Survey on Chocolate Consumption in Food Allergic Individuals

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_English version_

*The purpose of this survey is to evaluate the consumption of chocolate products with a precautionary allergen statement such as “may contain allergen [X]” in individuals with food allergy.*

This survey is being carried out as part of research work on allergens by the PARERA laboratory at Laval University in Quebec, Canada. This is a completely anonymous survey; at no time you will be asked to give personal information. This survey focuses on four priority allergens (milk, egg, peanut, tree nuts).

*Approximate duration of the survey: 5 minutes*

Precautionary allergen statements such as “may contain allergen [X]” are commonly used by food industries to warn consumers of possible risks of cross-contamination that can result in an allergic reaction.

To evaluate the risk of having an allergic reaction, it’s important to know how much an allergic individual would eat of a specific chocolate product. Consumption data and average serving sizes for the general population are available, however, for those individuals at risk of an allergic reaction, they may have different serving sizes, particularly if they are choosing to eat products that have an allergen precautionary label.

In addition to consumption data from the general population and on allergen presence in foods, the results of this short study will help us to 1) better know the consumption of food products with “may contain” by allergic individuals ; 2) evaluate the risk of allergic reactions if a product with “may contain” is consumed; 3) have a better understanding of precautionary allergen statement use by food industries; 4) look into the possibility of proposing a new regulation on “may contain” labeling in Canada.

*Eligibility* You are invited to answer this survey in your name or on behalf of a member of your family (children and teenagers). In that case, please act as if the child or teen was answering this survey for themselves.

*Important*: If you have many people with food allergy in your family, please fill in one survey per allergic individual (for example, two allergic children = 2 surveys).

Date *

YYYY

Initials of the food allergic participant (ex.: EM or SLV): *

1. Please indicate if you are: *

Male individual with food allergy

Female individual with food allergy

Parent of a male child with food allergy

Parent of a female child with food allergy

Other:

2. What age group do you/your child belong to? *

If you are answering the following question on behalf of your child or teen, please provide their age

0-12 years old

13-17 years old

18-25 years old

26-64 years old

65 and over

3. In which province do you live? *

Ontario (ON)

Quebec (QC)

Maritimes (NB, NS, PE)

Newfoundland (NL)

Prairies (MB, SK, AB)

British Columbia (BC)

Northern Canada (NU, NT, YT)

4. To which food(s) are you allergic? *

More than one answer is possible; chose all allergens that apply to you.

Milk

Egg

Peanut

Tree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios and walnuts)

None of the above

Required

Did you answer "None of the above" *only* at the question 4 (you are not allergic to milk/eggs/peanuts/tree nuts)? *

Yes

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