Although elimination diets are the mainstay of therapy, the researchers identified only 1 randomized controlled trial (RCT) of an elimination diet. "Many authorities would consider RCTs of elimination diets for serious life-threatening food allergy reactions unnecessary and unethical; however, it should be recognized that such studies are generally lacking for other potential food allergic conditions "

Immunotherapy, although currently not a licensed method for the treatment of food allergy, may be effective in generating desensitization, but whether this treatment can also generate long-term tolerance remains to be determined. The safety of immunotherapy is likely to vary with the food allergen and the route of therapy administration and, to date, has not been adequately studied.

Among high-risk infants, hydrolyzed formula may prevent against cow's milk allergy but standardized definitions of high risk and hydrolyzed formula do not exist. Probiotics in conjunction with breastfeeding, hypoallergenic formula, or both may help prevent food allergy but their independent effects remain unclear.

"This systematic review of food allergies found that the evidence on the prevalence, diagnosis, management, and prevention of food allergies is voluminous, diffuse, and critically limited by the lack of uniformity for the diagnosis of a food allergy, severely limiting conclusions about best practices for management and prevention," the authors write.

Source JAMA