Nutritional Management of Patients With Pollen Food Syndrome: Is There a Need?

Abstract

Pollen food syndrome (PFS) is a highly prevalent condition causing mild oropharyngeal reactions to plant foods due to recognition by pollen-specific antibodies. It is most frequent in adults, but it can also occur in children. This review aims to establish the pitfalls of diagnosis and the nutritional consequences, and whether individuals with PFS require an individualised dietary and nutritional management strategy. The diagnosis of PFS can be made through history alone but is greatly enhanced by undertaking component-resolved diagnostic (CRD) tests to individual allergens in birch pollen and relevant foods. Management of PFS requires dietary avoidance of trigger foods, but often, many foods have to be avoided, which can affect quality of life and nutritional intake. Not all symptoms are mild, especially if concentrated forms of allergen are taken, which may occur more frequently with the increased emphasis of the health benefits of fruits and vegetables. Oral food challenge (OFC) and, in the future, novel immunotherapy may minimise necessary avoidance. Due to the high homology of the allergens involved, multiple allergy tests can result in mass exclusion of antioxidant-rich fruits and vegetables, which are important nutritional contributors to the diet. Thus, those with PFS should receive individual dietary counselling to prevent deficiency diseases, especially expectant mothers, children and those who are avoiding multiple foods.