Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

Abstract

Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food—along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management.

Maternal Influences and Intervention Strategies on the Development of Food Allergy in Offspring

“…Based on the current understanding of the immunological mechanisms involved, the scientific community accepts that food allergies encompass IgE-mediated, non-IgE mediated, or a combination of both responses ( 21 ). IgE-mediated responses are the best-characterized amongst the few and involve the expression of antibodies known as IgE ( 22 ).…”

Alimentos alergênicos na infância: revisão de literatura

“…Logo, em um próximo contato com este mesmo alimento ocorrerá a liberação de mediadores vasoativos que estimulam as reações clínicas de hipersensibilidade imediata (GARGANO, et al, 2021).…”

Efficacy and Safety of a Novel Therapeutic of Natural Origin (NTN) in Adult Patients with Lactose Intolerance: A Multicenter, Randomized, Crossover, Double-Blind, Placebo-Controlled Study

“…Food intolerance affects up to 20% of the population [ 1 , 2 ], with lactose intolerance being the most common form. In contrast to food allergies, which are immune mediated [ 3 ], etiologies of food intolerances include non-coeliac gluten/wheat sensitivity, enzyme/transport defects, and/or pharmacological activity of substances present in food or food additives [ 1 , 2 ]. Despite the different pathogenic mechanisms, food intolerance and food allergy can be difficult to separate due to overlap in certain triggers (e.g., wheat, milk) and in signs/symptoms [ 1 , 3 ].…”