Living with Food Allergies - interview with Dr Lauri-Ann Van Der Poel

Dr Lauri-Ann Van Der Poel – Foodmaestro Clinical Advisor

Lauri-Ann is an experienced doctor, children’s allergy specialist, with a demonstrated history of working in the hospital and health care. She is very active in promoting the profile of Paediatric Allergy training and research through work for EAACI and BSACI Paediatric boards.

We took the opportunity to talk to Lauri-Ann about the challenges her patients face when living with allergies and how they overcome them.

How does having an allergy affect the lives of consumers?

The answer to this question has to be divided into more than one area.

First one is about safety and how it effects quality of life. The anxiety related to not being able to find the right foods easily is massive in patients that have life threatening allergies. In practical terms, this translates to going out less – not going out to restaurants, not participating in parties, which affects social relationships and ability to join in with things. These can become very overwhelming especially when they are first diagnosed with an allergy. Even if the allergy is not a life threatening one, sufferers have to deal with pain and discomfort if they do end up eating foods that don’t suit them, and then still try to act as if everything is normal.

“When you have a medical condition, you don’t expect to be treated as if there is something wrong with you”

This highlights the importance of feeling normal, which is my second point. When you have a medical condition, you don’t expect to be treated as if there is something wrong with you, and that happens. What we try to do with Foodmaestro is to give people an easy way to make the right choices so that they can live their lives as normal as possible.

Allergies do not only affect lives of patients, but also their families. I’ve seen many families where mothers have had to give up working to look after their children. They are faced with people not believing that the symptoms are real, or that they are a little bit crazy. These are huge things. In addition to the social aspect, simple things like grocery shopping or cooking becomes challenging. Time to shop increases, having to bake things from scratch when they may not have been natural cooks or bakers becomes a must, and learning how to do food substitutions takes time.

What I see Foodmaestro is already doing is to help make those food choices easier for people to allow them to make more choices, be safer with their choice and know that this is coming from a source that they can trust.

What are the biggest challenges people are facing with food allergies when grocery shopping?

I think the major thing that I hear the most about is the “may contain” issue. Most people don’t know what it means, and unfortunately we don’t have a clear consistent common language related to what is called precautionary allergen labeling. Let me give an example. One of the manufacturers I met has incredible rigor, has hired people to do testing to make sure that when they do the next run of nut butters, it’s completely clear of the previous nut and that is rigorously tested. So when they say “may contain” they may mean it is clear, but we do work with another nut and it’s not impossible for there to be a contamination. OR, here is another example. I’ve come across a specific scenario where there is a company that has manufacturing sites all over the UK including Ireland. All of the sites in the UK are clear of the allergen, but in the factory in Ireland they have the allergen on the next door run. So, they have to write “may contain” simply because they are using the same packaging. Actually in real terms, the risk of contamination Is extremely low especially if you are buying in England because the manufacturer sites in the UK don’t have that allergen in the factory at all. So, they are missing a lot of people for no reason and they are losing trust.

One of the things that really annoys people is if they feel the brand is just saying may contain to “cover” themselves. In other words, they are blocking people from being able to eat those foods but they really don’t know what the risk is.

Another important aspect of this is being really clear about which foods are the potential contaminants. Instead of saying may contain nuts, say more specifically which nuts your factory is working with (e.g. hazelnuts and almonds), and make it clearer so that people can make safe choices.

The second major issue is manufacturers’ unclarity about certain food ingredients. E numbers and spices are the common headaches! There are quite a lot of foods that say herbs and spices (or natural flavourings) without specifying the ingredient.

Which food categories are especially of concern?

There are two main reasons why food categories become concerning for people with allergies. First are the common allergens. There are 8 allergens that account for most of the allergic reactions in the world, but of those, milk, egg, nuts and seeds are the greatest. For people with gastrointestinal issues and certain types of allergies, soya and wheat are very tricky. For most people, soya sounds like an easy ingredient to exclude if they are not consuming foods like tofu or edamame. But in reality, it is one of the trickiest ones as it presents in many products (soya lecithin as emulsifier). Try avoiding soya for a week – it IS a challenge to completely avoid it.

The Second aspect is related to people not recognizing what is in their food. In this category, newer allergens – such as kiwi – or products that historically didn’t include that allergen as an ingredient – such as pesto sauces which are prepared with different nuts instead of only pine nuts – are especially of concern. Soya and milk are other common hidden ingredients. Most people don’t realize that their bread may contain soya or that crisps may contain milk. With Foodmaestro app people are able to find specific examples themselves, quickly and easily during grocery shopping.

What would you say is the biggest reason for people eating something they should not and having a reaction? A lack of understanding on the consumers part or lack of transparency?

It’s both and Foodmaestro also has an important role to play within both of these issues. We are working on educational series and our blogs to improve understanding on the consumers part. For the lack of transparency, our role is to get the dialog moving to improve the conversation between healthcare – retail and the consumer.

Would you say patients with severe allergies have enough of a choice on the products they want to consume?

I think most of the patients with allergies would say NO. But they may not be aware of the food choices available to them. One of Foodmaestro’s strengths is that there are actually foods on the shelves which are not specifically marketed as free from foods, but YES it is still suitable for people with allergies. So that product discovery feature of Foodmaestro is one of the exciting things that we actually can do for our consumers.

“We have moved away from the era where we have just the free from aisle. Consumers with allergies want to move away from the feeling that they are special”

Consumers are upset that there are not enough choice and what choice there is are premium priced. Some of that premium pricing has to do with marketing and I’m sure that manufacturers will say that’s to make sure that people are informed which things are safe for them by having really bold labeling. However, we have moved away from the era where we have just the free from isle. Consumers want to move away from the feeling that they are special – that they need to pay extra because they have got a problem, they want to just be able to quickly scan something on the shelves and get “yes that’s fine for me”.

How have food manufacturers helped consumers with food allergies?

As someone from the medical allergies perspective, going to the Anaphylaxis Campaign corporate conference and having to speak to manufacturers in person for Foodmaestro reasons, I’ve been really pleasantly surprised about how larger retailers and manufacturers really put a lot of rigor into being allergy aware. I’m really sad that consumers don’t know enough about that.

In your opinion, how has trust in packaged food industry changed over time?

I’m not sure if perception has changed. I think that people find the brands that they trust and chose them regularly as a safe option. A lot of the people will find that the bigger brands are trusted more because they are more regulated.

With the new legal requirements, all manufacturers are declaring allergens in brackets on food labels, which have definitely had an impact on convenience of consumers. However, many of my patients are not allergic to those common allergens. Therefore for many people with allergies and intolerances, those highlighted ingredients become irrelevant. We still need more clarity about ingredients even if the 14 common allergens are highlighted. Digital tools are ideal for those kinds of things because you are limited in space in the label but we actually need more clarity about the ingredients. Many people don’t understand what some ingredients are. For example, many people try to avoid ingredients that have E numbers, but if you look at E300 – it is just vitamin C.

What would you like to see change in the near future for people with allergies/ intolerances?

Long story short: Transparency and clarity with ingredients and food labeling. I can understand people not wanting their commercial recipes out of the bag but there should be a channel whereby professionals can easily get the information to be able to help patients better. Right now, we need to phone the manufacturer and speak to their consumer services or the patient has to do that – it isn’t ideal – it should be on the label. They don’t have to give the exact proportions, but they need to be honest with people about what is in the products.

Another very important aspect is education. I would really like to see more education about foods, food allergens and what goes into food. It is important to recognize allergy risks related to foods which depends on how it is cooked, how it is processed, and what the individual thresholds are. After all, we all deserve to know what is in the foods we eat everyday.