Food allergy has become more prevalent in recent decades. Without a curative treatment for food allergies, prevention is critical. Can we intervene and halt the food allergy epidemic?
There were three hypotheses to explain regarding the rise in food allergy: the dual-allergen exposure hypothesis, the hygiene hypothesis, and the vitamin D hypothesis. In a recent systematic review, only introduction of allergenic foods in the diet at the time of weaning and avoiding temporary supplementation with cow’s milk formula in the first few days of life showed low to moderate evidence of a preventive effect.
For primary prevention, introducing allergenic foods at the time of weaning and avoiding temporary supplementation with cow’s milk formula in the first few days of life has been recommended. Introduction of foods once the allergy has been excluded may be beneficial for sensitized subjects (secondary prevention). Once food allergy has been established, it is essential to minimize complications (tertiary prevention) through allergen avoidance, timely treatment of allergic reactions, control of atopic comorbidities, and dietetic and psychological support appropriate. Immunomodulatory therapies can potentially be disease-modifying and require further research.