Identifying key priorities for research to protect the consumer with food hypersensitivity: a UK Food Standards Agency Priority Setting Exercise

Paul J Turner; Elizabeth Andoh-Kesson; Sarah Baker; Alexa Baracaia; Alisha Barfield; Julie Barnett; Karen Brunas; Chun-Han Chan; Stella Cochrane; Katherine Cowan; Mary Feeney; Simon Flanagan; Adam Fox; Leigh George; M Hazel Gowland; Christina Heeley; Ian Kimber; Rebecca Knibb; Kirsty Langford; Alan Mackie; Tim McLachlan; Lynne Regent; Matthew Ridd; Graham Roberts; Adrian Rogers; Guy Scadding; Sarah Stoneham; Darryl Thomson; Heidi Urwin; Carina Venter; Michael Walker; Rachel Ward; Ross Yarham; Maggie Young; John O'Brien

doi:10.1111/cea.13983

Identifying key priorities for research to protect the consumer with food hypersensitivity: a UK Food Standards Agency Priority Setting Exercise

Paul J Turner, Elizabeth Andoh-Kesson, Sarah Baker, Alexa Baracaia, Alisha Barfield, Julie Barnett, Karen Brunas, Chun-Han Chan, Stella Cochrane, Katherine Cowan, Mary Feeney, Simon Flanagan, Adam Fox, Leigh George, M Hazel Gowland, Christina Heeley, Ian Kimber, Rebecca Knibb, Kirsty Langford, Alan MackieTim McLachlan, Lynne Regent, Matthew Ridd, Graham Roberts, Adrian Rogers, Guy Scadding, Sarah Stoneham, Darryl Thomson, Heidi Urwin, Carina Venter, Michael Walker, Rachel Ward, Ross Yarham, Maggie Young, John O'Brien

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Abstract

Introduction: Food hypersensitivity (FHS), including food allergy, coeliac disease and food intolerance, is a major public health issue. The Food Standards Agency (FSA), an independent UK Government department working to protect public health and consumers’ wider interests in food, sought to identify research priorities in the area of FHS. Methods: A priority setting exercise was undertaken, using a methodology adapted from the James Lind Alliance—the first such exercise with respect to food hypersensitivity. A UK-wide public consultation was held to identify unanswered research questions. After excluding diagnostics, desensitization treatment and other questions which were out of scope for FSA or where FSA was already commissioning research, 15 indicative questions were identified and prioritized by a range of stakeholders, representing food businesses, patient groups, health care and academia, local authorities and the FSA. Results: 295 responses were received during the public consultation, which were categorized into 70 sub-questions and used to define 15 key evidence uncertainties (‘indicative questions’) for prioritization. Using the JLA prioritization framework, this resulted in 10 priority uncertainties in evidence, from which 16 research questions were developed. These could be summarized under the following 5 themes: communication of allergens both within the food supply chain and then to the end consumer (ensuring trust in allergen communication); the impact of socio-economic factors on consumers with FHS; drivers of severe reactions; mechanism(s) underlying loss of tolerance in FHS; and the risks posed by novel allergens/processing. Discussion: In this first research prioritization exercise for food allergy and FHS, key priorities identified to protect the food-allergic public were strategies to help allergic consumers to make confident food choices, prevention of FHS and increasing understanding of socio-economic impacts. Diagnosis and treatment of FHS was not considered in this prioritization.

Original language	English
Pages (from-to)	1322-1330
Number of pages	9
Journal	Clinical and Experimental Allergy
Volume	51
Issue number	10
Early online date	7 Jul 2021
DOIs	https://doi.org/10.1111/cea.13983
Publication status	Published - 31 Oct 2021

Bibliographical note

Funding Information:
All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare competing interests as follows: PJT reports grants from the Food Standards Agency, JM Charitable Foundation, Medical Research Council, NIHR/Imperial Biomedical Research Centre and End Allergies Together, outside the submitted work; personal fees from UK Food Standards Agency, Aimmune Therapeutics, AllerGenis and ILSI Europe outside the submitted work. JB reports personal fees and grants from Food Standards Agency, outside the submitted work. SC reports financial activities with Unilever, outside the submitted work. KC is an independent facilitator and senior adviser to the James Lind Alliance. She is co‐author/editor of the JLA Guidebook and supports the JLA Secretariat and team of JLA advisers. She was an independently contracted adviser for this work. MF reports personal fees from Aimmune Therapeutics and Danone outside the submitted work. ATF is current President of the British Society for Allergy & Clinical Immunology (BSACI) and Chair of the Health Advisory Board of Allergy UK, both of which receive corporate sponsorship from companies involved in food allergy. He also reports consultancy work with Aimmune, without receiving a personal fee. MHG reports personal fees from Food Standards Agency (as a subcontractor), outside the submitted work. IK reports personal fees from Food Standards Agency, outside the submitted work. J’OB John O'Brien is a trustee of the Institute of Food Science & Technology, a member of the non‐executive board of Campden BRI, and Director of the Food Observatory; personal fees from Food Standards Agency, outside the submitted work. GR reports grants from European Union and Food Standards Agency outside the submitted work; he is also President Elect of the BSACI. CV reports grants from National Peanut Board; grants and personal fees from Reckitt Benckiser; personal fees from Nestle Nutrition Institute, Danone, Abbott Nutrition, INTENT Study, and Else Nutrition, outside the submitted work. The other authors do not report any conflicts of interest.

Funding Information:
This work was funded by the UK Food Standards Agency. The funders had no role in data collection, data analysis, data interpretation or writing of the report. We thank Paul Nunn and Rachel Whiteside at the UK Food Standards Agency (FSA) for administrative support, Hannah Lambie-Mumford (member of the FSA?s Advisory Committee for Social Science) and the following individuals who acted as independent facilitators: Jonathan Gower, Toto Gronlund, Sally Crowe and Maryrose Tarpey.

Publisher Copyright:
© 2021 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

Keywords

James Lind Alliance
allergen labelling
coeliac disease
food allergy
research prioritization

ASJC Scopus subject areas

Immunology and Allergy
Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/cea.13983Licence: CC BY

Cite this

Turner, P. J., Andoh-Kesson, E., Baker, S., Baracaia, A., Barfield, A., Barnett, J., Brunas, K., Chan, C.-H., Cochrane, S., Cowan, K., Feeney, M., Flanagan, S., Fox, A., George, L., Gowland, M. H., Heeley, C., Kimber, I., Knibb, R., Langford, K., ... O'Brien, J. (2021). Identifying key priorities for research to protect the consumer with food hypersensitivity: a UK Food Standards Agency Priority Setting Exercise. Clinical and Experimental Allergy, 51(10), 1322-1330. https://doi.org/10.1111/cea.13983

Turner, PJ, Andoh-Kesson, E, Baker, S, Baracaia, A, Barfield, A, Barnett, J, Brunas, K, Chan, C-H, Cochrane, S, Cowan, K, Feeney, M, Flanagan, S, Fox, A, George, L, Gowland, MH, Heeley, C, Kimber, I, Knibb, R, Langford, K, Mackie, A, McLachlan, T, Regent, L, Ridd, M, Roberts, G, Rogers, A, Scadding, G, Stoneham, S, Thomson, D, Urwin, H, Venter, C, Walker, M, Ward, R, Yarham, R, Young, M & O'Brien, J 2021, 'Identifying key priorities for research to protect the consumer with food hypersensitivity: a UK Food Standards Agency Priority Setting Exercise', Clinical and Experimental Allergy, vol. 51, no. 10, pp. 1322-1330. https://doi.org/10.1111/cea.13983

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title = "Identifying key priorities for research to protect the consumer with food hypersensitivity: a UK Food Standards Agency Priority Setting Exercise",

abstract = "Introduction: Food hypersensitivity (FHS), including food allergy, coeliac disease and food intolerance, is a major public health issue. The Food Standards Agency (FSA), an independent UK Government department working to protect public health and consumers{\textquoteright} wider interests in food, sought to identify research priorities in the area of FHS. Methods: A priority setting exercise was undertaken, using a methodology adapted from the James Lind Alliance—the first such exercise with respect to food hypersensitivity. A UK-wide public consultation was held to identify unanswered research questions. After excluding diagnostics, desensitization treatment and other questions which were out of scope for FSA or where FSA was already commissioning research, 15 indicative questions were identified and prioritized by a range of stakeholders, representing food businesses, patient groups, health care and academia, local authorities and the FSA. Results: 295 responses were received during the public consultation, which were categorized into 70 sub-questions and used to define 15 key evidence uncertainties ({\textquoteleft}indicative questions{\textquoteright}) for prioritization. Using the JLA prioritization framework, this resulted in 10 priority uncertainties in evidence, from which 16 research questions were developed. These could be summarized under the following 5 themes: communication of allergens both within the food supply chain and then to the end consumer (ensuring trust in allergen communication); the impact of socio-economic factors on consumers with FHS; drivers of severe reactions; mechanism(s) underlying loss of tolerance in FHS; and the risks posed by novel allergens/processing. Discussion: In this first research prioritization exercise for food allergy and FHS, key priorities identified to protect the food-allergic public were strategies to help allergic consumers to make confident food choices, prevention of FHS and increasing understanding of socio-economic impacts. Diagnosis and treatment of FHS was not considered in this prioritization.",

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author = "Turner, {Paul J} and Elizabeth Andoh-Kesson and Sarah Baker and Alexa Baracaia and Alisha Barfield and Julie Barnett and Karen Brunas and Chun-Han Chan and Stella Cochrane and Katherine Cowan and Mary Feeney and Simon Flanagan and Adam Fox and Leigh George and Gowland, {M Hazel} and Christina Heeley and Ian Kimber and Rebecca Knibb and Kirsty Langford and Alan Mackie and Tim McLachlan and Lynne Regent and Matthew Ridd and Graham Roberts and Adrian Rogers and Guy Scadding and Sarah Stoneham and Darryl Thomson and Heidi Urwin and Carina Venter and Michael Walker and Rachel Ward and Ross Yarham and Maggie Young and John O'Brien",

note = "Funding Information: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare competing interests as follows: PJT reports grants from the Food Standards Agency, JM Charitable Foundation, Medical Research Council, NIHR/Imperial Biomedical Research Centre and End Allergies Together, outside the submitted work; personal fees from UK Food Standards Agency, Aimmune Therapeutics, AllerGenis and ILSI Europe outside the submitted work. JB reports personal fees and grants from Food Standards Agency, outside the submitted work. SC reports financial activities with Unilever, outside the submitted work. KC is an independent facilitator and senior adviser to the James Lind Alliance. She is co‐author/editor of the JLA Guidebook and supports the JLA Secretariat and team of JLA advisers. She was an independently contracted adviser for this work. MF reports personal fees from Aimmune Therapeutics and Danone outside the submitted work. ATF is current President of the British Society for Allergy & Clinical Immunology (BSACI) and Chair of the Health Advisory Board of Allergy UK, both of which receive corporate sponsorship from companies involved in food allergy. He also reports consultancy work with Aimmune, without receiving a personal fee. MHG reports personal fees from Food Standards Agency (as a subcontractor), outside the submitted work. IK reports personal fees from Food Standards Agency, outside the submitted work. J{\textquoteright}OB John O'Brien is a trustee of the Institute of Food Science & Technology, a member of the non‐executive board of Campden BRI, and Director of the Food Observatory; personal fees from Food Standards Agency, outside the submitted work. GR reports grants from European Union and Food Standards Agency outside the submitted work; he is also President Elect of the BSACI. CV reports grants from National Peanut Board; grants and personal fees from Reckitt Benckiser; personal fees from Nestle Nutrition Institute, Danone, Abbott Nutrition, INTENT Study, and Else Nutrition, outside the submitted work. The other authors do not report any conflicts of interest. Funding Information: This work was funded by the UK Food Standards Agency. The funders had no role in data collection, data analysis, data interpretation or writing of the report. We thank Paul Nunn and Rachel Whiteside at the UK Food Standards Agency (FSA) for administrative support, Hannah Lambie-Mumford (member of the FSA?s Advisory Committee for Social Science) and the following individuals who acted as independent facilitators: Jonathan Gower, Toto Gronlund, Sally Crowe and Maryrose Tarpey. Publisher Copyright: {\textcopyright} 2021 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.",

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doi = "10.1111/cea.13983",

language = "English",

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T2 - a UK Food Standards Agency Priority Setting Exercise

AU - Turner, Paul J

AU - Andoh-Kesson, Elizabeth

AU - Baker, Sarah

AU - Baracaia, Alexa

AU - Barfield, Alisha

AU - Barnett, Julie

AU - Brunas, Karen

AU - Chan, Chun-Han

AU - Cochrane, Stella

AU - Cowan, Katherine

AU - Feeney, Mary

AU - Flanagan, Simon

AU - Fox, Adam

AU - George, Leigh

AU - Gowland, M Hazel

AU - Heeley, Christina

AU - Kimber, Ian

AU - Knibb, Rebecca

AU - Langford, Kirsty

AU - Mackie, Alan

AU - McLachlan, Tim

AU - Regent, Lynne

AU - Ridd, Matthew

AU - Roberts, Graham

AU - Rogers, Adrian

AU - Scadding, Guy

AU - Stoneham, Sarah

AU - Thomson, Darryl

AU - Urwin, Heidi

AU - Venter, Carina

AU - Walker, Michael

AU - Ward, Rachel

AU - Yarham, Ross

AU - Young, Maggie

AU - O'Brien, John

N1 - Funding Information: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare competing interests as follows: PJT reports grants from the Food Standards Agency, JM Charitable Foundation, Medical Research Council, NIHR/Imperial Biomedical Research Centre and End Allergies Together, outside the submitted work; personal fees from UK Food Standards Agency, Aimmune Therapeutics, AllerGenis and ILSI Europe outside the submitted work. JB reports personal fees and grants from Food Standards Agency, outside the submitted work. SC reports financial activities with Unilever, outside the submitted work. KC is an independent facilitator and senior adviser to the James Lind Alliance. She is co‐author/editor of the JLA Guidebook and supports the JLA Secretariat and team of JLA advisers. She was an independently contracted adviser for this work. MF reports personal fees from Aimmune Therapeutics and Danone outside the submitted work. ATF is current President of the British Society for Allergy & Clinical Immunology (BSACI) and Chair of the Health Advisory Board of Allergy UK, both of which receive corporate sponsorship from companies involved in food allergy. He also reports consultancy work with Aimmune, without receiving a personal fee. MHG reports personal fees from Food Standards Agency (as a subcontractor), outside the submitted work. IK reports personal fees from Food Standards Agency, outside the submitted work. J’OB John O'Brien is a trustee of the Institute of Food Science & Technology, a member of the non‐executive board of Campden BRI, and Director of the Food Observatory; personal fees from Food Standards Agency, outside the submitted work. GR reports grants from European Union and Food Standards Agency outside the submitted work; he is also President Elect of the BSACI. CV reports grants from National Peanut Board; grants and personal fees from Reckitt Benckiser; personal fees from Nestle Nutrition Institute, Danone, Abbott Nutrition, INTENT Study, and Else Nutrition, outside the submitted work. The other authors do not report any conflicts of interest. Funding Information: This work was funded by the UK Food Standards Agency. The funders had no role in data collection, data analysis, data interpretation or writing of the report. We thank Paul Nunn and Rachel Whiteside at the UK Food Standards Agency (FSA) for administrative support, Hannah Lambie-Mumford (member of the FSA?s Advisory Committee for Social Science) and the following individuals who acted as independent facilitators: Jonathan Gower, Toto Gronlund, Sally Crowe and Maryrose Tarpey. Publisher Copyright: © 2021 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

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Y1 - 2021/10/31

N2 - Introduction: Food hypersensitivity (FHS), including food allergy, coeliac disease and food intolerance, is a major public health issue. The Food Standards Agency (FSA), an independent UK Government department working to protect public health and consumers’ wider interests in food, sought to identify research priorities in the area of FHS. Methods: A priority setting exercise was undertaken, using a methodology adapted from the James Lind Alliance—the first such exercise with respect to food hypersensitivity. A UK-wide public consultation was held to identify unanswered research questions. After excluding diagnostics, desensitization treatment and other questions which were out of scope for FSA or where FSA was already commissioning research, 15 indicative questions were identified and prioritized by a range of stakeholders, representing food businesses, patient groups, health care and academia, local authorities and the FSA. Results: 295 responses were received during the public consultation, which were categorized into 70 sub-questions and used to define 15 key evidence uncertainties (‘indicative questions’) for prioritization. Using the JLA prioritization framework, this resulted in 10 priority uncertainties in evidence, from which 16 research questions were developed. These could be summarized under the following 5 themes: communication of allergens both within the food supply chain and then to the end consumer (ensuring trust in allergen communication); the impact of socio-economic factors on consumers with FHS; drivers of severe reactions; mechanism(s) underlying loss of tolerance in FHS; and the risks posed by novel allergens/processing. Discussion: In this first research prioritization exercise for food allergy and FHS, key priorities identified to protect the food-allergic public were strategies to help allergic consumers to make confident food choices, prevention of FHS and increasing understanding of socio-economic impacts. Diagnosis and treatment of FHS was not considered in this prioritization.

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Identifying key priorities for research to protect the consumer with food hypersensitivity: a UK Food Standards Agency Priority Setting Exercise

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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