Retailers learn more about the allergy-free market as sales continue to grow.

Glad to be free from gluten? Petrified of peanuts? Leery of lactose? Scared of soy? You’re not alone. Food allergies, sensitivities and intolerances are a growing health concern, but tracking the prevalence is challenging and can be contested, as popular and scientific definitions differ and diagnosis can be problematic, noted Audra Foster, ND, member of the California-based Vitalah’s (maker of Oxylent) Board of Advisors.

But according to FAAN (The Food Allergy & Anaphylaxis Network), approximately 15 million Americans have food allergies. This figure includes an estimated nine million U.S. adults (or four percent) and approximately six million (or eight percent) U.S. children. The prevalence also appears to be on the rise—FAAN cited figures from a 2008 study by the Centers for Disease Control and Prevention (CDC) that found a roughly 18 percent increase in food allergies between 1997 and 2007. FAAN also reported that the prevalence of peanut allergy, in particular, seems to have tripled among children between 1997 and 2008. Dairy allergies also appear to be on the rise.

Continued Growth

The market for allergy-free foods continues to grow exponentially, according to Elizabeth Jarrard, RD, LDN, regional educator for Canadian-based Vega. She pointed out that in just the gluten-free category, SPINS market research reports that sales were $12.4 billion in 2012. And Global Industry Analysts, Inc., projects the entire allergy-free market to surpass $26.5 billion by the year 2017. “On a daily basis, the team at Vega receives countless emails and phone calls from customers inquiring about our product line as it is gluten- and dairy free,” she said. “Questions on allergens are the most common out of all those posed to our product education team.”

As public awareness of the problem increases and studies continue to show the prevalence of food allergies, demand for retailers to stock solutions also increases, and thus the market for allergen-free foods also continues to grow, Foster confirmed. “The category has consistently seen double-digit growth rates over the last several years. Gluten-free foods, in particular, have shown the most influence within the category,” she said.

That has been the case for Wellness Manager Carmela Wolf with Down to Earth, a retail store in Honolulu, HI. She agreed that allergy-free demand is growing, product offerings are expanding and the biggest growth in the category has been gluten-free. “Our customers are ones with celiac or a sensitivity,” she said. “It’s interesting to see gluten-free in supplements and cosmetics and skin care. You are seeing more products labeled as ‘allergy-free.’”

Health Effects

A food allergy is an immune system response to a protein in food. When exposed to the allergen, the body produces immunoglobin E (IgE)—an antibody— to a normally harmless food, resulting in symptoms that can range from itching in the mouth, hives on the skin, trouble swallowing, abdominal pain or anaphylactic shock, Jarrard explained. Some foods that are not proteins, such as lactose, can cause a sensitivity, which can exhibit some of the same symptoms, as well as fluid retention, sinus congestion, fatigue, abdominal pain or discomfort, joint inflammation, mood swings, indigestion, headaches, chronic ear infections, asthma and depression. “It is important to speak to a health care practitioner if you believe you have a food allergy or sensitivity,” she noted.

In addition, unlike allergy or food sensitivity, food intolerance is recognized as a digestive deficiency, according to Rachel Szpond, regulatory affairs coordinator with Florida based Enzymedica, Inc. “Food intolerance is an abnormal physiological response to an ingested food or food additive. Because food intolerance does not involve the immune system, there is no test for a physician to perform for diagnosing intolerance to a specific food or food group,” she said. “In contrast to food allergies, the symptoms of food intolerance are often delayed and may not occur until several hours or even days after the intolerable food is ingested. Common symptoms of food intolerance include abdominal discomfort, occasional diarrhea, gas and bloating.”

At the other end of the spectrum, anaphylactic reactions can be serious and even life-threatening: breathing difficulties, swelling of the throat and/or lips, abdominal cramps, gastrointestinal distress, vomiting or even death, noted Vitalah’s Foster. “Administering epinephrine (i. e. adrenaline) within minutes is crucial in the case of such reactions,” she said.

Finding the Culprit

To pinpoint the specific digestive distress issue, the first step is to talk with a licensed health care practitioner— a physician, naturopath or registered dietitian— who will take a detailed history to learn more about the sensitivity or allergy, said Vega’s Jarrard. “The practitioner may perform a series of diagnostic tests to determine if your body produces IgE when introduced to a certain food. From there, an elimination diet protocol may be suggested to see if isolating the suspect food improves your symptoms,” she said, noting that before going to see a health care practitioner, it is important to keep a detailed record of one’s dietary intake and any experienced symptoms.

Brendan Brazier, former vegan professional Ironman triathlete and Vega formulator, launched Thrive Forward (http://thriveforward. Com), a free, personalized, interactive program on clean, plant-based nutrition that offers a detailed explanation and template for an accurate food journal. Lesson No. 5 from Thrive Forward explains common food sensitivities, such as gluten, lactose and soy, and provides background on elimination diets to help identify sensitivities.

The best way to determine if you have a digestive sensitivity to a food is by the process of elimination, according to Szpond. “Evaluating digestive symptoms while eliminating trigger foods from your diet may be a good indicator whether you need digestive assistance. While an elimination diet allows you to identify a food induced digestive reaction, reintroduction of eliminated foods provides verification of digestive sensitivity to foods,” she said, noting that as a complement to a healthy diet, enzyme supplementation may assist and enhance the digestion of the offending foods.

With allergens, strict avoidance is the most important measure, according to Vitalah’s Foster. “Recommendations for isolating allergens and avoiding cross contact with allergens include always cleaning cooking and food preparation surfaces and washing hands after contact with an allergen. Eating away from home also poses a significant risk and thus must be done carefully.”

Why Such Growth?

This issue is widely debated among experts, but some potential factors that could explain the increases in food allergies are the growing influence of a Western diet and changes in food manufacturing practices. For example, dry roasting peanuts increases their allergenicity compared with other practices.

Foster pointed out that, according to FAAN, eight foods account for 90 percent of all food-allergic reactions: milk, eggs, peanuts, tree nuts (e.g. walnuts, almonds, cashews, pistachios, pecans), wheat, soy, fish and shellfish.

“GMOs (genetically modified organisms), chemicals, preservatives and the like are also becoming a common sensitivity in patients—usually manifesting as symptoms associated with sensitivity reactions rather than allergic reactions,” she added.

Foster also noted that allergies or adverse health reactions are not only caused by what’s in our food, but also from what’s in our multivitamins or supplements, and cautioned that labels need to be read carefully. “I recommend that everyone take a high-quality multivitamin in order to support optimal health, but choosing one without questionable ingredients such as binders, fillers, preservatives, excipients, sugar, artificial sweeteners, artificial colors— this is just as important,” she said. “These ingredients have been linked to a long list of serious health hazards, and the last place we need them is in the supplements we take for health—especially for children.”

New Understanding

There has been an increased awareness and diagnosis of food allergies and sensitivities in the last 15 years, which has resulted in more accurate diagnostic tools, effective treatments and an increase in food products that are allergen- friendly. “It is now far more common to see gluten-free, dairy-free and soy-free foods labeled in restaurants and grocers across North America than only a few years ago,” Jarrard said.

We’ve also learned that indirect contact, such as skin contact, inhalation, vapor or steam while cooking, is unlikely to cause significant allergic reactions— ingestion is the primary concern, according to Foster. “We know that food allergies are associated with other allergic conditions, such as atopic dermatitis and eosinophilic gastrointestinal diseases, and that people with food allergies as well as asthma are often at an increased risk for severe or life threatening reactions.

“In addition to avoiding food allergens or sensitivities, it is important to support overall immune health and function with a high-quality daily multivitamin/ mineral, along with other possible natural remedies,” she added. “Further, people with food allergies at risk of life-threatening reactions should carry an epi pen at all times.”

Better Products

The new generation of allergen-free foods aims to be great-tasting products that everyone can eat, rather than special food for people who have food allergies, according to Foster. Jarrard agreed, pointing out that the popularity of gluten-free pseudo-grains, such as quinoa, amaranth and millet, has exploded in the last five years. “These nutrient-rich grains are a huge benefit to any diet, whether you are excluding gluten or not. The multisource plant-based protein powder category continues to rise, while whey protein sales are plateauing, and soy protein sales are starting to decline as consumers reach for soy- and dairy-free products in the nutritional supplement shelves,” she said.

Natural health retailers can act as an “allergen-guide” to highlight products, supplements and foods that will be safe and nutritious to consume, said Jarrard, suggesting that retailers do this by ensuring that all food labels are easily accessible to consumers to read. Staying on top of allergen research and new products coming to market is a key part of this role. “Those customers allergic to foods or who identify a food sensitivity worry that their food choices will become limited and not as favorable as their past diet options,” she said. “To comfort these customers, make sure you and your staff taste new allergenfree products before they go on the shelf so you can share first-hand experience of the many great products you carry that meet their dietary restrictions.”

Another important role that retailers can play is increasing consumer awareness that multivitamins and nutritional supplements can also pose problems for people with food allergies, Foster added. “In addition to gluten and other allergens, many multivitamins contain fillers, preservatives, excipients or artificial colors, which have all been linked by research to serious health risks. This is a particularly important issue in the children’s category.”

Retailer Wolf said Down to Earth has been successful by clearly labeling allergy- free products on shelves, creating gluten-free sections, offering educational materials and making sure team members are well informed. “There can be a lot of confusion,” she explained. “For example, buckwheat can be confusing because the word ‘wheat’ is in the name, even though it’s gluten-free. The staff has to help point that out to customers.”

Lastly, Wolf recommends her customers cook at home and eat whole foods. “Go with whole grains—amaranth, quinoa, buckwheat, whole grain rice, wild rice, teff (similar to quinoa), millet—and explore the ones available,” she said. “Don’t eat many processed foods, gluten-free or not.”

References:

Branum A, Lukacs S. Food allergy among U.S. children: Trends in prevalence and hospitalizations. National Center for Health Statistics Data Brief. 2008. Retrieved from www.cdc.gov/nchs/data/databriefs/db10.htm.

Gupta RS, Springston, MR, Warrier BS, Rajesh K, Pongracic J, Holl JL. The prevalence, severity, and distribution of childhood food allergy in the United States. J Pediatr.2011; 128.doi: 10.1542/peds.2011-0204.

(Allergy-) Free Retail Advice

New Frontiers Natural Marketplace, with two stores in California and three in Arizona, offers its customers a comprehensive guide to gluten-free. Visitors to the stores’ website can download a “Gluten-Free Brochure” that lists information on gluten-free diets as well as all the gluten-free products available in the stores.

Inside the brick-and-mortar stores, New Frontiers’ “team members,” including it’s demo staff, are well versed on every department’s products, explained Erica Nealey, dairy team leader in the San Luis Obispo, CA store. “We offer a variety of products and each department has a large selection of gluten-, soy- and nut-free products.” In the dairy aisle, coconut milk, coconut yogurt, other nut milks as well as soyfree eggs are in high demand, she said. Allergy free foods “are continuing to grow and each year offers something new. We don’t slow down, we get busier.”

Donna Wilkinson, a team member in the well-being department, agreed. “Allergy-free is growing and getting busier every day,” she said, noting that Dr. Oz has a lot to do with it, as well as a widening of the store’s demographics. “A lot of people are going toward plant-based and dairy-free, and steering away from soy and gluten.” For other retailers to succeed in the allergy free category, she noted that New Frontiers’ biggest strengths are excelling at customer service and having a well-staffed store. “Our staff knows what they’re talking about,” she said. “We are well versed across departments and available to help customers.”

Food Allergy Research Update

For up-to-date research on food allergies, Elizabeth Jarrard, RD, LDN, Vega’s regional educator, suggests retailers watch these consumer groups:

• Food Allergy and Anaphylaxis Network (FAAN), www.foodallergy.org

• American Academy of Asthma, Allergies and Immunology, www.aaaai.org

• National Institute of Allergy (part of National Institute of Health), www.niaid.nih.gov/topics/foodallergy