It is well established that the prevalence of true IgE-mediated food allergy is significantly less common than food allergy identified as self-reported disease, yet even epidemiological data reflect the difficulty in the identification of bona fide IgE-mediated allergy, as several reports do not include a clinical confirmation of disease. non-immunologic adverse reactions to food. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food-along with general diagnostic and therapeutic strategies. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. Furthermore, there is a discrepancy between the perceived vs. However, this distinction and the involvement of different pathogenetic mechanisms are often confused.
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