South Florida Sun-Sentinel

Nicolas’ mom tucked a marshmallow into his lunch bag as a treat. But it made him so ill, he struggled to breathe.

The guilty ingredient: casein, which comes from milk. Nicolas is allergic to milk.

“I read the label,” says his mom, Terri Cloutier of Wellington. “Who’d think that was milk?”

Label reading just got easier for Cloutier and others dealing with food allergies.

More important, it got safer.

A new federal law that goes into effect Jan. 1 requires manufacturers to label eight allergy-triggering substances in common language.

The “Big 8,” which account for 90 percent of food allergies in the United States, include milk, egg, wheat, soy, peanuts, tree nuts, fish and shellfish.

For Cloutier, whose son is also allergic to soy, eggs and peanuts, this is a breakthrough.

In the future, she won’t just see “artificial flavorings” on a label. The label must identify in everyday words what’s in the flavoring. Eggs for albumin; milk for lactoferrin; soy for edamame and wheat for seitan.

“Now it’s like walking into a foreign country trying to feed your children,” she says. “You just need to see words everyone understands: milk, soy. It’s easy. Just put E-G-G … egg.”

These new labels will help more than parents. Relatives, teachers, babysitters, day-care workers, friends – anyone dealing with kids with food allergies – need to know what they’re feeding these children.

“To anyone caring for your kids, this is helpful,” says Andrea Siemer of Miramar, Fla., whose son Nathan, 5, has a peanut allergy. Just as important, as Nathan grows older he can understand food labels and select his own food without needing a degree in food science.

But the new law can mean costly and complex changes for food manufacturers, which frequently reformulate products.

Ultimately, it could mean fewer choices and more confusion for consumers already eating food with tiny amounts of allergens, says Campbell’s spokesman John Faulkner.

“It can signal potential allergens that won’t impact someone who’s allergic,” he says.

The law – the Food Allergen Labeling and Consumer Protection Act – does allow for exemptions. Companies are expected to take this route so trace amounts of an allergen needn’t be labeled.

In the meantime, consumers might see any number of allergens on ingredient lists that weren’t named before. For instance, allergens used in spices, flavorings, additives and colorings – exempt from previous label laws – now must be disclosed.

Take fish gelatin, for example, used to help color some soup. In the past, it wasn’t identified. Now it must be.

But in other situations, the law isn’t as clear. For instance, potential allergens are used in food production – soy lecithin, for example, is commonly used in baking to keep food from sticking.

“It’s on the equipment, but it may or may not contact the food directly,” says Regina Hildwine of the Food Products Association, an industry group.

In addition, only some grades of soy lecithin include tiny amounts of soy protein, which can trigger a reaction, she says. So the question is, does the particular grade of soy lecithin used contain protein and does the protein move into the food? And if it moves into the food, is there enough to cause a reaction?

“They’re all valid questions,” Hildwine says. “There are few, if any, answers.”

In addition, allergens also can creep into products during “cross contact.” That happens when food with no known allergens picks up an allergen from another product made in the plant, perhaps on the same production line.

For instance, consider a candy company that makes chocolate bars, some with peanuts, some without.

Today, some food producers already advise consumers that cross contact is a possibility. Though the new law doesn’t address the use of such advisory labeling, it does require the Food and Drug Administration to study the issue.

At the heart of it all is this: How much of an allergen in a product is too much?

Because reactions to allergens are so individual and scientific studies so scant, there’s no answer. Until science fills in the blanks, expect the battles to rage with food companies pushing for allowable thresholds and allergy-affected consumers pushing for full disclosure.

“Absolute zero is only achievable in mathematics,” says Hildwine. “Not in the real world.”

But Rose Boccio, a Chicago-area writer for foodallergyinfo.com argues for full disclosure.

“If something has milk in it, list it,” says Boccio, whose son, Corey, 13, nearly died from a tot-sized gulp of milk when he was 2.

In reality, both sides may have to give a little.

“The law puts an allergic person in a Catch 22,” says Nancy Anne Munoz-Furlong, founder of the non-profit Food Allergy and Anaphylaxis Network. “Doctors say avoid any amount. The food industry says, “if we put everything on the label, you’ll have nothing to eat.””

For the roughly 4 percent of Americans grappling with food allergies, knowing what’s in their food is serious business. Allergic reactions can range from mild, such as a runny nose or an itchy throat, to life threatening.

Reactions kill an average of 150 people annually and result in 30,000 visits to the emergency room.

In severe cases, exposure can cause anaphylactic shock, which sends blood pressure tumbling. Then the heart races to keep up, but if it can’t, the brain doesn’t get enough oxygen.

“Many times that whole process happens within 10 minutes,” says Kathryn Eisermann-Rogers, a pediatric allergist at Memorial Hospital West in Pembroke Pines, Fla.

Timely treatment, typically epinephrine, is critical. In extreme cases, the person can die.

Some people are so sensitive, just being around the food triggers a reaction.

Kimberly LeMaster of Miami home schools her children, Will, 6, and Rachel, 5, because their allergies are so severe. Neither can tolerate peanuts and tree nuts. Will is also allergic to egg whites.

Will swells like a balloon when exposed to peanuts, his eyes sealing shut, his throat constricting. Contact with another child’s saliva once caused his face to swell. Turns out the child had recently eaten peanut butter crackers.

“It’s that sensitive,” LeMaster says.

In November, a 15-year-old Canadian girl with a peanut allergy died after kissing her boyfriend, who’d eaten peanut butter hours earlier.

“I cringe when I hear someone say a little won’t hurt,” says Eisermann-Rogers, the physician. “You don’t know which person is going to react with a runny nose and which person is going to go into anaphylactic shock. Strict avoidance is extremely important.”

In responding to the new law, some food companies, such as Campbell’s, are reformulating some products to remove allergens altogether. Others, including Kellogg, will add a “contains” statement – listing allergens in plain English – following the ingredient list. That way a consumer can quickly tell if the product has soy, nuts, etc.

To help avoid cross contact, Kellogg already has improved its equipment and cleaning procedures, according to Jill Saletta, a company spokeswoman.

Even with the new law in place, those affected by food allergies can’t lower their guard. The law addresses the Big 8, but more than 160 foods – everything from corn to tomatoes – can trigger a reaction.

In addition, the law only applies to products labeled on or after Jan. 1. Products made before then can still be shipped and remain on store shelves until their expiration date, possibly a year or more.

The law also doesn’t cover meat, poultry and egg products or fruits and vegetables in their natural state. So careful label reading is still a must.

“You find milk in places you’d never imagine,” Boccio says. “Bologna has milk. Sometimes salami. Sometimes turkey. They’re injected with a broth that has milk in it.”

But for all its limitations, the law will make shopping easier.

Cloutier, whose son has multiple allergies, recalls her husband’s first foray into the grocery store. He spent about 90 minutes in the cookie and cracker aisle reading ingredients with names he didn’t understand.

“All this time, we’re poring through labels because we have to,” she says. “For these kids, it’s a life-or-death situation.”

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WHAT’S IN A NAME?

Before the new law, food labels could read like a chemistry book. Check out a few names that indicate the presence of milk, eggs, soy, wheat or peanuts in a product.

Milk

Lactoferrin; Lactalbumin; Lactalbumin phosphate; Nisin; Rennet casein; Whey; Ghee

May indicate the presence of milk protein

Luncheon meat, hot dogs, sausages; Non-dairy products; Caramel candies; High protein flour; Lactose; Flavorings (including natural and artificial)

Eggs

Albumin (also spelled albumen); Lysozyme; Meringue

May indicate the presence of egg protein

Lecithin; Marzipan; Marshmallows; Nougat; Surimi; Flavorings (including natural and artificial)

Wheat

Kamut (relative of wheat); Durum; Farina; Spelt; Vital gluten; Seitan; Bulgur; Semolina

May indicate the presence of wheat protein

Hydrolyzed protein; Starch (gelatinized starch, vegetable starch, modified starch); Surimi; Soy sauce; Flavorings (including natural and artificial)

Soy

Edamame; Miso; Natto; Shoyu sauce; Tamari; Tempeh

May indicate the presence of soy protein

Vegetable broth; Vegetable starch; Vegetable gum; Flavorings (including natural and artificial)

Peanuts

May indicate the presence of peanut protein

Chili; Egg rolls; Enchilada sauce; Marzipan; Nougat; Flavorings (including natural and artificial)

SOURCE: The Food Allergy & Anaphylaxis Network

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Q & AQ & A

A new federal food-labeling law that will affect people with allergies goes into effect Jan. 1. Here are answers to often-asked questions.

Q. Simply speaking, what does the law say?

A. The eight major foods or food groups that cause most allergic reactions must be labeled in plain language.

Q. What are the eight?

A. Milk, egg, fish, shellfish, tree nuts, wheat, peanuts and soy.

Q. What does “plain language” mean?

A. If a product contains a derivative of a food, the food’s common name must be used. If albumin is an ingredient, the label must also say egg.

Q. Is it specific enough to label something fish, shellfish or tree nuts?

A. No. The type of nut must be identified, such as almonds, pecans, walnuts.

The species must be declared for fish, such as bass, flounder, cod. For shellfish: crab, lobster or shrimp.

Q. What if just a little bit of the allergen is in the food?

A. The Food and Drug Administration is expected to consider threshold levels for allergens as companies request certain ingredients be exempt from labeling requirements.

Source: U.S. Food and Drug Administration

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WEB SITES

To learn more:

foodallergy.org – Food Allergy and Anaplylaxis Network offers advocacy, research, recalls and recipes

kidswithfoodallergies.org – A support community that offers news, tips, resources and recipes

www.fda.gov – Food and Drug Administration offers nformation on the new law and food allergens

foodallergyinfo.com – Web log offers a compilation of news items, resources, personal columns

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(c) 2005 South Florida Sun-Sentinel.

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AP-NY-12-30-05 0616EST

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