Food allergies and intolerances

Food allergies and food intolerance's can be unpleasant, complicated and can cause death. However, food allergies and intolerance can be managed, to improve quality of life. Below is more information on managing food allergies and intolerance, especially when food shopping or eating out.

The majority of recalls in Australia are due to undeclared allergens in packaged foods. Visit the FSANZ recall page for up to date information.

SA Health is responsible for ensuring that packaged foods containing undeclared allergens are removed promptly from the marketplace in South Australia. Information of what to do if you think a packaged product has an undeclared allergen is provided below.

If you are a food business looking for allergen management information, see the allergen information for food businesses or visit theFSANZ Allergen Portal.

The difference between food allergy and intolerance:

Food allergy = Immune system reaction to a food

A food allergy causes the immune system to react to a particular food with immediate symptoms, such as itchiness, rash and swelling. Sometimes a reaction can be so severe that it can trigger a life-threatening reaction known as anaphylaxis.

Symptoms

• low blood pressure, dizziness, faintness or collapse
• swelling of the lips and throat, nausea and feeling bloated
• diarrhoea, and vomiting
• dry, itchy throat and tongue, coughing, wheezing and shortness of breath and a runny or blocked nose
• itchy skin or a rash, hives and sore, red and itchy eyes.

A severe food allergy can cause a life-threatening reaction called anaphylaxis. Anaphylaxis affects the whole body, often within minutes of eating the food. Symptoms such as rapid spreading of hives, swelling of the face, tongue and throat, difficulty breathing, wheezing, vomiting and loss of consciousness are common signs of an anaphylactic attack.

Immediate treatment with injected adrenaline can be lifesaving.

If you have been prescribed an adrenaline/epinephrine autoinjector (EpiPen®), keep it with you at all times.

Food intolerance = Inability to digest a food

Food intolerance doesn’t involve the immune system. Food intolerance is an adverse reaction to a particular food. The symptoms can be unpleasant and in some cases severe, but are generally not life-threatening.

Symptoms

• stomach and bowel upsets
• bloating
• headaches and migraines
• wheezing and a runny nose
• hives
• generally feeling under the weather.

Coeliac disease

Coeliac disease is a disorder of the small bowel caused by an immune reaction to dietary gluten (a protein found in wheat, barley and rye). It is not a food allergy but an auto-immune disease. In coeliac disease, the lining of the bowel is damaged by the white blood cells of the immune system and not by antibodies (as in food allergic reactions).

Symptoms

• nausea
• wind
• tiredness
• constipation
• reduced growth
• skin problems.

Packaged foods can make a gluten-free claim on its product label if it contains no detectable gluten. See Gluten-free claims in packaged foods for more details.

If you think you have a food allergy or intolerance, it’s important to get a proper diagnosis from a qualified medical practitioner.

In an emergency, follow the instructions on the ASCIA action plan for anaphylaxis (available on the Allergy & Anaphylaxis website) & seek immediate medical attention.

Food shopping

Packaged food - Label information to look for

If you have a food allergy or intolerance or shop for someone who does, it’s important to check the label on any pre-packed food you buy.

Check the ingredients every time you buy a product – The recipe might have changed since last purchase

The Food Standards Code requires that certain allergenic ingredients must be declared on the label – even when if they are a small part of another ingredient or processing aid:

• crustaceans
• eggs
• fish
• milk
• peanuts
• soybeans
• tree nuts
• sesame seeds
• cereals containing gluten, namely, wheat, rye, barley, oats and spelt and their hybridised strains
• lupin
• sulphite preservatives in concentrations of 10 mg/kg or more

These allergens are not always easy to find on labels. Other words may also refer to the allergen, eg.a milk product may be referred to as casein.

Allergy & Anaphylaxis Australia, in association with the NSW Food Authority and Food Standards Australia New Zealand (FSANZ), has produced allergen ingredient cards that list ingredients you should avoid if you are allergic to milk, peanuts, eggs, fish, tree nuts, sesame, soybean, crustacea or lupin.

To order your free copies of these cards call Allergy & Anaphylaxis Australia on 1300 728 000.

NOTE: Edible insects are an emerging food trend – The presence of chitin may have an effect on people who are sensitive to shellfish products. See Allergen Bureau's media release for more information.

Ingredients lists

There are 3 ways you might see allergens declared in ingredients lists:

1. In brackets — wheat flour, sugar, margarine (contains milk), salt, flavour (contains wheat starch)
2. In bold — wheat flour, sugar, margarine (contains milk), salt, flavour (contains wheat starch)
3. In a separate declaration — wheat flour, sugar, margarine (contains milk), salt, flavour (contains wheat starch). Contains wheat and milk

Always check the ingredients list carefully. All ingredients must be listed on the labels of pre-packaged foods.

'May contain' warnings

Some food labels may also have a warning to show the food product may contain foods people are commonly allergic to, eg.‘may contain traces of nuts’ or ‘may contain seeds’. This means that even if nuts or seeds aren’t deliberately included as ingredients in the food, the manufacturer cannot be sure the food doesn’t accidentally contain small amounts of the allergen.

If you are allergic to any of the foods mentioned in ‘May contain’ warnings, you should avoid these food products.

Tip: You can call food manufacturers and ask about ingredients or manufacturing processes if unsure about a product.

What you should do if you think a food has been incorrectly labelled

If you think a food has been incorrectly labelled, or an allergen has not been properly declared on packaged food, email us on Healthfood@sa.gov.au

Please provide the following information:

• a description of the problem (allergic reaction or noting that an undeclared allergen is visible in the product)
• product name, size and, the date on the package (use by, best before etc)
• name and full street address of the business on the label
• where and when you purchased the product
• photos of the product and packaging
• your details and best way to contact you
• keep any leftover food, packaging and receipts.

SA Health has powers under the Food Act and the Food Standards Code to investigate labelling complaints and take action against food businesses breaking the law.

Foods not pre-packed or not labelled

Consumers are legally entitled to ask for information about the allergen content of foods for sale that are not pre-packed or labelled.

If you have a severe food allergy, you should always disclose your allergy clearly, ask about ingredients and never make presumptions about food content. You should always have your emergency medication with you.

Foods that aren’t pre-packed or labelled include those sold from:

• bakeries
• butchers
• deli counters
• salad bars
• foods weighed and sold loose eg bulk bins.

It’s possible that this type of food could contain small amounts of allergens in the ingredients. The allergen may have also been introduced to these products due to contact with another food, knife or spoon, or from being wrapped in a bag that has touched another food containing an allergen.

Unlabelled food also includes meals served in:

• restaurants
• takeaways
• other eating out venues.

Allergies and eating out

Eating a meal from a restaurant, café or takeaway can be a stressful experience if you have a food allergy or intolerance. When food is prepared by someone else you can’t be absolutely sure that it won’t contain allergens. There are however some guidelines to make eating out safer and more simple.

If you are a food business looking for allergen management information, SA Health has provided allergen information for food businesses, or visit the FSANZ Allergen Portal

Tell the restaurant

• When you book a table, tell the person taking the booking about your food allergy or intolerance and ask them to check with the chef that they can provide you with a meal that doesn’t contain the food you are allergic to.
• On arrival, make sure the waiter knows about your food allergy.

Ask about the dishes

• Read the menu carefully to see if there is any mention of the food you are allergic to in the name or description of the dish
• Always ask the waiter – food allergens are not always stated on menus
• Give staff your order and ask them to check with the chef that the dish does not contain the food you need to avoid. Speak to the chef personally if you can
• If the staff can’t answer your questions or don’t seem certain, it’s better to order something else or eat elsewhere.

Ask about cross contamination

• Ask staff if your food will be prepared with equipment and utensils that are separate to those used for foods containing the allergen, to avoid cross contamination
• Don’t assume because you ate a dish safely in one restaurant that it will be made the same way the next time or in a different restaurant.

Avoid self-service areas

• If you have a severe allergy, it’s best to avoid eating food from a self-service area or buffet. It’s easy for small amounts of allergenic ingredients to get into food accidentally, (eg people might use the same spoons for different dishes) so even if it looks safe, you can’t be sure.

Take your Epipen®

If you have been prescribed an adrenaline/epinephrine autoinjector (EpiPen®) and you don’t have it with you, DO NOT EAT! Studies have shown prompt administration of your adrenaline autoinjector is first line first aid treatment for anaphylaxis.

More tips for eating out with food allergies can be found on the Allergy & Anaphylaxis Australia website.

Acknowledgments to NSWFA and Anaphylaxis Australia for the information provided on this page.

If you disclosed your allergy, but were served a meal that caused a reaction

Email Healthfood@sa.gov.au or contact the local council where there business is situated.