Svetlana Sergejeva, MD, PhD

allergofood@ut.ee

Estonian Biotechnology Programme

Preamble

In accordance to the requirements set by the European parliament and the council in the regulation (EU) no 1169/2011 on the provision of food information to consumers, food producers are obligated to assess and appropriately notify consumers about 13 potential allergies or intolerances causing substances and products in their manufacture.

MANDATORY FOOD INFORMATION

List of mandatory particulars 1. In accordance with Articles 10 to 35 and subject to

the exceptions contained in this Chapter, indication of the following particulars shall be mandatory:

(1) the name of the food; (2) the list of ingredients; (3) any ingredient or processing aid listed in Annex II

or derived from a substance or product listed in Annex II causing allergies or intolerances used in the manufacture or preparation of a food and still present in the finished product, even if in an altered form; …..

(12)

European parliament and the council in the regulation (EU) no 1169/2011

Food allergy

• A true rise in prevalence over the past 10 to 20 years• The symptoms can range from mild to severe and, in rare

cases, can lead to anaphylaxis, a severe and potentially life-threatening allergic reaction

• Currently, the only treatment is the management of symptoms as they appear and avoidance of the causative food

• Most common food allergens are highly prevalent in the diet, patients and their families must remain constantly vigilant. This may occasionally lead to malnutrition that is of major importance in childhood and it changes quality of life in a profoundly negative way causing anxiety about severe reactions

• Food labelling regarding food allergens is essential to help allergic consumers manage their conditions

Problem in Estonia?

• The last data about childhood food allergy more than 10 years old.

• Published data on adults not available!

Atopic dermatitis

• In 93/94: at the age of 1 10.5%• In 93/94 at the age of 2 15%• In 93/94 at the age of 6-7 12%• In 93/94 at the age of 13-14 8%• In 96/97 at the age of 1 7%• In 96/97 at the age of 2 12%• In 96/97 at the age of 10-12 6% • In 01/02 at the age of 6-7 13.5%• In 01/02 at the age of 13-14 9.5%• Born 07/08 at the age of 1 30% (unpublished)

Sensibilisation in kids till 5 y.o

• Milk: – born 93/94 2%– born 97/98 7%

• Egg white: – born 93/94 5%– born 97/98 6.5%

Aim I

Determination of food allergy and sensitization causing food allergens in Estonian population

Allergofood

• Started on 20.05.13, evaluated 2 y.o kids• Atopic dermatitis 29.2%, up to 50% (currently

unconfirmed; in query on demand)• Urticaria 2%, up to 10.5 % (currently

unconfirmed; in query on demand)• Gastroenteritis 4%35%!• Asthma 6.25%, up to 18.75% (currently

unconfirmed; in query on demand)

Allergens

• Egg white 12.5%• Nuts 4%• Fish 2%

• Fruits and vegetables 16%

Adults 20-44 (2001, unpublished)

Self reported:• Milk 22.5%• Egg 7.5%• Hazelnut 1.5%

2013 Allergofood study: same people are evaluated by the specialist regarding food allergy

Gluten

• 1976-2010 156 people (up to 19 years old) has been diagnosed. Prior 1976 incidence rate 0.1/100 000 person-years, 2010 3.14/100 000 person-years

• Estimate (born 1940-2013) ~ 350 people

Aim II

Development of quantitative and qualitative allergen testing on protein and DNA level in food

Annex II: to be labeled

• Cereals (gluten)

• Crustaceans

• Molluscs

• Egg

• Fish

• Peanuts

• Soybeans

• Milk

• Nuts: Almonds, Hazelnuts, Walnuts, Cashews, pecan nuts, Brazil nuts, pistachio nuts, macadamia nuts

• Celery

• Mustard

• Sesame

• Lupin

European parliament and the council in the regulation (EU) no 1169/2011

Thresholds

• 0 -1.0 mg of protein 10% responders• For instance:

– Peanuts 0,78mg ~ 38ng DNA (1 peanut weights ~ 1g)

– Hazelnuts 0,43mg ~ 16ng DNA (1 hazelnut weights ~ 2g)

• Recent data indicate that more severe patients can react to traces of allergen!!!

Currently developed (not yet accredited)

• Cereals (gluten)

• Crustaceans

• Molluscs

• Egg

• Fish

• Peanuts

• Soy (DNA)

• Milk

• Nuts: Almonds, Hazelnuts, Walnuts, Cashews, Pecan nuts, Brazil nuts, Pistachio nuts (DNA), macadamia nuts

• Celery

• Mustard (DNA)

• Sesame (DNA)

• Lupin

ALERGOFOOD 01.11.2012-01.08.2013

Make your food safer!

Allergofood@ut.ee