Advisory food labels: consumers with allergies need more than “traces” of information

BMJ 2011; 343 doi: (Published 13 October 2011) Cite this as: BMJ 2011;343:d6180
  1. Paul J Turner, clinical lecturer12,
  2. Andrew S Kemp, clinical paediatric research immunologist23,
  3. Dianne E Campbell, professor of paediatric allergy and clinical immunology24
  1. 1Molecular Immunology Unit, Institute of Child Health, London WC1N 1EH, UK
  2. 2University of Sydney, Sydney, Australia
  3. 3Murdoch Children’s Research Institute, Melbourne, Australia
  4. 4Children’s Hospital at Westmead, Sydney, Australia
  1. Correspondence to: P Turner paulyt{at}
  • Accepted 5 September 2011

Vague warnings of possible allergen contamination of food are often unhelpful and may contribute to unintentional exposure. Paul Turner, Andrew Kemp, and Dianne Campbell call for a standardised approach

Immunoglobulin E mediated food allergy is increasing, affecting up to 2% of adults and 8% of children in the United Kingdom.1 The mainstay of management remains avoiding the implicated allergen, which requires accurate labelling on packaged foods. A bewildering array of warning labels can be found on food products (box), leaving consumers confused and anxious. Leading consumer associations and health professionals have raised concerns over widespread use of such advisory labels. Are these products safe to eat for someone who is at risk of a life threatening anaphylactic reaction? What does the consumer understand by such warnings, and are they useful in preventing food reactions?

Examples of advisory warnings found on food labels2

  • May contain . . .

  • May contain traces of . . .

  • Produced in a factory which handles . . .

  • Produced on shared equipment which also processes . . .

  • Made in a production area that also uses . . .

  • Made in a factory that also produces . . .

  • Not suitable for . . . allergy sufferers

  • Packed in an environment where . . . may be present

  • Due to the methods used in the manufacture of this product, it may occasionally contain . . .

Consumers’ perspective

Advisory labels are helpful if they provide reliable information on the allergen content. However, manufacturers widely use them as a “safety net” to convey an unspecified risk of possible contamination. An audit by the UK Anaphylaxis Campaign found that 69% of cereals and 56% of confectionery items were labelled as containing traces of nuts, despite none listing peanut or tree nuts as an ingredient.2

Allergen labelling causes considerable anxiety to people with allergies …

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