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Management of food allergy: Nutritional issues

Marion Groetch, MS, RD, CDN
Section Editor
Scott H Sicherer, MD, FAAAAI
Deputy Editor
Elizabeth TePas, MD, MS


The goals of nutritional intervention in patients with food allergy are twofold: prevent acute and chronic food allergic reactions through allergen elimination and ensure optimal nutrition within the context of the allergen-restricted diet.

Nutritional management of food allergy requires careful planning to ensure that the nutrients inherent in the eliminated food(s) are adequately replaced. Nutrient-dense alternative food sources should be recommended when elimination diets are initiated. Follow-up to ensure that the alternative nutrient sources have been accepted and incorporated into the diet is also recommended.

This topic will focus on the prevention of nutritional problems that can arise with food elimination diets. Food allergen avoidance is discussed separately. (See "Management of food allergy: Avoidance" and "Patient education: Food allergy treatment and avoidance (Beyond the Basics)".)

The indications for nutritional assessment, clinical features of nutrition disorders, measurements of growth, and laboratory evaluation of nutritional status are also discussed separately. (See "Indications for nutritional assessment in childhood" and "Measurement of growth in children" and "Laboratory and radiologic evaluation of nutritional status in children" and "Dietary assessment in adults".)


Dietary limitations secondary to food allergy can lead to failure to thrive and/or deficiencies in specific macro and micronutrients. Several studies have demonstrated that children with food allergies have lower intakes of total energy and macro/micronutrients than children without food allergy [1,2]. (See "Failure to thrive (undernutrition) in children younger than two years: Management" and "Poor weight gain in children older than two years of age" and "Failure to thrive (undernutrition) in children younger than two years: Etiology and evaluation", section on 'Etiology'.)

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Literature review current through: Nov 2017. | This topic last updated: Aug 18, 2016.
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