Does a healthy diet always mean a safe diet? Food allergy as an obstacle to a healthy lifestyle

Introduction:
Regular physical activity and a balanced diet are considered indispensable components of a healthy lifestyle, yet they can also have adverse health effects.

Aim:
The aim of the study was to evaluate the characteristics of patients suffering from anaphylaxis and the efficacy of the component resolved diagnosis in the search for causative food allergens in combination with exercise.

Material and methods:
A single-centre, prospective, observational study was conducted in adults. The inclusion criterion was at least one episode of anaphylaxis. Skin prick tests with inhalant and food allergens, serum specific IgE assessment and component-resolved diagnosis (CRD) were performed. Follow-up was performed at 1 year.

Results:
28 adults with a mean age of 39 ±14.6 years were recruited into the study. In 14 patients we found specific IgE to highly allergenic components, i.e. storage proteins, lipid transfer proteins PR-10, tropomyosins and ovalbumin. Specific IgE to more than one protein family was found in 6 (21%) patients. A subgroup (FDEIA; food-dependent exercise-induced anaphylaxis) of 4 patients was identified from the total group studied and that subgroup tolerated all foods at rest and developed anaphylaxis after ingesting the offending food with exercise as a cofactor. During 1-year follow-up none of our patients had a repeated anaphylaxis and none used an adrenaline autoinjector.

Conclusions:
Female gender/sex is a predisposing factor for exercise-induced food anaphylaxis. Correct diagnosis prevents recurrent anaphylaxis. Our 1-year follow-up demonstrated the importance of dietary education to promote a healthy lifestyle.