Diagnostic elimination diets and oral food provocation

Accurately diagnosing patients with suspected food allergy is obviously critically important. The patient's health may be compromised if problem foods are left in the diet, while nutrition and quality of life may be negatively affected if foods are unnecessarily removed from the diet. In some patients, the diagnosis is very straightforward, such as with anaphylaxis with the first known exposure to peanut, but in many cases, the diagnosis will not be clear based on the history, skin tests, and serologic tests, especially because these tests often yield falsely positive results. In these instances, further testing will be needed, typically including diagnostic elimination diets and/or oral food challenges, which are the gold standard for the diagnosis of food allergy.