Review article: the diagnosis and management of food allergy and food intolerances

J. L. Turnbull; H. N. Adams; D. A. Gorard

doi:10.1111/apt.12984

journal article Oct 14, 2014

Review article: the diagnosis and management of food allergy and food intolerances

J. L. Turnbull H. N. Adams D. A. Gorard

Alimentary Pharmacology & Therapeutics Vol. 41 No. 1 pp. 3-25 · Wiley

View at Publisher Save 10.1111/apt.12984

Abstract

SummaryBackgroundAdverse reactions to food include immune mediated food allergies and non‐immune mediated food intolerances. Food allergies and intolerances are often confused by health professionals, patients and the public.AimTo critically review the data relating to diagnosis and management of food allergy and food intolerance in adults and children.MethodsMEDLINE, EMBASE and the Cochrane Database were searched up until May 2014, using search terms related to food allergy and intolerance.ResultsAn estimated one‐fifth of the population believe that they have adverse reactions to food. Estimates of true IgE‐mediated food allergy vary, but in some countries it may be as prevalent as 4–7% of preschool children. The most common food allergens are cow's milk, egg, peanut, tree nuts, soy, shellfish and finned fish. Reactions vary from urticaria to anaphylaxis and death. Tolerance for many foods including milk and egg develops with age, but is far less likely with peanut allergy. Estimates of IgE‐mediated food allergy in adults are closer to 1–2%. Non‐IgE‐mediated food allergies such as Food Protein‐Induced Enterocolitis Syndrome are rarer and predominantly recognised in childhood. Eosinophilic gastrointestinal disorders including eosinophilic oesophagitis are mixed IgE‐ and non‐IgE‐mediated food allergic conditions, and are improved by dietary exclusions. By contrast food intolerances are nonspecific, and the resultant symptoms resemble other common medically unexplained complaints, often overlapping with symptoms found in functional disorders such as irritable bowel syndrome. Improved dietary treatments for the irritable bowel syndrome have recently been described.ConclusionsFood allergies are more common in children, can be life‐threatening and are distinct from food intolerances. Food intolerances may pose little risk but since functional disorders are so prevalent, greater efforts to understand adverse effects of foods in functional disorders are warranted.

Topics

No keywords indexed for this article. Browse by subject →

References

173

[1]

10.1155/2013/482108

[2]

10.1097/mib.0b013e3182802acc

[3]

10.3748/wjg.v19.i43.7652

[4]

10.1111/j.1365-2036.2011.04792.x

[5]

10.1016/s0140-6736(94)90234-8

[6]

10.1046/j.1398-9995.2003.00403.x

[7]

10.1111/j.1365-2222.2008.03184.x

[8]

10.1016/j.jaci.2010.11.044

[9]

10.1016/j.jaci.2010.10.008

[10]

10.1079/pns2005458

[11]

10.1016/j.jaci.2007.05.026

[12]

10.1016/j.jaci.2010.07.026

[13]

10.1542/peds.2009-1210

[14]

10.1542/peds.2011-0204

[15]

10.1001/jama.2010.582

[16]

EuroPrevall. Available at:http://www.europrevall.org/(accessed October 2013).

[17]

10.1038/nature10213

[18]

10.1038/nrgastro.2010.80

[19]

10.1007/s11882-009-0028-z

[20]

10.3928/00904481-20130522-09

[21]

NICE Clinical Guideline 116 ‐ Food Allergy in Children and Young People.London:National Institute for Health and Clinical Excellence.2011.

[22]

10.1067/mai.2001.118515

[23]

10.1111/j.1365-2222.2011.03759.x

[24]

10.1016/j.jaci.2004.01.779

[25]

10.1016/s0091-6749(99)70479-3

[26]

10.1155/2014/543195

[27]

10.1007/s11882-003-0012-y

[28]

10.1111/j.1365-2222.2004.02103.x

[29]

10.1016/j.iac.2007.03.005

[30]

10.1016/j.jaci.2005.12.1303

[31]

10.1016/j.jaci.2010.10.040

[32]

10.1111/cea.12211

[33]

Beaudouin E "Food‐dependent exercise‐induced anaphylaxis ‐update and current data" Eur Ann Allergy Clin Immunol (2006)

[34]

10.1016/s0091-6749(99)70123-5

[35]

10.2332/allergolint.11-rai-0329

[36]

10.1007/s11882-010-0150-y

[37]

10.1067/mai.2001.119914

[38]

10.1159/000053825

[39]

10.1111/j.1365-2222.2008.03148.x

[40]

10.1046/j.1365-2133.2001.04329.x

[41]

10.1097/00042737-200512000-00003

[42]

10.1007/s11882-012-0301-4

[43]

10.1152/jappl.1997.82.2.571

[44]

10.1046/j.1365-2133.1998.02254.x

[45]

10.1111/j.1365-2222.2005.02213.x

[46]

10.1152/japplphysiol.00225.2007

[47]

10.1016/j.anai.2009.12.002

[48]

10.1177/0009922809337528

[49]

10.5021/ad.2009.21.2.203

[50]

10.1111/j.1365-2222.2007.02861.x

Showing 50 of 173 references

Cited By

230

Saudi consensus statements on the management of irritable bowel syndrome

Mohammed A. Alzahrani, Saeed R. Alzubide · 2026

Saudi Journal of Gastroenterology

Impact of Heat Treatment on the Allergenic Potential of Penaeus chinensis TM: A Comprehensive Analysis of Structural Changes, Molecular Dynamics, Digestibility, Allergenicity and Gut Microbiota Alterations

Lu Liu, Xin Qu · 2025

Journal of Agricultural and Food Ch...

Food Intolerances, Food Allergies and IBS: Lights and Shadows

Andrea Pasta, Elena Formisano · 2024

Nutrients

The “Worst Dinner Guest Ever”

Megan A. Dean · 2022

Gastronomica

The Two Faces of Wheat

Herbert Wieser, Peter Koehler · 2020

Frontiers in Nutrition

Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy

Boudewijn J.H. Dierick, Thys van der Molen · 2020

Expert Review of Pharmacoeconomics...

The food matrix: implications in processing, nutrition and health

José Miguel Aguilera · 2018

Critical Reviews in Food Science an...

Jennifer L. P. Protudjer, Mirja Vetander · 2016

PLoS ONE

Metrics

230

Citations

173

References

Details

Published: Oct 14, 2014
Vol/Issue: 41(1)
Pages: 3-25
License: View

Authors

J

J. L. Turnbull

Department of Paediatrics John Radcliffe Hospital Headington Oxford UK

H

H. N. Adams

Department of Gastroenterology Wycombe Hospital High Wycombe Bucks UK

D

D. A. Gorard

Department of Gastroenterology Wycombe Hospital High Wycombe Bucks UK

Cite This Article

J. L. Turnbull, H. N. Adams, D. A. Gorard (2014). Review article: the diagnosis and management of food allergy and food intolerances. Alimentary Pharmacology & Therapeutics, 41(1), 3-25. https://doi.org/10.1111/apt.12984

Review article: the diagnosis and management of food allergy and food intolerances

You May Also Like