title: Food intolerance and allergy: increased incidence or contemporary inadequate diets?
abstract: OBJECTIVE
  The role of nutrients in the study of allergic disease has been studied for many years, but recent evidence suggests that it is the quality and variety of the whole diet which affects the development of food allergy. This review seeks to understand whether food allergy prevalence is increasing and the role of diet in the development of the disease.
  
  
  RESULTS
  New data on the European and global prevalence of food allergy suggest that both reported and actual rates are increasing. Recent findings from studies in infants and children indicated that a Western diet could enhance the development of allergic disease, possibly due to an effect on the homeostasis of the gut microbiome, impacting the immune status of individuals.
  
  
  CONCLUSIONS
  With overall prevalence rates for food allergy increasing, it is important to ascertain the relevance of dietary influences. Attention has shifted from single-nutrient prevention studies to evaluation of the effect of different dietary patterns on allergic outcomes. Evidence suggests that introduction of complementary foods should not be delayed, and the diversity of the diet in early life is important. The increasingly processed nature of the Western diet, in combination with influences on the gut microbiome, may contribute to the rising prevalence of allergic disease, including food allergy.
authors.affiliation: aRoyal Brompton and Harefield NHS Foundation Trust, London, UK bEmma Children's Hospital, Pediatric Respiratory Medicine and Allergy, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Isabel
authors.initials: I
authors.lastname: Skypala
authors.forename: Berber
authors.initials: B
authors.lastname: Vlieg-Boerstra
mesh_terms: D004032:Diet; D066273:Diet, Western; D005512:Food Hypersensitivity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence