[Allergy diet: procedures in diagnosis and therapy of food allergy and pseudo-allergy].

Apart from patient history, skin tests and in vitro methods, certain in vivo techniques such as elimination or provocation tests are of great importance in the diagnosis of food allergy. A variety of dietary approaches are used: elimination diets allow the evaluation of clinical improvement after the stepwise removal of suspected foods; on the other hand, provocation diets involve introducing suspected allergenic foods under clinical control. In each individual patient, a specific selection of food provocations is desirable. Food additives are tested according to the schedule of the oral provocation test for idiosyncrasy (OPTI) by the administration of increasing doses in gelatine capsules. In order to rule out psychological influences, blind techniques should be used. For longer periods, three variably intense allergy diets are recommended: Allergy diet 1 ("allergen-free" diet) is used in patients with severe clinical symptoms over a period of up to 2 weeks. Allergy diet 2 (allergen-poor diet) consists of a positively defined mixture of few permitted foods empirically rated as being weak allergens; this diet is suitable as a baseline diet over longer periods of time in patients with marked hypersensitivity reactions. Allergy diet 3 (additive-free diet) distinguishes permitted and prohibited foods. This diet is recommended for patients with pseudo-allergic reactions to additives such as colouring, preservatives or other triggers of pseudo-allergic reactions. In all dietary procedures, the problem of compliance has to be considered, not only with respect to the patient but also with regard to the medical personnel.(ABSTRACT TRUNCATED AT 250 WORDS)