When nutrition and allergy collide: the rise of anaphylaxis to plant foods

Purpose of review: Interest in nutrition is increasing, but in the world of internet health gurus, whilst the nutritional benefits of fruits and vegetables are extolled, wheat is often vilified. This review will assess the positive nutritional effects of plant foods in relation to allergy prevention, the effectiveness of gluten-avoidance and the likelihood of anaphylaxis to fruits and vegetables. Recent findings: Although the numbers of people who report gluten sensitivity is rising, hard evidence of mass sensitivity to gluten is scant. Also, the avoidance of wheat containing foods could lead to nutritional imbalance and effects on the gut microbiome. The evidence that fruits and vegetables have a protective effect on the development of allergy is inconsistent, although fruit juices may promote beneficial changes to gut microflora. Fruits and vegetables can cause severe allergic reactions, especially due to the presence of lipid transfer proteins, but this is not just a Mediterranean phenomenon, and not limited to peaches. Summary: These findings emphasise the importance of a keeping an open mind about reported reactions to plant foods, to ensure the correct diagnosis is made and nutrition is optimised to prevent any adverse effects of avoidance on the gut microbiome.

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