The National Academies of Sciences, Engineering, and Medicine convened an expert, ad hoc committee to examine critical issues related to food allergy. The authors of the resulting report, “Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy,” evaluated the scientific evidence on the prevalence, diagnosis, prevention, and management of food allergy and made recommendations to bring about a safe environment for those affected. The committee recommended approaches to monitor prevalence, explore risk factors, improve diagnosis, and provide evidence-based health care. Regarding diagnostics, emphasis was placed on utilizing allergy tests judiciously in the context of the medical history because positive test results are not, in isolation, diagnostic. Evidence-based prevention strategies were advised (for example, a strategy to prevent peanut allergy through early dietary introduction). The report encourages improved education of stakeholders for recognizing and managing as well as preventing allergic reactions, including an emphasis on using intramuscular epinephrine promptly to treat anaphylaxis. The report recommends improved food allergen labeling and evaluation of the need for epinephrine autoinjectors with a dosage appropriate for infants. The committee recommended policies and guidelines to prevent and treat food allergic reactions in a various settings and suggested research priorities to address key questions about diagnostics, mechanisms, risk determinants, and management. Identifying safe and effective therapies is the ultimate goal. This article summarizes the key findings from the report and emphasizes recommendations for actions that are applicable to pediatricians and to the American Academy of Pediatrics.
Critical Issues in Food Allergy: A National Academies Consensus Report
POTENTIAL CONFLICT OF INTEREST: Drs Sicherer, Allen, Lack, Taylor, and Donovan served as members of the committee for the report discussed herein. Dr Oria was the study director for the report discussed herein. Dr Lack has received research support from the NIAID and the UK Food Standards Agency, is on the DBV Technologies scientific advisory board, has received a contribution to NIAID contract and/or grant from Food Allergy Research and Education, has received a contribution to King’s College London Division of Asthma Allergy and Lung Biology from MRC & Asthma UK Centre, has received the Biomedical Research Centre award to Guy’s and St Thomas’ NHS Foundation from the UK Department of Health through the National Institute for Health Research, has received support for a pediatric allergy clinical trial’s unit from the National Peanut Board, has received a discounted Bamba peanut snack from Osem, and has stock and/or stock options in DBV Technologies.
FINANCIAL DISCLOSURE: Dr Sicherer received grant support for research from the National Institute of Allergy and Infectious Diseases (NIAID) and Food Allergy Research and Education and royalties from UpToDate. Dr Donovan received grant support for pediatric nutrition research from the National Institutes of Health as well as food and pharmaceutical companies. Dr Taylor received grant support for research from the National Institute of Food and Agriculture and from the Food Allergy Research and Resource Program consortium of over 90 food manufacturers and/or suppliers as well as royalties from Neogen Corp. Drs Allen, Lack, and Oria have indicated they have no financial relationships relevant to this article to disclose.
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Scott H. Sicherer, Katrina Allen, Gideon Lack, Steve L. Taylor, Sharon M. Donovan, Maria Oria; Critical Issues in Food Allergy: A National Academies Consensus Report. Pediatrics August 2017; 140 (2): e20170194. 10.1542/peds.2017-0194
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