Why Mexico Needs To Tackle Food Allergies

Adverse reactions to food have been registered for more than 2,000 years but the alarming rate in which food allergies have been growing over the past three decades led the World Health Organization to declare in 2019 they had reached epidemic proportions. An estimated 10% of the adult population has at least one current food allergy – three times the amount that had been previously reported. 

Nine foods account for more than 90% of the (potentially mortal) reactions in Europe and the US, which send sufferers to emergency rooms every three minutes, converting them into major health concerns nearly worldwide, except in Latin America and most of Africa. 

Although the cause of food allergies is unknown, their manifestation follows a pattern – certain people interpret certain nutrients in food as harmful, triggering an inflammatory response that can endanger life, causing quasi-immediate death. 

Food allergies and adverse reactions can arise at any age and may suddenly appear at any stage. Their outcome can range in severity from mild (causing rashes, hives, and other external signs of inflammation) to severe (breathing complications and/or swelling of the throat). In their most severe form, food allergies can even cause anaphylaxis, a life-threatening condition in which the body goes into shock.

Data provided by the World Allergy Organization in 2011 estimated that between 1.1 and 10.8% of the global population has a food allergy, and the rates of food allergies appear to be increasing. Documenting food allergies can be difficult, since food intolerances (less-serious adverse reactions to foods that are not allergies but may cause symptoms like gastrointestinal discomfort) are often mistaken for food allergies; self-reported food allergies are prone to bias; and the diagnostic process for identifying food allergies in patients varies between countries. In the US, about 32 million people report having a food allergy, and each year around 200,000 people seek emergency medical care due to food allergies. Food allergies are particularly common in youth, with about one in every 13 children being diagnosed with a food allergy in the US (and around 40% of children with food allergies being allergic to more than one food). To reflect this, Food Allergy Research & Education (FARE.org) recently swapped their vision to provide for “85 million Americans living with life-threatening food allergies and intolerances,” catering to all family members of allergic people. FARE is the leading charity on food allergy in the US and one of the most influential in the world. 

Asthma sufferers with other allergic reactions, and/or who have a family history of food allergies may be more susceptible to developing a food allergy. Food allergies are generally diagnosed in childhood, but around 15% of cases are first diagnosed in adulthood. Newer research contradicts traditional suggestions that delaying the introduction of potential allergens to infants and toddlers can provide protection against an allergy. In 2015, data from the Learning Early About Peanut Allergy (LEAP) study found that introducing potential allergens earlier and more frequently can lower the chances of developing a food allergy. In fact, the LEAP study came as a result of an analysis of the lower prevalence of peanut allergies in Israel, where peanut products historically have been introduced early in infancy. By contrast, in the United Kingdom, where peanut introduction has been frequently delayed, there were 10 times as many peanut allergy cases. The LEAP study found that infants who were introduced to peanuts early on were much less likely to have a peanut allergy compared with infants who avoided peanuts. This research changed the previous guidance about food allergen introduction; today paediatric current recommendation is to introduce food allergens around 6 months (and by 12 months) of age.

Although it has been reported that more than 170 foods have triggered an allergic reaction, the Top 9 allergens are responsible for almost all food-related allergic reactions in North America. From most likely to least likely, these include: milk/dairy, eggs, fish, crustacean shellfish (crab, lobster, and shrimp, among others), tree nuts ( including almonds, walnuts, and pecans), peanuts, wheat, soybeans and recently added to the list: sesame. Other common allergens across the globe include cereals with gluten, sulfites, celery, lupin, and mustard, among others.

Regions such as the US, Canada, Europe, the United Kingdom and Australasia have strengthened their regulatory frameworks to ensure clear and transparent labeling around the mandatory declaration of gluten and the eight most common allergens stipulated by the Codex Alimentarius. These compelling advances have only been achieved in countries where there is intrinsic collaboration among the health sector, food industry and civil society, where all food companies are required to provide whole ingredients in food products, pre-packaged meals and increasingly more destinations enforce and promote gluten and allergen training in the hospitality industries.

In the case of Mexico, just last year, frontal labeling on food and beverages was launched to guide consumers about excess fat, sodium, sugar and calories in the second-most obese country in the world and the first in childhood obesity. This initiative has generated a proliferation of phantom labels generated by the producers themselves to counteract the impact of labels that indicate that the product contains excessive unhealthy ingredients. Their claims “gluten free”, “soy free” or “Non-GMO” (without genetically modified organisms) lack scientific evidence and dangerously confuse the allergic, celiac or intolerant who depend on transparency to protect their health and potential death.

Labeling food allergens varies across the world given that the foods implicated in food allergies also vary with dietary practices; while in the US, allergy to peanuts and tree nuts is high, in some regions of Spain and Portugal, reactions to fish and shellfish are more common, in Israel to sesame and in France to mustard.

Most studies on food allergies have been conducted in Europe and the US and little is known about food allergy in Latin America, where there is a high cultural diversity, which makes dietary habits and food preparation different to European countries and the US. In Latin America, the second-most common cause of anaphylaxis reactions was associated with foods, with various fruits primarily involved. The tropical and subtropical climate promotes the growth of a high number of fruits in Latin America, and eating them could increase the risk of food sensitization.

Although several Latin American groups are describing allergenic proteins and trying to produce hypoallergenic foods, little is known about the frequency of sensitization to foods and possible risk factors in Latin America, so the aim of this article is a call to action to invite the health sector to come forward and review the available information on the epidemiology of sensitization and food allergies in Latin America and identify similarities and differences with existing international data, taking into account the main foods involved, the underlying immune mechanism, and the clinical symptoms associated with food allergic reactions, and its risk factor for the development of other allergic diseases.

Allergen Free Mexico is keen to work with academics and medical experts to study the epidemiology of food allergies in Mexico and beyond  to provide a better understanding of the characteristics of allergic diseases in the tropics and to identify potential risk factors for food allergy and food sensitization. 

Findings will aid in lobbying the government, private sector and academia to join forces with a view to accommodate people in need of special diets and enforce transparent labeling and food allergen and gluten management in food service outlets. 

Allergen Free Mexico is an NGO constituted as the peak industry body in gluten, allergen and animal origin, to inform and collaborate with the food and beverage, health and education industries to provide leading solutions that will improve the lives of people who need to conduct special diets. We aim to keep pace with global regulations, which are dynamic, in a bid to support authorities and in turn to strengthen the national legal framework to benefit our community.