Food allergy guidelines and assessing allergic reaction risks

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Abstract
To review information in food allergy guidelines and the literature on assessing and understanding food allergic reaction risks. Current food allergy guidelines have focused on tools for better diagnosis of food allergy and treatment of reactions. These guidelines have not addressed the growing body of literature on risk assessment and diagnostic tools being used to assess dose-response relationships in relation to food-allergen exposures. The literature includes substantial data from food-allergen challenges performed in sensitive individuals, and probabilistic modeling of these data may help to elucidate the relationship between allergen dose exposures, including thresholds, and reaction risk in allergic individuals. Understanding this relationship has potential to improve the health-related quality of life of allergic consumers. Recent findings in the literature have highlighted improved diagnostic tools and other information that can be used to assess risks for allergic reaction to low-dose allergen exposures (thresholds) and reaction severity in food allergic consumers. Recommendations to better define and stratify allergic reaction risks for consumers could be adopted into guidelines for the diagnosis and clinical management of food allergy.

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