Trips to the grocery store can leave individuals and families wondering what products might be safe for life with FPIES. Regardless of the foods a person is avoiding, these simple tips and tricks can help to ease the daunting task of interpreting food labels.
1.Research: If possible, do a little bit of research in advance. You won’t know for sure that the ingredient list is safe for your family until you have the product in hand (as some foods may have different recipes in different areas of the country/world) but you can take a look at some potential winners in advance by going online and searching for foods that are either free of the foods you are avoiding or contain your safe foods only. Shopping through the products at amazon.com and other websites that offer online grocery shopping can help to learn about products you might not have otherwise been aware of.
*** A Picture Speaks a Thousand Words— sometimes printing out a picture of the product or the brand logo to take with you to the store is helpful for better locating the product, or can be helpful when having an associate help you to locate the product.
2. Tracking: Once you have a list of potential foods from your research, seek out which stores carry these foods and where they are located. Whole Foods, Trader Joes, some larger grocery store chains, and many health food stores offer allergy-friendly food choices. You just need to figure out who carries the ones your family requires.
3. Word of Mouth: If you know of other individuals or families that live with food allergies, talk to them about what food/foods have worked for them in the past. It is not a guarantee that these foods will be safe for you or your family, but again, it can help to give you a place to start.
4. Ingredients: Every food product is required to contain an ingredients list, listing all food products contained in the product. However, some ingredients listed can be difficult to decipher— only the top 9 “most common allergens” are legally required to be written out in plain language. Often, the top 9 allergens are bolded in the ingredient list, but not always. It is important to read all items listed and if you do not know what an ingredient is or what it is derived from (i.e. ascorbic acid can be derived from different sources, for instance, and the ingredient list will not typically disclose the specific source), be sure to locate information on contacting the manufacturer so as to better determine whether or not the product may be safe for your family.
5.“Contains”: This part of a label lists in plain language which of the top 9 allergens the product contains in the ingredients themselves, but does not list what cross contamination risks may be involved. Sometimes a brand will elect to include other foods in the “contains” list in addition to any the top 9 allergens involved, but they are not required by law to do so.
6.“May Contain”: This refers to the risk of cross-contamination that may be involved with a specific product, typically involving the top 9 allergens. This is not a required part of the labeling process. If you do not see it on the label, it does not guarantee that the product is free of any possible cross-contamination involved in the processing/packaging of the product.
7.“Shared Equipment/Processed on Equipment That Also. . .”: This refers to when a product is processed on equipment that also processes other products containing the allergens listed in the statement (typically, you will only find one of the top 9 allergens listed here). This is not a required part of the labeling process and does not disclose any information regarding how the equipment is prepared between product runs. One factory may completely disassemble and clean/sterilize all machinery between each separate product run on those production lines. A second factory may run the products back to back without cleaning or wiping down the lines in between runs. It is very important to contact the company and inquire specifically about their processing and packaging process in regards to shared equipment in order to help prevent potential cross-contamination reactions.
8.“Processed in a Facility That Also Processes. . .” : This refers to a product that is processed in a facility that also processes other products containing the listed allergens. Again, this is not a required part of the labeling process. This statement can mean:
that a product is processed on shared equipment with another product containing the listed allergens,
that a product is processed on a machine next to a separate machine that processes another product containing the listed allergens,
that a product is processed on a machine in another room in the same factory that also processes a product (though in another room) containing the listed allergens
9. Call It In: Depending on the sensitivity of yourself or your family member, you may elect to call the company any time you consider using a new product. Or you may elect to call only when the language on the packaging causes you concern, or you or your loved one seems to be reacting to the product. No matter the reason, here are some tips for navigating your phone call:
Be Specific: Companies are not required to disclose all information about a product’s “protected” recipes due to other corporate competition worries. If you ask specific questions, you will get more helpful answers. For example, ask “Does product X contain corn/any corn derivatives in the ‘natural flavors’ ingredient listed?” rather than “What food/food derivatives are contained in the ‘natural flavors’ ingredient listed?” Be sure to not only inquire about processing, but also about packaging and equipment cleaning procedures.
Allow Time to Talk: Depending on the issue and/or depending on the company, you may be on the phone for a good bit of time to figure out your answer. Sometimes it may take a week or more for the company’s “food scientists” to research your question.
Be Persistent: If you or your loved one experiences a reaction or if you simply really would like to trial this product, be persistent. When you call initially, make note of the call centers hours, phone number, and information on who you speak with initially. If you do not hear back from the company when you expect to or if your question is not sufficiently answered, call again. Sometimes it takes speaking with the right person in order to get the answers that you need.
Plan Ahead: If you are calling about a food/ingredient for a special occasion (like a birthday cake), call and inquire as far in advance as possible. You want the food to be a success and you want as much information as possible before you make your decision. No amount of planning is perfect, but it can certainly help to make things a bit safer.
10. Ingredient Changes: Once you get comfortable using a product, it is easy to fall into the habit of not checking the packaging with each new purchase of the same thing. But ingredient lists and packaging/processing procedures can change without warning, so it is important to check carefully each time you purchase a new item, even if it is the same product that you have been using for months or years.
***Recalls: Pay attention to recalls. You can do periodic searches on your computer using any web browser for past or current recalls of the products that your family uses. Sometimes it is helpful to schedule a regular time (i.e. once a month, etc) to give the products a quick search.
11.Non Top 9 Allergens: This can get tricky! FDA regulations only require the top 9 allergens to be listed in plain language on food labels. If you or your loved one is allergic to foods not included in the Top 9, you may have to be more proactive in your research and your contact with the products’ companies. Rice and corn are particularly difficult as they are used in a lot of flavorings, thickeners, and additives.
*** Report! If your loved one experiences an allergic reaction that seems to be definitively tied to a specific product (specifically whose ingredient list matches up with your safe food list), be sure to report this incident to the company involved. There may have been a processing error, there may be reason for a recall. But unless someone reports it, they may never know and someone else may experience a reaction too.
*** Remember that all individuals have varying degrees of sensitivity. One person may need to avoid foods processed on shared equipment with his/her/their allergen whereas another individual may not need to take such precautions. Discussing your or your child’s degree of sensitivity with a knowledgeable practitioner may help you to determine what precautions you and your family feel most comfortable taking.