6. Food Allergen Thresholds of Reactivity

  1. Dean D. Metcalfe MD3,
  2. Hugh A. Sampson MD4,
  3. Ronald A. Simon MD5,6 and
  4. Gideon Lack MBBCh (Oxon), MA (Oxon), FRCPCH7
  1. Steve L. Taylor1,
  2. Jonathan O'B. Hourihane2 and
  3. Joseph L. Baumert1

Published Online: 24 FEB 2014

DOI: 10.1002/9781118744185.ch6

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

How to Cite

Taylor, S. L., Hourihane, J. O'B. and Baumert, J. L. (2013) Food Allergen Thresholds of Reactivity, in Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition (eds D. D. Metcalfe, H. A. Sampson, R. A. Simon and G. Lack), John Wiley & Sons Ltd, Chichester, UK. doi: 10.1002/9781118744185.ch6

Editor Information

  1. 3

    Chief, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

  2. 4

    Kurt Hirschhorn Professor of Pediatrics, Dean for Translational Biomedical Sciences, Director, Jaffe Food Allergy Institute Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

  3. 5

    Head, Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA

  4. 6

    Adjunct Professor, Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, CA, USA

  5. 7

    Professor of Paediatric Allergy, King's College London Clinical Lead for Allergy Service, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK

Author Information

  1. 1

    Department of Food Science and Technology and Food Allergy Research and Resource Program, University of Nebraska, Lincoln, NE, USA

  2. 2

    Department of Pediatrics and Child Health, University College Cork, Cork, Ireland

Publication History

  1. Published Online: 24 FEB 2014
  2. Published Print: 10 DEC 2013

ISBN Information

Print ISBN: 9780470672556

Online ISBN: 9781118744185



  • threshold;
  • elicitation;
  • definition;
  • food;
  • challenge;
  • symptom;
  • severe;
  • regulatory;
  • labeling


Threshold doses, also known as minimal eliciting doses, exist, below which food-allergic patients will not react adversely to an allergenic food. Considerable variation exists with respect to threshold doses for individuals with specific food allergies. As an example, the individual threshold doses for peanut can range from 0.1 mg up to 2.5 g of peanut protein. The clinical determination of threshold doses is best done through double-blind placebo-controlled food challenges. Ideally, such challenges should start at rather low doses to identify patients with the highest sensitivity to the specific allergenic food. The adoption of population thresholds that would protect the vast majority of individuals with specific food allergies by public health agencies would provide the food industry with a sounder basis for labeling and especially advisory labeling. Improved knowledge of individual threshold doses can provide guidance to patients in the successful implementation of avoidance diets.