Author: Belinda Martin, Accredited Practising Dietitian | FOOD ALLERGY
Currently the standard treatment for food allergy is strict avoidance of eating the specific allergen or allergens you are allergic to. Food allergy occurs in around 5-10% of children, and 2-4% of adults in Australia and New Zealand. Most kids will outgrow food allergies, but studies have shown that 5% of children still have their food allergy at five years of age.
Oral Immunotherapy (OIT), otherwise known as desensitisation, has become a popular topic on social media recently with some claiming that OIT is a potential treatment for food allergy, particularly in America. However, it is extremely important to be aware that there are NO Oral Immunotherapy (OIT) or desensitisation methods that are standardised or approved for routine treatment of food allergy globally.
OIT involves administering gradually increasing amounts of the food allergen under medical supervision with the aim of inducing tolerance to the allergen in an allergic individual.
There are several clinical trials on OIT and food allergy happening in Australia and other countries. The trials are all based in hospitals due to the high rates of subjects who have allergic reactions while on OIT, including anaphylaxis. Until these trials are completed with standard methods, and until we know more about safety and effectiveness, the Australian Society of Clinical Immunology and Allergy (ASCIA) recommends that OIT for food allergy should not be conducted outside of clinical research trials.
The possible benefits of OIT are desensitisation and tolerance. Published trials have shown that OIT for food allergy can result in desensitisation in many patients. Desensitisation is a temporary state of protection that allows an increased amount of food allergen to be eaten without having an allergic reaction. BUT, you need to eat the food in a specific amount on a regular (usually daily) basis and it still may result in mild, moderate or severe allergic reactions, including anaphylaxis.
Published trials have also shown a limited ability for OIT to result in ongoing tolerance and permanent benefit for patients. Tolerance means that once you stop OIT, you can still tolerate the allergen in the longer term without having an allergic reaction and you don’t have to eat it every day. Most trials have not yet been able to show sustained tolerance to allergens after OIT.
Until OIT for food allergy is proven and standardised for routine use, and shown to be safe to undertake at home, avoidance of confirmed food allergens is still essential and recommended for the management of food allergy. OIT is most definitely not something that should be done without the supervision of an experienced clinical allergist!
Adapted from ‘ASCIA Information for patients, consumers and carers, Oral Immunotherapy for Food Allergy, 2019’
About the Author
Belinda Martin is a Perth Dietitian specialising in paediatric nutrition, food allergy, pregnancy nutrition and infant nutrition. She is the co-founder of Advanced Dietitians Group and loves working with people and families. She has been a dietitian for 20 years. She has worked as a Senior Dietitian and Paediatric Dietitian in various teaching hospitals in Western Australia and the United Kingdom. When she is not working, she is trying to tame a 4-year-old and a 2-year-old (and a 40+ year old) at home.
About Advanced Dietitians Group
Advanced Dietitians Group was founded in 2014 by Belinda Martin and Ingrid Roche, Perth dietitians with a combination of over 40 years’ experience in the industry. Both dietitians have a range of experience across the lifespan but specialise in food allergy, paediatric nutrition, pregnancy nutrition and infant nutrition. They provide up to date evidence-based nutrition advice. This coupled with their wealth of experience in dietetics ensures you get the best possible nutrition service. They get a buzz out of helping their clients and their families.
