Vegan diets from an allergy point of view-Position paper of the DGAKI work- ing group on food allergy

Vegan diets are currently attracting a great deal of attention. However, avoiding animal-based foods restricts the diet and is associated with risks, the extent and medi-cal implications of which, are at present not sufficiently understood. Elimination diets represent the usual therapeutic long-term management in the presence of food aller-gy. In order to understand the risks of vegan diets and to discuss these critically from the perspective of food allergies, the expertise of a nutritionist/dietitian with expertise in this area is indispensable. The position pa-per deals with the incentives behind and the benefits of a plant-based diet. The knowl-edge required to cover macro-and micro -nutrient dietary requirements is presented. Using the avoidance of cow's milk as an ex-ample, the challenges of adequately meet-ing nutritional needs are identified and (so called) milk alternatives are evaluated from an allergy and nutritional point of view. Fi-nally, other plant-based (substitute) prod-ucts are evaluated from the same perspec-tive, as significant protein sources in vegan diets (e.g. legumes, nuts and oilseeds) are at the same time potential and potent triggers of allergic reactions. However, the allergic potential of many substitute products can-not be fully assessed at present due to gaps in research. Wheat as the most important anaphylaxis trigger in adults is also evalu-ated. Finally, the increase in ultra-processed products in the (vegan) food sector and their potential consequences for the immune sys-tem are discussed.