Food Allergies and Food Intolerances Across the Lifespan: Advances, Challenges, and Future Perspectives

Food hypersensitivity is a prevalent and increasingly recognized condition worldwide, characterized by adverse reactions to specific food components. It encompasses both immune-mediated reactions, such as food allergy (FA), and non-immune-mediated reactions, referred to as food intolerance (FI). In recent decades, the incidence of food-related adverse reactions has risen significantly, making them a major public health concern. Several factors may have contributed to this trend, including environmental changes, increasing urbanization, greater exposure to novel and potentially immunogenic foods (such as pre-cooked products and insect-based foods), reduced exposure to infections in early life, and broader shifts in lifestyle and dietary habits. In parallel, growing evidence highlights the pivotal role of the gut microbiome in shaping immune responses and influencing susceptibility to allergic and intolerant reactions. Food allergies, in particular, often begin in early childhood but may develop de novo at any age, with similar underlying etiologies in both pediatric and adult populations. The clinical presentation, triggers, and natural history of FA vary significantly across the lifespan, with important implications for diagnosis, management, and prognosis. Age and gender may influence both the severity of allergic reactions and their impact on health-related quality of life (QoL). At the same time, patients reporting food sensitivities frequently present with functional gastrointestinal symptoms, for which specific biomarkers and pathophysiological mechanisms remain poorly understood.Despite rapid advances in omics technologies—including genomics, epigenomics, and metabolomics—and increasing interest in the impact of food processing methods and cooking techniques on allergenicity, many grey areas persist in our understanding of the pathogenic mechanisms underlying FA and FI. Although research has expanded considerably, significant gaps remain in identifying reliable diagnostic biomarkers, clarifying disease endotypes, and understanding the interplay between genetic, environmental, and immunological factors. An accurate and timely diagnostic approach is essential to prevent unnecessary long-term dietary restrictions and avoid harmful nutritional consequences, particularly in children and adolescents.The management of food allergies and intolerances evolves dramatically across the lifespan. Preventive strategies may begin as early as pregnancy and the neonatal period, while therapeutic approaches must be tailored to the patient’s age and clinical profile. Continuity of care is especially challenging during the transition from childhood to adolescence and adulthood, requiring coordinated efforts between healthcare providers and patients. Although elimination diets remain a cornerstone of management, they are associated with nutritional risks and psychosocial burdens. Emerging therapies, including various forms of immunotherapy, represent promising alternatives; however, their efficacy and safety profiles may differ by age group.The growing economic burden of food hypersensitivity, along with its profound impact on QoL, underscores the urgent need for innovative, personalised strategies for prevention, diagnosis, and treatment. Therefore, key questions driving current research include: What are the major challenges and frontiers in FA and FI research and management? How can advances in biomarker discovery and precision medicine improve diagnostic accuracy and therapeutic outcomes? Moreover, how can lifelong, age-adapted care pathways be optimized to ensure continuity and safety?This Research Topic welcomes original research articles, reviews, and perspectives that deepen our understanding of food allergies and intolerances across different age groups. Contributions addressing epidemiology, pathogenesis, diagnostic criteria, biomarkers, management strategies, transition medicine, and emerging therapeutic approaches are particularly encouraged, to highlight unmet needs, recent advances, and future directions in this rapidly evolving field. Topic editors: Angela Rizzi, Sara Manti, Mona-Rita Yacoub, Paola Lucia Minciullo Source: https://www.frontiersin.org/research-topics/79316/food-allergies-and-food-intolerances-across-the-lifespan-advances-challenges-and-future-perspectives