Prevention of food allergy in the real life

The prevalence of food allergy has increased exponentially in the last decade and is fast becoming the second wave of the allergy epidemic. Secondary prevention methods such as treatment of accidental exposures and immunotherapy are still fraught with difficulties and unanticipated adverse events still occur. The future of food allergy management may lie in primary prevention, of which practical strategies and current evidence are summarized in this review. No maternal dietary restrictions are required during pregnancy and lactation. High risk infants should be exclusively breastfed for at least 4 to 6 months with early introduction of complementary solid foods. Hydrolyzed formulas may be used for high risk infants who are not exclusively breastfed. A healthy balanced diet inclusive of fresh fruits, vegetables and vitamins may play an important role in prevention of allergies and has myriad advantages to general health and well-being. There remains a need for large scale randomized controlled trials for all other nutritional interventions in the hope that more can be done for the primary prevention of allergies in the future. (Asian Pac J Allergy Immunol 2014;32:1624)