By Katherine Hobson

A review of available evidence published earlier this year found a whole lot of confusion on the subject of food allergies.

Now a panel sponsored by the National Institute of Allergy and Infectious Diseases has issued its first set of U.S. guidelines to help doctors in their diagnosis and management of the problem. Among the recommendations: Reports of food allergies by patients or their parents should be confirmed by objective measures such as a skin-prick test or consumption of a small amount of the food under close medical supervision (known as an oral food challenge). “Multiple studies demonstrate that 50% to 90% of presumed [food allergies] are not allergies, the panel says.

But the research also identifies some gaps in the knowledge about food allergies, showing how much more there is to learn about some key issues. for example:

*Studies on the “incidence, prevalence and epidemiology” of food allergies in the U.S. are still needed, the panel says. about 12% of kids and 13% of adults report a food allergy, according to research, but only about 3% of them have one when reports of symptoms are combined with an objective measure.

*Little is known about what other factors — aside from asthma — increase the odds of serious health problems or death from food allergies. There’s no information at all available on the impact of asthma treatment on food allergies, the panel says.

*There’s also not much published research on what differences and similarities there are in food allergies in kids and adults.

*Better diagnostics are needed, the panel says. The oral food challenge is the “gold standard” test, but it’s also the most risky for the patient, who is actually ingesting the food that may provoke a reaction. Lab tests used to diagnose different types of food allergies have their drawbacks, the panel says.

*It’s unclear whether restricting a mother’s diet during pregnancy or breast-feeding can influence the development or manifestation of food allergies in her child.

*The relative benefits of alternative routes (such as an under-the-tongue tablet) for administering epinephrine to people in food-related anaphylaxis, the severe and life-threatening whole-body allergic reaction, aren’t known.

Photo by tamburix via Flickr