Nature and Complexity of Food Importance of the Gastrointestinal Tract SAFETY STANDARDS FOR FOODS, FOOD INGREDIENTS, AND CONTAMINANTS Food and Color Additives SAFETY OF FOOD • Adverse Reactions to Food or Food Ingredients • Food Allergy • Food Toxicity (Poisoning) • Food Idiosyncrasy • Anaphylactoid Reactions • Food–Drug Interactions • Metabolic Food Reactions Toxins in Fish, Shellfish, and Turtles • Neurotoxic Shellfish Poisoning (NSP) • Amnesic Shellfish Poisoning (Domoic Acid) • Ciguatera Poisoning • Palytoxin Poisoning • Puffer Fish Poisoning (Tetrodotoxin) • Moray Eel Poisoning • Abalone Poisoning (Pyropheophorbide Microbiological Agents—Preformed Bacterial Toxins
• Clostridium Botulinum, C. butyricum and C. baratti
• Clostridium perfringens • Bacillus cereus • Staphylococcus a SAFETY OF FOOD Adverse Reactions to Food or Food Ingredients • Food Allergy • Description Food hypersensitivity (allergy) refers to a reaction involving an immune-mediated response. Such a response is generally IgE-mediated, although IgG - and cell-mediated 4
immunity also may play a role in some instances (Fukutomi et
al., 1994) Food hypersensitivity (allergy) • An immunologic reaction and may occur only in some patients, may occur after only a small amount of the substance is ingested, and is unrelated to any physiological effect of the food or food additive • Immune-mediated (cellular or humoral response), requires prior exposure to antigen or cross-reacting antigen. First exposure may have been asymptomatic Food anaphylaxis • A classic allergic hypersensitivity reaction to food or food additives • A humoral immune response most often involving IgE antibody and release of chemical mediators. Mortality may result Food intolerance • A general term describing an abnormal physiological response to an ingested food or food additive; this reaction may be an immunologic, idiosyncratic, metabolic, pharmacological, or toxic response • Any untoward pathological reaction resulting from ingestion of a food or food additive. May be immune-mediated. Celiac disease(intolerance to wheat, rye, barley, oats) Food toxicity (poisoning)
• A term use to imply an adverse effect cased by the direct action
of a food or food additive on the host recipient without the involvement of immune mechanisms. This type of reaction may involve nonimmune release of chemical mediators. Toxins may be contained within food or released by microorganisms or parasites contaminating food products • Not immune-mediated. May be caused by bacterial endo- or exotoxin (e.g.,hemorrhagic E. coli) fungal toxin (e.g.,aflatoxin), tetrodo-toxin from pufferfish,domoic acid from mollusks, histamine poisoning from fish (scombroid poisoning),nitrate poisoning (i.e., methemoglobinuria) Food idiosyncrasy • A quantitatively abnormal response to a food substance or additive; this reaction differs from its physiological or pharma- cological effect and resembles hypersensitivity but does not involve immune mechanisms. Food idiosyncratic reactions include those which occur in specific groups of individuals who may be genetically predisposed • Not immune-mediated, Favism (hemolytic anemia related to deficiency of erythrocytic glucose-6-phosphate dehydrogenase), fish odor syndrome, beetanuria, lactose intolerance, fructose, intolerance, asparagus urine, red wine intolerance Anaphylactoid reaction to a food • An anaphylaxis-like reaction to a food or food additive as a result of nonimmune release of chemical mediators. This reaction mimics the symptoms of food hypersensitivity (allergy) • Not immune-mediated. Scombroid poisoning, sulfite poisoning, red wine sensitivity Food–drug interaction • A change in the pharmacokinetic or pharmacodynamic action of a drug as the result of ingestion of a food • Not immune-mediated. Ingestion of fats, phytates, or fiber to change absorption; upregulation of genes by Brassica, polyunsaturated fats; unregulation of polypeptide transporters by St. Johns wort Metabolic food reaction • Toxic effects of a food when eaten in excess or improperly prepared • Cycasin, vitamin A toxicity, goiterogens, licorice Symptoms of IgE-Mediated Food Allergies >Cutaneous : Urticaria (hives), eczema, dermatitis, pruritus, rash >Gastrointestinal : Nausea, vomiting, diarrhea, abdominal cramps >Respiratory : Asthma, wheezing, rhinitis, bronchospasm >Other : Anaphylactic shock, hypotension, palatal itching, swelling including tongue and larynx, methemoglobinemia*