Doing the Food Allergy Diagnosis

Abstract

Most people can eat a variety of foods without problems. However, in a small percentage of the population, certain foods can cause adverse reactions, from which the origin should be investigated: Perhaps food poisoning, a psychological aversion to a food, an intolerance to an ingredient in a meal or a true food allergy. Diagnosis of food allergy requires a combination of a detailed medical history, laboratory data and in many cases, an oral food challenge, which is confirmatory of either tolerance or an adverse food reaction (allergy or non-allergic). The cornerstone of food allergy management is the elimination of the allergen involved, however the allergen elimination process could predispose patients, especially children to inadequate diets and cause nutritional deficiencies thus eliminating diets should be done in the most specific way possible. Keywords: Food allergy, Allergy; Patient; Children DefinitionAdverse reactions to food may be due to intolerance, toxicity or immunological mechanisms. Food allergy is defined as an adverse immune response that occurs reproducibly on exposure to a given food. This is different from food intolerance, which refers to a nonimmunological adverse reaction to food [1][2][3][4]. Food allergy is the result of an immune response, which may be mediated by IgE (type I) and non-IgE mediated (type II, III, IV or mixed hypersensitivity); and which occurs by sensitization to food allergens [5][6][7][8]. Food Allergy EpidemiologyFood allergy is common, in developed countries, the prevalence of food allergy has increased over the last two or three decades, with no universal theory to explain this phenomenon and no interventions appear to curtail a similar increase in developing countries. The prevalence of food allergy seems to vary greatly with age. Currently estimated to affect between 2 and 8% of the world's population. The prevalence of food allergy is highest in infants and toddlers; affecting 6% to 8% of children and can be both life-impacting and lifethreatening [1][2][3]8,9].2.5% of infants suffer from milk allergy and up to 10% of 1-yearolds suffer from allergies to food, including cow's milk, egg, nuts, soya, wheat and fish/shellfish [2,10]. Some children may "outgrow" their symptoms of allergy, but for others, the food allergies may be lifelong. Because reported cases increase each year, food allergy should be considered a public health problem. In fact, some authors have described it as "the second wave" of the allergic epidemic [8].Cross-reactivity between different species of foods in allergic patients is also common. Dietary avoidance is currently the most essential component in the management of food allergy. However, it may not be beneficial for children during periods of active growth, as it can limit their intake of nutrients from different foods. Conflicting information regarding cross-reactivity often leads to an inconsistent understanding of food allergies among physicians and other health care givers which lead to disparate recommendations and confusion...

Food Allergy

“…Identification of allergen present in food involves a combination of a detailed medical history, along with the laboratory data and also, an oral food challenge, a confirmatory of either tolerance or an adverse food reaction. Medina et al [1], conferred the cornerstone of food allergy management is the elimination of the allergen present, however it is suggested that the allergen elimination process could predispose patients, especially in children to inadequate diets and cause nutritional deficiencies thus eliminating diets should be done in the most specific way possible.…”