Natural course of food allergy

Food allergy incidence and prevalence have increased worldwide to epidemic proportions. While most food allergy develops in childhood and is outgrown, the natural resolution and understanding of these mechanisms can guide physicians in long-term management decisions. Appreciating the natural history of food allergies is essential to improving quality of care, refining treatment recommendations, informing targeted education and prevention efforts, and exploring new therapeutic options. Understanding the clinical decision points with specific IgE and skin testing procedures will help identify those patients who may safely undergo an oral food challenge or the timing of subsequent testing. Recent studies have also identified early prognostic markers and component-resolved diagnostics as diagnostic aids. Continued advancements identified in prospective studies will help to further narrow the gaps in understanding food allergy resolution. However, much is already known and can help guide the clinician to improve patient outcomes and care.