Yesterday was a day for celebration – but sad celebration. Celebration because Natasha’s law came into effect. Sad because what prompted it was was the death in 2016 of 15 year of Natasha Ednan-Laparouse as a result of eating a Pret a Manger baguette which contained sesame seeds to which she was fatally allergic. They had not been highlighted on the packaging.
For those not familiar with the issues, under the 2014 Food Information for Consumers (FIC) regulations, all packaged food sold in retail must carry full ingredients labelling with any one of the 14 major allergens highlit, usually in bold. In food service, which includes everything from a sandwich outlet to a five star restaurant or a factory canteen, allergen information has to be available but does not (for obvious practical reasons) have to be displayed on the food.
But, inevitably, there are (or rather were) grey areas. One of these is what is now known as PPDS – food that is PrePacked for Direct Sale – foods such as sandwiches made in dedicated outlets (such a Pret a Manger) but then packed and sold from the chillers or from behind a counter. Although to you and me they might have appeared to be a standard packaged food that should carry full ingredient labelling, because they were sold in what was deemed to be a food service outlet, they did not. Instead the requirement was that the information be displayed near the fitment, or available from the servers. But such notices are not easy to see and often get damaged or destroyed and getting information from a ‘server’ in a busy outlet such as Pret is time consuming and often unreliable.
In Natasha’s case the bagette that she bought was flagged up as containing olives and artichokes. But because it did not have to carry full ingredient labelling (with allergens highlighted) it did not say anything about the sesame seeds that had been actually baked into the bread and to which she was allergic
What difference does Natasha’s law make?
Under Natasha’s law (UK Food Information Amendment) all foods that are prepared and prepacked in a food outlet and then offered for sale (on a shelf of from behind a counter) must carry full ingredients labelling with allergens highlit.
The regulation does not apply to food that is packaged after you order it – such as a sandwich or baguette made to your order – as you will then have had the opportunity to question the maker on whether any element of it contains allergens.
Will Natasha’s Law make it safe for people with allergies to eat out?
Only in the specific case when you are buying food from an outlet such as Pret. But…… Given how many people eat on the go and the fact that they are often rushed so would not have time to find a notice or ask the question, it is another really important step in keeping those with food allergies safe.
And that is how it goes, little by little, step by step. And although progress can often seem painfully slow, so much has been achieved over the last 20 years.
What it was like then
When I first got involved with food allergy in the 1990s we did have to declare the ingredients on retail food packs – sort of…. But only if that ingredient constituted more than 25% of the total product. So, for example, if you made a pepperoni pizza you would not need to declare the ingredients in the pepperoni sausage on the top of your pizza because it made up less than 25% of the total pizza. A seriously allergic person took their life in their hands everytime they ate anything preprepared.
The 25% rule was banished in 2005 so that you did have to declare all the ingredients in the product although compound ingredients such as a dairy free spread, for example, still escaped and were just listed as ‘dairy free spread’. Meanwhile, there were no 14 major allergens, no highlighting of allergens in ingredients lists, no warnings of allergens in the recipes, no ‘may contain’ warnings about possible contamination, no dedicated gluten-free or nut free facilities. The Food Standards Agency had only been launched four years earlier. Allergy UK, the Anaphylaxis Campaign and even the FoodsMatter website were only in their infancy.
So we have come a very long way. But… There is still a very long way to go.
The future? The medics and the food industry
Both are crucial to the wellbeing of the allergic person.
The medics
Tanya and Nadim Ednan-Laparouse, Natasha’s parents, and Natasha’s Foundation are already funding core research to unearth some clues as to what is fuelling the apparently unstoppable rise in food allergy. But we don’t just need more research, we desperately need more allergy expertise both at consultant and primary care level. As I said in a post a few weeks ago with reference to the Natasha’s Foundation petition to appoint an allergy Tsar:
….. the shortage of allergy posts available within the NHS is a significant disincentive to ambitious trainee doctors looking for a challenging area in which to specialise…… So it is not that the training is unavailable. It is that, once trained, a budding allergist may have diffculty in finding a post in which he/she can concentrate on his or her chosen speciality. As a result a patient with what could be a potentially fatal allergy could wait six months or longer to get an appointment.
So we need more allergy consultant posts.
Meanwhile, allergy awareness and even basic expertise remain extremely poor and very patchy within primary care. We desperately need allergy modules to be added to basic medical training so that the average GP can do a bit better than just give a prescription for an epipen with no understanding or advice as to how it should be used.
The food industry
Catering safely for allergic guests in busy eateries, whatever their size or price bracket, is not easy – but it is possible. But it requires effort and training on the part of management. Most kitchen and waiting staff, if they really understand what is at stake, are super allergy friendly – but they have to be given that training. And although there are now many excellent training courses available and although awareness (thanks sadly to cases such as Natasha’s) is very much greater, there is still a long way to go.
But take heart. There may be a long way to go, but we have also come a long way. All is possible…..
The Gut-Brain Axis