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American Journal of Clinical Nutrition, Vol. 77, No. 3, 754, March 2003
© 2003 American Society for Clinical Nutrition


Book Review

Adverse Reactions to Food,

edited by Judith Buttriss, 2002, 256 pages, softcover, $52.99. Blackwell Science, Oxford, United Kingdom.

Pearl Barzaga and Suzanne S Teuber

Division of Rheumatology, Allergy and Clinical Immunology University of California, Davis One Shields Avenue Davis, CA 95616 E-mail: ssteuber{at}ucdavis.edu

This text of 190 pages, excluding glossary, references, and index, is a collective report written by members of the British Nutrition Foundation Task Force. It is divided into 16 chapters with the title designation of "adverse reactions to food" serving as an umbrella phrase for discussions on such topics as immunoglobulin E–mediated food allergies, nonimmunoglobulin E–mediated immune reactions, enzymatic deficiencies, pharmacologic effects of certain foods, food aversions, and food poisoning. The book is comprehensive and includes discussions on the epidemiology of food allergy, perinatal sensitization, common food allergy syndromes in children and adults, foods most commonly associated with allergy, diagnostic tests for and management of food allergies, effects of nutrition on the immune system, the role of the food industry, and upcoming technologies with respect to food allergies.

The text is well organized and allows for quick referencing and review. Each chapter is divided into subtopics with descriptive headings for each. For example, from the table of contents, the reader can find the specific page number that describes the influence of zinc on immune function by glancing through the subtopics in the chapter on nutrition and the immune system.

Tables and diagrams are used appropriately to help simplify subjects and summarize reviewed data. Twelve of the first 13 chapters conclude with a summary table entitled "key points" that highlights the main concepts, and the other chapter ends with a conclusions section. Chapter 14 provides a chapter-by-chapter enumeration of the conclusions of the Task Force, and chapter 15 outlines the recommendations of the Task Force. Areas that need further research are also identified. The last chapter is in the form of a question-and-answer section that tests the knowledge the reader gained from the text. Citations are made sparingly, and a full bibliography is provided. The frequent referral to subsequent chapters for a more detailed discussion of certain topics is distracting. The brief glossary is welcome, albeit somewhat limited and simple. The brevity of the text is both a positive point, in that this text is a good review that will actually be read from cover to cover, and a negative point, in that certain topics could benefit from a more critical analysis of the literature. For example, food additives (benzoate, glutamate, metabisulfite, and tartrazine) are listed in a table (Table 7.1) as food ingredients "commonly associated with [the] causation or exacerbation of atopic dermatitis in the [United Kingdom]," but the data for this assertion are scanty or nonexistent.

Overall, this is a concise, informative book. It clarifies several common misconceptions about food allergies, which is important, because {approx}20% of the population believes that they are food-allergic despite a true prevalence of food allergy of < 2%. It is a suitable review for allergists and immunologists, primary care physicians with an interest in food allergy, graduate students in immunology or nutrition, dietitians, and food scientists.





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Agricola
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