Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper.

The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines.

Guidance for healthy complementary feeding practices for allergy prevention in developed countries: An EAACI interest group report.

The goals of the complementary feeding period starting from 4 to 6 months of age are to fulfill the infant's nutritional need for nutrients and expose the infant to foods of varying flavors and textures to encourage acceptance of a diverse and nutritionally complete diet. Healthy complementary feeding consists of the timely introduction of a high diversity of whole, nutrient dense, and home-cooked foods or alternatively commercially frozen meals based on whole ingredients without added sugar or salt. These meals consist of predominantly plant-based foods, such as fruits, vegetables, legumes, grains, as well as fermented foods such as yoghurt.

IgE-mediated lipid transfer protein allergy in children.

Lipid Transfer Protein (LTP) allergy, traditionally more prevalent in adults from Southern Europe, is increasingly recognized in pediatric populations worldwide. This review explores the epidemiology, pathogenesis, clinical manifestations, diagnosis, and management of LTP allergy in children. LTP allergy can present with severe systemic symptoms both in children and adults; in children-only studies, anaphylaxis is reported in up to half of the patients.

A Food-Focused Approach Is Needed to Progress Food Allergy and Hypersensitivity Diagnosis and Management in Adults.

Food-focused approach in the management of adverse reactions to food in adults aids diagnosis and ongoing treatment plans. This is a holistic approach to care, addressing wider issues including nutritional deficiencies, food intake, diet diversity and availability whilst reducing fear and anxiety and time and cost associated with management.

Diagnosis and Management of Lipid Transfer Protein Allergy-A BSACI Clinical Practice Statement.

Although the most prevalent plant food allergy in the United Kingdom (UK) is pollen food syndrome (PFS), there is increasing evidence that reactions to plant foods could also be due to sensitisation to Lipid Transfer Proteins (LTP). These proteins, highly resistant to heat and processing, are present in raw, cooked and processed plant foods and often provoke moderate to severe symptoms. LTP allergy is common in Mediterranean countries, but there is a lack of epidemiological data from Northern Europe, although small case series have been published characterising LTP allergy in both England and Scotland.

The impact of climate change in pollen food allergy syndrome.

Purpose Of Review: To evaluate the effect of climate change on pollen allergenicity, lengthening of the pollen season, and the spread of invasive species such as ragweed. To assess evidence to determine whether these effects are impacting the prevalence of pollen food syndrome (PFS).

Recent Findings: There is good evidence to demonstrate that markers of climate change, including rising temperatures and to some extent greenhouse gases, are responsible for a rise in the allergenicity of pollen and an increase in the duration of the pollen season, especially for trees.

An International Delphi Consensus on the Management of Pollen-Food Allergy Syndrome: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee.

Background: Pollen-food allergy syndrome (PFAS) is common among patients with allergic rhinitis. Treatment recommendations for patients with PFAS remain variable.

Objective: To develop consensus recommendation statements for managing patients with PFAS.

EAACI guidelines on the management of IgE-mediated food allergy.

This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist.

Food-triggered anaphylaxis in adults.

Purpose Of Review: Adult food allergy, either unresolved from childhood, or new-onset in adult-life, is known to be increasingly prevalent. Although much of the reported anaphylaxis in adults is due to drug reactions, foods are becoming an increasingly important trigger, affecting adults of all ages, with a wide variation in food triggers which are often quite different to those reported in children.

Recent Findings: Peanuts are well known to cause anaphylaxis in some adult populations, but other legumes such as soy may be more relevant in others.

The Diagnosis of Allergy to Lipid Transfer Proteins.

Purpose Of Review: To provide an update on the diagnosis of non-specific Lipid Transfer Protein (nsLTP) allergy.

Recent Findings: More publications report the presence of nsLTP allergy in Northern European countries and nsLTP sensitisation in children. Individuals are more likely to have severe reactions if there is recognition of increasing numbers of LTP components.

A systematic review and meta-analysis of nutritional and dietary interventions in randomized controlled trials for skin symptoms in children with atopic dermatitis and without food allergy: An EAACI task force report.

This systematic review and meta-analysis aimed to consolidate evidence on dietary interventions for atopic eczema/dermatitis (AD) skin symptoms in children without food allergies, following PRISMA 2020 guidelines. Systematic review updates were conducted in May 2022 and June 2023, focusing on randomized placebo-controlled trials (RCTs) involving children with AD but without food allergies. Specific diets or supplements, such as vitamins, minerals, probiotics, prebiotics, symbiotics, or postbiotics, were explored in these trials.

Core Outcome Set for IgE-mediated food allergy clinical trials and observational studies of interventions: International Delphi consensus study 'COMFA'.

Background: IgE-mediated food allergy (FA) is a global health concern with substantial individual and societal implications. While diverse intervention strategies have been researched, inconsistencies in reported outcomes limit evaluations of FA treatments. To streamline evaluations and promote consistent reporting, the Core Outcome Measures for Food Allergy (COMFA) initiative aimed to establish a Core Outcome Set (COS) for FA clinical trials and observational studies of interventions.

EAACI guidelines on the diagnosis of IgE-mediated food allergy.

This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods.

Food allergy-A holistic approach to dietary management. A joint EAACI Research & Outreach Committee and INDANA review.

Following a diagnosis of IgE-mediated food allergy, to secure the best outcome, the patient should receive individualized advice tailored to their specific needs, which considers the type and presentation of the food involved, level of exclusion required, risk of cross-contamination and any variance required for age, ethnicity, financial issues, and lifestyle. Issues such as food labels "may contain" statements, and variation in the threshold of reaction and impact of cofactors should also be considered. Most important is the need to ensure that the diagnosis is robust, especially given the nutritional, psychological, and socioeconomic issues that can affect an individual with a diagnosis of food allergy.

New arrivals in anaphylaxis to foods.

Purpose Of Review: More people are excluding wheat from their diet, or turning to a more sustainable diet in which includes meat substitutes or is mainly or wholly plant-based. This increases the availability of new foods and with it the increasing likelihood of novel allergens.

Recent Findings: There is a growing body of evidence which suggests that allergies to seeds and legumes are increasing potentially due to their use in concentrated form in vegan or health foods.