Allergy and intolerance

On this page

• Living safely with food allergies and intolerances
• Food allergies and intolerances – a growing concern
• The difference between food allergy and food intolerance
• Think you have a food allergy or intolerance?
• Food allergies
• Food intolerances
• What about Coeliac disease?
• Buying food
• Eating out
• How the NSW Food Authority works to help you

Living safely with food allergies and intolerances

Food allergies and food intolerances can be unpleasant, complicate life and in the worst cases, are fatal. However having a food allergy or intolerance doesn’t have to ruin your life! Food allergies and intolerances can be managed.

This site will give you information on managing food allergies and intolerances including when you’re buying food or eating out and point you to where you can get more help.

Food allergies and intolerances – a growing concern

Food allergy occurs in around 1 in 20 children and in about 1 in 100 adults in NSW. That’s approximately 65,000 children and 96,000 adults. In fact, Australia has one of the highest allergy prevalence rates in the world and it tends to run in families.

Food intolerance is even more common. Surveys indicate that up to 25 percent of the population believe they have some sort of food intolerance.

The high incidence of food allergies and intolerance is concerning. Currently there is no cure for food allergies and the only successful method to manage a food allergy or intolerance is to avoid the foods containing that allergen or food component.

The difference between food allergy and food intolerance

Food allergy and food intolerance are both types of food sensitivity and both can make you feel very ill. If you have a food allergy this means your immune system reacts to a particular food and causes immediate symptoms, such as itchiness, rash and swelling. Sometimes this reaction can be so severe that it can trigger a life-threatening reaction known as anaphylaxis.

Food intolerance however, doesn’t involve the immune system. Instead food intolerance is actually an adverse reaction to a particular food. The symptoms can be unpleasant and in some cases severe but are generally not life-threatening.

Food allergies

Having a food allergy means you experience an abnormal immune reaction to a food that is harmless for most people. This is because antibodies are produced in your body against the protein in a food (the allergen) so that when you eat the food, histamine and other defensive chemicals are released into your system causing inflammation. It is these chemicals that trigger reactions that can affect your respiratory system, gastrointestinal tract, skin or cardiovascular system.

What are the symptoms of food allergy?

• Low blood pressure, dizziness, faintness or collapse.
• Swelling of the lips and throat, nausea and feeling bloated.
• diarrhoea, and vomiting.
• Dry, itchy throat and tongue, coughing, wheezing and shortness of breath and a runny or blocked nose.
• Itchy skin or a rash, hives and sore, red and itchy eyes.

If someone has a severe food allergy, this can cause a life-threatening reaction called anaphylaxis. Anaphylaxis affects the whole body, often within minutes of eating the food. Anaphylactic attacks are commonly characterised by symptoms such as the rapid spreading of hives, swelling of the face, tongue and throat, difficulty breathing, wheezing, vomiting and loss of consciousness.

Immediate treatment with injected adrenaline can be lifesaving. People at risk of anaphylaxis should always carry an EpiPen^® for emergency use.

What are the most common food allergens?

The eight most common food allergens are:

• Crustaceans
• Eggs
• Fish
• Milk
• Peanuts
• Soybeans
• Tree nuts
• Sesame seeds

These allergens as well as gluten (from wheat, rye, barley, oats and their products) and sulphites (which are added to food as a preservative) are required by law to be declared on food labels.

Food intolerances

Having a food intolerance means you will experience an adverse reaction to certain food components but this does not involve the immune system. In fact, it is quite different from a food allergy.

What are the symptoms of food intolerance?

• Stomach and bowel upsets
• Bloating
• Headaches and migraines
• Wheezing and a runny nose
• Hives
• Generally feeling under the weather

What are the most common food intolerances?

There are many different types of food that people can be intolerant to but the most common include milk and lactose (the sugar in milk), gluten, wheat, food preservatives, and naturally occurring compounds in foods such as caffeine.

Lactose intolerance is caused by a shortage of the enzyme lactase, which is used to ensure lactose is absorbed properly into the bloodstream from the stomach.

Milk intolerance is common in children under the age of two years. If left untreated it can result in malnutrition.

Food additive intolerance only affects a very small number of children and adults. The additives most commonly linked to food intolerance are artificial colours, e.g. tartrazine, sulphites and benzoates (types of preservatives).

Sulphites have to be declared on all packaged products under the Food Act. They are preservatives and are commonly found in wine and dried fruit. The additive numbers for Sulphites are 220-228 and appear in the ingredient list. Sulphite reactions cause asthma, rashes, irritable bowel syndrome and headaches in sensitive people.

What about Coeliac disease?

Coeliac disease is a disorder of the small bowel caused by an immune reaction to dietary gluten (a protein found in wheat, barley and rye). It is not a food allergy but an auto-immune disease. In coeliac disease, the lining of the bowel is damaged by the white blood cells of the immune system and not by antibodies (as in food allergic reactions). Symptoms include nausea, wind, tiredness, constipation, reduced growth and skin problems.

Buying food

What should I look out for on food labels?

If you have a food allergy or intolerance or shop for someone who does, it is essential to look carefully at the label on any pre-packed food you buy.

Food labelling rules in Australia state that the eight most common allergens (crustaceans, eggs, fish, milk, peanuts, soybeans, tree nuts, sesame seeds and their products), gluten and its products plus sulphite preservatives must be declared on packaging or in connection with the display.

These allergens are not always easy to find on labels. Other words may also refer to the allergen, e.g. a milk product may be referred to as casein. Anaphylaxis Australia, in association with the NSW Food Authority and Food Standards Australia New Zealand (FSANZ), has produced some allergen ingredient cards that list ingredients you should avoid if you are allergic to milk, peanut, egg, fish, tree nut, sesame, soy or shellfish. To order your free copies of these cards call the NSW Food Authority on 1300 552 406 or Anaphylaxis Australia on 1300 728 000.

Ingredients lists

There are three ways you might see allergens declared in ingredients lists:

IN BRACKETS wheat flour, sugar, margarine (contains milk), salt, flavour (contains wheat starch)

IN BOLD wheat flour, sugar margarine (contains milk), salt, flavour (contains wheat starch)

IN A SEPARATE DECLARATION wheat flour, sugar margarine (contains milk), salt, flavour (contains wheat starch). Contains wheat and milk

Even if you are allergic to an uncommon allergen, all ingredients have to be listed on the labels of pre-packaged foods. So always check the ingredients list carefully.

May contain…

Some food labels may also have a warning to show that the food product may inadvertently contain foods that people are commonly allergic to, for example, ‘may contain traces of nuts’ or ‘may contain seeds’. This means that even if nuts or seeds aren’t deliberately included as ingredients in the food, the manufacturer cannot be sure that the food doesn’t accidentally contain small amounts of them. If you are allergic to any of the foods mentioned in these warnings you should avoid these food products.

Tip: You can call food manufacturers and ask about ingredients or manufacturing processes if you are unsure about a product.

What about foods which are not pre-packed or not labelled?

Foods that aren’t pre-packed or labelled include those sold from a bakery, butcher, deli counter or salad bar, and foods weighed and sold loose. It also includes meals served in restaurants, takeaways and other eating out venues.

It’s possible that this type of food could contain small amounts of allergens in the ingredients or they could have accidentally got into one of these products. (e.g. from being next to another food, from a knife or spoon, or from being wrapped in a bag that has touched another food containing an allergen). If you have a severe allergy it is safer to avoid unpackaged foods.

What should I do if I think a food has been incorrectly labelled?

If you think a food has been incorrectly labelled or that an allergen has not been declared properly on packaged food, call us on 1300 552 406. The NSW Food Authority has powers under the Food Act and the Food Standards Code to investigate labelling complaints and take action against food businesses breaking the law.

Eating out

Eating a meal from a restaurant, café or take-away can be a stressful experience if you have a food allergy or intolerance. When food is prepared by someone else you can’t be absolutely sure that it won’t contain allergens. There are, however, some guidelines you can follow to make eating out safe and simple.

Tell the restaurant

• When you book a table, tell the person taking the booking about your food allergy or intolerance and ask them to check with the chef that they can provide you with a meal that doesn’t contain the food you are allergic to.
• When you arrive at a restaurant, make sure the waiter knows about your food allergy.

Ask about the dishes

• Read the menu carefully to see if there is any mention of the food you are allergic to in the name or description of the dish.
• Always ask the waiter or waitress – food allergens are not always stated on menus.
• Tell them what you would like to order and ask them to check with the chef that the dish does not contain the food you need to avoid. If you can, speak to the chef personally.
• If the staff can’t answer your questions or don’t seem certain, it’s better to order something else or eat elsewhere.

Ask about cross-contamination

Ask staff whether your food will be prepared with different equipment and utensils that are separate to those used for foods containing the allergen in order to avoid cross-contamination, e.g. your food will not be cooked in the same oil as the ‘risk’ food or cut up with the same knife.

Don’t assume because you ate a dish safely in one restaurant that it will be made the same way the next time or in a different restaurant.

Avoid self-service areas

If you have a severe allergy, it’s best to avoid eating food from a self-service area or buffet. It’s easy for small amounts of allergenic ingredients to get into food by accident (e.g. because people use the same spoons for different dishes), so even if it looks safe, you can’t be sure.

If you have a severe allergy, don’t eat out without your Epipen^®

How the NSW Food Authority works to help you

The NSW Food Authority works to ensure that you get accurate information about the food you buy and that the food you eat is safe.

The Authority enforces the Food Act and the Food Standards Code, which requires all food businesses in NSW to provide information about the most common allergens (crustaceans, eggs, fish, milk, peanuts, soybeans, tree nuts, sesame seeds), gluten and sulphite in their food by either:

• Declaring allergens on the label (usually in the ingredient list)
• Displaying information about allergens next to food on sale (if it’s not packaged)
• Providing information about food allergens in food if requested by a customer

If you find a food business that doesn’t provide information or if an allergen is found in food that was not declared or you were specifically told did not contain that allergen, the business may be breaking the law. Call us and report it on 1300 552 406.

The Authority will investigate suspected breaches, penalise non-compliance and can recall food to protect public health.