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Tuesday Apr 19, 2016

Ah, Nuts: Is Kellogg's Putting Consumers at Risk by Adding Allergen to Food?

Editor's Note: This blog post was updated after Kellogg's announced that one of the eight products it had planned to add peanut flour to will be peanut-free again in September.

Kellogg's Co. recently made big waves in the allergy community when the manufacturer announced plans to add peanut flour(www.foodallergy.org) to several varieties of Austin and Keebler brand crackers. The products affected previously had been considered safe for consumers with peanut allergies.

The change largely went unnoticed by the mainstream media, and I'll admit that my initial reaction was not extreme concern. No one in my family has food allergies, and neither do any of my close friends. But then my instincts as a doctor and a mother kicked in. As a physician, I know food allergies are a major public health concern. As a mother, I understand that they are a life-or-death matter for a parent of a child affected by food allergies.

But how wide-scale is the problem of food allergies? I didn't know, so I went looking.

Eight percent of U.S. children have a food allergy,(www.ncbi.nlm.nih.gov) and allergies to peanuts and tree nuts are the leading causes of fatal allergic reactions. Peanut allergies tripled from 1997 to 2008(www.jacionline.org), and 3 million Americans have peanut and tree nut allergies.  

Eight foods are responsible for 90 percent of serious allergic reactions(www.cdc.gov): milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. Even trace amounts of these products can cause a reaction. Milk, eggs and peanuts are the top three allergens, and although milk and egg allergies often are outgrown by school age, roughly 80 percent of peanut allergies remain.  

At a time when the number of children with food allergies and intolerance issues is skyrocketing -- and knowing that peanut allergies account for one of the most persistent and most dangerous allergies -- why would a manufacturer add a peanut ingredient to a previously peanut-free product?  

Many manufacturers are working to eliminate food allergens from their products, and indeed the market for foods free of major allergens is booming(www.cnbc.com), creating a large market for food manufacturers.

In its responses to angry consumers on social media, Kellogg's positions itself as if it's trying to figure out how to expand, not shrink, that market: "We are truly sorry to disappoint you. We appreciate you sharing your concerns and understand why you're upset. We know it's not easy to find foods that people with peanut allergies can eat, and are looking at ways to make a cracker sandwich you and your family can buy."

My thought when I read that was, "You already had one, so why change it?"

Since the announcement by Kellogg's, more than 20,000 people have signed a petition on Change.org(www.change.org) that says, in part, that peanuts are "the allergen most responsible for triggering anaphylaxis, an allergic reaction that can result in horrific consequences including death." The petition calls adding peanuts to previously peanut-free products "unethical and irresponsible."

As family physicians we need to be aware of changes that can affect the health of millions of our patients, and act as advocates when possible. The petition allows people to say why they are signing it. My comment says, "Because I am a family physician and believe that the safety of my patients is important."  

Kellogg's assured consumers that any product including allergens will be clearly labeled and later said that one of the eight affected products will again be peanut-free beginning in September. But a big concern is that all eight of these products have long been known to be safe in the allergy community. Parents, grandparents, allergy sufferers themselves, coaches and teachers who are familiar with these products would have little reason to think that an allergen would be added. Most consumers likely would not expect to find peanut ingredients in a cheese cracker, nor would they be likely to check the allergy label on a food they have known to be safe.  

As physicians, we can remind our patients with food allergies (and their parents or caregivers) that they should check product labels every time, even on familiar foods, because manufacturers may change their ingredients or manufacturing processes. We can also inform them that there are blogs and websites -- like the one at the beginning of this post -- that alert consumers with allergies to such changes. Although manufacturers might not make decisions with our patients in mind, we can help our patients make good decisions for themselves.

Beth Oller, M.D., practices full-scope family medicine with her husband, Michael Oller, M.D., in Stockton, Kan.

Posted at 10:25AM Apr 19, 2016 by Beth Oller, M.D.

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