Living with Food Allergy in Adolescence - The Nutritional and Psychological Impact of Allergen Avoidance

Sep 30, 2026

Food allergy prevalence continues to rise worldwide, with allergen profiles changing across development: milk, egg, wheat, and soy are more typical in early childhood and often resolve before adolescence, while peanut, tree nut, fish, and shellfish allergies tend to persist and become more evident in teenagers. This narrative review evaluates how food allergy and elimination diets affect adolescents’ nutritional status, psychological functioning, and quality of life, including risks such as micronutrient deficiencies and growth concerns, alongside fear of accidental exposure and social difficulties. Multidisciplinary care, education, and psychological support are emphasized to strengthen adherence and self-management safety.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Abstract

1. Introduction

2700 BC to modern understanding of food allergy

Prevalence trends and regional allergen differences

Age-related allergen profiles and contributing factors

2. Food Allergy: Mechanisms, Major Allergens, and

Review Living with Food Allergy in Adolescence: The Nutritional and Psychological Impact of Allergen Avoidance Hanna Sikorska-Szaflik *, Joanna Połomska and Barbara Soza ´nska Academic Editor: Linda Monaci Received: 14 November 2025 Revised: 15 December 2025 Accepted: 19 December 2025 Published: 23 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Department and Clinic of Paediatrics, Allergology and Cardiology, Wroclaw Medical University, ul. Chałubi ´nskiego 2a, 50-368 Wrocław, Poland * [Correspondence: hanna.sikorska-szaflik@umw.edu.pl](Correspondence: hanna.sikorska-szaflik@umw.edu.pl) Abstract The prevalence of food allergy continues to rise worldwide. The allergen profile of affected individuals changes with age: milk, egg, wheat, and soy allergies are more common in early childhood and often resolve before adolescence, whereas peanut, tree nut, fish, and shellfish allergies tend to persist and become more apparent in teenagers. The aim of this narrative review is to discuss the impact of food allergy and elimination diets on the nutritional status, psychological functioning, and quality of life of adolescents. Although an elimination diet remains the main way of treatment, it may lead to the risk of vitamin D, calcium, iron, and protein deficiencies, and potentially to growth disorders. In adolescents, irregular eating habits and poor adherence to dietary recommendations pose additional challenges. The psychological burden of living with food allergy include fear of accidental contact with the allergen, difficulties in peer relationships, and reduced quality of life, particularly in terms of social and emotional functioning. Lack of training in using an adrenaline autoinjector and embarrassment about its use are further risk factors in this age group. Optimal care for adolescents with food allergies requires a multidisciplinary approach, including an allergist, dietitian, and psychologist. Education, psychological support, and gradual development of self-management skills are crucial to improving the safety and quality of life of adolescents with food allergies. Further efforts by medical societies are warranted to advance the development of alternative therapeutic approaches for food allergy, including immunotherapy and biologic therapies, as well as to strengthen public health strategies for individuals affected by food allergies. Keywords: food allergy; adolescence; elimination diet; quality of life 1. Introduction Awareness of food allergy (FA) dates back many centuries. As early as 2700 BC, Chinese records recommended that pregnant women avoid certain foods believed to cause skin lesions. In the 1st century BC, Titus Lucretius Carus wrote “What is food to one, to another is rank poison”, clearly indicating that adverse reactions to food were already recognized at that time [1] . Recent advances in medical science, technology, and nutrition research have greatly improved our understanding of how certain foods can trigger harmful reactions in the body. The prevalence of FA continues to rise worldwide. It is estimated to affect approximately 8% of children and 10% of adults in highly industrialized countries [2] . Significant regional differences are observed, and the reported prevalence varies depending on the specific food analyzed: in Europe and North America, peanut and egg allergies are the most common allergens, while in Asia, shellfish and fish allergy predominate [3] . Reactions to lipid transfer proteins (LTPs) in fruits, lentils, and walnuts are frequently reported in Southern Europe, whereas allergies to birch pollen and birch pollen cross-allergens (e.g., apple, carrot, celery, hazelnut) are common in Central and Northern Europe. Furthermore, the patient’s allergen profile changes with age: milk, egg, whea

FAQs

How does the allergen profile of food allergy change from childhood to adolescence?

Allergies to milk, egg, wheat, and soy are more common in early childhood and often resolve before adolescence. In contrast, peanut, tree nut, fish, and shellfish allergies tend to persist and become more apparent in teenagers.

What nutritional risks can elimination diets create for adolescents?

Elimination diets may increase the risk of vitamin D, calcium, iron, and protein deficiencies and can potentially contribute to growth disorders. Irregular eating habits and poor adherence to dietary recommendations add further challenges.

What psychological and quality-of-life impacts are highlighted for adolescents with food allergy?

Adolescents may experience fear of accidental allergen contact, difficulties in peer relationships, and reduced social and emotional functioning, lowering quality of life. Lack of training in using an adrenaline autoinjector and embarrassment about its use are also identified as additional risk factors.

Sep 30, 2026

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