Food allergy is an immune-based disease that has become a serious health concern in the United States. A recent study1 estimates that food allergy affects 5% of children under the age of 5 years and 4% of teens and adults, and its prevalence appears to be on the increase. The symptoms of this disease can range from mild to severe and, in rare cases, can lead to anaphylaxis, a severe and potentially life-threatening allergic reaction. There are no therapies available to prevent or treat food allergy: the only prevention option for the patient is to avoid the food allergen, and treatment involves the management of symptoms as they appear. And because the most common food allergens—eggs, milk, peanuts, tree nuts, soy, wheat, crustacean shellfish, and fish—are highly prevalent in the US diet, patients and their families must remain constantly vigilant.
The development of the Guidelines for the Diagnosis and Management of Food Allergy in the United States began in 2008 to meet a long-standing need for harmonization of best clinical practices related to food allergy across medical specialties. The resulting Guidelines reflect considerable effort by a wide range of participants to establish consensus and consistency in definitions, diagnostic criteria, and management practices. They provide concise recommendations on how to diagnose and manage food allergy and treat acute food allergy reactions. In addition, they provide guidance on addressing points of controversy in patient management and also identify gaps in our current knowledge, which will help focus the direction of future research in this area.
The Guidelines were developed over a 2-year period through the combined efforts of an Expert Panel and Coordinating Committee representing 34 professional organizations, federal agencies, and patient advocacy groups. The Expert Panel drafted the Guidelines using an independent, systematic literature review and evidence report on the state of the science in food allergy, as well as their expert clinical opinion. The National Institute of Allergy and Infectious Diseases (NIAID), a component of the National Institutes of Health (NIH), provided funding for this project and played a pivotal role as organizer and ‘‘honest broker’’ of the Guidelines project.
As the lead NIH institute for research on food allergy, NIAID is deeply committed to improving the lives of patients with food allergy and is proud to have been involved in the development of these Guidelines. As our basic understanding of the human immune system and food allergy in particular increases, we hope to translate this information into improved clinical applications. Although there are many challenges, the potential benefit for human health will be extraordinary.
Anthony S. Fauci, MD
National Institute of Allergy and Infectious Diseases