I had a chance to ask my colleague NYC allergist Dr. Clifford W. Bassett what he thinks about the new food allergy guidelines. [Disclosure: Dr. Bassett is a colleague and in my forthcoming book.]
Allergic Girl: What was your biggest takeaway from the food allergy guidelines?
Clifford Bassett, MD: We need to encourage individuals who may have a food allergy to have appropriate testing including skin tests, blood tests and oral food challenges in order to properly diagnose and manage this condition, as education and avoidance measures are essential for reducing risk of having an allergic reaction.
AG: Can you clarify the difference between sensitization and tolerance as it relates to food allergies?
CB: In some cases testing may indicate possible sensitization to a food, but this does NOT necessarily imply a food allergy exists. If an individual can safely tolerate a food without any symptoms, it is unlikely there is a clinically relevant allergy.
AG: Where do you see the biggest leaps forward?
CB: Food allergy researchers are in the process of studying the benefits of a food allergy vaccine in several academic centers throughout the US. For now, the only real treatment is avoidance and intensive consumer and patient education, and of course to be "prepared" to treat a reaction should it occur.
AG: Where, if any, are there still gaps in knowledge according to the food allergy guidelines?
CB: We need in invest more dollars and cents in understanding the rising prevalence of food allergies, in children, adolescents and adults and work to provide better options for those at risk.
AG: Were you surprised by any of the food allergy guidelines findings?
CB: No not really. An experienced food allergy savvy allergist will provide guidance in the appropriate "interpretation" of the food allergy test results. It is essential to not over interpret test results and the food allergy guidelines suggest that we need to consider more in-office oral food challenges, whenever the need arises, whenever they can be performed safely.
AG: What important point of the food allergy guidelines will you underscore to your food allergy patients as it relates to definitions, diagnosis or treatment of food allergy?
CB: It is necessary to start with some basics when it comes to defining a food allergy, and of course in contrasting it from an even more common food condition, food and/or alcohol intolerance syndromes: (i.e. lactose intolerance, gluten intolerance, gastro-esophageal reflux, sulfite sensitivity, MSG reactions, etc). The prevalence of food allergy is increasing throughout the world and the number of those with peanut allergy has doubled over the past several decades. We are also seeing an increase in allergic sensitivities to a variety of newer and international ingredients. The most common food allergens that affect adults and children are: milk, egg, shellfish, peanut, tree nuts, fish, soy and wheat. Learn to "decode" food labels and become a true "label detective" to properly identify food allergens. Be pro-active, keep a food allergen card with you when traveling or eating outside of the home. Have a written food allergy action plan in place, and be prepared to treat an allergic reaction, if it should occur.
Thanks Dr. B!
Clifford W. Bassett, MD FAAAAI, FACAAI
Diplomate, American Board of Allergy and Immunology
Medical Director, Allergy and Asthma Care of NY
Faculty, NYU School of Medicine
Asst. Clinical Professor of Medicine & Otolaryngology - LICH-SUNY
Fellow, American College and Academy of Allergy, Asthma and Immunology