Diet regimen in the treatment of food allergy.
Dipartimento di Pediatria, Università degli Studi, Florence, Italy.Annali dell'Istituto superiore di sanita (Impact Factor: 1.11). 02/1995; 31(4):481-8.
Adverse reactions to food may be mediated by immunological or non immunological mechanisms. The term "food allergy" describes an event in which a definite immunopathological process can be demonstrated and a cause and effect relationship must be present. Symptoms and signs of food allergy may appear in any organ system, depending in part on the age of the subject and on the allergen involved. At present it is generally agreed that the only effective therapy for food allergy is strict elimination of the offending food antigen. Institution of a food elimination diet should be considered comparable to prescribing a medication, which carries along definite risk-benefit ratio. Consequently, appropriate diagnostic measures base on history, skin test, or radioallergosorbent test (Rast) and blind food challenges, must be utilized before implementing special diets. The allergist and other health care professionals must recognize the advantages of elimination diets (improvement of symptoms) as well as disadvantages (increase of the time required to purchase food and prepare meals, impossibility to eat at restaurants, at friends' houses or at school with consequent possible social isolation, nutritional disorders) and choose the most appropriate elimination diet.
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ABSTRACT: Elimination diets are the cornerstone of the treatment of food allergies. The diagnosis has to be confirmed by double-blind placebo-controlled food challenges (DBPCFC). The diet regimens need close collaboration of allergologists and dietitians. Allergy to cow's milk and the multiple food allergy syndrome benefit from amino-acid formulas. The main causes of failure of diets are: multiple FA misdiagnosed, non identified cross-allergies, masked food allergens in the diet, errors due to a lack of compliance or comprehension, risks of collective catering. Eviction diet regimens are published by CICBAA (). Dietary guidance in in atopic dermatitis of young children leads to a clear-cut improvement in 69% of cases over two months, 80% over six months, 91% over one year (with complete recovery in 46% of cases). The duration of elimination diets depends on the clinical follow-up and the modification of the reactive dose of DBPCFC. They may give place to oral tolerance protocols.
Article: Food allergy in children[Show abstract] [Hide abstract]
ABSTRACT: Food allergy is being increasingly recognised with the highest prevalence being in preschool children. Pathogenesis varies so diagnosis rests on careful history and clinical examination, appropriate use of skin prick and serum-specific IgE testing, food challenge, and supervised elimination diets. A double blind placebo controlled food challenge is the gold standard diagnostic test. Avoidance of the allergenic food is the key towards successful management. IgE mediated food allergy may present as a potentially fatal anaphylactic reaction, and management consists of the appropriate use of adrenaline (epinephrine) and supportive measures. Sensitisation remains a key target for intervention. Disease modifying agents are currently under trial for managing difficult allergies. Management requires a multidisciplinary approach and follow up.