We are a nation of comfort eaters, big food survey reveals. But don't quit chocolate just yet

Kimberley Madden-Snoad and her daughter Mikayla Madden-Snoad, who has been allergic to milk, eggs and some other foods all her life and has been diagnosed with coeliac disease. Photo / Jason Oxenham

Mikayla Madden-Snoad had her first allergic reaction to food when she was a baby.

That was to dairy. Soon after allergies to eggs, tree nuts and kiwifruit were diagnosed.

Aged 3, a severe reaction resulted in her getting her first EpiPen, an auto-injector containing a pre-filled syringe of adrenaline used in an emergency to quickly treat anaphylaxis.

"Then, when I was 12, I was diagnosed with coeliac disease, which means I can't eat gluten."

The 17-year-old Pakuranga College student knows the milestones that have shaped the way she lives and eats.

"When I go out, I have to always take my own food and I have to have my adrenaline with me. I have to be careful of traces and contamination."

A large-scale study of Kiwis' food habits has revealed a higher than expected proportion of the population have food allergies.

In the Bayer Food Focus Project, almost a quarter of households reported having one or more people who had a doctor-diagnosed food allergy. The proportion rose to 40 per cent when the question was widened to include food intolerance or undiagnosed allergies.

Madden-Snoad said she has had a lot of anxiety about food as a result of her allergies.

Kimberley Madden-Snoad and her daughter Mikayla Madden-Snoad, who has been allergic to milk, eggs and some other foods all her life and has been diagnosed with coeliac disease. Photo / Jason Oxenham

The burden is eased a little by the availability of alternatives. "There's dairy-free chocolate, that's pretty good, and dairy-free icecream. They have even invented egg-free omelette."

At home there are separate shelves in the pantry and the fridge for Mikayla and the rest of the family's food.

Alternative foods are expensive and the family can't decide on a whim to go out for a meal.

"We can't just go to a restaurant," says her mother, Kimberley, "and if we go away we have to stay in the place where there is a kitchen so we can cook our own food."

Tiny traces potentially have dire consequences. A trace of milk in a beauty soap sparked a reaction that constricted her airwaves, making it hard for her to breathe.

The gene that can result in coeliac disease is hereditary. Kimberley has hay fever and her husband has asthma.

Kimberley, who runs a support group for people with food allergies, says she is seeing an increase in the number of people affected. These are separate to food intolerances.

"There's not much support around. People have to struggle through, getting advice on diets. Even getting a diagnosis can be difficult."

The Bayer food survey also reveals that more than three-quarters of Kiwis say they are comfort eaters.

Our favourite food friends are chocolate and lollies. Salt-rich products such as savoury snacks and chips ranked second equal with fast-food options but tend to displace fast food among Kiwis aged 55 years and over.

Almost all younger Kiwis (90 per cent of those aged 15-34) say they are comfort eaters, compared with 82 per cent of women and 72 per cent of men.

The survey, the biggest snapshot in a decade of our eating habits, was a joint project between worldwide life sciences and pharmaceuticals company Bayer and the NZ Nutrition Foundation.

The sample of 1346 people - adjusted to reflect New Zealand's gender, age, area and ethnic proportions- canvassed a wide range of topics and captured our habits, including eating out, buying in and popping supplements.

It found that the older tradition of buying a meal from a takeaway shop and taking it home was still widespread but done less frequently, with relatively few households doing this more than once a week.

Meal delivery kits such as My Food Bag are yet to take off. They had the lowest patronage of the options at 8 per cent, though interest from the young suggests that kit services may be on the rise.

By comparison, nearly one in five buy a meal at least once a week from a restaurant or fast food outlet, delivered by Uber or a similar service.

Almost half of Kiwis reported taking supplements, but only 9 per cent did so to treat a diagnosed health issue. Multivitamins were taken by 28 per cent, with vitamin C and D
and magnesium next most popular.

A key finding was that nearly half of those surveyed reported that they don't eat the minimum five veges and fruit a day. And 50 per cent thought healthy foods were too expensive.

Food

AUT nutrition expert Professor Elaine Rush said this was disappointing, particularly when results showed a good awareness of what foods were better and worse for us. She favours a sugar tax, removing GST from some foods and perhaps following the lead of Australia where people are encouraged to eat seven veges and pieces of fruit a day.

Although there is room for improvement, Jess Campbell of Body Balance Nutrition is concerned the low rate of vege and fruit consumption will be used in anti-obesity rhetoric, even though she says there is no difference in consumption of vegetables and fruit across the body mass index (BMI) bands.

Campbell and Rush say that although it is not widely realised, malnourishmentoccurs across all BMI bands. "I think the term 'obesity' is misused," says Rush. "It's a form of malnourishment. In fact you can be malnourished at any size."

Campbell, who describes herself as "a non-diet nutritionist", says obesity is highly complex and she cautions against singling out comfort eating as a big problem.

"Eating is an emotional experience. For some, comfort eating may be one of the few tools they have to care for themselves. It is something we have become hyper-focused on and there is a danger in framing it as a problem.

"We shouldn't pathologise it, shouldn't treat it as a cut-and-dried negative. It can be a legitimate coping strategy. I think, actually, icecream does make us happy. An icecream on a hot day at the beach - some of my best memories are of that."

Problems arise, she says, if you eat to the point that it becomes stressful or uncomfortable, or interferes with your normal activities.

"We eat for a variety of reasons, physiological and psychological. It needs to be satisfying as well as nourishing. Denying those needs can lead to restrictive eating patterns, which can result in periods of under or over eating."

Campbell believes public health messaging is missing the role satisfaction plays in eating. "We are asking people to restrict and cut things out rather than focussing on how can we make eating a satisfying experience.

"Denial is not the answer and restricting food choices can be viewed as punishment."

Food

However, the health system is overwhelmed with illnesses related to type 2 diabetes, which exercise and diet play a part in.

The proportions of the various food we eat is key. The American dietary advice, My Plate, is half of your dinner plate should be colourful vegetables, a quarter a good carbohydrate and a quarter a good source of protein.

The survey found 90 per cent of Kiwis get their fruit and veges from the supermarket so, says Rush, your shopping trolley should be half vegetables and fruit, a quarter good sources of protein and a quarter of filler foods, which could include potatoes.

"You look at the supermarket trolleys going out and it's not exactly like that. We have a way to go. I think it would be a wonderful study to look at the nutritional value of the average supermarket trolley."

High proportion of allergy sufferers surprises

Elaine Rush, Professor of Nutrition at AUT and science director of the NZ Nutrition Foundation, was surprised by the high rate of allergies indicated by the survey's responses.

Nearly a quarter of households reported one or more people with a doctor-diagnosed food allergy. This rose to 40 per cent when the question was widened to include an intolerance or undiagnosed allergies. And households of younger respondents were more likely to be affected.

The food allergens most reported in the survey were cow's milk, peanuts, wheat, shellfish and eggs.

Rush, whose grandson is anaphylactic to walnuts, puts the high rate of intolerance reported in the survey down to greater knowledge.

"I think they are very real. Go back 100 years and we didn't know about these sorts of things, like gluten intolerance and coeliac disease." It was likely back then that people died without diagnosis, she says.

We now live longer and have a more supportive health environment better able to diagnose such conditions.

Our changing ethnic makeup was another factor as people from China and east Asia are genetically less tolerant to lactose.

Milk has been recognised as top of the allergy list for a few years now, said Allergy NZ chief executive Mark Dixon.

"As our principal industry in New Zealand is agriculturally based, we have a massive amount of dairy in our diets from a young age, compared to other countries.

"However, our immigrant populations have grown exponentially over the past decade and they come from areas where dairy is imported and therefore a premium product, from places such as the Pacific Islands, Asia, the Middle East. Their first sustained exposure to dairy occurs when they move to NZ.

"It is hypothesised that their immune system has not had the opportunity to code dairy protein as a harmless protein when they are infants, and instead sets off alarms - allergic reactions - when they first encounter it later in life."

Dixon said it was "a real concern" that nearly a quarter of New Zealand households across all ethnicities report living with this burden and it should send a clear signal to the Ministry of Health that food allergy is a major public health concern needing urgent attention.

It presents a significant burden for individuals and families, including the cost of special foods, major limitations on lifestyle, and the psychological impact of living with a life-threatening condition, Dixon said.

"This is made even worse by Pharmac's refusal to fund EpiPens for those with a severe allergy who are at risk of anaphylaxis."