Food allergies are no longer limited to the usual suspects. Peanuts and shellfish may still dominate the headlines, but a growing number of people are reacting to foods not recognised in allergen laws.

As cases of severe allergic reactions rise, experts are urging policymakers to rethink which foods require mandatory labelling.

As someone who has been caught out more than once by hidden allergens, I welcome the move.

Nearly one-third of the UK population – about 21 million people – live with some form of allergy. The proportion is similar in Australia, with more than five million of us living with an allergy.

In Britain, between 1998 and 2018, more than 100,000 people were hospitalised for food allergies, and 152 died as a result. About 6 per cent of UK adults – roughly 2.4 million people – have a medically confirmed food allergy.

Australian data notes a nine-fold increase in anaphylaxis hospital admissions between 1998-99 and 2018-19. An estimated one in 10 babies and one in 25 adults has a food allergy.

Under the Food Information Regulations 2014, British food businesses must clearly label 14 major allergens when used as ingredients. They include cereals containing gluten (such as wheat, barley and rye); crustaceans (for example crabs and prawns); molluscs (such as mussels and oysters); fish; peanuts; tree nuts (including almonds, hazelnuts and walnuts); soya; milk; eggs; mustard; sesame; celery; sulphur dioxide or sulphites; and lupin. The allergens must be declared on packaging or made available to diners when eating out.

A major advance came in October 2021 with Natasha’s Law. It requires all pre-packed foods for direct sale (PPDS) to display a full ingredients list, with the 14 major allergens clearly highlighted. This reform closed a dangerous loophole and greatly improved transparency and safety for people living with food allergies.

But recent clinical research suggests that even this updated list may no longer be enough. A large study analysed almost 3000 cases of food-induced anaphylaxis reported to the Allergy Vigilance Network (a European database that collects and monitors severe allergic reactions to food and other triggers) between 2002 and 2023.

It identified eight foods not on the European Union and British mandatory labelling list that were responsible for at least 1 per cent of anaphylaxis cases. They include goat’s and sheep’s milk (2.8 per cent), buckwheat (2.4 per cent), peas and lentils (1.8 per cent), pine nuts (1.6 per cent), kiwi (1.5 per cent), apple (1 per cent), beehive products (1 per cent), and alpha-gal – a sugar found in red meat – (1.7 per cent).

The study’s authors argue that at least four of these (goat’s and sheep’s milk, buckwheat, peas, lentils and pine nuts) should be considered for mandatory labelling because of their frequency, severity and potential for hidden exposure.

The popularity of vegan and plant-based diets is increasing the use of ingredients such as pea protein, lentil flour and buckwheat – all linked to allergic reactions. A 2022 study found that pea protein, now common in meat substitutes, triggered reactions in people with legume allergies. Some allergens share similar protein structures, leading to cross-reactivity, which raises concerns about hidden allergens even in “healthy” foods.

It’s important to distinguish a true food allergy from a food intolerance. Intolerance does not involve the immune system and typically causes digestive issues, such as bloating, diarrhoea or stomach pain, because the body struggles to digest certain foods.

A food allergy, by contrast, occurs when the immune system mistakenly identifies specific proteins as harmful. This triggers an immune response involving immunoglobulin E (IgE) antibodies, which release chemicals such as histamine. The symptoms can range from mild itching, hives or nausea to severe swelling, breathing difficulties and anaphylaxis, usually within minutes or within two hours after exposure.

Anaphylaxis is a medical emergency. Symptoms can include swelling of the throat or tongue, difficulty breathing or swallowing, dizziness, fainting, pale or blue skin, and loss of consciousness. Immediate treatment is vital: The Resuscitation Council UK advises giving intramuscular adrenaline into the outer thigh, using an auto-injector such as an EpiPen, and repeating the dose after five minutes if symptoms persist, while calling emergency services.

Beyond the physical risks, food allergies carry a heavy emotional and social burden. Studies show that children and their parents often experience heightened anxiety around eating out, attending school or travelling. The constant vigilance required to avoid a serious reaction can erode quality of life and mental health.

The 14 allergens enshrined in British law were a landmark in consumer protection. But science doesn’t stand still – and neither do allergies. As new triggers emerge, food safety regulations must adapt. Updating the allergen list isn’t just administrative housekeeping; it’s about preventing the next emergency and making sure everyone can eat with confidence.

Dipa Kamdar, senior lecturer in pharmacy practice, Kingston University

This article is republished from The Conversation under a Creative Commons licence. Read the original article.