Parker S L, Sussman G L, Krondl M
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ont.
CMAJ. 1988 Oct 15;139(8):711-8.
Dietary considerations play an important role in the diagnosis, treatment and management of immunologic and nonimmunologic reactions to foods. Food diaries and trial elimination diets may prove helpful in identifying the responsible foods. Elimination diets must be monitored carefully for nutritional adequacy and should be used no longer than absolutely necessary; in some instances appropriate vitamin and mineral supplementation may be necessary. Ideally the identification of foods that provoke symptoms should be confirmed by means of double-blind challenge testing. Avoidance of some problem foods is unlikely to cause nutritional problems, but the practical and nutritional implications of allergies to staple foods such as cow's milk, eggs and wheat are far greater. Nonimmunologic adverse reactions that may mimic food allergic reactions include gastrointestinal disorders, sensitivity to food additives and psychologically based adverse reactions. There may be some degree of tolerance in metabolic disorders, which makes dietary management easier. Sensitivity to food additives necessitates careful scrutiny of food labels. In psychologic adverse reactions to foods, several foods are often involved, which increases the risk of nutritional problems.
饮食方面的考量在食物免疫性和非免疫性反应的诊断、治疗及管理中发挥着重要作用。食物日记和试验性排除饮食可能有助于确定引发问题的食物。必须仔细监测排除饮食的营养充足性，且使用时间不应超过绝对必要的时长；在某些情况下，可能需要适当补充维生素和矿物质。理想情况下，应通过双盲激发试验来确认引发症状的食物。避免食用某些问题食物不太可能导致营养问题，但对牛奶、鸡蛋和小麦等主食过敏的实际和营养影响要大得多。可能模拟食物过敏反应的非免疫性不良反应包括胃肠道疾病、对食品添加剂的敏感以及基于心理因素的不良反应。代谢紊乱可能存在一定程度的耐受性，这使得饮食管理更加容易。对食品添加剂敏感需要仔细查看食品标签。在对食物的心理不良反应中，通常涉及多种食物，这增加了营养问题的风险。
