Meat and Other Novel Food Allergies

Meat and Other Novel Food Allergies

We likely all know someone allergic to peanuts, eggs, almonds or some of the other Big Eight allergens. But meat? That’s a new one. A meat allergy isn’t the only unique allergy you might run across. Cases of anaphylaxis to spices, celery, bananas and many other foods have also been reported in the past several years. Although these allergies affect a relatively small proportion of the population, they are still important to be aware of.

First, let’s review allergies

Before we dive into these novel food allergies, let’s recap the difference between an allergy and an intolerance. A food allergy is an immune-mediated response to a substance in foods and can be life-threatening. The immune system releases immunoglobulin E (IgE) antibodies in response to what it thinks is an invader, such as protein from peanuts or even peanut butter. On the flip side, an intolerance affects the digestive system and usually causes an upset stomach, nausea, vomiting or diarrhea, but is typically not life-threatening. Some symptoms might overlap, which for many, can be confusing to know whether it’s a true food allergy or an intolerance. It’s important to remember that only a board-certified allergist can truly diagnose an allergy. We’ll be discussing allergies here, but an intolerance to any of these foods is also possible.

The Food and Drug Administration (FDA) currently recognizes eight major allergens (the “Big Eight”) which are responsible for ~90% of allergic reactions in the U.S.: milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans. FDA enforces the Food Allergen Labeling and Consumer Protection Act (FALCPA) which regulates labeling of these major allergens. According to FALCPA, a food that contains any of these allergens as an ingredient must be labeled on the packaging. FDA also recognizes that more than 160 foods can and do cause allergic reactions for some people, though it is nearly impossible to mandate labeling for all of these ingredients.

“Meat” the new culprit

One of these 160 allergens is meat. Although the prevalence of the meat allergy is unclear at this time, experts estimate it has been rising in the past few years. What we’re calling a meat allergy is actually an allergy to the sugar molecule alpha-gal (galactose-α-1,3-galactose) which is found in most mammals. Alpha-gal is not found in humans, apes, monkeys or non-mammals (like poultry, fish and reptiles). That means people with this allergy are safe eating chicken and fish for dinner, but not beef and pork. Some experts suspect the alpha-gal allergy is related to the Lone Star tick, an insect native to the southern and eastern U.S. This might also explain why most cases of meat allergy are found in these regions. The Centers for Disease Control and Prevention (CDC) have not confirmed whether the tick bite causes alpha-gal allergy, but they do recommend taking measures to avoid tick bites when venturing outdoors since there is some correlation between the tick bite and allergy symptoms.

Not just animal meat

Animal meat is not the only problem we’re seeing in the food system. While plant-based meats are emerging throughout the food market, they also can pose a risk for people with known allergies. It’s not a secret that some plant-based proteins contain major allergens; tofu and tempeh are made from soy, seitan is made from wheat. However, these products are always properly labeled according to FDA rules for allergen labeling.

Those with peanut allergies may not have that same warning when trying out new plant-based meats. There are reported cases of people experiencing similar symptoms when eating a plant-based meat product as they would after eating a peanut. Scientists attribute this to the pea protein isolate in these products. Though only a small percentage of people with a peanut allergy have reactions to other legumes (like peas), the high concentration of the pea protein may trigger a reaction in some folks. Some plant-based meat companies have reacted by putting a warning label on their products to protect consumers with these known allergies.

Other novel allergies

Although rare, cases of severe allergic reactions to spices, among other foods, have also appeared recently. Allergies to spices like coriander may affect 2-3% of the population according to the American College of Allergy, Asthma, and Immunology (ACAAI). Spice allergies, however, may be difficult to identify for a few reasons. For example, ground pepper can make us sneezy in general or can trigger symptoms in those with asthma. It’s important to note that these are not symptoms of an allergic reaction. Additionally, sesame allergies have become more prevalent. The Food and Drug Administration (FDA) is considering adding sesame to the list of major allergens because of its prevalence, meaning it will be labeled similar to the way peanuts, soy and wheat are currently labeled. Both ground pepper and sesame may be included in spice mixtures or mixed foods in general, which may make it difficult to identify the true cause of the allergic reaction.

You may come across other unique food allergies, like coconut and corn, which makes it important to recognize that anyone can have an allergic reaction to any food at any time, even if that person has never been diagnosed with an allergy before. Being aware of symptoms of an allergic reaction are important in order to stay calm when faced with an emergency. It’s especially important to be aware of ingredients in products for these unique allergies, as there is no guidance for labeling lesser known allergens.

Recent data from the 2019 Food & Health Survey, suggests that 17% of Americans “have a food allergy in the household” and the an additional 37% “know someone with a food allergy.” Combined, that’s over 50% of the U.S. population connected to someone with a food allergy. Therefore, it’s important to know what to do in case of emergency. If you or someone you know is having an allergic reaction, dial 911 and seek immediate medical attention. Quick and prompt attention could save a life.

This blog post was written by Courtney Schupp, MPH, RD, our 2019 Sylvia Rowe Fellow.