Human & Veterinary
Medicine

Adverse reactions to food represent a growing public health concern worldwide, encompassing a heterogeneous spectrum of conditions ranging from non- immune-mediated food intolerances to potentially life-threatening IgE-mediated allergic responses. This review provides a comprehensive and mechanistically oriented analysis of the principal categories of food intolerance including lactose intolerance, fructose malabsorption, and non-celiac gluten sensitivity alongside the immunological pathways underpinning celiac disease and IgE-mediated food allergies. Particular attention is given to the biochemical basis of allergenicity, the role of food processing in modifying allergenic potential, and the clinical spectrum from localized oral allergy syndrome to systemic anaphylaxis. The review also examines the epidemiology of the major regulated allergens under EU Regulation (EU) No 1169/2011, summarizes current diagnostic approaches including skin prick testing, specific IgE assays, and double-blind placebo-controlled food challenges (DBPCFC), and discusses emerging immunotherapeutic strategies such as oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT). Finally, the review addresses the practical implications of cross-reactivity phenomena, including latex-fruit syndrome and pollen-food allergy syndrome, for clinical management and dietary counselling.