NIAID – first guidelines for food allergy management

Normally I do not blog about important scientific updates, but as a clinician who practices heavily in primary care and pediatrics, and as a past school nurse, I found this update worth blogging about.

The National Institute of Allergy and Infectious Disease (NIAID) has published their first guidelines for food and allergy management here, and the guidelines are quite compelling.  Food allergies are continuing to grow in the U.S. despite measures to decrease exposure to allergen proteins, think peanuts gone from airplanes and not exposing children to eggs or peanut butter before certain ages.  The time to clearly define testing and management has been past due, but the NIAID did an excellent job organizing and disseminating practice guidelines.

Key findings I took away from reading:

1. Testing is key.  In the natural history of allergies, tolerance to certain foods may eventually be achieved.  This combined with the fact that as much as 50% of food allergies are not confirmed by testing and may not in fact be allergies means that official food testing for food allergies, and type of testing depends on … health history!

2. Health history, health history, health history…. I have been trying to emphasize this with my health assessment students for years, but the importance of identifying significant symptoms is critical in identifying foods, triggers, type of testing, and possible treatment.  Physical exam and health history are key in moving forward.

3.  Identifying food allergies that are severe and treating anaphylaxis. Prevention of life threatening events and proper treatment, should they occur, is one of the most critical steps in food allergy management.

Nurses, there is so much more to learn. Read the entire report yourself here.