Food Allergy and Allergen Management Lecture

A comprehensive set of flashcards summarizing key points on food allergies, intolerances, immune mechanisms, labeling laws, and management strategies from the lecture.

What is the fundamental difference between a food allergy and a food intolerance?

A food allergy involves an immune-mediated hypersensitivity (often IgE) to a food antigen, while a food intolerance is a non-immune reaction, usually metabolic, pharmacologic, toxic, or idiopathic in origin.

Which immunoglobulin class is typically involved in immediate (Type I) food allergies?

IgE

Name the eight foods that make up the Codex ‘Big 8’ major allergens.

Peanut, tree nuts, soy, milk, egg, wheat (gluten), crustacean shellfish, and fish (plus sulfites are often listed).

Which two additional allergens must be declared on labels in Australia, expanding the Big 8?

Sesame seed and lupin.

What enzyme deficiency causes lactose intolerance?

Deficiency of β-galactosidase (lactase).

Is lactose intolerance an allergy?

No; it is a metabolic disorder, not an immune response.

What is celiac disease?

An autoimmune reaction to gluten in genetically predisposed individuals, leading to intestinal damage.

How does gluten intolerance differ from celiac disease?

Gluten intolerance (non-celiac) involves non-immune gastrointestinal discomfort, whereas celiac disease is an autoimmune condition that can become life-threatening if untreated.

Define anaphylaxis.

A severe, rapid, systemic allergic reaction that can include airway constriction, drop in blood pressure, and can be fatal without prompt treatment (e.g., epinephrine).

What device is commonly carried for emergency treatment of anaphylaxis?

An EpiPen (epinephrine auto-injector).

Which cells first present food antigens to initiate an IgE-mediated allergy?

Dendritic (antigen-presenting) cells.

Outline the basic cell pathway for an IgE-mediated food allergy.

Dendritic cell presents antigen → T-helper cell activation → B cell class-switching → IgE production → IgE binds mast cells → re-exposure triggers mast-cell degranulation and symptoms.

What diagnostic test lightly scratches the skin with small quantities of allergens to detect sensitization?

Skin prick test.

What is an oral food challenge?

A controlled, medically supervised test in which increasing doses of a suspected allergen are ingested to determine the threshold dose that provokes symptoms.

Define ‘cross-contact’ in allergen management.

Unintentional presence of an allergen in a food due to shared equipment, storage, agricultural practice, or employee error.

Give two common causes of cross-contact in food manufacturing.

Shared processing lines without adequate cleaning and shared harvesting/storage equipment in supply chains.

What does PAL stand for in food labeling?

Precautionary Allergen Labeling.

Provide an example of PAL wording.

“Manufactured in a facility that also processes peanuts.”

Why is the statement “may contain” not permitted on labels in the USA and Japan?

Regulators consider it too vague; responsibility is placed on manufacturers to know and state actual contents rather than use uncertain wording.

What is PEAL in Australia?

Plain English Allergen Labelling – a regulation requiring common names (e.g., ‘egg’, ‘milk’) to be clearly listed in ingredient statements and ‘contains’ boxes.

Which regulatory body provides global guidance on allergen labeling?

Codex Alimentarius (via the Codex Committee on Food Labelling).

State the primary responsibility of consumers in allergen management as outlined by Allergy & Anaphylaxis Australia.

To declare their allergies, read food labels, and make informed choices about the foods they consume.

What responsibility do food manufacturers have regarding allergens?

Implement robust allergen management, conduct quantitative risk assessments, and provide clear, consistent labeling including unintended allergen warnings.

What role must food-service establishments play in allergen safety?

Maintain allergen-safe practices, train staff, and accurately inform customers about potential allergens in menu items.

Name three categories of non-immune (intolerance) reactions to food.

Metabolic (e.g., lactose intolerance), pharmacologic (e.g., caffeine sensitivity), and toxic (e.g., bacterial toxins).

What term describes adverse food reactions with an unknown mechanism but reproducible symptoms (e.g., migraine from chocolate)?

Idiosyncratic reactions.

Define an anaphylactoid reaction.

A reaction that mimics anaphylaxis clinically but is not IgE-mediated; mechanism may involve direct mast-cell activation.

According to Food Standards Australia New Zealand (FSANZ), what is the most common reason for allergen-related food recalls?

Undeclared allergens (incorrect or missing labeling).

Explain why food manufacturing is considered a ‘high volume, low margin’ business and how this relates to allergen risk.

Profit relies on large production batches; high throughput increases the chance of cross-contact and contamination if cleaning and controls are insufficient.

Which quote by Lucretius summarizes individual variability to food?

“What is food to one man may be fierce poison to others.”

State Paracelsus’s principle relevant to food toxicity.

“The dose makes the poison.”

What does a ‘Contains: egg, milk, wheat, sesame’ box on a label represent?

Mandatory allergen declaration identifying intentional ingredients from regulated allergen lists.

Why are milk and honey called the only two ‘ready-to-eat’ foods in nature?

They are naturally produced by animals/insects to be consumed without further preparation: milk for infants and honey by bees.

List two diagnostic methods used specifically for celiac disease.

Serologic blood tests for antibodies (e.g., anti-tTG) and intestinal biopsy via endoscopy.

What immediate gastrointestinal symptoms often indicate lactose intolerance?

Abdominal pain, flatulence, and diarrhea after dairy consumption.

Why might toasting bread reduce symptoms in some gluten-sensitive individuals?

Heat and Maillard reactions can slightly alter gluten structure, sometimes lowering reactivity (though not safe for celiac patients).