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1 Introduction
Pages 19-38

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From page 19...
... Many stakeholders are concerned about these increases, including the general public, policy makers, regulatory agencies, the food industry, scientists, clinicians, and especially families of children and young people suffering from food allergy. Food allergy has important implications not only for those individuals directly affected but also for their families, day care and school settings, and society (Gupta, 2014; Pawanker et al., 2011)
From page 20...
... Those not afflicted with such a disorder may have difficulty even imagining what life is like for severely food-allergic individuals, some of whom are allergic to multiple commonly encountered foods, such as milk, eggs, peanuts, tree nuts, and shellfish. To illustrate some of these issues, Box 1-1 includes real-life example statements from children, adolescents (DunnGalvin et al., 2009)
From page 21...
... . As a parent of a child with food allergies, I always have to be pre pared.
From page 22...
... Professional medical associations continue to update their practice guidelines for food allergy despite limitations in the evidence, based on the most recent knowledge on diagnosis, prevention, treatment, and management. Yet, unlike other chronic diseases related to diet, such as diabetes or cardiovascular diseases, where specific strategies for prevention or management have been established (ADA, 2015; Goff et al., 2014)
From page 23...
... Federal, state, and local governments also are beginning to include allergy management as an element of their food safety policies. However, despite all the policies and guidelines for the various settings (e.g., food industry practices, regulatory agencies, early care and education centers, schools, higher education, and public transport)
From page 24...
... STATEMENT OF TASK This study originated as a result of the broad public interest in the health aspects of food allergy; the relevance to public health, health care, and society; and the current lack of solutions both for the prevention of food allergy and its management. The apparent increase in food allergies, and concerns about a lack of good management strategies, prompted informal discussions that resulted in a planning meeting in Washington, DC, under the auspices of the National Academies of Sciences, Engineering, and Medicine on May 24, 2014.
From page 25...
... The committee will develop a framework for future direction in understanding food allergy and its impact on individuals, families, and communities; recommend ing steps to increase public awareness of food allergy; promoting research on both disease causation and management; and informing preventive approaches to food allergy. Research gaps will be identified and recommendations made to fill them.
From page 26...
... However, the literature reviews, findings, conclusions, and recommendations reviewed in this consensus study refer exclusively to IgEmediated food allergies. Other food-related diseases, such as celiac disease, or food intolerances, such as lactose intolerance, or toxicity of food additives, are not covered in this report because they were beyond the scope of the statement of task.
From page 27...
... These key guidelines include the following: 2010 NIAID/NIH-sponsored Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel (Boyce et al., 2010) , the European Academy of Allergy & Clinical Immunology (EAACI)
From page 28...
... Systematic review: RAND systematic review Expert Panel Chafen et al., 2010 Food Allergy and Anaphylaxis European Academy of Allergy Muraro et al., 2014 EAACI Guidelines Guidelines & Clinical Immunology (EAACI) Systematic reviews: EAACI systematic reviews • de Silva et al., 2014 • Dhami et al., 2014 • Nwaru et al., 2014 • Panesar et al., 2013 • Salvilla et al., 2014 • Soares-Weiser et al., 2014
From page 29...
... Joint Council of Allergy, Asthma & Immunology (JCAAI) Anaphylaxis -- A Practice Joint Task Force on Practice Lieberman et al., 2015 AAAAI Practice Parameter Parameter Update Parameters, representing AAAAI, ACAAI, and JCAAI Clinical Report -- Management American Academy of Pediatrics Sicherer et al., 2007 2007 AAP Clinical Report of Food Allergy in the School (AAP)
From page 30...
... However, for questions related to current practices in the various settings encountered by those with food allergies, the committee relied more often on information gathered at workshops and/or by consulting the "gray literature" (published reports or research outside the traditional peer-reviewed scientific journals and commercial publications)
From page 31...
... From a societal and public health perspective, the safety and well-being of many potential individuals with food allergy requires recognition that risks and protections for public safety are spread across many systems, including food production and distribution systems, health care systems, and education systems, among others. This section explains how the committee undertook a developmental and ecological approach toward the health and safety of individuals with food allergy.
From page 32...
... Research is revealing that the timing of exposure to potential allergens can be a key determinant of whether or not food allergy develops in those at risk. The development and vulnerabilities to food allergy likely depend on an array of sensitivities to context that also may be shaped by the timing of exposures to potential allergens and other environmental fac
From page 33...
... . Efforts to change the safety of complex adaptive systems are complicated, whether the target of change is the entire public health care system, the commercial transportation systems, or the food production and service industries.
From page 34...
... Chapter 4 includes the current diagnostic and prognostic methods used and others that are under investigation. Chapter 5 presents current knowledge about prenatal and early life determinants of food allergies, including genetic and environmental factors.
From page 35...
... 2010. Diagnosing and managing common food allergies: A systematic review.
From page 36...
... 2014. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines.
From page 37...
... 2014. Prevalence of common food allergies in Europe: A systematic review and meta-analysis.


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