# Sustainable Plant-Based Diets and Food Allergies: A Scoping Review Inspired by EAT-Lancet
## 3 Results
### Overview of Included Studies
Systematic and narrative reviews, including that by [PERSON] and colleagues [1], which analyzed approximately 30 studies, suggest that professionally supervised plant-based diets can reduce exposure to traditional allergens (e.g., dairy and egg) and maintain nutritional adequacy across diverse populations, particularly in pediatric and adult allergic individuals. The same review stresses that attention to food variety, nutrient balance, and allergen labeling is critical when animal-derived foods are replaced. Expert consensus, as reported by [PERSON] and colleagues [2], reinforces that plant-based diets--when grounded in whole foods--may support prevention strategies by minimizing allergen burden and enhancing dietary richness in polyphenols and fiber. These nutrients exert systemic effects by promoting regulatory T cell (Treg) differentiation via SCFA signaling and by reducing oxidative stress, thus contributing to the attenuation of sensitization cascades. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline
**Author and Year** & **Level of Evidence (CEBM 2009)** & **Study Population and Design** & **Main Findings** \\ \hline [PERSON] et al., 2024 [1] & Level 5 & Narrative review; \(\sim\)30 studies on plant-based diets in allergic individuals (children and adults). & Plant-based diets may reduce symptom burden if well-balanced, but risk of hidden allergen exposure (soy and nuts) remains. Nutrient adequacy and avoidance strategies are critical. \(p\)-values not applicable. & Plant-based diets may reduce symptom burden if well-balanced, but risk of hidden allergen exposure (soy and nuts) remains. Nutrient adequacy and avoidance strategies are critical. \(p\)-values not applicable. & Plant-based diets may reduce symptom burden if well-balanced, but risk of hidden allergen exposure (soy and nuts) remains. Nutrient adequacy and avoidance strategies are critical. \(p\)-values not applicable. \\ \hline [PERSON] et al., 2023 [2] & Level 5 & Expert consensus paper; \(\sim\)50 sources reviewed; focus on vegan diets and allergy management. & Vegan diets may alleviate symptoms via exclusion of common allergens (e.g., dairy and egg), but introduce novel exposures (e.g., lupin and pea protein). Highlights need for diagnostic protocols. \(p\)-values not applicable. \\ \hline [PERSON] et al., 2022 [3] & Level 4 & Cross-sectional study; \(n\) = 43 vegetarians with legume hypersensitivity. & In allergic vegetarians, symptom control is challenging due to reliance on allergenic protein sources. Clinical dietetic support improves outcomes. \(p\) = 0.04 for association between dietary patterns and allergic burden. Symptom burden may rise when allergenic plant proteins are relied upon without adequate supervision; fiber and polyphenol content remain protective when diversified. \(p\)-values not applicable. \\ \hline [PERSON] et al., 2021 [17] & Level 5 & Review on nut allergy management strategies; includes dietary approaches in allergic patients. & Exclusion of tree nuts from plant-based diets reduces allergic episodes, but nutritional adequacy must be preserved. Substitution with tolerated seeds can support symptom control. \(p\)-values not applicable. \\ \hline [PERSON] et al., 2023 [18] & Level 5 & Systematic review of Mediterranean diet and allergy; mixed populations including allergic adults. & Mediterranean diet associated with improved asthma and allergic rhinitis control. Anti-inflammatory profile may attenuate allergic symptoms. \(p\) < 0.05 in multiple included studies. Mediterranean diet benefits may stem from its anti-inflammatory and microbiota composition, not simply from the absence of animal products. \(p\)-values not applicable. \\ \hline \end{tabular}
\end{table} 
Table 4: Plant-based dietary patterns and the modulation of allergic symptoms in sensitized individuals. Conversely, several narrative reviews and observational data also highlight new risks.