When she started school in Rocanville, Sask., population 863, Mikayla Rudniski didn’t know anyone else with a peanut allergy.
“Even as a kid, being the only person with a food allergy and having that affect the lives of everybody else around you, it’s a weird feeling,” she says. “I don’t really know how to describe it other than feeling like a burden.”
There was no bakery in town, and the local grocery was so small it was classified a convenience store. With a complete lack of peanut-free treats in the vicinity, Rudniski learned to be self-sufficient. Cooking and baking for herself was the most practical — and safest — option.
Diagnosed at 18 months old, Rudniski is accustomed to living with a potentially life-threatening food allergy. “To me, it’s not like a challenge,” she says. “It’s just something that I do and something that I have to deal with.”
Now a fourth-year student in the honours biology and physiology program at McMaster University, Rudniski is the president of the Food Allergy Club. No longer the only one, she has plenty of people she can share her search for a flaky peanut-free croissant with, or allergy-safe restaurant options near campus.
Food allergies such as Rudniski’s are on the rise around the world and there’s no clear answer why. A new report from Dalhousie University’s Agri-Food Analytics Lab (AAL) suggests that between 2.5 and 3.1 million Canadians have at least one food allergy.
“We think the number will continue to increase in Canada. And that’s unfortunate for Canadians who suffer from allergies, because it’s really a life-changing condition — for them and families involved,” says Dr. Sylvain Charlebois, professor and senior director of the AAL.
One-quarter of Canadians have food allergies and/or food intolerances, according to the report. Of the more than three million who live with allergies, 41.3 per cent reported being diagnosed by an allergy expert; 36.2 per cent said they were self-diagnosed. Nearly half (48.1 per cent) of the 6.8 to 7.4 million with intolerances indicated they were self-diagnosed.
Jennifer Gerdts, executive director of Food Allergy Canada, attributes the suggestion that nearly as many Canadians are professionally as self-diagnosed to confusion around the difference between allergy and intolerance, as well as lack of access to allergy specialists and diagnostics.
In people with food allergies, Gerdts explains, the immune system mistakes an element of a food (usually a protein) as a threat, which triggers a potentially life-threatening allergic reaction. Onset is rapid and as chemicals such as histamines are released, symptoms can involve the skin, respiratory, gastrointestinal and cardiovascular systems. Food intolerances, on the other hand, don’t involve the immune system, aren’t fatal and symptoms are often limited to digestive issues.
In addition to the potential confusion between the two, there’s a “significant lack” of access to allergy specialists, says Gerdts. With just over 200 in Canada, waiting lists are long, especially in northern and rural regions. And the “gold standard diagnostic” — an oral food challenge, in which you consume gradually increasing amounts of a food in a clinical setting — is difficult to come by.
“Nevertheless, getting an accurate diagnosis is important because living with a food allergy carries a burden of the daily vigilance of managing avoidance, like knowing what’s in your food every time you sit down to eat,” says Gerdts. “But also, there’s some fear associated with an allergic reaction, which could be severe. And so it’s better to know and be prepared.”
(If you think you might have a food allergy, Gerdts suggests visiting allergycheck.ca, an app designed to help people determine if they should see a specialist.)
Food allergies do not have to hold you back as long as you have a really strong plan in place that can keep you safe.
Michael Sawers, a recent Western University business administration graduate who, like Rudniski, has had food allergies his whole life, understands the value of self-advocacy and being prepared. Anaphylactic to dairy, eggs, peanuts and tree nuts, he had his first solo allergic reaction in his first year living away from home.
“We had thorough plans in place to keep me safe but sometimes despite people’s best intentions, accidents can still happen,” says Sawers. “I knew going into it that there was some level of risk, and that it was a level I chose to accept so that I could still have a fun residence experience.”
“It was really scary,” he adds, but the experience of using his epinephrine auto-injector on his own gave him confidence.
As he’s gotten older, Sawers has gained trust in his ability to manage his food allergies, and he enjoys sharing his experiences navigating health and social challenges with youth as a Food Allergy Canada lead mentor. “Food allergies do not have to hold you back as long as you have a really strong plan in place that can keep you safe,” he says.
People with food allergies rely on access to ingredient information to make safe choices and avoid allergic reactions. In this way, the condition is not solely a matter of personal health, says Gerdts; it’s a food safety issue.
According to the AAL’s estimates, 35 per cent of the food recalls in Canada in 2020 were due to concerns over undeclared allergens. “If you take out problems with allergens, it really reduces the amount of recalls we have in Canada,” says Charlebois.
As supply chains become more multifaceted and food allergies increasingly common, he adds, recalls must be executed more effectively and companies should rethink how they manage risk: “We need to figure out a way to use technologies to protect people from food that may be recalled much faster.”
Whether ordering groceries or meals for delivery — directly from food service outlets or via third-party delivery services — access to ingredient information online is key, Gerdts underscores.
The AAL report found that among Canadians with a condition, 27.7 per cent believe menus indicate allergens appropriately; 46.3 per cent believe food products are properly labelled; and 57.8 per cent are satisfied with the number of options for people with allergies or intolerances.
“Everyone has a right to know what’s in their food. But for those with food allergy, it’s essential,” says Gerdts. “Effort needs to be put in place to address the gaps in access to ingredient information, so it’s available regardless of how food is purchased.”
Adding to the risk for people with food allergies, precautionary allergen labels, or “may contain” statements, can be confusing and aren’t always unitary. A bag of 50 chocolate bars, for example, might not bear “may contain” on the individual pieces, says Charlebois, adding that COVID-safe trick-or-treating may be the focus, but for children with food allergies and their parents, Halloween can be stressful regardless.
“Individual labelling is a big thing,” says Montrealer Annie Boisvert, a legal translator and mother of three children, two of whom have food allergies — Thomas, 10, and Noah, four. A “witch” has visited on past Halloweens, swapping unlabelled or allergenic Halloween candy for safe sweets under cover of darkness. “In the morning, there are no chocolates left,” she laughs. “But the kids still take part, which is a nice thing.”
Food Allergy Canada’s #ShineATealLight campaign and the Food Allergy Research & Education organization’s Teal Pumpkin Project — both of which indicate allergy-safe houses for trick-or-treaters — help raise awareness, says Boisvert. A few years ago, theirs was the only house in the neighbourhood with a teal pumpkin on the porch. In 2019, the last year they trick-or-treated, there were five or six.
“It’s really fun and heartwarming to see that people are doing it for basically the one kid on the street,” says Boisvert. “We need to keep talking about it and we need to carry on with (pushing for stricter labelling) regulations…. When we have good labelling, we have more choice.”