Food allergy: epidemiology, pathogenesis, diagnosis, prevention, and treatment.

Food allergy affects up to 10% of the population. The identification of modifiable risk factors including skin barrier dysfunction, vitamin D deficiency, microbiome, and route and timing of allergen exposure is leading to effective prevention strategies, and some of which are now included in public health guidelines. An increasing understanding of the pathophysiology has improved diagnostic options and revealed novel manifestations such as delayed anaphylaxis to mammalian meat related to sensitization to a sugar moiety triggered by tick bites. Current diagnosis has improved with the commercialization of allergen component testing, and the diagnostics pipeline shows imminent advances for predicting reactivity, threshold and severity. The first FDA-approved food allergy therapy has come to fruition with superb additional approaches under investigation.