Oral Food Challenge: It's Not a New Reality Series

Many children are avoiding potentially nutritious food unnecessarily based on incomplete information about possible food allergies, according to a new study from National Jewish Health.

The study finds that children, especially those with eczema, unnecessarily avoid food based on data primarily culled from blood tests known as serum immunoassays. A host of factors -- including patient and family history, physical examination, skin and blood tests and sometimes an oral food challenge, in which patients consume the suspected allergenic food -- should comprise evaluations used to determine if children are susceptible to food allergies.

Researchers looked at data from a retrospective chart review of 125 children evaluated for possible or suspected food allergies at National Jewish Health. After an oral food challenge, 84 percent to 93 percent of avoided foods were restored to diets.

David Fleischer, MD, lead author of the study and Assistant Professor of Pediatrics at National Jewish Health, said patients with a proven history of allergy and especially those with anaphylactic reasons should avoid these foods at all costs. He added a growing number of referred patients placed on strict, unproven food-elimination diets have led to malnutrition because of an over-reliance on immunoassay tests. These tests have been validated to accurately predict only five food allergies: cow's milk, hen egg, fish, peanut and tree nuts.

Children in the study avoided 177 different foods based mostly on blood tests. National Jewish Health elected not to exposure children to egg, milk, shellfish, peanuts and tree nuts in oral food challenges because of the severe complications those allergies present. Oral food challenges were performed on 71 foods in which about 86 percent of children with blood-test confirmed allergies returned to eating foods after passing these tests.

It may be time to get a second opinion, and a second helping.