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Adverse food reactions--an emerging issue for adults.

Abstract

Adverse reactions to foods are classified according to the presence or absence of involvement of the immune system, which may or may not include the production of immunoglobulin E (IgE) antibodies. This review focuses on the epidemiology, diagnosis, and management of adverse food reactions, primarily in adults, and excluding celiac disease and lactose intolerance. Reported reactions to foods are often believed to be manifestations of a food allergy; however, IgE-mediated food allergy only affects 1% to 4% of adults, with seafood, tree nuts, peanuts, fruits, and vegetables being the most common triggers. Diagnosis is challenging and most commonly achieved through careful evaluation of clinical history followed by elimination and reintroduction or challenge with the suspected offending food. With acute-onset allergic reactions, estimation of food-specific IgE antibodies is frequently used to confirm or refute the diagnosis. Recent developments, such as single allergen assays, enhance the diagnosis of IgE-mediated food allergy, but the gold standard remains oral food challenge. Despite recent advances in the management of food allergy, including the promotion of oral tolerance, the mainstay of management is still the avoidance of food triggers. Dietary management can be compromised by nutritional inadequacy, accidental exposure, food labeling, and quality of life or adherence issues. It is essential that adults with confirmed food allergy receive optimal nutrition and dietetic support to enable them to manage their condition.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Royal Brompton & Harefield NHS Foundation Trust, London, UK. i.skypala@rbht.nhs.uk

    Source

    MeSH

    Adult
    Age Factors
    Allergens
    Diagnosis, Differential
    Food Hypersensitivity
    Humans
    Immunoglobulin E
    Medical History Taking
    Nutrition Therapy
    Quality of Life

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22117664

    Citation

    Skypala, Isabel. "Adverse Food Reactions--an Emerging Issue for Adults." Journal of the American Dietetic Association, vol. 111, no. 12, 2011, pp. 1877-91.
    Skypala I. Adverse food reactions--an emerging issue for adults. J Am Diet Assoc. 2011;111(12):1877-91.
    Skypala, I. (2011). Adverse food reactions--an emerging issue for adults. Journal of the American Dietetic Association, 111(12), pp. 1877-91. doi:10.1016/j.jada.2011.09.001.
    Skypala I. Adverse Food Reactions--an Emerging Issue for Adults. J Am Diet Assoc. 2011;111(12):1877-91. PubMed PMID: 22117664.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Adverse food reactions--an emerging issue for adults. A1 - Skypala,Isabel, PY - 2010/03/29/received PY - 2011/05/20/accepted PY - 2011/11/29/entrez PY - 2011/11/29/pubmed PY - 2012/1/11/medline SP - 1877 EP - 91 JF - Journal of the American Dietetic Association JO - J Am Diet Assoc VL - 111 IS - 12 N2 - Adverse reactions to foods are classified according to the presence or absence of involvement of the immune system, which may or may not include the production of immunoglobulin E (IgE) antibodies. This review focuses on the epidemiology, diagnosis, and management of adverse food reactions, primarily in adults, and excluding celiac disease and lactose intolerance. Reported reactions to foods are often believed to be manifestations of a food allergy; however, IgE-mediated food allergy only affects 1% to 4% of adults, with seafood, tree nuts, peanuts, fruits, and vegetables being the most common triggers. Diagnosis is challenging and most commonly achieved through careful evaluation of clinical history followed by elimination and reintroduction or challenge with the suspected offending food. With acute-onset allergic reactions, estimation of food-specific IgE antibodies is frequently used to confirm or refute the diagnosis. Recent developments, such as single allergen assays, enhance the diagnosis of IgE-mediated food allergy, but the gold standard remains oral food challenge. Despite recent advances in the management of food allergy, including the promotion of oral tolerance, the mainstay of management is still the avoidance of food triggers. Dietary management can be compromised by nutritional inadequacy, accidental exposure, food labeling, and quality of life or adherence issues. It is essential that adults with confirmed food allergy receive optimal nutrition and dietetic support to enable them to manage their condition. SN - 1878-3570 UR - https://www.unboundmedicine.com/medline/citation/22117664/Adverse_food_reactions__an_emerging_issue_for_adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8223(11)01543-4 DB - PRIME DP - Unbound Medicine ER -