Should all hidden allergenic components in processed foods be mandatory to label?

Question:
Should all hidden allergenic components in processed foods be mandatory to label?

Answer
Despite strict manufacturing practices and modern food processing techniques, hidden allergens can still be present in processed foods due to cross-contamination. To address this, manufacturers use precautionary allergen labeling (PAL), such as “May contain” or “Manufactured on shared equipment”, to warn consumers about the possible presence of hidden allergens(1). Contamination of an otherwise “safe” food is one of the most common causes of accidental allergen exposure in allergic individuals(2).

Understanding hidden allergens is crucial for physicians and patients, as it improves the prevention, diagnosis, and management of food allergies, ultimately reducing misdiagnoses, such as idiopathic anaphylaxis(3).

The term hidden allergen is often used to describe food components that are not among the most recognized allergens but are increasingly present in a variety of processed foods. For instance, some legumes—beyond the well-known allergenic groups—can trigger allergic reactions and even anaphylaxis, either through primary sensitization or cross-reactivity. Therefore, identifying and managing these hidden allergens is essential for ensuring food safety(4).

The industry uses the term (“may contain”) (PAL) within labeling standards as a precautionary measure about the unintended allergen presence (UAP) that may be in certain processed foods, thus indicating the potential risk of the same towards patients who may suffer from certain food allergies(5). According to the Codex Alimentarius “PAL should be accompanied by education/information programs to ensure understanding and appropriate use of PAL by consumers, health care providers and food business operators”(6).

In some countries, there is no specific regulation mandating PAL for cross-contamination risks, leading food manufacturers to use PAL inconsistently. This has raised concerns among health professionals, as many products with PAL labels do not contain detectable levels of allergens and may not pose a real risk to the majority of food-allergic individuals. Consequently, allergic consumers may take the risk of consuming foods with PAL, and excessive or indiscriminate use of PAL may unnecessarily limit food options for allergic individuals(7).

According to the 2024 revision of the Codex Alimentarius International Food Standards, “When it is not possible to provide adequate information on the presence of these food allergens through labelling, the food containing the allergen should not be marketed”(8).

Food labeling regulations also vary depending on the country, as dietary staples and processed food formulations differ worldwide. With the increasing prevalence of food allergies, legislative measures are needed to ensure that individuals with food allergies can purchase and consume food safely. However, the mandatory inclusion of all hidden allergenic components in packaged foods is currently unfeasible due to variability in international regulations and manufacturing complexities. As the Codex Alimentarius states: “Ideally all ingredients in a commercial food should be listed. Food labeling laws differ from one country to another.”(9) 

Ultimately, while regulatory improvements are necessary, the responsibility for avoiding accidental allergen ingestion and anaphylaxis still largely falls on the individual, who must stay informed about labeling laws and implement additional protective measures(10).

 

Answered by:

Marie Angelique Lazo-Betetta, MD
Consultorios de Enfermedades Alérgicas “Dr. Luis E. Betetta”

Peruvian Society of Immunology (SPI)

 

References

  1. Zurzolo GA, Mathai ML, Koplin JJ, Allen KJ. Hidden Allergens in Foods and Implications for Labelling and Clinical Care of Food Allergic Patients. Curr Allergy Asthma Rep. agosto de 2012;12(4):292-6. 
  2. Steinman HA. “Hidden” allergens in foods. Journal of Allergy and Clinical Immunology. agosto de 1996;98(2):241-50. 
  3. Parrinello G, Fontana DE, Villalta D. An overview of hidden food allergens: need for change to the priority food allergen lists? Eur Ann Allergy Clin Immunol [Internet]. octubre de 2024 [citado 13 de febrero de 2025];(online first). Disponible en: https://www.eurannallergyimm.com/an-overview-of-hidden-food-allergens-need-for-change-to-the-priority-food-allergen-lists/
  4. Vera-Berrios R, Uriarte Vega L, Marco-Martín G, Fernández-Rivas M. Nonmandatory Labeled Legumes Are an Emergent Safety Concern: An Illustrative Case Report. J Investig Allergol Clin Immunol. 17 de febrero de 2025;35(1):58-60. 
  5. Turner PJ, Bognanni A, Arasi S, Ansotegui IJ, Schnadt S, Vieille SL, et al. Time to ACT-UP: Update on precautionary allergen labelling (PAL). World Allergy Organization Journal. octubre de 2024;17(10):100972. 
  6. CODEX ALIMENTARIUS COMMISSION. GUIDELINES ON THE USE OF PRECAUTIONARY ALLERGEN LABELLING (STEP 4) [Internet]. 2024. Disponible en: https://www.fao.org/fao-who-codexalimentarius/sh-proxy/en/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FMeetings%252FCX-714-48%252FWorking%2Bdocuments%252Ffl48_05e%2B%2528Part%2BB%2529.pdf&utm_source=linkedin&utm_medium=cta
  7. Ontiveros N, Gallardo JAL, Arámburo-Gálvez JG, Beltrán-Cárdenas CE, Figueroa-Salcido OG, Mora-Melgem JA, et al. Characteristics of Allergen Labelling and Precautionary Allergen Labelling in Packaged Food Products Available in Latin America. Nutrients. 4 de septiembre de 2020;12(9):2698. 
  8. CODEX ALIMENTARIUS COMMISSION. GENERAL STANDARD FOR THE LABELLING OF PRE-PACKAGED FOOD CXS 1-1985. 2018. 
  9. Bahna SL. New insights in hidden food allergies. J Food Allergy. junio de 2023;5(1):19-24. 
  10. Chang F, Eng L, Chang C. Food Allergy Labeling Laws: International Guidelines for Residents and Travelers. Clin Rev Allergy Immunol. octubre de 2023;65(2):148-65. 

 

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