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Survey of Food Allergies in the UAE Research Paper

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Updated: Apr 29th, 2019

Introduction

Nearly each one of us eats to live and there is no doubt that most of us enjoy eating. However, recent studies have established that nearly 1 in 20 young children below the age of 5 years and almost 1 in 25 adults are allergic to at least one type of food. There have also been studies indicating that food allergy, and especially allergy to peanuts, is on the increase.

According to a 2010 report by the National Institute of Allergy and Infectious Diseases (NIAID), this has led a large number of people to create more awareness on food allergy, thus making it a topic of rising public concern. Indeed, when a person in a family is allergic to any food, the whole family is involved. In such a situation, the family lives in constant anxiety that a loved one may consume a food that could result into a serious allergic reaction, which is commonly known as anaphylaxis (NIAD, 2010).

The purpose of this research paper is to create a survey about food allergies in the UAE with the aim of establishing the seriousness of the situation within the region. The paper will also seek to examine the economic impact of food allergies and investigate whether the UAE region offers allergic consumers alternative products for their needs.

Statement of the Problem

In UAE, a federal public health law is on the making and government agencies hope that it will prevent people from losing their lives from food allergies. Although the law is supposed to reduce the number of fatalities resulting from food allergies, it will definitely not diminish all death cases in the region. The change in food-packaging laws is a welcome move for thousands of UAE residents who suffer from one or multiple food allergies.

In UAE, there are already laws in place that demand warning labels about possible food allergens. The labeling guidelines formulated four years ago require all possible allergens to be clearly indicated on the food packaging. Despite these legislations, many foods still do not contain the required cautions and this has led to numerous hospitalizations over the past several years.

The passing of new legislations will be a welcome move to majority of allergic patients who want to buy allergen free products but face numerous challenges due to the current lax food labeling laws. The blame for this does not entirely lie on food producers since most UAE residents do not know what the food regulation entails (World Health Organization, 2002).

Since there is very little information on the issue of food allergy in the UAE, this paper undertakes to review the matter with a view of making conclusions that will be beneficial to both patients and various stakeholders in this field.

Significance of the Study

Generally, one is at a greater risk of developing an allergy if the family they come from has a history of food allergy. The reason that makes food allergies a very significant subject in UAE is that the allergies might not necessarily be food related but may even be other allergic diseases such as asthma or eczema or atopic dermatitis.

If one’s both parents have allergies, then the risk of being allergic is higher than that of someone whose only one parent is allergic. An allergic reaction to food usually occurs a few minutes to several hours or even days after contact with the culprit allergen.

This is because the process of intake and absorption of food and the placement of mast cells both affect the timing and position of the reaction (DeWaal, & Robert, 2005). All these factors make the subject of food allergy an important one to all of us.

Limitations of the Study

This research paper relies mostly on secondary data, which include electronic media and online libraries. These sources are subject to manipulation and stereotyping in order to suit the personal interests of the researcher and therefore may substantially impair objectivity and integrity of the report. The study is also limited in that there is very little information regarding the issue of food allergy in UAE that is in circulation and the little that is available does not incorporate all the aspects of the problem (DeWaal, & Robert, 2005). This will undoubtedly leave many loopholes in the research and it is hoped that these loopholes will form the basis for future research in this field.

Brief Overview of Food Allergies

In order to effectively investigate the issue of food allergies, it is prudent to first get a general overview of this term. According to the National Institute of Allergy and Infectious Diseases (2010), food allergy is an unusual response to a food generated by the immune system.

The response might be slight or in scarce cases, it can be linked with the acute and life-threatening reaction known in medical terms as anaphylaxis. For this reason, it is crucial for people to work closely with healthcare professionals to know what foods can trigger an allergic reaction to their body. Right from the onset of this research paper, it is important to highlight that food allergy should not be confused with food intolerance (NIAID, 2005).

According to experts, a food allergy occurs when the immune system reacts to a harmless food as though it were a threat. When a person is at first exposed to the food, no reaction is witnessed. However, it is believed that this exposure leads the body to respond the next time. When the person is exposed to the food again, an allergic reaction can be witnessed. In most cases, the first exposure to food occurs when you eat it.

However, there are occasions when this happens without ones knowledge. An example of this is in the case of peanut allergy. In most cases, a person who experiences anaphylaxis on the first documented contact with peanut may have previously used a skin care product that had peanut as one of its ingredients or might even have inhaled peanut dust at a social place or at home (NIAID, 2005).

When one is initially exposed to a food allergen, the body’s immune system acts as though the food was harmful and transmits definite IgE antibodies to counter that allergen. These antibodies revolve through the blood and fasten to mast cells and basophils. Initially, mast cells are located in all tissues of the body, and mainly in body parts that are prone to allergic reactions.

Some of these parts include the nose, esophagus, lungs, skin and the gastrointestinal tract. On the other hand, basophilis are located in the blood and in tissues that have become inflamed because of an allergic reaction. The next time that one is exposed to an identical food allergen, it fastens to the mast cells and basophilis.

The fastening triggers the cells to discharge massive quantities of chemicals such as histamine. Depending on the placement of the tissue where the chemical discharge takes place, one experiences various forms of food allergy. These symptoms can range from mild to acute. When the allergic reaction is acute, it leads to a potentially life threatening reaction called anaphylaxis (NIAID, 2005).

Food Allergy in the UAE

Food allergy is indeed a complex disease. The reason for this is that both polygenic genes as well as environmental factors can trigger it. It is sad to note that this is one of the least studied topics despite the fact that it has been identified as an important problem within UAE. Just like any other type of allergies, food allergies have too been on the rise.

In America, 3.5 to 4% are considered to have food allergy and 4 to 6% of children population around the globe are believed to be affected (NIAID, 2005). The prevalence and causes of food allergy in UAE is still unclear. Individual studies show-varied data. However, if the trends elsewhere in the world are anything to go by, then the situation warrants immediate attention (NIAID, 2005).

In one of the privately funded research, (The Food Allergy and Anaphylaxis Network (FAAN), 2011) a meta-analysis was carried out to establish the prevalence of food allergy in UAE. The foods reviewed were cow’s milk, eggs, peanut, fish, shellfish and wheat. The prevalence rate of self-reported food was ranging from 3% to 35% for any kind of food and was very high once evaluated against objective measures.

Fascinatingly, there was a noted heterogeneous association between studies irrespective of assessment or the food item reviewed. Whether this mirrors actual differences or is a problem of varied study designs cannot be established. In another study conducted in 2005 (DeWaal, & Robert) where 12,000 newborns were recruited, a rather interesting finding was established.

During the study, all the children who developed atopic dermatitis or signs orchestrated by food allergy were summoned for homogeneous clinical evaluations. This included the diagnostic gold standard and the double-blind placebo-controlled food challenge tests. During the food allergy test, it was established that eggs, cow’s milk, peanut and wheat were the most frequent food allergens in UAE (DeWaal, & Robert, 2005).

Patterns of Food Allergy outside UAE

In order to effectively examine how the allergy issue affects consumers in UAE, it is important to briefly look at patterns of food allergy outside the region. There is no doubt that food allergy is a widespread problem affecting children and adults in developed countries. Although there is limited data on this issue, the little that is available shows that the prevalence and models of food allergies are slightly different from that of UAE.

In one such study carried out by Wong (2011) from the Department of Paediatrics and School of Public Health in Hong Kong, clinic based studies in Japan showed that the common allergens were milk, eggs, wheat, peanuts, soybeans, sesame and buckwheat. In China, it was established that the common allergens were shellfish, fish, and peach while the pattern of allergy in Russia was similar to that in UAE.

Although there is no probable explanation for this, it might be due to dietary differences and similarities in the countries where the studies were carried out. This might also be due to factors associated with the protection against food allergies in these areas (Wong, 2011).

As discussed elsewhere in this paper, food allergy is an important social health problem that affects close to 5% of children and almost 4% of adults and this might be rising in prevalence (DeWaal, & Robert, 2005). Despite the threat of acute allergic reactions and even death, there is no known treatment for food allergy in either UAE or elsewhere in the world.

As it is, the disease can only be handled by avoiding possible allergens or treatment of symptoms. The identification and management of food allergy may differ from one clinical practice setting to another. As pointed out earlier, patients and medical practitioners frequently confuse non-allergic food reactions, such as food intolerance with food allergies.

It is therefore important for UAE to come up with guidelines to establish the difference between food allergy and food intolerance. However, what is most important for UAE is to be prepared to deal with the economic challenges brought about by food allergies (NIAID, 2010).

Economic Impact of Allergy Prevention in UAE

The subject of food allergy cannot be effectively tackled without looking at the economic perspective of it. Since the paper has already established that there is no known medication for food allergy, then it is only right if we examine the economic impact of allergy prevention in the UAE (Drummond et al, 1997).

There is no denying that the economic impact of allergy prevention is a very broad and complex matter, depending on the perspective of policy makers. In trying to examine the economic issues of this matter, it is then only right to examine what sort of economic questions might be important.

Although there might be varied definitions for economics, one thing that is agreeable across the board is that economics is about resources and happiness in society. Economics concerns itself with how all the available productive resources are used to enhance happiness.

Perhaps the reason why Thomas Carlyle termed economics as the ‘dismal science’ is that there can never be sufficient resources to completely satisfy each need and want. One has to make choices. The best choices obviously result into economic gains for everyone, but majority of choices necessarily result in losers as well as winners. The big question then is to determine how this gets resolved (Drummond et al, 1997).

Money and Markets

One way how this can get resolved is through valuation of goods and services for exchange using cash. Generally, there is a consensus among societies when it comes to the issue of right values through market price systems. Economics is commonly reflected upon as the examination of money and markets, but it is often beyond this. The reason for this is that markets fail to deliver optimal social welfare in many ways (Drummond et al, 1997).

Markets and Market Failure

There is no doubt to any economist that free organization and distribution of wealth and power in production can give rise to monopoly. According to Drummond et al (1997), consumers and producers do not necessarily have ideal information on goods and services, nor about their wants. This is especially true in health and health care.

On top of this, many services unlike goods are not exchanged in the marketplace and can be underestimated or fail to be valued at all in market transactions. One example of an undervalued resource is the parent’s care of their little ones. Finally, a number of goods are not marketable to individuals, but are refereed to as ‘public goods’, such as clean air or hygiene in public schools. In UAE and other societies, these needs are met through socially organized systems.

Viewpoints, Domains and Economic Questions

Different economic queries are crucial at different stages and for different groups. Solutions favoring one side might not favor all. An example of this is a situation where individuals and families are concerned with upholding their own health and comfort, thus creating an interest on particular costs of living with or preventing allergy.

In UAE where the state is the main provider of healthcare, the costs of the services utilized by allergic people may not be recognized as costs to them. In comparison, when health-care givers consider costs and benefits, they do not necessarily consider the consequences of illnesses or medication of ailments on household earnings, and this is not taken in within the direct responsibility of health care administrators (Drummond et al, 1997).

The reason why it is prudent to look at the economic impact of allergies in UAE is partly because firms that produce goods and services in the region are affected in diverse ways by food allergy. Apart from the healthcare industry, there are foods and other producers of products which may activate allergy or which may aid sufferers in some way.

Companies may get concerned through their own corporate social responsibility or through directives with tracking social purposes for maintenance of the health of the population, but in the end they have to live up to their purpose, which is to make profits.

In UAE, the government has taken a broader viewpoint and has actively been involved in balancing the conflict between interests in the political economy. The methods of economists advising the public-sector policy have advanced to take a communal viewpoint (Drummond et al, 1997).

Methods Used by Economists

In the field of health economies in the UAE, cost-of-illness analysis (COI) is commonly used as an expressive tool. This takes a wide ‘top-down’ approach, which examines crude sector level estimates of impact or a much more pronounced ‘bottom up approach’, which studies a defined group of the populace with prospective data collection and/or analysis of routinely gathered information.

However, it is important to be conscious that COI does not give answers to economic allocation decisions, where diverse strategies for dealing with problems are being weighed against each other (Drummond et al, 1997). Economic evaluation compares the stresses of alternative policies, comparing costs of inputs and values of outcomes.

The methods used to achieve this include the cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and the cost-utility analysis (CUA). These analytic approaches in health economies progressively incorporate techniques of decision analysis and modeling gotten from Operational Research and other administration methods. Option evaluation or investment appraisals are utilized for industry and public sector planning.

Cost of Allergy in the UAE

There have been various estimates of the costs of allergy in the UAE. One source, (Table 1) gives estimates of direct costs showing three forms of allergy, but fails to include the estimate for food allergy. Asthma counts for the largest communal cost of all.

Table 1. Direct costs to society of allergy in UAE

Asthma 4.6bn
Contact dermatitis 2.3bn
Allergic rhinitis 1.3bn
Food allergies [???]

Source: (Drummond et al, 1997).

The authors of the report admit the shortage of adequate data on any of the allergies at this level. Even in areas where there is availability of data, the methodology of cost of illness research is not well described or scientifically authenticated and it is usually seen and utilized as a technique for persuading those in power to take notice of this scourge.

In order to gain more confidence on these figures, it is important to create methods that are replicable and useful. It is sad to note that there is no cost estimate of food allergies, which is the most prevalent form of allergy in UAE.

Socio-Economic Costs of Food Allergy in the UAE

From what has already been discussed, the team who prepared the UAE Allergy Report (Drummond et al, 1997) had not found enough to attempt an estimate of UAE impact on food allergy. There have also been attempts by other parties (O’Connell, 2003) to search for further review on the subject.

This has included looking at the Web of Science Journals using search terms shown in Figure 1. As expected, this search did not establish specific studies or costs on economics of food allergy in UAE, but rather came up with several papers highlighting how this subject might be researched.

From this review, it is then right to assume that costs might fall to one or more of the below economic sectors. Individual or family, health sector, industry and public sector. Society incorporates all of these sectors. It is obvious that this is not just a simple case of adding up since what might be a cost to one sector might actually be a benefit to another i.e. family costs of medications over the counter are an advantage to the pharmaceutical industry.

• Web of Science 2002
• allerg* AND (cost OR econ) AND food*
• No specific primary research on costs of food allergy
• Discussions of possible costs in several papers

Figure 1. Literature Review for Economics of Food Allergy. Source O’Connell, 2003.

Possible Costs of Food Allergy in the UAE

There is no doubt that there are associated costs when it comes to the issue of food allergy. These costs can be sustained directly in the form of managing allergy, or they can be an indefinable effect of the allergy that is not easy to measure but one that affects people’s decisions (see Table 2).

costs of food allergy Individual or household Health sector Industry Public Sector Society
Direct Costs Out-of pocket expenses Hospital Primary care Loss (or gain) of sales revenue Outreach and social care All
Indirect Costs Informal care Loss of education or income Public-health campaigns Costs of regulation Lost work from sick employees Regulation All
Intangible costs Quality of life Public Opinion

Table 2. Possible costs of food allergy. Source: Drummond et al, 1997.

Many families in UAE have direct out of pocket costs, indirect costs of loss of labor time, or indefinable costs of effects on quality of life. Consequently, the health sector experiences direct and indirect costs, such as the express costs of providing hospital primary care and the public health crusades may be an indirect effect (or cost). Both industry and other public-sector agencies in UAE will experience the effects of food allergy.

Communal costs and benefits are the product of all of these various factors. In economic policy decisions, the effects of public opinion in UAE are as important as the benefits to concerned individuals in the final decision, especially where taxpayers’ money is utilized for services. From what has just been discussed, a few issues come out clearly about the cost of food allergy.

One of this is that health-care costs may be small for some people and high for others. Additionally, it can also be noted that effective self-management may result in lower health care and indefinable costs. It has also been proved beyond doubt that productivity in the workplace as well as education can be affected not only by absence, but also by controlled movement and effectiveness at work.

Lastly, it has also emerged out that the existing quality of life measures might not be susceptible to definite outcomes of food allergy (Drummond et al, 1997). Despite these clear observations, it is important to note that there is no clear evidence to back these findings.

Research Agenda on Economics of Food Allergy in UAE

In order to realize the full economic impact of food allergy in the UAE region and provide clear evaluation interventions to cope better with the problem, there is need for better knowledge about the nature and costs associated with food allergy. Currently, there are numerous interventions, which change the way food allergy can be managed in UAE.

Some of these include diagnosis and testing, health and food education and sponsorship, food labeling, self-management instruction and support, food preparation methods both at industrial level and at home and immunotherapy. All of these methods carry a certain cost in at least one economic sector, and may or may not be efficient. Economic evaluation of various approaches could help in setting priorities in order.

Since good interpretation of economic data in food allergy is reliant on good clinical and epidemiological investigation evidence on classification and acuteness of illnesses, utilization of healthcare services, effectiveness of treatments, and standard of life information, interdisciplinary partnership is important for both cost of illness research and economic evaluation.

Since food allergy also involves producers of food, the effects on the industry of approaches for mitigating food allergy are an integral part of social costs. Public policy often incorporates trade-off between best solutions for customers and producers in the short and long term (Wong, 2011). One aspiration of economic analysis is to enlighten this discussion. However, there is a great deal of work ahead to make this a reliable venture in UAE.

Inequalities in the Economic and Social Cost of Food Allergy in UAE

As discussed earlier, the economic and social impact of food allergy affects many sectors of the society. There are associated costs to individuals, their careers and their households, most likely for the whole of their lives. In the healthcare sector, resources are needed for prognosis, support and education. The entire food chain in the UAE is affected through fluctuated costs, food regulations and ethical obligations.

The employment sector is also affected in terms of reduced productivity. Currently, there is no specific information or a clear methodology for establishing the economic and social impact of food allergy to individuals and the society. It is even harder to quantify the costs associated with quality of life factors such as health, quality of living, family and acquaintances and general well-being.

While it is hard to establish some of these facts, it is probable to illustrate the social and economic impact of food allergy from the viewpoint of the individual and their families and caregivers through and assessment of the issues constantly brought to the attention of patient support groups in UAE. Although these might not be quantifiable, they are nevertheless very real (Drummond et al, 1997). These impacts can be eased by ensuring that individuals and households receive the services they require and through heightened appreciation, responsiveness and education.

How to Manage Food Allergy in UAE Restaurants

The stress of bringing up a child with food allergies in UAE affects each family differently, depending, in large part, on how the doctor initially hands the news and the family’s coping method. Based on how the information is presented, the family can leave the hospital scared and uncertain whether they will be capable of averting the next reaction, or concerned but confident that they can keep their child secure.

Most doctors in UAE educate their patients on how they can lead secure lifestyles without taking any precaution. Despite the provision of this information, families still have a reason to get worried especially when it comes to the issue of eating food that is prepared outside the home (FAAN, 2011).

A rising number of consumers with food allergies in the UAE encounter a myriad of challenges when eating food from restaurants, cafeterias and fast food outlets, and when selecting food that is not industry packaged. The trends in eating habits have also changed in the recent past.

Unlike in the past, most families in UAE prepare less food at home from ingredients something that has robbed the young generation of key skills on preparation and knowledge of food. At the same time, the rate of traveling has increased, and people now enjoy a variety of foods, which come from various parts of the world served by our neighborhood food businesses (WHO, 2002).

Those patrons who need to shun certain food products to guard their health encounter a range of practical challenges, starting with the need to establish the ingredients contained in the dishes. After this, the patron has to investigate whether the food establishment has managed to prepare that particular dish without running the risk of contamination from the culprit allergen, at times in trace amounts.

Evidence from lethal reactions to foods and that reported by patient group members indicate that the most critical factor in effective avoidance is access to the ACCURATE information on what is contained in the food (NIAID, 2010). Most lethal reactions involve consumption of dishes containing the cause allergen.

In some cases, the allergic party might not have been evading the particular allergen, or may be through lack of accurate analysis or protection advice, but even those with precise diagnoses and well-honored averting skills have been caught in the mix. Some of the practical barriers include failing to retain the correct information, bad information-sharing between preparation and service staff, contradictory recipes, and menu statements from other languages/ cultures, which are not understood by staff/customers.

Other barriers might be cross- infectivity in preparation or service, including shared utensils on self-service buffets, customers being nervous about enquiring for information in the presence of their colleagues, and now wanting to make a commotion (O’Connell, 2003).

In one research carried out in UAE (DeWaal, & Robert, 2005), food businesses were asked different aspects, by questionnaire and interview, on how they handled a food allergic guest. In this survey, 95% of the respondents indicated that they would offer a safe meal, but only a dismaying 26% indicated that they had any sort of food allergen training. Like many UAE households, 5.5% believed that the heat would destroy the allergen and 46% had faith that a small amount of allergen would cause no significant harm.

Close to 50% of the respondents believed a buffet would be allergen free if it was kept in clean condition while 21% indicated that doing away with the allergen (like nut topping) would ensure that the meal was safe. In this survey, an impressive 85% recognized the possible allergens prevalent in the UAE but then only 18% had an action plan to offer allergy free meals.

Like so many citizens in the UAE, none of the respondents knew what to do in case of an allergic emergency. What was interesting is that a whopping 78% believed that regulation on food safety and food hygiene did not cover food allergens (DeWaal, & Robert, 2005).

From the results of this study, it is encouraging to note that restaurant and catering industries in UAE are ready to offer allergy safe meals to their allergic consumers but they have to be warned in advance. The apparent lack of basic knowledge on food allergy and allergens indicates the necessity for more education and training.

Food allergic patrons need to present themselves, but still need to take extra caution. A solution to this could be the proposal for a new UAE regulation on the provision of food information to end users, as this will mark a big step onward in protecting the food allergic individual (DeWaal, & Robert, 2005).

Food Safety

Having established that staying away from possible allergens is critical in protecting the health of people with food allergies makes the issue of food safety an important topic in UAE and indeed elsewhere in the world. According to the World Health Organization, food borne diseases are prevalent in all parts of the world and the toll in terms of human life and suffering is enormous.

Contaminated food is estimated to be the cause of 1.5 billion cases of diarrhea in children each year, translating into more than three million early deaths (WHO, 2002). These deaths and sicknesses are distributed in both the developed and developing nations.

In America, it is estimated that food borne diseases contribute to nearly 76 million illnesses annually among the country’s 290 million inhabitants, as well as 325,000 hospitalizations, and 5,000 fatalities. In the Middle East, statistics show that approximately one million children under the age of five years die each year from diarrhea diseases after consuming contaminated food. Although there is no sufficient data to identify and track food borne allergies, the statistics are believed to be overwhelming (WHO, 2002).

Food Safety in UAE


Food safety is progressively viewed as an important health issue in the whole of the Eastern Mediterranean Region. In collaboration with the WHO, most countries in that region have undertaken extensive reviews of their food safety system and some have modernized their national legislation on the issue. Despite efforts to update food safety laws, there is limited information available to fully appraise the food safety problems and issues.

Although United Arab Emirates has adopted the use of customized software for food inspection to monitor and control the safety of food – whether domestically produced or imported, more still needs to be done in order to curb the problem of food allergy (Wong, 2011).

According to the World Health Organization (2002), allergies are generally perceived as mild and self-limiting illnesses, and comprise a reality of every day life in UAE. Medications, if administered at all are procured over the counter and most allergy episodes go unreported. Some diseases like diarrhea are usually viewed as strictly waterborne other than an allergy-triggered disease. In most cases, medical attention is sought too late, and often in asphyxia cases.

This shows that improvements are undoubtedly needed in the detection and prognosis of allergens. Despite the difficulty of obtaining accurate allergy surveillance data, it appears that there is a reduction of allergen-induced cases in UAE and other Gulf countries. This is likely due to increased food monitoring and improved consumer information.

Policies and Plans of Action in UAE

In the UAE region, land suitable for growing food is scarce. Meeting food needs and guaranteeing food security largely depend on food imports. For this reason, putting in place a system to control their safety and quality are imperative for public health. What is most interesting to note in this mix is that the food imports that the UAE rely on has been found to be unsafe for human consumption.

Beginning January to June 2001, close to 27% of food exports from Egypt, Jordan, Lebanon and Syria to the United States were discarded by America’s Food and Drug Administration for failing to comply with the U.S. safety regulations (WHO, 2002).

What is even more disheartening is that these foods were found to have high level of microbiological contamination and food additives while close to 58% of the foods were rejected for labeling problems. What makes this significant to UAE is that she gets most of her food through direct imports from these countries within the region (O’Connell, 2003).

Although UAE has food control systems in place, those systems are largely unable to cope with new challenges. In UAE, the set legislation is largely inflexible, the standards are obviously not consistent with global and even domestic needs, and training in efficient food handling is lacking as observed elsewhere in this paper (NIAID, 2010).

In most cases, food inspection models are old-fashioned and the supervisors do not possess adequate knowledge of modern risk-based approaches to food control. Additionally, the laboratories that have been set up do not possess the required scientific and technical expertise, financial resources, and equipments.

Due to lack of government’s commitment to the matter, these laboratories have a difficulty in procuring reagents and reference materials and lack a globally recognized certification. There has also been a lot of resistance to change from local administrators who do not necessarily support this initiative.

There is also the issue of underreporting something that further compromises the quality of the food products. For this reason, the frequency of food borne allergens is not used to help define national food safety strategies, and chemical and microbiological contaminants are not accorded the priority that they deserve (WHO, 2002).

Under the UAE law, food companies are required to provide safe foods. As a result, food companies have the mandate to find out whether their products create any risk for allergic people. This particular law has specific labeling requirements for those products that contain possible allergens so that the consumers buying packaged labeled food should never be in doubt on its constituents.

For example, labels need to point out that casein is derived from milk and that peanut oil might not be labeled as simply vegetable oil. However, the labeling law does not cover unintentional presence of allergens in food. Regardless of this, food manufacturers have the obligation of ensuring that there is no risk of unintentional presence of allergenic food in their products.

This helps them to decide if it is significant to warn allergic people of the possible risk. An example of this may be adding simple warnings such as a simple phrase stating, “May contain traces of nuts” (FAAN, 2011).

Although the law has been in effect for a long time now, it is still hard to access how big a risk a food product might pose for an allergic person, since researchers are yet to come into harmony on the level of food required to cause an allergic reaction. Recent research has shown that there exist lower perimeters of intake below which food allergens will cause only mild or even no visible symptoms and that these symptoms range from one allergic individual to the other and even within the same person at different occasions.

The amount that may prompt an allergic reaction observable by second parties ranges from a tenth of a milligram in rare cases, up to grams and sometimes tens of grams, with extensive dissimilarities between individuals as well as between allergic substances.

In UAE, there is adequate scientific data for cow’s milk, eggs and peanuts to permit statistical analyses to forecast doses of those foods safe to consume for the majority of allergic people. However, scientists in the UAE region and regulatory authorities have only in the recent past begun to deliberate on how to make statistical evaluations of the data (Dewaal, & Robert, 2005).

Potential Allergenicity of Biotechnology Products

Regulatory guidelines for establishing the safety of new food crops developed using biotechnology in UAE were published in the dying years of the last century before the inception of Genetically Modified (GM) products. Many GM crops are now widely accepted as 77% of global soybean and 26% of maize produce is from GM selections (FAAN, 2011).

The early safety assessment seems to be functional since there are no major cases of harm from these products. The greatest potential risk of food allergy would be gene transference encoding an allergen or protein adequately identical to an allergen being introduced to a different food crop so that unforeseen reactions might happen upon eating.

The risk of GMOs containing possible allergens is minimal since UAE like many other nations requires a thorough assessment of these foods before they are allowed into the country. The GMO Panel of the United Arab Emirates first evaluates data originating from the studies carried out by the applicant.

The panel then publishes a scientific opinion, which includes a conclusion on the food safety of the product in review. With these stringent rules in place, the GMO products in the UAE market might be the only food product that might be deemed free from possible allergens but even then, there is no enough research to proof this point (O’Connell, 2003).

In the case of cow’s milk allergy prevention, the available data is not also complete since no study has so far been published that meets all the criteria recommended by the World Health Organization. Nevertheless, the studies carried out to date point to a greater effectiveness of extensive hydrolyzed protein formulae over partially hydrolyzed formulae, although the latter might offer nutritional advantages and reduced costs.

There is no doubt that further efforts are required in the classification of the commercially available milk formulae used for the management and avoidance of cow’s milk allergy. In the absence of well-documented researches proving the prophylactic value of partially hydrolyzed formulae, children at high risk of allergy should be fed with a prophylactic hypoallergenic diet centered on extensive hydrolyzed formulae.

However, even these have been found to be deficient in terms of quality for the brands sold in UAE. This means that cow’s milk allergic patients from UAE will have to stay away from milk products until that time when a safe alternative product can be procured (O’Connell, 2003).

Functional Food Market in UAE

Functional foods are defined as foods that provide health benefits on top of their basic nutritional value. These extra health benefits constitute the basis for producer’s health claims on foods. Legislation demands that health claims should be centered on and authenticated by publicly accepted scientific evidence. For allergic people in UAE, numerous products that offer an alternative to foods that are known possible allergens are available in the market.

One of these products is the hypoallergenic formulae, which is used in the treatment and prevention of cow’s milk allergy. In UAE, there are a large number of commercially available milk formulae products clearly labeled as ‘hypoallergenic’. However, only a fraction of these conforms to the standards highlighted in the guidelines of subcommittee on Nutrition and Allergic Diseases of the World Health Organization.

As far as the treatment and prevention of cow’s milk allergy is concerned, the broad hydrolyzed protein formulae and amino-acid concentrated formulae are the only two products that meet the recommended standards for hypoallergenicity, which is defined as nonexistence of reactions in 90% allergic patients with 95% confidence.

Even in these cases, there is a greater variability on the wide-ranging hydrolyzed brands in the UAE market, and for some of them, the clinical information in support of the claim of hypoallergenicity is conspicuously absent. On top of this, other products referred to as ‘partially hydrolyzed formulae’ have in the past been promoted as suitable for cow’s milk allergic people but in the end turned out to be ineffective.

This products have actually been accused of being responsible for several anaphylactic reaction in numerous cases reported in various parts of UAE. This data lie beneath the fact that it is compulsory to define the products put on the UAE markets as hypoallergenic formula for treatment of cow’s milk allergy (O’Connell, 2003).

The Way Forward

Despite rising efforts to prevent food allergies in children, IgE arbitrated food allergies are on the rise in UAE. The World Health Organization recommends that during the opening six months of life, infants be exclusively breastfed, and that weaning onto solids and other milk formulae should only commence after the lapse of that period.

Definite avoidance of foods such as hen eggs and peanut in atopic infants is believed to prevent the possible allergic reaction to these products. While there is data proposing that exclusive breastfeeding and the utilization of extensively hydrolyzed formulae may prevent the progress of eczema, there is still inadequate evidence to prove that such dietary interventions prevent the progression of IgE-triggered food allergy.

The double exposure to allergen hypothesis posits that tolerance to antigens happens in the neonate through high dose oral exposure and that allergic sensitization happens through low dose cutaneous contact. In one study carried out in a prospective birth cohort, it was shown that low dose exposure to peanut in the type of arachis oil applied to exposed skin on young children was linked with heightened risk of peanut allergy by the time the child turned five years.

Recent studies have also showed that young children who are exposed to allergens in the first six months of their life through the oral route have a high tolerance for such allergens than children who did not have such an exposure. However, such studies are subject to reviews and have the possibility of causing opposite reactions.

What this means for UAE residents is that they will have to wait for a little while longer before they know the truth regarding this issue (Wong, 2011). In the meantime, UAE parents have the responsibility of ensuring that their children are not exposed to any possible allergens until that time when the truth on the matter will be established.

Conclusion

Food allergy is a complex disease. This is because it is not only influenced by polygenic genes but also by environmental factors. Despite the complex nature of the disease, it has been one of the least studied research topics even though it has been recognized as an important problem within UAE. Currently there is no known cure for food allergies.

One can only evade the symptoms of food allergy by not being exposed to the allergenic substance. After someone with the help of a healthcare professional has identified the food that he/she is allergic to, one must remove those foods from their diet.

In order to avoid coming into contact with such foods, there is need to always read the list of ingredients on the sticker of each prepared dish that one is considering eating. It is also important to note that majority of the food allergens such as peanut, egg, and milk, are present in prepared foods that one would not directly link with those foods.

Since 2007, UAE food manufacturers have been obligated by the law to label the ingredients of packaged foods. On top of this, the law mandates that food manufacturers must use simple language to reveal whether their products contain or have traces of any of the eight known allergenic foods-egg, milk, peanut, tree nuts, soy, wheat, shellfish and fish.

Easy measures of hygiene can remove most allergens from the environment of a person with a food allergy problem. For example, a simple act of washing the hands with soap and water will do away with peanut allergens, and a good number of household cleaners will eradicate allergens from surfaces. Despite the efforts adopted by food allergic people to keep away from possible allergens, they will from time to time be forced to deal with unintentional exposure.

Given the enormity of the matter, the UAE government must come up with stringent regulations to cushion the public from unintentional exposure to possible allergens. There is also need for the public to be educated on allergy management since majority of them do not know what to do incase of a food allergy attack. Effective education will also help the public to know what is stipulated in the law regarding the issue of food allergies in UAE.

References

DeWaal, S., & Robert, N. (2005). Global and Local: Food Safety around the World. Washington: Center for Science in the Public Interest.

Drummond, M., O’Brien, B., Stoddart, G., (1997). Methods for Economic Evaluation in Health Care. Oxford: Oxford University Press.

Food Allergy & Anaphylaxis Network. (2011). Parents of Children with Food Allergies Survey. PDF File. Retrieved from

National Institute of Allergy and Infectious Diseases. (2010). Food Allergy: An Overview. U.S Department of Health and Human Services. PDF File. Retrieved from

O’Connell. (2003). Pediatric Allergy: A Brief Review of Risk Factors Associate with Developing Allergic Diseases in Childhood. Ann Allergy Asthma Immunol 90 (3), 53-58.

World Health Organization. (2002). Health situation in the South East Asia Region 1998-2000. Retrieved from

Wong, G. (2011). Patterns of Food Allergy outside Europe. Clinical and Translational Allergy, 56 (1), 42-48.

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IvyPanda. (2019, April 29). Survey of Food Allergies in the UAE. Retrieved from https://ivypanda.com/essays/survey-of-food-allergies-in-the-uae-research-paper/

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"Survey of Food Allergies in the UAE." IvyPanda, 29 Apr. 2019, ivypanda.com/essays/survey-of-food-allergies-in-the-uae-research-paper/.

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IvyPanda. "Survey of Food Allergies in the UAE." April 29, 2019. https://ivypanda.com/essays/survey-of-food-allergies-in-the-uae-research-paper/.

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IvyPanda. 2019. "Survey of Food Allergies in the UAE." April 29, 2019. https://ivypanda.com/essays/survey-of-food-allergies-in-the-uae-research-paper/.

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IvyPanda. (2019) 'Survey of Food Allergies in the UAE'. 29 April.

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