When bread becomes deadly - paying the allergy premium in a cost of living crisis

For most people, the type of bread they buy is rarely a matter of life and death.

But for millions of Britons living with allergies eating the wrong food could see them hospitalised - or worse.

Amid the rising cost of living - and spiralling food prices that mean customers are left with little change from a fiver for a mere loaf of specialist bread - it is these families facing particular pressure.

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The Bolton family, from Southampton, faces a double whammy of food restrictions.

Eli Rana, aged 14, is allergic to dairy, egg and soya while his older sister, Darshi Rana, aged 17, has coeliac disease - which means a single crumb of gluten can leave her feeling like "all her internal organs are being squeezed".

This means the family cannot eat something as simple as the same loaf of bread.

A comparison of foods by Allergy UK in December found it costs on average 157% more for some free-from alternatives.

Bread had one of the sharpest price differences, with the allergy alternative up to 254% more costly.

"All gluten-free bread normally has egg or soya in it," said mum Lisa. "So I have to buy two loaves.

"We have to have different milk, we have to have separate butter - my daughter has to have her own butter because the smallest grain of bread will make her so ill, so she can't even use the same knife."

And getting it wrong can quickly turn deadly.

"My son has anaphylaxis so he could potentially die if he ingested dairy or soya," said Lisa, adding that they are "generally not taken seriously, and that breaks my heart".

Families spend an extra 40 days a year dealing with allergies

All of this specialist food comes at a cost.

The Food Standards Agency found food hypersensitivity households - those living with a food allergy, intolerance and coeliac disease - spend an additional 12 to 27% more on their weekly food shop.

They also spend an additional 40.37 days per year on activities related to food, including researching, shopping for suitable items and discussing their condition.

For Lisa, there is no such thing as a single weekly shop.

"I have to go to at least three on a weekly basis," she told Sky News.

When her son was first diagnosed she said she "could have cried every time" she stepped into a supermarket.

The number of products that listed food as "may contain" was "soul-destroying", she said.

While some people living with allergies may be able to eat food that is made in the same factory - and labelled "may contain" - for those with more severe reactions, this is not possible.

Around 2.6 million people in the UK live with a diagnosed food allergy, affecting between five and seven percent of children.

From pre-baking birthday cake and freezing it so her four-year-old daughter isn't left out, to providing her own sweets at the end of term, Rebecca Bull is always on alert to the risk of allergies.

"I think of every scenario where food might crop up, but occasionally you miss something.

"I've been at a party where an entertainer just threw sweets out to the kids, I hadn't anticipated that.

"And when you do that to a four-year-old, the temptation is massive. She just grabbed one and I had to jump up straight away."

Why it is more expensive

"When manufacturers and brands swap out ingredients, the allergen-friendly option will often be more expensive," said Bari Stricoff, a registered dietitian.

"This is due to the increased difficulty in sourcing the ingredients, as well as the demand.

"Your average gluten-free flour will be nearly double the price as the standard flour, and almond flour could be 3x as high as the standard plain flour.

"Many allergen-friendly foods are produced by speciality brands.

"Because these are often smaller or newer brands, it means their costs are higher. They're not able to produce their items at scale and struggle to get into the larger retailers. This means they’ll have higher price tags to cover their margins."

Knives, forks, and extra dishwashing

Hand-in-hand with the need to buy different food for each child comes a hidden energy cost.

"We have the cost of cooking most things twice," she said.

"If we cook pizza, we have to do them in two separate ovens.

"If we are making sandwiches to go out, we have to use about five different knives because you have to use a different knife for each person."

Alongside that comes the extra fuel cost for the multiple supermarket visits.

'We don't have a choice': Food on prescription

In England, some gluten-free bread and flour mixes are available on prescription, although this can be a postcode lottery.

While Darshi does qualify, Lisa said: "When you go to the chemist you have to order in batches of 20 loaves, so it's not practical to do that.

"And then when you order stuff they can't tell you when it's coming in."

There is currently no similar programme for those living with food allergies.

"I think it should be anybody who has food restrictions," said Lisa.

"I understand that it's more expensive for manufacturers to make. So they should have some help in bringing it into line with everybody else.

"Because it's not a choice. We don't have any choice."

52 fewer bagels: The allergy premium

Holly Holland, co-founder of Financelle - an online financial wellness platform, said she is "new to the allergy and intolerance game" and can't eat gluten or lactose.

"People don't realise how much stuff they are in," she told Sky News.

"Even if you pick up a pack of Doritos, lactose is used as a coating and powder. It's in cakes, it's in biscuits.

"And nine times out of 10 the package will just say 'may contain' anyway, so if you are battling a serious allergy, you can't even risk it."

For Holly, bagels are a prime example of the allergy premium.

A pack of five from Asda costs her 95p, yet going gluten-free will set her back £2.50 for a pack of four. That's 63p a bagel compared to 19p.

"If I bought a pack of bagels each week for the rest of the year that's £130 compared to my gluten-eating friends forking out just £49.40," she said.

"And I would have 52 less bagels in 12 months."

She said bread items are some of the most expensive because they are so "heavily processed".

The extra costs have forced Holly to be more creative with cooking.

"Arguably, it forces you to have any more fresh things because you can just pick up a packet of fish fingers or whatever it might be," she said.

But her weekly shop, which used to be around £40 for a family of four (with top-ups during the week) has now gone to £60.

Over the course of the year, this seemingly small amount adds up to £780 extra.

'It's not a good thing the gap has narrowed'

Sarah Knight from The Allergy Team - who also lives in an allergen household - said when the basics of your weekly shop remain so high, it's hard to keep costs down.

"Whether that's fortified dairy-free milk, whether that's gluten-free or wheat-free bread or dairy-free spread, when they are so high then makes it really hard to get the sort of overall price of your shop down."

The organisation tracked the price of 10 of these basics at the four main supermarkets last year.

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Food inflation hit a record annual rate in December as cash-strapped households prepared for Christmas.

"At the beginning of last year the allergy stuff was going up disproportionately higher," she said.

"Now that other food has sort of caught up. It's not a good thing that the difference between an allergy basket and a non-allergy basket now is narrower because it is only because the non-allergy basket has also gone up.

"And so families living with food allergies are just hit super hard by any of this price inflation because they're already living with such inflated prices just trying to get the basics in."