Unregulated allergens linked to significant risk: A summary

  • Nearly half of cases of food anaphylaxis contain unregulated allergens
  • Buckwheat, sheep and goats milk, peas and lentils, and pine nuts should be added to regulated list, study suggests
  • Sheep and goat’s milk have been linked to two child deaths
  • Kiwi, apple, beehive products and alpha-gal also associated with anaphylaxis – these four are easier to avoid so should not be regulated, according to study

In the EU, common allergens are regulated. Food containing these allergens must be clearly labelled as such, to ensure that consumers do not suffer adverse effects.

Yet some are now suggesting that more should be added to the list. A recent study found that goat’s and sheep’s milk, peas and lentils, buckwheat and pine nuts are all responsible for significant numbers of allergic reactions – and suggests that regulation could be the solution.

EU regulated allergens

The European Union has 14 regulated allergens. These are: Cereals containing gluten, crustaceans, soybeans, molluscs, sesame seeds, mustard, fish, eggs, milk, peanuts, nuts, celery, sulphur dioxide and sulphites, and lupin. 

These 14 ingredients must be indicated on the packaging if present in food. 

The list has not been updated since 2011.

High frequency of reactions

The study, published in the journal Clinical and Experimental Allergy, found a high incidence of food anaphylaxis from eight ingredients – goat’s milk, buckwheat, kiwi, apple, peas and lentils, pine nuts, beehive products and alpha-gal (a molecule commonly found in mammalian meat).

The study looked at incidences of food anaphylaxis in French-speaking countries (mainly France, Belgium and Luxembourg) since 2002, the frequency of these reactions, their severity, and how hidden the related ingredient was in food (for example, whether it was present as the result of contamination, or simply not mentioned on the label).

Of the foods assessed by the study, only 62.1% involved one of the 14 foods regulated by the EU.

Other foods and ingredients were prominent causes of food anaphylaxis even though they were not regulated. For example, goat’s and sheep’s milk were responsible for 2.8% of cases. These cases could be severe and had resulted in two deaths at school.

Another allergen was buckwheat, responsible for 2.4% of cases. Cases involving buckwheat were mostly linked to adults rather than children, and more in Asia than in Europe.

Analysed together because of frequent cross-reactivity, peas and lentils collectively made up 1.8% of cases. Reactions normally occurred in children. In cases of food anaphylaxis, peas were consumed not only in their natural form but as part of ultra-processed foods as well.

Reactions resulting from pine nuts made up 1.6% of cases, and often occurred in children.

These four foods were suggested as necessary to regulate by the study. The other four – kiwi, apple, alpha-gal and beehive products – were not, as they are significantly easier to avoid.

The frequency of reactions to the ingredients explored in the study were higher than two of the EU-regulated allergens, mustard and sulphites.