Abstract
RATIONALE: Recent legislation in USA and Europe aimed to improve information on packaged foods to assist food allergic consumers identify allergens. Legislation does not cover ‘may contain’ labels. There is little information on how information is used by allergic consumers when purchasing food. METHODS: We studied how peanut and nut allergic individuals use allergy advice boxes, ingredients lists, and other packaging information, excluding ‘may contain’. Thirty-two peanut and/ or nut allergic participants were observed during their normal food shop. Their spoken thoughts were audio-recorded. This was followed by a semi-structured interview. They were also given 13 potentially problematic packaged foods, and asked to explain whether they would purchase the food and their reasoning for the decision. Transcribed data from the shop, interview and 13-product task were analysed to explore use of label information. RESULTS: Most participants used the allergy advice box rather than the ingredients list for their primary check. Package-based information was generally considered reliable, but some brands were trusted more than others. Participants suggested a number of improvements, particularly more ‘nut free’ labelling. CONCLUSIONS: Participants used a combination of non-package based strategies (e.g. previous experience), in conjunction with label information to make purchase decisions. Trust of the food producer or supermarket informed interpretation of and confidence in labels. Images and product names, not intended by manufacturers as an allergen risk assessment aid were also used to inform choices.