Food allergy and food intolerance

Area of Science:

• Immunology
• Gastroenterology
• Nutrition Science

Background:

• Adverse reactions to foods and food additives are broadly classified into immune-mediated food allergies and non-immunological food intolerances.
• Food intolerance is more prevalent across all age groups and often linked to food additives, though its exact role is under investigation.
• Classic allergic symptoms typically involve skin and gastrointestinal manifestations.

Purpose of the Study:

• To differentiate between food allergies and food intolerances.
• To outline diagnostic approaches for adverse food reactions.
• To emphasize evidence-based management strategies.

Main Methods:

• Clinical history assessment to identify patterns suggestive of allergy or intolerance.
• Diagnostic elimination diets followed by open or double-blind, placebo-controlled food challenges (DBFC).
• In vitro immunologic tests and skin testing for suspected food allergies.

Main Results:

• Food allergies present with classic allergic symptoms, while food intolerances are more common and not immune-mediated.
• Diagnostic methods like elimination diets and food challenges aid in confirming adverse reactions.
• While skin and in vitro tests can supplement allergy diagnosis, their role in intolerance is less defined.

Conclusions:

• Accurate diagnosis of food allergy versus food intolerance is crucial for effective management.
• Dietary elimination and challenge are key diagnostic tools.
• Avoidance of the offending food or additive is the cornerstone of treatment; unproven methods are not recommended.