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Favism
Dietary vigilance for certain populations
Favism is a disease affecting people with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, an enzyme involved in numerous mechanisms of biosynthesis (amino acids, steroids, lipids, etc.). This enzyme deficiency mainly affects male populations from Africa, India, the Mediterranean basin and South East Asia.
120,000 people in mainland France reportedly suffer from this deficiency according to WHO. Consumption of medicines (quinine-based medicines in particular), broad beans (hence the term favism), particularly fresh and raw and certain substances such as quinine or vitamin C present in food can cause reactions. Although the mutation associated with this deficiency is not significant enough to be symptomatic in the majority of cases, in other cases serious clinical signs can appear (icterus neonatorum in infants or haemolytic anaemia that is potentially fatal at any age).
Food and ingredients that should be avoided
On 27 May 2006, the Directorate General for Health (DGS) requested Afssa to formulate food recommendations for people with this enzyme deficiency. As knowledge currently stands, the consumption of broad beans, horse beans and broad bean-based food supplements is unadvised for people with G-6-PD deficiency, however they are stored and prepared.
As well as broad beans, quinine and vitamin C are the only two substances found in food described as causing haemolytic accidents. The consumption of drinks containing quinine is not recommended in the event of G-6-PD deficiency. The same applies for products that are naturally high in vitamin C (especially fruit, nuts, berries and some fruit juices), and fortified foods or vitamin C-based food supplements. The threshold of 1 g/day is to be adopted as the safety limit for people with G-6-PD deficiency.
Raising the awareness of professionals
Given the risks of this disease and the little healthcare professionals and food manufacturers know about them, it seems necessary to better inform them of the potential risks that broad beans and certain substances found in food (quinine, vitamin C) may pose for people with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency.
Flour made from broad beans or horse beans, even if it is used as an ingredient in the food industry, must be indicated on the labeling of the finished product as stipulated by law. However, because this labeling is subject to numerous exemptions in the bread and pastry sector, Afssa recommends warning professionals in this sector against using too many broad beans and against exceeding the threshold set at 2%.
Moreover, it recommends the drafting of an information guide describing the disease and its potential consequences for professionals in the restaurant and catering sector and for school canteens.
Lastly, Afssa highlights the importance of raising awareness about this disease among healthcare professionals as the non-specialised medical profession know very little about it.
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