Role of the elimination diet in adults with food allergy

The aim of the study was to check whether, after a period of complete exclusion of the offending foods in adult subjects suffering from food allergy, these foods could subsequently be safely reintroduced into the diet. Patients with chronic urticaria and/or perennial rhinitis negative for secondary pathology or other allergies were subjected to a strict diagnostic protocol for food allergy. Briefly, out of a case list of 207 patients, we found 23 patients whose symptoms were clearly related, on open reintroduction, to at least one food. The really offending foods in these patients were subsequently identified by double-blind, placebo-controlled food challenges. Only 10 of the 23 patients had positive challenges for 13 foods. Double-blind challenges were repeated after 1 year or more of avoidance of the offending foods to evaluate the persistence or disappearance of sensitivity. We found that five (38%) of the 13 previously offending foods were well tolerated. Thus, in adults, as previously proved in children, dietary avoidance of the offending foods appears to be an effective measure for dealing with food allergy. The kind of foods involved and the completeness of their avoidance appeared to be important factors favoring the reestablishment of tolerance in adults.