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. 2021 Oct;51(10):1374-1382.
doi: 10.1111/cea.13975. Epub 2021 Jul 20.

Poor understanding of allergen labelling by allergic and non-allergic consumers

Bregje C Holleman  1 , Harmieke van Os-Medendorp  2   3 , Huub van den Bergh  1 , Liselotte M van Dijk  1 , Yvette F M Linders  1 , W Marty Blom  2   4 , Kitty C M Verhoeckx  2 , Anouska Michelsen-Huisman  2 , Geert F Houben  2   4 , André C Knulst  2 , Leo R Lentz  1
Affiliations

Poor understanding of allergen labelling by allergic and non-allergic consumers

Bregje C Holleman et al. Clin Exp Allergy. 2021 Oct.

Abstract

Background: Understanding consumers' interpretation of allergy information is crucial for effective food safety policies. We evaluated consumer understanding of allergy information on foods in controlled, experimental studies.

Method: Using 18 packaged foods, we evaluated consumer understanding of information about allergens in two experiments: First, a comparison of foods with no stated allergen versus allergen as a stated ingredient versus a precautionary allergen label (PAL); second, a comparison of three common variants of PAL. In each experiment, consumers with and without self-reported food allergy were asked to estimate the risk of allergic reaction and to rate the comprehensibility of the allergen information. In the second experiment, consumers were also asked which form of PAL they preferred.

Results: Risk of reaction was assessed as high and low for foods with the allergen stated as ingredient, or without any mention of allergen. However, risk assessment for PAL varied and was judged as higher by non-allergic than allergic participants (82% vs. 58%, p < .001). Understanding of risk associated with PAL also varied by health literacy (p < .001). Both allergic and non-allergic consumers judged all forms of allergy information to be unclear, especially products with no allergy information for non-allergic consumers. Products with a 'Produced in a Factory' PAL were perceived as less risky than 'May contain' or 'Traces of' PALs (p < .001), less than 40% of participants judged PAL information to be comprehensible, and participants preferred 'May contain' over the other PALs.

Conclusion: Both allergic and non-allergic consumers find allergen information difficult to interpret on packaged foods and misunderstand PAL, incorrectly distinguishing different risk levels for different PAL wording. Clearer allergy information guidelines are called for, and the use of only one PAL wording is recommended.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
(A) The effect of types of allergy information on risk assessment in the ingredients experiment by allergy). Percentage of participants (0–100%) attributing risk of eating a product (mean across 18 food products) for an allergic person after reading food labels with different information about peanut: peanut as an ingredient; peanut not in the ingredients list and not in PAL; and peanut in PAL. Note: I indicates standard errors. (B) The effect of types of allergy information on risk assessment in the ingredients experiment by health literacy. Percentage of participants (0–100%) attributing risk of eating a product (mean across 18 food products) for an allergic person after reading food labels with different information about peanut: peanut as an ingredient; peanut not in the ingredients list and not in PAL; and peanut in PAL. Note: I indicates standard errors
FIGURE 2
FIGURE 2
The effect of types of allergy information on comprehension assessment in the ingredients experiment by allergy. Percentage of participants (0–100%) judging the allergy information to be comprehensible (mean across 18 food products) after reading food labels with different information about peanut: peanut as an ingredient; peanut as PAL; and peanut not in the ingredients. Note: I indicates standard errors
FIGURE 3
FIGURE 3
The effect of types of PAL information on risk assessment in the PAL experiment by health literacy. Percentage (0–100%) of participants (across 18 food products) attributing risk to eating a product for an allergic person after reading food labels with different PAL wordings about peanut: May contain peanut—May contain traces of peanut—Produced in a factory which also processes peanut, distinguishing between participants with relatively low health literacy (LitM‐) and relatively high health literacy (LitM+). Note: I indicates standard errors
FIGURE 4
FIGURE 4
The effect of types of PAL information on comprehension assessment in the PAL experiment by allergy. Percentage (0–100%) of participants judging labels as comprehensible after reading 18 food labels with different PAL wordings about peanut: May contain peanut—May contain traces of peanut—Produced in a factory which also processes peanut, distinguishing between participants with a (self‐reported) food allergy or intolerance versus non‐allergic participants. Note: I indicates standard errors
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References

    1. Nwaru BI, Hickstein L, Panesar SS, et al. The epidemiology of food allergy in Europe: a systematic review and meta‐analysis. Allergy. 2014;69(1):62‐75. 10.1111/all.12305 - DOI - PubMed
    1. Lyons SA, Burney PG, Ballmer‐Weber BK, et al. Food allergy in adults: substantial variation in prevalence and causative foods across europe. J Allergy Clin Immunol In Pract. 2019;7(6):pp. 1920–1928. e111. 10.1016/j.jaip.2019.02.044 - DOI - PubMed
    1. Muraro A, Roberts G, Worm M, et al. Anaphylaxis: Guidelines from the European academy of allergy and clinical immunology. Allergy. 2014;69(8):1026‐1045. 10.1111/all.12437 - DOI - PubMed
    1. Stensgaard A, Bindslev‐Jensen C, Nielsen D, Munch M, DunnGalvin A. Quality of life in childhood, adolescence and adult food allergy: patient and parent perspectives. Clin Exp Allergy. 2017;47(4):530‐539. 10.1111/cea.12849 - DOI - PubMed
    1. European Commission . Food information to consumers – legislation. http://ec.europa.eu/food/safety/labelling_nutrition/labelling_legislatio... Updated 2014.

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