FAO/WHO consultation on food allergens levels, new report published

The Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) reconvened the Ad hoc Joint FAO/WHO Expert Consultation on Risk Assessment of Food Allergens for a second meeting to provide scientific advice on review and establish threshold levels in foods for the priority allergens.    

Eating low doses of food allergens may have different consequences on allergic individuals, ranging from no reaction, or mild itching sensations, to serious medical emergency that can be life threatening (i.e. anaphylactic reactions).    

The FAO/WHO panel of experts met to establish the amount or level of several priority food allergens (defined during the first meeting of this FAO/WHO Consultation, held earlier this year) that are not expected to result in significant health risks among the majority of consumers.  

After extensive discussion, consensus was obtained on reference doses (RfD, an index or range of the highest amount of allergen that does not cause even a mild objective allergenic symptoms among a proportion of allergenic patients), which should be health-based and conform with the established definition of health-based guidance values, reflecting a range of exposure without appreciable health risk.    

The expert committee concurred that an advanced benchmark dose/probabilistic hazard assessment approach was best suited to establish Reference Doses (RfD) for this meeting.

Then, the experts focused their attention on the amount of allergen that would cause notable clinical response in a specific portion of the population (known as the population-based eliciting doses, EDs). The committee considered the doses causing reactions in five (ED05) or one percent (ED01) of the population. To define these doses, the experts used clinical data related to allergic patients, and the most up-to-date scientific literature to improve their assessment.  

After this process, the experts concluded that although the total number of mild-moderate illness was predicted to be different if an ED01 or ED05 was used as threshold, the number of expected severe anaphylactic reactions did not change. Therefore, the committee decided that the ED05 could be an appropriate threshold to protect the highest number of consumers prone to anaphylaxis.  

This work helps in the understanding about the doses of food allergens that result in disease, and it can be used to conduct quantitative risk assessments for new or emerging allergens, or other allergens not reviewed in this meeting that are prevalent on national or regional scales.