Clearing Up the Mystery of Food Allergies

Abstract

With the increase in prevalence in food allergies and an increase in food allergy research, there is a corresponding increase in public confusion about the best way to identify and manage food allergies. Current descriptions are provided to clarify the various types of adverse food reactions, specifically what is classified as food allergy and the different types of food allergies. Understanding the type of food allergy can be crucial to making a formal medical diagnosis and providing high-quality nutrition care. Patients rely on healthcare teams' expertise to manage their food allergy and improve their quality of life. A summary of current evidence-based guidelines and roles of the multidisciplinary healthcare team set the stage for this series of articles on food allergies. Nutr Today 2023;58:58-68 W ith food allergies on the rise globally, the currently expanding landscape of food allergies and intolerances impacts many individuals (Figure 1). 2,3 Adults, children, parents, students, schoolteachers, administrators, bus drivers, friends, coworkers, community members, and family members may identify as being in 1 of 2 categories or sometimes both: (1) someone living with food allergy or intolerance or (2) someone impacted directly or indirectly by an individual living with food allergy or intolerance. 4 Despite the increase in prevalence, there is an abundance of confusion regarding:-What constitutes food allergy -Differences between the types of immune-mediated food allergies, primarily differentiated as immunoglobulin E (IgE)-mediated or non-IgE-mediated allergy -How the different diagnosis are managedThe good news is that the medical community is rising to meet the challenge and combat the common misunderstandings related to adverse food reactions. Adverse food reactions can be immune mediated or non-immune mediated. Reproducible adverse food reactions triggered by the immune system are defined as food allergy. The types of immune mediated food allergies are primarily differentiated as immunoglobulin E mediated or non IgE mediated allergy. These different diagnoses are managed in different ways. Interest in food allergies is rising. Citations indexed in PubMed for food allergy-related publications increased approximately 8-fold from 1990 to 2020, whereas all PubMed citations increased approximately 3-fold in the same period. 5,6 THE PREVALENCE OF FOOD ALLERGIES IS INCREASING…BUT SO IS THE AMOUNT OF RESEARCHThis series aims to provide the reader a current foundational summary of adverse food reactions, specifically those that elicit an immune response. In particular, the focus is on IgE-mediated allergy, non-IgE-mediated allergy, and those that overlap as mixed IgE-and non-IgE-mediated allergy.