Food allergy and food intolerance

Food allergy

Some people are allergic to the protein in common foods. Contact with the food can be life threatening and induce what is called an anaphylactic reaction, usually within minutes of exposure. The most common triggers of anaphylaxis are:

• peanuts
• tree nuts (cashews, walnuts etc.)
• cow’s milk
• egg
• wheat
• soy, and
• fish and shellfish.

Food allergy should be diagnosed by a specialist. Strict avoidance of the food is extremely important. Some schools may have a ‘nut policy’ in place. Canteen staff need to be aware of the school’s policy regarding nuts and, if necessary, remove products containing nuts from the menu.

Food intolerance

Some people are intolerant to some of the chemicals found in foods (for example: salicylate, amines, glutamate, preservatives and artificial colours). These chemicals can be Naturally present or Added by food manufacturers (glutamates, for example). The one you might be most familiar with is MSG (monosodium glutamate, also represented by the number 621 on food packaging labels). This chemical occurs Naturally in certain foods such as aged cheese, tomato sauce and mushrooms, or it can be Added during processing to enhance flavour in savoury snack foods such as flavoured crisps and two-minute noodles.

Unlike food allergy, food intolerance is difficult to diagnose. Not all chemicals will be a problem for people who are sensitive and even if an intolerance is diagnosed, the individual may be able to tolerate small amounts with no symptoms. Symptoms will vary for each individual and may take several days to appear. The most common symptoms being hives, swellings, headaches and behavioural changes (for example: irritability and hyperactivity). (See table 4 on page 43 for a list of the additives most likely to cause problems.)

More information

Food Authority NSW
Food Standards Australia New Zealand
Royal Prince Alfred Hospital Allergy Unit
The Australian Society of Clinical Immunology and Allergy

Table 4: Additives most likely to be a problem

Note: not all additives are a problem for sensitive individuals

Artificial colours	Where these colours are Added
Yellows 102, 107, 110	Added to colour foods, drinks and medicines although various colours are banned in some countries particularly in Europe. Found in a wide variety of foods, including lollies and sweets, cakes and cake icing,buns and biscuits, custard mixes, sauces, commercial mint jelly, jellies, savoury snacks, cordials and ice cream, to enhance the colour to make pale products look richer and creamier.
Reds 122–129	Added to colour foods, drinks and medicines although various colours are banned in some countries particularly in Europe. Found in a wide variety of foods, including lollies and sweets, cakes and cake icing,buns and biscuits, custard mixes, sauces, commercial mint jelly, jellies, savoury snacks, cordials and ice cream, to enhance the colour to make pale products look richer and creamier.
Blues 131, 132	Added to colour foods, drinks and medicines although various colours are banned in some countries particularly in Europe. Found in a wide variety of foods, including lollies and sweets, cakes and cake icing,buns and biscuits, custard mixes, sauces, commercial mint jelly, jellies, savoury snacks, cordials and ice cream, to enhance the colour to make pale products look richer and creamier.
Greens 142	Added to colour foods, drinks and medicines although various colours are banned in some countries particularly in Europe. Found in a wide variety of foods, including lollies and sweets, cakes and cake icing,buns and biscuits, custard mixes, sauces, commercial mint jelly, jellies, savoury snacks, cordials and ice cream, to enhance the colour to make pale products look richer and creamier.
Blacks 151	Added to colour foods, drinks and medicines although various colours are banned in some countries particularly in Europe. Found in a wide variety of foods, including lollies and sweets, cakes and cake icing,buns and biscuits, custard mixes, sauces, commercial mint jelly, jellies, savoury snacks, cordials and ice cream, to enhance the colour to make pale products look richer and creamier.
Browns 154, 155	Added to colour foods, drinks and medicines although various colours are banned in some countries particularly in Europe. Found in a wide variety of foods, including lollies and sweets, cakes and cake icing,buns and biscuits, custard mixes, sauces, commercial mint jelly, jellies, savoury snacks, cordials and ice cream, to enhance the colour to make pale products look richer and creamier.
Natural colours
Cochineal 120	Natural red dye from a female Mexican scale insect that lives on a cactus plant – true allergy reactions (even anaphylaxis) can occur.
Annatto – Natural 160b	Natural reddish yellow dye from seeds of a Central American native plant.
Annatto – Added	Added to cereals, snack foods, dairy foods (including yoghurt), ice cream and cheeses.
Preservatives are a varied group of compounds
Sorbates 200–203	Added to cheese spreads, cottage cheese, sliced cheese, dried fruit, fruit drinks, fruit juices, yoghurts with fruit or nuts, licorice, low-sugar jams, soft drinks and some juices.
Benzoates – Natural	Naturally present in berries and other fruits but low compared to Added amounts.
Benzoates – Added 210–218	Added to cordials, fruit flavoured drinks and juices, soft drinks and marinades.
PABA	Added to cosmetics, skin creams and sunscreens.
Sulphites (labelling mandatory) 220–228	Produced Naturally in fermented grape products (wine and vinegar) and found in all foods containing wine, wine products and vinegar. May be Added to wines, particularly cask wine, to ensure appropriate fermentation. Added to dried fruits that brown during processing (e.g. apricots, pears, peaches and apples), potato products, dried coconut, sausages, all crustaceans (prawns, lobsters and crab), dessert toppings, cordials etc.
Nitrates, Nitrites 249–252	Added as a colour fixative (pink colour) for cured meats (ham, salami and corned beef) and to inhibit dangerous germs growing in these meats. Also used in cheeses in low levels.
Propionates 280–283	Naturally produced in the large intestine as a by-product of digestion of dietary fibre. Added to breads, bread crumbs, dressings and fruit and vegetable juices to stop fungal and mould growth.
Antioxidants
Antioxidants – Natural	Natural antioxidants are found in many foods and essences can be Added as a Natural product. For example rosemary is Added to baby rice cereals. Of all the Natural antioxidants tested to date, rosemary has been found to have the highest antioxidant capacity.
Gallates 310–312	Added to chewing gum, bubble gum, butter blends, cereal desserts such as rice pudding, soft sweets, dried vegetables, nuts (particularly walnuts and pecans), seeds, seasoning for instant noodles, powdered soup mixes, flaked cereals, grains, meat, baked goods that contain fat, snack foods, dehydrated potatoes and oils for deep-fried foods (chips, battered fish and doughnuts).
TBHQ 319	Added to chewing gum, bubble gum, butter blends, cereal desserts such as rice pudding, soft sweets, dried vegetables, nuts (particularly walnuts and pecans), seeds, seasoning for instant noodles, powdered soup mixes, flaked cereals, grains, meat, baked goods that contain fat, snack foods, dehydrated potatoes and oils for deep-fried foods (chips, battered fish and doughnuts).
BHA 320	Added to chewing gum, bubble gum, butter blends, cereal desserts such as rice pudding, soft sweets, dried vegetables, nuts (particularly walnuts and pecans), seeds, seasoning for instant noodles, powdered soup mixes, flaked cereals, grains, meat, baked goods that contain fat, snack foods, dehydrated potatoes and oils for deep-fried foods (chips, battered fish and doughnuts).
BHT 321	Added to animal feeds (even those labelled hypoallergenic), cosmetics, rubber products and petroleum products. Many plastic packaging materials incorporate BHT.
Flavour Enhancers
Natural glutamates	Natural glutamates occur in high levels in strong cheeses (parmesan, camembert,brie and gruyere), soy sauce, oyster sauce, black bean sauce, tomato sauce, miso, TVP, HVP, yeast extracts, mushrooms, plums and spinach.
Monosodium glutamate (MSG) 621	Added glutamates and similar compounds are flavour enhancers and salts. They are Added to nearly all savoury snack foods such as flavoured crisps, biscuits and two-minute noodles.
Similar flavour Compounds 620, 622, 623, 627–635

Reproduced with the kind permission of the dietitians at The Royal Prince Alfred Hospital Allergy Unit