As a patient, you will (and you must) see a doctor if you ever present a symptom associated with an adverse food reaction. Indeed, that will be the correct thing to do, and your health care provider will prescribe the right way to treat and manage the symptoms, depending on their severity. Interestingly, it is more likely that your doctor will recommend avoiding the food that might have caused the symptoms in the first place. Additionally, they will refer you to a dietitian or nutritionist to manage such avoidance of food.

This might seem odd, you might think. I am only avoiding one or two foods. Why am I being referred to a nutritionist? Do I need to lose weight?

As a matter of fact, the avoidance of allergens is a fundamental part of the treatment and management of food allergies, intolerances, and sensitivities. Considering that the most common studied allergens are cow’s milk, hen’s eggs, soy, fish and shellfish, wheat, and last but not least, peanuts and/or tree nuts. Did you know that you are most likely to have an unbalanced diet if you take 2 to 3 of these foods? Ultimately, eating an unbalanced diet will lead you to nutrition deficiencies, which will additionally affect your quality of life and health.

Since it is more likely that you will end up having a nutritional consultation, here are some of the questions that the nutrition specialist should be asking.

Questions

Is there any antecedent of diseases like asthma, eczema, or allergic rhinitis?

Do you have family members with food allergies?

Are there foods that you avoid? Why?

History of symptom associated with the ingestion of food allergens: §  Age of the patient when symptoms started. §  How much time did it took for the symptoms to appear? §  How much did they last? §  How severe was the reaction? §  Frequency of the reaction. §  Where did it happen? (school, home a restaurant) §  Did the reaction happen again with the same food? §  What was the amount of food that caused the reaction? §  Is there any food that is avoided because of cultural or religious factors? §  What is the suspected allergen? §  Breastfeeding and complementary feeding history. §  Have you done an elimination diet before? §  What happened when you reintroduced foods? §  What kind of medication was previously prescribed?

Have you experienced any reaction when ingesting the following foods? §  peanuts or tree nuts. §  sesame seeds. §  celery. §  milk. §  egg. §  wheat. §  fish and mollusks. §  soy. §  mustard.

Have you experienced adverse reactions to pollens?

Where do you commonly eat your food?

Who prepares your food?

Overall, a nutritionist should consider the relevance of positive test results and be informed about the common cross-reactors between food and environmental allergens. Besides, some factors might affect the presence of adverse food reactions, such as medication, introduction to vitamin supplementation, stress, hormonal changes or unbalance, infection, exercise, and herbal medication.

A nutritionist or dietitian intervention should be fundamental to avoid nutritional deficiencies and promote a normal growth rate in children. It is especially recommended to those patients who are encouraged to avoid more than one food on their diets, additionally to prevent unnecessary avoidance of food. The provision of alternatives to avoided food will ensure a nutritionally dense diet and prevent exposure to allergenic foods.

In conclusion, nutritional advice and management are essential for the treatment of food allergies or intolerances. The avoidance of various foods can promote nutritional deficiencies and affect the quality of life of the patient. Having nutritional management of food allergies and intolerances will provide psychological support to the patient, avoid the risk of exposure to the mentioned allergens, promote a better quality of life through a healthy and nutrient-dense diet.

Venter, Carina, Kirsi Laitinen, and Berber Vlieg-Boerstra. “Nutritional Aspects in diagnosis and management of food hypersensitivity—the dietitian’s role.” Journal of allergy 2012 (2012).