Food allergies and intolerances are among the most common chronic medical conditions in children and adults. In many cases, people are not yet aware that they have an allergy, sensitivity, or intolerance to a particular food or ingredient.

Technically, a food allergy is a medical condition in which exposure to a food or ingredient triggers a harmful immune response. It’s estimated that some 15 million Americans have diagnosed food allergies, including nearly 6 million children under age 18. That’s 1 in 13 children, or roughly two in every classroom.

Caring for children with food allergies costs US families nearly $25 billion annually, according to recent data from the Food Allergy Research and Education (FARE) organization. The eight major food allergens – milk, egg, peanut, tree nuts, wheat, soy, fish, and shellfish – are responsible for most of the serious food allergy reactions in the country.

Between 1997 and 2008, the prevalence of peanut or tree nut allergy appears to have more than tripled among US children. The Centers for Disease Control & Prevention reports that the prevalence of food allergy in children increased by 50% between 1997 and 2011.

Celiac disease is a serious genetic autoimmune disorder where the ingestion of gluten (a protein found in wheat, rye, and barley), leads to damage in the small intestine, causing a variety of health issues. The disease is estimated to affect 1 in 100 people worldwide. According to the Celiac Disease Foundation, 2.5 million Americans are undiagnosed and are at risk for long-term health complications.

Free-From Growth

Food products bearing labels stating claims such as “gluten-free” and “dairy-free” have experienced tremendous sales growth as more consumers have reported making changes to their diets in order to adopt what they feel are healthier lifestyle and food choices. For example, whether they have celiac disease of not, many consumers associate gluten-free foods with such benefits as increased energy and weight loss.

The market research company TechNavio Co. cites a 2013 survey conducted by Monash University that revealed that 78% of those consumers who purchase gluten-free products say they do so for some health reason, especially in relation to the increased incidence of obesity across Europe and the Americas. Preference of gluten-free food items also has risen sharply among persons with diabetes due to perceived long-term health benefits related to weight control and blood-sugar management.

While sales in recent years have hinted at a slowing down after the initial meteoric growth, the global gluten-free packaged food market still is projected to grow at a compound annual growth rate (CAGR) of approximately 6% between now and 2019. In its report, “Gluten Free Food Market – Global Industry Analysis, Size, Share, Growth, Trends, and Forecast, 2015-2021,” Transparency Market Research Ltd., projects the gluten-free foods segment to reach nearly $5 billion by 2021.

The gluten-free market in the US is driven principally by the growing number of diagnosed celiac disease patients and the positive consumer reaction to a gluten-free diet. The category of baked goods appears to be the largest segment by both value and volume during this forecast period.

On the dairy-free side, research firm MarketsandMarkets Research Private Ltd. projects the annual global dairy alternatives market to grow to about $20 billion by 2020, with 15.5% CAGR growth since 2015. Soymilk is expected to be largest segment, reaching $13.6 billion by 2020. However, as soy is one of the “Big 8” allergens, the “alternate alternates” are on a steeper  trajectory. For example, almond milk is expected to have fastest growth rate through 2020, at 16%.

Almond milk and coconut milk have been used increasingly in dairy-free analogs of yogurt and frozen desserts. Along with rice derivatives, they are being made into cheeses as well. Rice-based cheeses have the added advantage of being ideally suited for hypoallergenic formulations.

Flax seeds are not only gluten-free but packed with omega-3s, fiber, protein, and minerals such as manganese, magnesium, and phosphorus. While flax seeds have been used as a fiber source in cereal bars and breads, they also are used to manufacture flax milk and even dairy-free yogurt.

When manufacturing products targeting consumers with allergies or sensitivities, cleanliness and good sanitation practices are uncompromisingly important. Crossovers from stations where allergenic ingredients are used can result in disaster for both the unsuspecting consumer and the company unlucky enough to have caused the issue.

“We’ve created specific processes that hold our suppliers, facilities, and teams to the highest standards of allergen safety,” says Kevin O’Rell, COO for Good Karma Foods Inc., one of the leading manufacturers of flax milk. “[We] select the highest-quality ingredient suppliers, who must pass our allergen safety procedures and standards.” Those standards are stringent, more so than is required in the US. Good Karma sets a limit of 5 ppm for any potential “Big 8” allergen.

“This also includes our sources across North America providing our flax oil,” stresses O’Rell. “All our own manufacturers must follow the Global Food Safety Initiative food safety practices, manufacturing products only after complete cleaning has been performed. Also, testing of equipment is done to make sure it’s free from the presence of allergenic proteins, down to 5 ppm. In fact, if any test results in higher than 5 ppm, we repeat the whole cleaning and test again before we start production on any of our products.”

Ancient Solutions

While food manufacturers may want to incorporate so-called “ancient” grains to create value-added snacks and baked goods, when it comes to using them in allergen-free formulations, extra caution is required. Not all ancient grains are axiomatically gluten-free. Kamut, spelt, faro, and triticale, for example, are members of the wheat family.

It should be noted that some research indicates that, among those who are not Celiac but sensitive to wheat, some of these grains might not trigger a negative reaction. For the processor, however, there are other grains and seeds the products of which are suitable to use in formulations for celiac patients.

Among these are amaranth, buckwheat, chia, millet, sorghum, and teff. Many such grains have similar protein-to-carbohydrate ratios and in some cases perform similarly to the aforementioned wheat relatives.

Quinoa also has significantly greater amounts of the normally limited amino acids lysine and isoleucine (especially lysine). These greater amounts of lysine and isoleucine allow the protein in quinoa to serve as a complete protein source. Moreover, two antioxidant flavonoid phytonutrients in quinoa —quercetin and kaempferol—are available  in especially concentrated forms.

“In addition to being a complete and balanced protein containing all essential amino acids, many of these whole, heritage grains also contain natural choline, plus omega 3, 6, and 9 fatty acids for brain and eye development in infants and growing children,” says Caroline Freedman, co-founder of Freed Foods LLC/NurturMe brand of allergen-free baby and toddler foods.

“To further promote overall digestive health, we’ve removed common allergens that can irritate sensitive tummies,” adds Freedman. “This includes gluten, dairy, soy, and egg. Also, we add a daily dose of probiotics to our
ancient-grain based lines for all our baby and toddler foods.”

First Consumers

As demonstrated by NurturMe, a significant application for allergen-free foods is that of foods for the 0-6 age group. As many food sensitivities have an early onset, little ones can’t exactly say it’s the wheat flour-thickened veggie purée upsetting their tummy.

Ancient grains can be a great help here. Most whole grains—for example, quinoa, amaranth, millet, and sorghum—have many nutritional benefits superior to traditional wheat. All are naturally hypoallergenic, easily digestible, contain dietary fiber for good digestive health, and also immune-boosting antioxidants to support children’s growth.

Peas of Mind LLC makes food products geared toward growing kids. Many of the company’s products are gluten-free and free from dairy, soy, and nuts. These products include pizza with a veggie crust, vegetable “tater” tots, vegetable-based French fries known as “Veggie Wedgies,” and milkshake smoothie kits.

“Our vegetable tots are composed of more than 50% vegetables—broccoli, carrots, or cauliflower, depending on the flavor—and a serving of tots contains a full day’s serving of veggies,” says Jill Litwin, founder and CEO. The tots use a combination of potato and brown rice flour as a gluten replacer and whole liquid egg as the binder to keep the product’s shape

As with standard tater tots, Peas of Mind’s tots were formulated to be crunchy on the outside and fluffy on the inside. “Brown rice flour was the perfect ingredient to help produce that crunchy exterior while keeping our tots light and fluffy on the inside,” says Litwin. “We wanted our ‘Veggie Wedgie’ French fries to be as healthy and clean as possible, and we let the consumer add the salt and oil if they choose.”

The canola oil in the company’s product line is used as a processing aid during the production process to help eliminate sticking issues. It also helps optimize the product’s health profile, as the tots and wedges are baked, not fried. “The fries are sprayed with a small amount of canola oil on their surface, which helps them crisp up in the oven,” explains Litwin.

Covering All Bases

Many processors opt to focus on excluding specific combinations of allergens. For example, since many gluten-free formulations make use of non-GMO ingredients, it’s easier to take that extra step and make sure all the ingredients are non-GMO. Kayco Co.’s Absolutely Gluten Free brand team has developed crackers and flatbreads using non-GMO ingredients.

Absolutely Gluten Free products are sold in flavors such as cracked pepper and toasted onion. The company uses a combination of tapioca starch,
potato starch, and potato flour to form the dough structure and uses egg yolks as a binder.

For its regular and non-dairy cheese pizzas, the company uses a light, flourless crust made from cauliflower. The non-dairy version contains only 170 kcals, 6g fat, 4g of dietary fiber, and 6g of protein per pizza. A combination of tapioca and arrowroot flours, pea protein, and xanthan gum are used to create the imitation mozzarella-style cheese.

Enjoy Life Foods Inc. developed a number of products that are gluten-free, non-GMO, and also free-from the top eight food allergens. Many of the baked products the company produces utilize ancient grains. The company has a line of baking mixes for brownies, pancakes and waffles, muffins, and pizza crust. It also has an all-purpose flour that contains the probiotic fiber inulin and the probiotic spore-former Bacillus coagulans.

“These mixes not only deliver 5g of protein per serving, but the protein source is a unique, plant-based algal protein not normally seen in allergy-friendly baking products,” says Joel Warady, CSMO for Enjoy Life. “Because B. coagulans is a spore, it can survive the baking process intact and deliver 500 million CFU of the beneficial microbe per serving, even after baking.”

The Enjoy Life baking mixes use sprouted brown rice protein, high-protein teff flour, flaxseed meal (a good source of omega fatty acids) plus the minerals manganese, calcium, and iron. “The added probiotics help support good immune health,” says Warady.

The company also recently developed a line of mini cookies. They contain a blend of flours from brown rice, sorghum, and buckwheat. They also use xanthan gum and konjac, both hydrocolloids that act synergistically as binders. These provide a chewy mouthfeel, and take the place of the allergens egg and wheat in the formulation.

Elevation Brands LLC’s Ian’s Natural Foods manufactures a wide variety of prepared entrées such as pizzas, breaded meat products, appetizers, and kids’ meals. These products are free from six of the common allergens (specifically, wheat, casein, eggs, peanuts, tree nuts, and soy).

Ian’s also makes croutons that use a blend of brown rice flour, tapioca starch (modified and unmodified), and potato starch. A combination of egg whites and xanthan gum serves as a binder to replace the wheat gluten structure. The company uses cornflake crumbs and also brown rice flour, and brown rice crisps as coatings for its meat products because rice is hypoallergenic and easy to digest.

Gelling without Allergens

Wheat flour has traditionally been one of the primary thickeners for soups, sauces, and similar formulations. While rice flour and corn starch can be adequate substitutes, many formulators have been moving toward completely grain-free solutions.

Tapioca, once the workhorse of thickeners, has enjoyed an impressive resurgence in popularity.

Konjac fiber has been used for thousands of years as a dietary fiber used to thicken stews and soups and other formulations. It is extracted from a type of Asian sweet potato of the Amorphophallus konjac variety.

The fiber also is familiar by its chemical name, glucomannan, and is a long-chain, high-molecular-weight, water-soluble polysaccharide. Konjac can act as a reversible or irreversible gel or in a highly viscous, non-gelling product. Once fully hydrated, these gels and viscous solutions are salt-tolerant and will withstand low-pH systems.

Konjac also combines synergistically with other hydrocolloids to create a wide range of mouthfeels, textures, and gel strengths. Xanthan gum, carrageenan, tara gum, and starch each create different properties when blended with konjac. Konjac and xanthan combinations provide a set that is elastic enough to act as a gluten replacer, allowing the dough to withstand processing conditions.

This combination can also create the chewy mouthfeel that consumers expect. As a highly functional hydrocolloid, konjac is more effective in controlling a greater amount of water than many other gums. It can bind up to 200 times its own weight in water, a property which makes it a useful ingredient for providing freeze/thaw stability, as it controls the water migration in a product.

Moreover, konjac contains between 85-95% soluble dietary fiber, and thus, as an ideal ingredient for use in allergen-free functional foods. On the nutritionally functional side, has shown beneficial effects in improving blood lipid profiles and reducing serum cholesterol levels.

From Sea to Nuts

For those consumers with seafood allergies, there traditionally has been no replacement option, only simple avoidance. While shellfish allergies specifically are not as common as some other food allergies, the reaction in the inadvertent consumer can often be severe and even life-threatening.

The surge in demand for, and development of, plant-based meat analogs has led to numerous fake fish and seafood products that are remarkable in their mimicry. Companies such as VegeUSA LLC, with its Vegetarian Plus line of fish analogs, and Pinnacle Foods Inc.’s Gardein line’s fish and crab replacers originally created their products to serve the vegetarian/vegan markets demands, but also opened the door for consumers allergic to the real thing.

The aforementioned companies use such ingredients as konjac, algae, and potato starch for texture, and seaweed for flavor. Ingredients such as these can fill the needs of manufacturers wishing to target the allergic consumer. It should be noted, though, that while in many cases of fish and seafood allergies, the offending compound is a protein called tropomyosin, in some cases the culprit is iodine. This would rule out the use of seaweed as an ingredient in a truly allergen-free fish formulation.

For some persons with shellfish allergies, calcium sourced from coral has been suspected of triggering adverse reactions. However, calcium from oyster shells is commonly derived from ancient seabeds and thus contains no stray proteins that could trigger an allergic reaction.

All sources of calcium used in foods and supplements are required to be subjected to rigorous purification processes. Still, these sources must be labeled on the off chance a consumer does somehow have an allergic reaction to a substance in the ingredient.

On land, nut and peanut allergies, too, are known for the severe and dangerous reactions they can trigger. For formulators wishing to address these allergens specifically, several nut analogs exist that perform admirably in most formulations. Some are wheat gluten-based, and suitable only for those consumers needing to avoid nuts and peanuts. In this case, some toasted and formed ancient grains can make adequate replacers for nuts in coatings and inclusions.

Nut butters from sources such as sunflower seeds have been available for decades, and the sesame spread tahini for thousands of years before that. But a recent entry into the peanut butter substitute field is Sneaky Chef Foods LLC’s “No Nut Butter.” The smooth and creamy product is made from roasted dried yellow peas, avoiding peanuts, tree nuts, soy, gluten and even GMOs.

Number Nine

Off the Big 8 track, certain ingredients have been subjected to increased attention as suspected allergens. Additives such as monosodium glutamate, certain food dyes, and other such compounds have generated both scrutiny and controversy. One class, however, has a strong scientific backing.

There is a comparatively small number of people who are known to be sensitive or allergic to garlic and sulfites. Garlic has a variety of biologic activities, including anti-inflammatory properties. Garlic allergy has been known since at least 1950. It is not limited to hand contact, where it can cause dermatitis, but can also be induced, with different symptoms, by inhaling garlic dust or ingesting garlic.

The major contributor to the dermatitis issue is a chemical called diallyl disulfide (DADS), together with related compounds allyl propyl disulfide, and allicin. These chemicals occur in oils of plants of the genus Allium, including garlic, onion, and leek.

Unfortunately, DADS penetrated through most types of commercial gloves, therefore, wearing gloves while handling garlic has proven inefficient against this allergen. Instead, treatment would involve administering acitretin (a vitamin A derivative) at 25 mg/day, orally, or applying psoralen and ultraviolet light to the affected skin area over a period of 12 weeks (PUVA therapy).

For those who cannot ingest these compounds, the only option currently is avoidance. However, truffles have been reported to have a garlicky flavor that would allow processors to create a product, such as garlic-free garlic bread, without the offending allium. Market demand, though, is not strong as of yet.

Sulfites have been used for centuries, mainly as food preservatives, however, they can also occur naturally in foods such as fermented beverages and wines and are also used as antioxidants in the cosmetic industry. Examples include sodium sulfite, sodium bisulfite, sodium metabisulfite, potassium bisulfite, and potassium metabisulfite. Sulfites can cause allergic reactions in sensitive individuals, with a range of symptoms including dermatitis, hives, flushing, hypotension, or even—though rarely—potentially deadly anaphylactic reactions.

According to the FDA, about 1 in 100 people are sensitive to sulfites. Scientific studies have reported a 3-10% prevalence of sulfite sensitivity among asthmatic patients following ingestion of these additives.

Originally appeared in the July, 2017 issue of Prepared Foods as No Allergens.

Gluten-Free in Translation

In 2013, the FDA published regulations defining the voluntary “gluten free” claim for food labels. To use the terms “gluten-free,” “no gluten,” “free of gluten,” or “without gluten” in the US, a food must contain fewer than 20 parts per million (ppm) of gluten. However, most other countries have stricter limits, allowing levels no higher than 10 or even 5 ppm. Processors wanting to sell their product in the overseas market should make it a point to “know before they go.”

More Allergen Free

Want to know more about allergen free or gluten-free formulating? Check out “Allergen Free Formulating” plus dozens of other past articles and ingredient profiles at www.preparedfoods.com.

No-Myth Solutions

Know more about “Food Allergy Myths and Facts” and brush up on the regulations with “Food Allergen Labeling 101” — with “Food Allergen Update”.