Food allergy and dietetic implications

Many patients with atopic dermatitis (AD) and their families focus on foods as major triggering factor for their disease. Often they adhere to elimination diets without indication and without any existent benefit. In the worst case this can lead to malnutrition and deficiency of specific nutrients. But even if a sufficient supply is maintained, elimination diets have a great impact on the quality of life. Thus it is vital for AD patients to undergo a step-by-step diagnosis to reveal their own triggering factors. The diagnostic procedure should include immediate type as well as late-phase reactions. For the latter reactions, food and symptom protocols are a useful tool to identify individual triggering factors. These protocols are also extremely helpful in case of augmentation factors (such as season, medication, alcohol, hormones, etc.) being relevant, for instance in pollen-associated food allergies. After diagnosis of food allergy or other adverse reactions, a nutritional education and therapy is important for the patient, especially if basic foods or multiple food items are to be avoided. Patients must be informed how to avoid their offending food(s) and where hidden sources of the allergen can be suspected. Apart from this information, safe alternative foods have to be found in order to maintain a nutritionally balanced diet. Nutritional therapy helps patients to effectively manage their food allergy and thereby preserve a high quality of life.