The prevalence of food allergy appears to be steadily increasing in infants and young children. One of the major challenges of modern clinical nutrition is the implementation of individualized nutritional recommendations. The management of food allergy (FA) has seen major changes in recent years. While strict allergen avoidance is still the key treatment principle, it is increasingly clear that the avoidance diet should be tailored according to the patient FA phenotype. Furthermore, new insights into the gut microbiome and immune system explain the rising interest in tolerance induction and immunomodulation by microbiota-targeted dietary intervention. This review article focuses on the nutritional management of IgE mediated food allergy, mainly focusing on different aspects of the avoidance diet. A personalized approach to managing the food allergic individual is becoming more feasible as we are learning more about diagnostic modalities and allergic phenotypes. However, some unmet needs should be addressed to fully attain this goal.

Design/Method/Approach -Registered Dietitians (RD´s) (N=14) were recruited from the UK, Canada, South-Africa, Australia, Mexico and Israel. Six qualitative interviews and two focus groups were conducted online using a conference calling platform. Data were recorded, transcribed and thematically analysed.Findings -Early adopters of Nutrigenomics (NGx) were experienced, self-efficacious RD's who actively sought knowledge of NGx through communication with one another and the broader scientific community. They considered NGx an extension of current practice and believed RD's had the skills to deliver it. Perceived barriers to widening the application of NGx were linked to skepticism among the wider dietetics community.Proliferation of unregulated websites offering tests and diets was considered 'pseudoscience' and detrimental to dietetics fully embracing NGx. Lack of a sustainable public health model for the delivery of NGx was also perceived to hinder progress.Results are discussed with reference to 'diffusion of innovation theory'.Originality/Value -The views of RD's who practice NGx have not been previously studied. These data highlight requirements for future dietetic training provision and more inclusive service delivery models. Regulation of NGx services and formal recognition by professional bodies is needed to address the research/practice translation gap. Further research is required to enquire as to the views of the wider dietetics profession. Paper Type Research article. IntroductionNutritional genomics (NGx) is an emerging field focused on interactions between food, nutrition and genes (Ferguson et al., 2016). Increased understanding of gene-nutrient interactions may facilitate health and disease prevention (Casas et al., 2016; Corella et al., 2016;Celis-Morales et al., 2016). A growing market offers genetic tests "direct-toconsumer" as well as via healthcare professionals. The Food4me project has illustrated how personalized nutrition can be delivered online to the public (Celis-Morales et al., 2016). Tests can deliver information linking diet to health, lifestyle, weight or improved fitness (Covolo et al., 2015; Bloss et al., 2011). Omics technologies (metabolomics, lipidomics and transcriptomics) enable highly personalized and targeted approaches to dietary health promotion (Sun and Hu, 2016) which have already been shown effective for outcomes related to cardiovascular disease (Fitó et al., 2016). Consumer interest is high and demand for trained practitioners expected to increase (Berezowska et al., 2015). Registered Dietitians (RD´s) will be key professionals for translating the science of nutrigenomics into practice (Berezowska et al., 2015; Abrahams et al., 2017;Stewart-Knox et al., 2016; Fallaize et al., 2015;Stewart-Knox et al., 2013). TheAcademy of Nutrition and Dietetics (A.N.D), however, do not consider the field ready for routine practice (Camp and Trujillo, 2014), so that application of nutritional genomics has tended to be low amongst the dietetics profession (Collins et al., 2013; W...

Conflict of Interest MA has worked with several start-ups as a consultant in the area of nutrigenetic testing.

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