrient digestibility of mixed diets fed to humans.

Food labeling regulations implemented by the U.S. Food and Drug Administration emphasize nutrient composition and energy content of foods. Dietary energy and digestibility of complex foods can be affected by the content and type of dietary fiber. The metabolizable energy (ME) content and apparent digestibility of dietary fiber in human diets are difficult to assess. Fiber can affect the digestibility of fat and protein and, subsequently, the ME content of the diet. This study was conducted to measure the ME content of nine diets with different fat and fiber concentrations. Diets varied in level of fat (18, 34 or 47% of energy) and level of total dietary fiber (3, 4 or 7% of diet dry matter) and were consumed for 2 wk. Subjects (n = 17) consumed three diets (14 d for each diet) containing different levels of fiber and one level of fat. Food consumption was measured and all urine and feces were collected during a 5-d period. Combustible energy, protein, fat, total dietary fiber (TDF) and neutral detergent fiber (NDF) were measured in composite samples of food and feces, and urine was analyzed for combustible energy and nitrogen. Metabolizable energy and apparent digestibility coefficients were calculated. Overall, increasing fiber intake decreased fat and protein digestibility. As a consequence of these interactions, the ME content of the diets decreased as fiber intake increased, and TDF and NDF had similar effects on the ME value. A published empirical formula accurately predicted the ME content of diets using either TDF or NDF.

Adult↗

British Diabetic Association's discussion paper on the role of 'diabetic' foods. Nutrition Subcommittee of the British Diabetic Association's Professional Advisory Committee.

1. Most diabetic foods provide slightly, but not substantially, less energy than comparable non-diabetic products. 2. Many diabetic foods have a higher fat content than their non-diabetic equivalents. This is contrary to the requirements of the 1984 Food Labelling Regulations. 3. Many diabetic products have a relatively high content of protein. 4. In percentage terms, the greatest difference between diabetic and non-diabetic foods remains that of carbohydrate content, particularly carbohydrate other than fructose or sorbitol. On a per portion basis (for instance, per teaspoon of jam) the difference is relatively small and likely to be of minimal practical significance. 5. Diabetic foods cost between 1.5 and 4 times as much as their non-diabetic equivalents. 6. Some ordinary reduced-sugar/low calorie products are preferable to diabetic products in terms of fat and energy content and cost. 7. The promotion and widespread availability of diabetic foods tend to delude patients into believing that these products are advantageous, or even necessary. Their existence also undermines current dietary teaching by implying that people with diabetes cannot eat normal foods. 8. Diabetic foods offer no significant physiological or psychological benefits to diabetic patients and can even be counterproductive to good diabetic control. There is no longer a need for special diabetic foods in the modern dietary management of diabetes.

Diet, Diabetic↗