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The Food and You Survey, Wave 5 Secondary Analysis: Consumers with Food Hypersensitivities

Published: October 2019

This secondary analysis of Wave 5 of the Food and You survey explored different areas of life for people living with food hypersensitivities, from self-reported prevalence of hypersensitivity to their behaviours when shopping, cooking and/ or eating out.

Aim

This secondary analysis of Wave 5 of the Food and You survey explored different areas of life for people living with food hypersensitivities, from self-reported prevalence of hypersensitivity to their behaviours when shopping, cooking and/ or eating out. We analysed those differences that may emerge between people with and without food hypersensitivity, as well as those with different types of food hypersensitivity: food allergies, food intolerances, and ‘other’ adverse reactions.

Definitions of hypersensitivity applied within this secondary analysis

A food allergy is an immune response to a food-based allergen, almost always a protein. Symptoms may be mild (for instance, itching and swelling), but in extreme cases can include anaphylactic shock with potentially fatal consequences. Many food allergies present in early childhood but are outgrown in later childhood.

A food intolerance is a condition in which an individual has difficulty in digesting certain foods or food components, (e.g., lactose), causing symptoms, such as abdominal pain, but which do not involve the immune system. Food intolerances include non-coeliac gluten sensitivity, gluten intolerance, lactose intolerance, cow’s milk intolerance and FPIES.

The ‘other’ adverse reaction category is derived from the ‘other’ answer option selected by respondents. The majority of respondents did not define their hypersensitivity, but examples given included Crohn’s disease and irritable bowel syndrome

Findings

Prevalence and diagnosis

  • Over a fifth of respondents (21%) self-reported having an adverse reaction to consuming certain foods.
  • Food intolerances were the most common type of hypersensitivity (12%) followed by food allergies (5%) and ‘other’ adverse reactions (5%).
  • Self-diagnosis was the most common form of diagnoses reported by 77% of those with food intolerances, 63% of those with food allergies and 61% of those with ‘other’ adverse reactions.

Demographic and socio-economic characteristics

  • Almost a quarter of respondents (24%) aged 65 and over reported an adverse reaction to food, compared to less than a fifth (17%) of those aged 16 – 34.
  • Women (24%) were more likely than men (18%) to report experiencing any food hypersensitivity.
  • Respondents who experienced an adverse reaction to food were more likely than those who did not experience a reaction to be unemployed (28%) than in work (19%) or in ‘other’ work status (21%).  

Eating out and shopping behaviours

  • There were no differences between individuals with and without a food hypersensitivity in how frequently they ate outside the home.
  • Respondents with food allergies (55%) were more likely to shop at mini supermarkets than respondents with no adverse reaction to food and respondents with an ‘other adverse reaction (both 42%).
  • People with food allergies (28%) and food intolerances (27%) were more likely to visit markets than respondents with an ‘other’ adverse reaction (21%) or no adverse reaction (18%).

Managing risks of hypersensitivities

  • Respondents with a food allergy were the most likely group to report always using a different chopping board for different foods (58%), to never store open tins in the fridge (79%), and to always wash fruit and vegetables to be eaten raw (67%).
  • When searching for information about safely preparing and cooking food, respondents with food allergies were more likely to use product packaging (46%), food television shows or cooking programmes (42%), food magazines (25%) and food websites (33%) than those with other food hypersensitivities.
  • In choosing where to eat out, people with food allergies (66%) and food intolerances (59%) were more likely to report recommendations from someone they knew as important, in comparison to 49% of people with no hypersensitivity.

Learning points

  • Few individuals (who self-reported some form of hypersensitivity) have clinical diagnoses of food allergies or intolerance. Over three quarters of people with food intolerances (77%) and almost two-thirds of those with food allergies (63%) indicated that such reactions have been ‘self-diagnosed’.
  • Absence of a clinical diagnosis could lead to increased risk of adverse reactions whilst self or over-diagnosis could lead to unnecessary elimination diets with nutritional and social implications. There is a need to explore how individuals can be encouraged to attend screening and, whether such testing results in greater self-management, mitigating inappropriate food behaviours and adverse reactions.
  • A greater proportion of older people, those aged 65 and over, report food allergies or intolerances (24%) when compared with their younger peers, those aged 16–34 (17%).
  • When experiencing their first reaction to any food hypersensitivity, 16% were over 45 with 8% aged 55 and over.
  • The concentration of research, policy and health information has, in the main, focused on the needs of children. Older people have been a fringe group in any allergy research. There is a paucity of longitudinal research that has explored the emergence or impact of food allergies or intolerances across the life course.
  • To address this evidence gap, the FSA has funded a research programme to understand the patterns and prevalence of adult food allergies across the life course, including adult onset hypersensitivities
  • People reporting food reactions are more likely to be unemployed (38%) than in work (19%). Further guidance and information on managing food hypersensitivities may support entry to the workplace as well as sustained employment
  • There continues to be a need for individuals to be sign-posted to the most accurate and up-to-date guidance if people are to appropriately (and safely) manage their food allergy or intolerance.

Methods

A secondary analysis of the Food and you (Wave 5) survey issued to 3,069 adults over 16 in England, Wales and Northern Ireland between June and December 2018. Along with bivariate analysis, a range of derived variables were applied. This analysis incorporated only those questions that concerning hypersensitivities (listed in Appendix A of the main report).

Researchers

Amelia Benson, Muslihah Albakri, Karen Windle (NatCen Social Research) and, Alizon Draper, University of Westminster.

 

Download from the Food Standards Agency website