FDA grants food industry flexibility on ingredient labels; consumers, medical professionals express concern

What's in a label: Healthcare professionals concern over FDA labels

NEW ORLEANS (WVUE) - As the COVID-19 pandemic continues the FDA has granted food manufacturers new flexibility in labeling food products. But that has some healthcare professionals and consumers concerned.

Food is something everyone needs in one form or another and for most people, the foods they choose involve what they like. But for millions of Americans, taste is not their first consideration.

Cori Crawford Van Oss has food allergies.

I have clear allergies to gluten and to hard shellfish like oysters and mussels and clams. The shellfish can trigger anaphylactic shock,” she said.

Anaphylactic shock can be life-threatening.

“Obviously, once I knew shellfish, that’s, you know I had my head swell. I had my tongue swell, I have to be very, very careful with that,” said Crawford Van Oss.

Dr. Sanjay Kamboj is an LSU Health allergist and immunologist. He has spent years treating patients with food allergies.

“The reaction can be mild, starting with the hives and just itching, lip swelling, or they can be severe like throat closing, bronchospasms which is difficulty breathing, dizziness or anaphylaxis which could be life-threatening,” said Kamboj.

Kamboj was asked if having food allergies amounts to the body mistaking food as an enemy.

“You can say in a way like that, so most of the people are able to tolerate food but if your body recognizes it as an antigen then you develop antibodies against it which are IgE antibodies and anytime you are exposed to that food those IgE antibodies attach to that antigen,” answered Kamboj.

An estimated 32 million Americans suffer from food allergies and food allergies are on the rise and children are not spared.

According to the Centers for Disease Control 1 in 13 children have food allergies.

Additionally, the CDC says there is no cure for food allergies and strict avoidance of the food allergen is the only way to prevent a reaction. Given that, the FDA’s coronavirus-related action to help food manufacturers has prompted questions.

Kenneth Mendez is President and CEO of the Asthma and Allergy Foundation of America.

“The concern is that because of COVID-19, explaining in simple terms, the FDA relaxed some of their labeling requirements,” said Mendez.

Due to the worldwide health crisis, the food industry warned of supply chain disruptions or ingredient shortages and requested flexibility in case manufacturers need to make formulation changes that make food labels incorrect.

In response, the FDA issued a temporary policy related to certain food labeling requirements.

The FDA wrote:

“The temporary policy provides flexibility for food manufacturers to make minor formulation changes in certain, limited circumstances without making conforming label changes on packages, as long as any substitutions or omissions of ingredients do not pose a health or safety issue and do not cause significant changes in the finished product. The food industry has advised FDA that there are shortages related to the pandemic in which they would not be able to make changes to the food label to reflect any temporary formulation changes without slowing down the flow of production and distribution of some foods.”

But some consumers said they were not aware of the changes and some healthcare professionals believe there should be more efforts to educate the public about the changes the FDA is allowing.

“I did not know that there had been changes made,” Crawford Van Oss said.

“People who are allergic and if in case they ingest the allergens by mistake they can develop anaphylaxis and that’s why it’s very important because sometimes it’s not even known. Let’s say you go to a restaurant, they’re using a product which may have that hidden allergen,” said Kamboj.

Federal law spells out the most common food allergens.

“They called out the eight allergens by law which are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soy and if you happen to switch those in--you have to change the label and you have to disclose that to the general public because those are eight allergens by law,” said Mendez.

But the FDA says close to 200 foods can cause allergic reactions in people with food allergies. Also, allergies can expand unexpectedly. So, the food labeling leeway causes some consumers to worry about the flexibility given to food manufacturers.

“The problem is where people are allergic to other antigens,” Kamboj stated.

Crawford Van Oss agrees.

“That is quite concerning because there are a lot of allergies that are not in the big, what is it eight that they count. I know in my family, my sister has quite an allergic reaction to bell peppers and when I read the brief from the FDA, you know, bell peppers were going to be allowed and, you know, and I’m thinking my dear sister, I need to send this to her,” said Crawford Van Oss.

AAFA and other organizations wrote a letter to the FDA soon after the temporary policy was announced.

“After meeting with the FDA and talking to them we were very encouraged by what was in the guidance because they called out some of the eight allergens and even some that aren’t listed as allergens in the U.S. as ingredients that you would have to flag if there were any changes,” said Mendez.

He discussed some of the other ingredients that are not included in U.S. law that the FDA says must be placed on labels if the manufacturers use them as substitutions.

“So, sesame was one of them, for example, celery, lupin, buckwheat and there are some others that are listed outside the U.S. and the FDA said if you happen to include those you would need to disclose it on your label. We see that as a good thing for the community,” said Mendez.

The federal government wants food manufacturers to put information about ingredient changes on their websites if they cannot modify the labels.

“The FDA strongly encourages manufacturers to comply with labeling requirements and continue to make conforming label changes, if this is not practical due to unforeseen supply disruptions or shortages brought upon by the COVID-19 pandemic, we recommend that manufacturers use alternative ways, such as posting information to their website or through point-of-sale labeling, to communicate to consumers any changes, such as minor ingredient omissions or substitutions, that are not reflected on the product label,” writes the FDA.

“Well, that would be impossible to deal with,” said Crawford Van Oss, of consumers having to check websites to learn of ingredient changes that are not on product labels.

Also, the FDA says its guidance provides temporary flexibility to the vending machine industry regarding labeling requirements.

Meanwhile, advocates for food allergy sufferers keep pushing for change.

“We feel that it is the right of every American to know what’s in their food,” said Mendez.

He said AAFA has been advocating for a label change related to allergen levels.

“We just feel that manufacturers should put in writing what the levels of allergens could be in there and then it’s up to the consumer and their doctor to talk about whether or not those are safe for them to eat,” said Mendez.

And consumers and doctors say it is critical that people with food allergies be ingredient detectives.

“Still read the labels and please go to the website of the manufacturer,” said Kamboj. “If you have any questions don’t hesitate to call your allergist and ask them questions.”

Crawford Van Oss says reading the ingredients has been her practice for decades.

“I have been a hawk on labels since my twenties,” she said.

AAFA says food allergies cost about $25 billion a year.

The FDA says consumers who have adverse effects such as allergic reactions should report them using its 1-888-SAFEFOOD hotline.

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