Copyright 2001 St. Louis Post-Dispatch, Inc.  
St. Louis Post-Dispatch (Missouri)
May 31, 2001 Thursday Five Star Lift Edition
SECTION: NEWS; Pg. A1

LENGTH: 3449 words

HEADLINE: WATCHING WHAT YOU EAT ;
GROUP PROPOSES RULES FOR LABELING PRODUCTS FOR FOOD-ALLERGIC PEOPLE

BYLINE: Tina Hesman Of The Post-Dispatch

BODY:
* Between 6 million and 7 million people in the United States have food allergies, which kill nearly 200 a year. Under the proposed guidelines, labels would contain warnings if food contains allergens.

Two weeks ago, 9-year-old Nathan Walters of Spokane, Wash., bit into a peanut butter cookie. It would prove to be a fatal mistake.

Just a few hours after eating the cookie from his school-provided lunch, the third-grader -- who was seriously allergic to peanuts -- became one of the nearly 200 people nationwide who die each year from allergic reactions to food. Nathan's cookie had not included a warning label that it contained peanuts -- the most common and serious of all food allergens.

Today, under increasing pressure from consumer groups and government regulators, a group of food industry representatives is set to release voluntary guidelines they say will make it easier for people with food allergies to identify problem ingredients.

The Food Allergy Issues Alliance, a group of food trade associations and other organizations concerned about food allergies, is urging food manufacturers to label ingredients in "plain English."

No longer would food-allergic consumers have to remember that terms such as "casein" and "whey" identify milk, or that "semolina" means wheat. Package labels would say clearly what ingredients might lead to a life-threatening allergic reaction.

Most serious food allergies are attributed to a small number of foods. Peanuts, milk, eggs, fish, crustaceans -- including shrimp, lobster and crab -- wheat, tree nuts and soybeans cause 90 percent of the allergic reactions to foods in the United States.

No thorough count has tallied the number of people who suffer from food allergies, but some experts estimate that 6 million to 7 million Americans -- including 2 percent of adults and 5 percent of children -- have some type of food allergy. Emergency rooms treat 30,000 people for allergic responses to a food, and roughly 2,000 of those people are hospitalized.

"Many people think that food allergies aren't that serious," said Anne Munoz-Furlong, president of the Food Allergy and Anaphylaxis Network. "They think you're talking about a few sniffles and some hives. They don't know how deadly a food allergy can be."

Peanut allergies are the most common and deadly, accounting for nearly half the fatal food allergies in both adults and children. In a recent study of deaths from food allergies sponsored by Munoz-Furlong's organizati on, 63 percent were attributed to peanuts and 31 percent to other nuts. Milk and fish each caused about 3 percent of food-allergy deaths.

Families on the defense

Many families in the St. Louis area know first-hand how traumatic a food allergy can be. For these families, the simple act of grocery shopping or eating out has become a defensive act to protect their children from otherwise harmless ingredients that could kill a food-allergic child.

"When you go to the grocery store, you have to set aside logic," said Monica James, 38, of Clayton. Her son Daniel, 2, is allergic to wheat, eggs, peanuts, salmon and peas.

Almost any food could contain one of the ingredients that would send the toddler to the hospital -- even things most people would never expect. Barbecue sauce might contain peanut butter. Egg may be the secret ingredient that gives products "improved flavor." Food products boasting of "natural flavors" often contain peanuts or other nuts.

Under the proposed guidelines being announced today, food processors would label the potential allergens in flavorings, even though such ingredients are exempt from that requirement under current governmental regulations. The FDA, which has been pushing the industry on the allergen-labeling issue since 1996, this month published its own food-manufacturing guidelines and again urged food companies to take action on labeling.

James has learned to read the labels on foods carefully and recognizes the laundry list of synonyms for the foods to which her son is allergic.

But young consumers and other people who prepare food might not understand the terms, said Regina Hildwine, senior director of food labeling and standards for the National Food Processors Association in Washington.

"Some words such as casein or semolina might not resonate with a food-allergic consumer, particularly one who's 8 years old," she said.

Companies frequently change the formulations of their products so parents have to be vigilant and keep checking the labels even on products they knew have been safe in the past, said Rosanne Prasuhn of Kirkwood. Prasuhn's son, Ben, 7, has a peanut allergy.

"If, last week, I bought a box of Ritz crackers and they were OK, I still have to read the label this week, because it could have changed," she said.

Ben, a first-grader at Keysor Elementary School in Kirkwood, has learned to stick to a few tried-and-true favorites when eating out -- mostly cheeseburgers and chicken nuggets, but "nothing gourmet or Chinese or anything odd or different," Prasuhn said.

Asian and gourmet restaurants often use peanuts or other nuts in their dishes. Nut oils can linger on cooking equipment or contaminate other foods and cause reactions in unsuspecting people.

At school, Ben eats at a peanut-free table. His photograph hangs in the cafeteria so workers will know not to give the boy anything that might contain peanuts.

Peter Harris, 9, a third-grader at New City School in St. Louis, also eats at a peanut-free table at his school. He carries a red card with him to restaurants. The card lists ingredients that could send him into a serious allergic reaction known as anaphylactic shock or could even kill him.

When someone brings a snack into Peter's class, he's careful to check all the ingredients. "It's kind of hard doing it. You feel a little left out," he said. "But my classmates make it up to me."

At show and share time, it's Peter who handles items first -- a protection his classmates devised to make sure sticky peanut residues from their hands don't cause Peter's allergy to flare. The children also make sure that no one who has eaten peanuts sits next to Peter.

The extra precautions might seem excessive to some, but they are necessary to prevent the type of incident that led to the death of Nathan Walters, experts say. Nathan's teachers knew about his peanut allergy but didn't make sure he had a peanut-free lunch. In addition to the cookie, the lunch contained a peanut butter-and-jelly sandwich and trail mix with peanuts.

They also didn't give him epinephrine until nearly two hours after he ate the peanut butter cookie that apparently killed him.

A hidden danger

Sometimes it's not easy to avoid food allergens. Major food allergens are often found in products where they don't belong and often don't appear on the label.

Over the past decade, the Food and Drug Administration had noticed a rise in the number of recalls of foods due to hidden allergen contaminations, said Kenneth J. Falci, director of the FDA's office of scientific analysis and support.

A study in January of bakeries and ice cream and candy manufacturers in Wisconsin and Minnesota showed that allergens often show up in products that don't list the ingredient. Peanut allergens were found in 18 of 73 food products tested, equal to 25 percent, even though peanuts were not listed as an ingredient.

The exercise was never intended to shut down companies but to help food producers learn how to more safely make their products, said Falci, of the Food and Drug Administration. The study helped manufacturers realize that practices such as re-using baking sheets for making cookies could lead to inadvertent contamination of other baked goods.

"A lot of these situations come up where people just stare at themselves and say 'Oh, my God, I never thought about that,' " Falci said.

The agency discovered that it also needs to increase training for its own inspectors, Falci said.

"If you don't know what you're looking for, you miss it," he said.

The agency does not have the authority to pull products contaminated with unlabeled allergens from the shelves. That type of regulation is sorely needed, said Michael Jacobson, executive director of the Center for Science in the Public Interest in Washington.

The voluntary guidelines proposed by the industry are good but don't provide the means to clamp down on companies that violate the rules, Jacobson said.

"What we need is legislation to put teeth into this," he said.

Rep. Nita Lowey, D-N.Y., is working on a bill that would do exactly that, but no legislation has been introduced.

More legislation isn't the answer, said Timothy Willard of the National Food Processors Association in Washington. Industry groups working under voluntary guidelines can move faster to get pertinent information to consumers than government agencies can act, he said. He denied that the new guidelines were an attempt to derail stronger regulation.

"This is no attempt to get (FDA) to back off on using their power," Willard said.

Increasingly, food manufacturers are emblazoning their products with cautionary labels such as a warning found on a Milky Way candy bar made by Mars Inc., of Hackettstown, N.J. -- "Allergy Information: Manufactured in a facility that uses peanuts."

The reaction to such labels is mixed. Some food-allergy sufferers say they are grateful for the information and will avoid any product that contains such a warning. But other food-allergic people say the labels impose unnecessary limits on what they can eat.

"Over-labeling really doesn't do a service to the consumer," said Peggy Harris of University City. Harris is Peter Harris' mother.

While reading the labels on some favorite Easter candy, Harris discovered that two of the treats Peter expected to find in his basket now warn that they may contain peanuts. Harris called the manufacturers -- Brach's Confections, based in Chattanooga, Tenn., and Russell Stover of Kansas City -- and discovered that although the candies are made on peanut-free lines, neither company was willing to take the chance that a peanut from another part of the plant wouldn't make its way into the food.

The proposed guidelines would set strict standards for when a company could use a "may contain" label, Hildwine said. Just being cautious is not justification for using the label.

"We are not interested in encouraging the proliferation of this type of labeling," Hildwine said. "We recognize that labeling is not a substitute for good manufacturing processes."

Most serious food allergies are attributed to a small number of foods. Peanuts, milk, eggs, fish, crustaceans - including shrimp, lobster and crab - wheat, tree nuts and soybeans cause 90 percent of the allergic reactions to foods in the United States.

No thorough count has tallied the number of people who suffer from food allergies, but some experts estimate that 6 million to 7 million Americans - including 2 percent of adults and 5 percent of children - have some type of food allergy. Emergency rooms treat 30,000 people for allergic responses to a food, and roughly 2,000 of those people are hospitalized.

"Many people think that food allergies aren't that serious," said Anne Munoz-Furlong, president of the Food Allergy and Anaphylaxis Network. "The y think you're talking about a few sniffles and some hives. They don't know how deadly a food allergy can be."

Peanut allergies are the most common and deadly, accounting for nearly half the fatal food allergies in both adults and children. In a recent study of deaths from food allergies sponsored by Munoz-Furlong's organization, 63 percent were attributed to peanuts and 31 percent to other nuts. Milk and fish each caused about 3 percent of food-allergy deaths.

Families on the defense

Many families in the St. Louis area know first-hand how traumatic a food allergy can be. For these families, the simple act of grocery shopping or eating out has become a defensive act to protect their children from otherwise harmless ingredients that could kill a food-allergic child.

"When you go to the grocery store, you have to set aside logic," said Monica James, 38, of Clayton. Her son Daniel, 2, is allergic to wheat, eggs, peanuts, salmon and peas.

Almost any food could contain one of the ingredients that would send the toddler to the hospital - even things most people would never expect. Barbecue sauce might contain peanut butter. Egg may be the secret ingredient that gives products "improved flavor." Food products boasting of "natural flavors" often contain peanuts or other nuts.

Under the proposed guidelines being announced today, food processors would label the potential allergens in flavorings, even though such ingredients are exempt from that requirement under current governmental regulations. The FDA, which has been pushing the industry on the allergen-labeling issue since 1996, this month published its own food-manufacturing guidelines and again urged food companies to take action on labeling.

James has learned to read the labels on foods carefully and recognizes the laundry list of synonyms for the foods to which her son is allergic.

But young consumers and other people who prepare food might not understand the terms, said Regina Hildwine, senior director of food labeling and standards for the National Food Processors Association in Washington.

"Some words such as casein or semolina might not resonate with a food-allergic consumer, particularly one who's 8 years old," she said.

Companies frequently change the formulations of their products so parents have to be vigilant and keep checking the labels even on products they knew have been safe in the past, said Rosanne Prasuhn of Kirkwood. Prasuhn's son, Ben, 7, has a peanut allergy.

"If, last week, I bought a box of Ritz crackers and they were OK, I still have to read the label this week, because it could have changed," she said.

Ben, a first-grader at Keysor Elementary School in Kirkwood, has learned to stick to a few tried-and-true favorites when eating out - mostly cheeseburgers and chicken nuggets, but "nothing gourmet or Chinese or anything odd or different," Prasuhn said.

Asian and gourmet restaurants often use peanuts or other nuts in their dishes. Nut oils can linger on cooking equipment or contaminate other foods and cause reactions in unsuspecting people.

At school, Ben eats at a peanut-free table. His photograph hangs in the cafeteria so workers will know not to give the boy anything that might contain peanuts.

Peter Harris, 9, a third-grader at New City School in St. Louis, also eats at a peanut-free table at his school. He carries a red card with him to restaurants. The card lists ingredients that could send him into a serious allergic reaction known as anaphylactic shock or could even kill him.

When someone brings a snack into Peter's class, he's careful to check all the ingredients. "It's kind of hard doing it. You feel a little left out," he said. "But my classmates make it up to me."

At show and share time, it's Peter who handles items first - a protection his classmates devised to make sure sticky peanut residues from their hands don't cause Peter's allergy to flare. The children also make sure that no one who has eaten peanuts sits next to Peter.

The extra precautions might seem excessive to some, but they are necessary to prevent the type of incident that led to the death of Nathan Walters, experts say. Nathan's teachers knew about his peanut allergy but didn't make sure he had a peanut-free lunch. In addition to the cookie, the lunch contained a peanut butter-and-jelly sandwich and trail mix with peanuts.

They also didn't give him epinephrine until nearly two hours after he ate the peanut butter cookie that apparently killed him.

A hidden danger

Sometimes it's not easy to avoid food allergens. Major food allergens are often found in products where they don't belong and often don't appear on the label.

Over the past decade, the Food and Drug Administration had noticed a ris e in the number of recalls of foods due to hidden allergen contaminations, said Kenneth J. Falci, director of the FDA's office of scientific analysis and support.

A study in January of bakeries and ice cream and candy manufacturers in Wisconsin and Minnesota showed that allergens often show up in products that don't list the ingredient. Peanut allergens were found in 18 of 73 food products tested, equal to 25 percent, even though peanuts were not listed as an ingredient.

The exercise was never intended to shut down companies but to help food producers learn how to more safely make their products, said Falci, of the Food and Drug Administration. The study helped manufacturers realize that practices such as re-using baking sheets for making cookies could lead to inadvertent contamination of other baked goods.

"A lot of these situations come up where people just stare at themselves and say 'Oh, my God, I never thought about that,' " Falci said.

The agency discovered that it also needs to increase training for its own inspectors, Falci said.

"If you don't know what you're looking for, you miss it," he said.

The agency does not have the authority to pull products contaminated with unlabeled allergens from the shelves. That type of regulation is so rely needed, said Michael Jacobson, executive director of the Center for Science in the Public Interest in Washington.

The voluntary guidelines proposed by the industry are good but don't provide the means to clamp down on companies that violate the rules, Jacobson said.

"What we need is legislation to put teeth into this," he said.

Rep. Nita Lowey, D-N.Y., is working on a bill that would do exactly that, but no legislation has been introduced.

More legislation isn't the answer, said Timothy Willard of the National Food Processors Association in Washington. Industry groups working under voluntary guidelines can move faster to get pertinent information to consumers than government agencies can act, he said. He denied that the new guidelines were an attempt to derail stronger regulation.

"This is no attempt to get (FDA) to back off on using their power," Willard said.

Increasingly, food manufacturers are emblazoning their products with cautionary labels such as a warning found on a Milky Way candy bar made by Mars Inc., of Hackettstown, N.J. - "Allergy Information: Manufactured in a facility that uses peanuts."

The reaction to such labels is mixed. Some food-allergy sufferers say they are grateful for the information and will avoid any product that contains such a warning. But other food-allergic people say the labels impose unnecessary limits on what they can eat.

"Over-labeling really doesn't do a service to the consumer," said Peggy Harris of University City. Harris is Peter Harris' mother.

While reading the labels on some favorite Easter candy, Harris discovered that two of the treats Peter expected to find in his basket now warn that they may contain peanuts. Harris called the manufacturers - Brach's Confections, based in Chattanooga, Tenn., and Russell Stover of Kansas City - and discovered that although the candies are made on peanut-free lines, neither company was willing to take the chance that a peanut from another part of the plant wouldn't make its way into the food.

The proposed guidelines would set strict standards for when a company could use a "may contain" label, Hildwine said. Just being cautious is not justification for using the label.

"We are not interested in encouraging the proliferation of this type of labeling," Hildwine said. "We recognize that labeling is not a substitute for good manufacturing processes."

=========================

Understanding food allergies

In the United States, eight foods cause more than 90 percent of food allergies.

PEANUTS: More than 3 million Americans have a peanut allergy, making it the most common food allergy in the United States.

TREE NUTS: Walnuts, Brazil nuts, cashews, almonds, hazelnuts, pecans, pistachios, chestnuts, macadamia nuts and pine nuts cause allergies nearly as often as peanuts.

FISH: Allergies are more common in adults than in children.

CRUSTACEANS: Commonly called shellfish, these foods mainly affect adults.

MILK: Young children often have allergies to milk. More than 20 different proteins in milk provoke allergic reactions. Most children outgrow milk allergies.

EGGS: Egg allergies are common among children under 6 years old, but may be outgrown.

SOY: Storage proteins in soybeans may provoke allergic reactions in children.

WHEAT: Young children also usually outgrow wheat allergies.

NOTES:
Reporter Tina Hesman:; E-mail: thesman@post-dispatch.com; Phone: 314-340-8325

GRAPHIC: PHOTO, GRAPHIC; (7) 2001 Graphic FILED: Allergies tms; (1) Color Photo by J.B. FORBES / POST-DISPATCH - Third-grader Peter Harris sits at a peanut-free lunch table at New City School in St. Louis. He can't be near anyone eating peanut butter and jelly sandwiches or any other products containing peanuts.; (2) Color Photo - (of a lobster); (3) Color Photo - (assorted nuts); (4) Color Photo - (of a glass of milk and a bottle of milk); (5) Graphic / Chart - Understanding food allergies (see text field.); (6) Photo from THE ASSOCIATED PRESS - Students at Aspen Street Elementary School in Thousand Oaks, Calif., eat at a peanut-free table last year. The table was set up in response to concerns that sharing food during lunch could pose problems for youngsters with food allergies.; (7) Graphic / Chart - Allergic reaction; Estimated percentage of Americans who suffer from various allergies.; ALL ALLERGIES (EXCEPT ASTHMA) 19%; HIVES, SWELLING OF THROAT 15%; HAY FEVER 10%; INSECT STINGS 3.3%; FOOD ALLERGIES 2.7%; Source: National Institutes of Health

LOAD-DATE: June 13, 2001