# Sustainable Plant-Based Diets and Food Allergies: A Scoping Review Inspired by EAT-Lancet
## 3 Results
### Core Dietary Determinants of Allergy Prevention and Management Within Sustainable Eating Models
#### 3.4.1 Food Processing and Allergy: Preventive and Symptom-Modulating Perspectives
Conversely, functional processing methods--such as polyphenol-protein conjugation, fermentation, and enzymatic hydrolysis--demonstrate promise in reducing allergenicity before symptoms appear. For example, [PERSON] and colleagues [29] reviewed multiple in vitro and animal studies showing that the covalent binding of polyphenols to allergenic food proteins can mask IgE epitopes, decreasing both antigenicity and immune activation. [PERSON] and colleagues [10] further confirmed that fermented or polyphenol-modified proteins improve epithelial tight junction function and reduce intestinal permeability, two hallmarks of a more resilient gut-immune interface. Incorporating these methods into preventive strategies may help reduce the sensitization potential of common allergens such as soy and nuts, provided they are applied in a controlled, evidence-based context. In individuals with established allergic disease, food processing can significantly alter the clinical expression of symptoms. Some techniques--such as high-heat processing or Maillard reactions--can increase allergenicity by exposing or stabilizing IgE-binding epitopes, as extensively reviewed by [PERSON] and colleagues [21]. Similarly, [PERSON] and colleagues [22] demonstrated that simulated digestion of processed foods can result in peptide fragments with unpredictable immunogenic potential, especially when tested in Caco-2 or mast cell models. However, emerging studies show that biotechnological approaches combining enzymatic treatment and fermentation can reduce IgE-binding capacity and immunoreactivity. [PERSON] and colleagues [23] found that soy proteins subjected to transglutaminase pre-treatment and lactic fermentation exhibited significantly altered secondary structure and reduced epitope exposure in 36 individuals. Likewise, [PERSON] and colleagues [24] demonstrated that fermentation of soymilk with _Enterococcus faecalis_ led to a measurable decrease in the allergenicity of \(\beta\)-congplycinin and glycinin proteins. Notably, [PERSON] and colleagues [10] also identified that polyphenol-protein conjugation not only reduced allergenicity in sensitization models but attenuated basophil degranulation during active allergic responses. This effect was linked to MAPK signaling modulation and inhibition of histamine and \(\beta\)-hexosaminidase release, supporting a direct application of processed hypoallergenic foods in clinical management. From a practical perspective, the selection of fermented, hydrolyzed, or polyphen-modified plant-based foods offers a promising low-risk strategy to reduce allergen exposure and symptom burden in sensitized individuals--particularly when dietary interventions are tailored and supervised. 4.2 Food Diversity and Seasonal Plant-Based Diets as Supportive Strategies in Allergy Prevention and Management  
The preventive and therapeutic contributions of dietary diversity and seasonal plant-based food intake in allergic disease contexts are documented in Tables 13 and 14. While the primary protective effects of sustainable dietary patterns such as Mediterranean, vegetarian, and EAT-Lancet-aligned diets are attributable to their fiber, polyphenol, and micronutrient content, food diversity emerges as an important--though not exclusive--factor in modulating gut-immune resilience. Several narrative reviews provide converging evidence that dietary variety, especially when based on a wide array of seasonal and minimally processed plant foods, can support immunological tolerance mechanisms. [PERSON] and colleagues [5], drawing on both human observational and preclinical data, reported that greater plant species richness increases microbiota diversity and promotes short-chain fatty acid (SCFA) production. These metabolic products, particularly butyrate and propionate, are key inducers of regulatory T cells (Tregs) and are associated with decreased Th2 cytokine signaling in allergic models. The review covered approximately 30 studies and emphasized how seasonal food variation enhances mucosal immune homeostasis.