F&Y2 Wave 5-6 NI: Chapter 5: Food allergies, intolerances and other hypersensitivities

Introduction

‘Food hypersensitivity’ is a term that refers to a bad or unpleasant physical reaction which occurs as a result of consuming a particular food. There are different types of food hypersensitivity including a food allergy, food intolerance and coeliac disease ^{(footnote 1)}.

A food allergy occurs when the immune system (the body’s defence) mistakes the proteins in food as a threat. Symptoms of a food allergy can vary from mild symptoms to very serious symptoms, and can include itching, hives, vomiting, swollen eyes and airways, or anaphylaxis which can be life threatening.

Food intolerance is difficulty in digesting specific foods which causes unpleasant reactions such as stomach pain, bloating, diarrhoea, skin rashes or itching. Food intolerance is not an immune condition and is not life threatening. 

Coeliac disease is an autoimmune condition caused by gluten, a protein found in wheat, barley and rye and products using these as ingredients. The immune system attacks the small intestine which damages the gut and reduces the ability to absorb nutrients. Symptoms of coeliac disease can include diarrhoea, abdominal pain and bloating.

The FSA is responsible for allergen labelling and providing guidance to people with food hypersensitivities. By law, food businesses in the UK must inform customers if they use any of the 14 most potent and prevalent allergens  in the food and drink they provide.

To help consumers make safe and informed choices, food businesses can voluntarily provide information about the unintentional presence of the 14 most potent and prevalent allergens, for example ‘may contain’ or ‘produced in a factory with’. This is called precautionary allergen labelling (PAL). PAL information can be provided verbally or in writing but should only be provided where there is an unavoidable risk of allergen cross-contamination that cannot be sufficiently controlled through risk management actions.

This chapter provides an overview of respondents’ understanding of food allergies and intolerances, the self-reported prevalence and diagnosis of food hypersensitivities, and experiences of eating out or ordering a takeaway among those with a hypersensitivity. 

Prevalence and diagnosis of food hypersensitivities 

One fifth (20%) of respondents reported that they suffer from a bad or unpleasant physical reaction after consuming certain foods or avoid certain foods because of the bad or unpleasant physical reaction they might cause ^{(footnote 2)}.

Figure 15. Prevalence of different types of food hypersensitivity.

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Hypersensitivity type	Percentage of respondents (%)
Coeliac disease	1
Food allergy	3
Food intolerance	10
No unpleasant reaction to food	80

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Source: Food and You 2: Wave 6

Most respondents (80%) reported that they did not have a food hypersensitivity. 10% of respondents reported that they had a food intolerance, 3% reported having a food allergy, and 1% reported having coeliac disease (Figure 15) ^{(footnote 3)}.

Diagnosis of food hypersensitivities

Respondents who reported having a bad or unpleasant reaction were asked how they had found out about their condition. Around 1 in 3 (29%) respondents who had a food hypersensitivity had been diagnosed by an NHS or private medical practitioner and 9% had been diagnosed by an alternative or complementary therapist but not by a NHS/private medical practitioner. However, 69% had not been formally diagnosed with a specific condition and 7% had used other methods ^{(footnote 4)}.

Eating out with a food hypersensitivity  

The FSA provides guidance for food businesses on providing allergen information. Food businesses in the retail and catering sector are required by law to provide allergen information and to follow labelling rules. The type of allergen information which must be provided depends on the type of food business. However, all food business operators must provide allergen information for prepacked and non-prepacked food and drink. Foods which are pre-packed or pre-packed for direct sale (PPDS) are required to have a label with a full ingredients list with allergenic ingredients emphasised ^{(footnote 5)}.

How often people checked allergen information in advance when eating somewhere new

Respondents who suffer from a bad or unpleasant physical reaction after consuming certain foods were asked how often, if at all, they checked in advance that information was available which would allow them to identify food that might cause them a bad or unpleasant reaction when they ate out or ordered a takeaway from somewhere new. 

One fifth (20%) of respondents always checked in advance that information was available which would allow them to identify food that might cause them a bad or unpleasant reaction, and 45% of respondents checked this information was available less often (i.e. most of the time or less often). However, 34% never checked in advance that information was available which would allow them to identify food that might cause them a bad or unpleasant reaction ^{(footnote 6)}.

Availability and confidence in allergen information when eating out or ordering takeaways 

Respondents who suffer from a bad or unpleasant physical reaction after consuming certain foods were asked how often information which allowed them to identify food that might cause them a bad or unpleasant reaction was readily available when eating out or buying food.

Around 1 in 10 (8%) respondents reported that this information was always readily available and 74% of respondents reported that this information was available less often (i.e. most of the time or less often). However, 12% of respondents reported that this information was never readily available when they ate out or bought food to take away ^{(footnote 7)}.

Respondents were asked how often they asked a member of staff for more information when it is not readily available. 17% of respondents reported that they always asked staff for more information, whilst 45% did this less often (i.e. most of the time or less often), and 29% never asked staff for more information ^{(footnote 8)}.

Respondents were asked how comfortable they felt asking a member of staff for more information about food that might cause them a bad or unpleasant physical reaction. Most respondents (62%) reported that they were comfortable (i.e. very comfortable or fairly comfortable) asking staff for more information, however 26% of respondents reported they were not comfortable doing this (i.e. not very comfortable or not at all comfortable) ^{(footnote 9)}.

Confidence in allergen labelling

Respondents who go food shopping and take into consideration a person who has a food allergy or intolerance were asked how confident they were that the information provided on food labelling allows them to identify foods that will cause a bad or unpleasant physical reaction. Overall, 92% of respondents stated that they were confident in the information provided on food labels ^{(footnote 10)}.

Respondents were asked how confident they were in identifying foods that will cause a bad or unpleasant physical reaction when buying foods which are sold loose, such as at a bakery or deli-counter. Respondents were more confident in identifying these foods at independent food shops (72%), in-store at a supermarket (69%), when buying food from a supermarket online (64%). However, respondents were less confident when buying food from food markets or stalls (52%) ^{(footnote 11)}.