Our role statement was developed by members of the Food Allergy and Intolerance Interest Group.

It defines the role an Accredited Practising Dietitian (APD) may fulfil when working in the area of adverse food reactions.

Knowledge

• Knowledge of the immune system; recognition of the clinical features of adverse food reactions and understanding of the typical presentation of the wide range of associated conditions and diseases
• Knowledge of food labelling and foods/food compounds (for example, allergens, gluten) and which commonly cause or trigger adverse food reactions
• Understand the orthodox and unorthodox³ diagnostic tests; including the concepts, value, interpretation, associated risks, contraindications, and practical applications
• Knowledge of the evidence base for nutritional intervention, monitoring, and evaluation of management of adverse food reactions
• Awareness of risks of nutritional inadequacy, appropriate products for substitution and supplements to use if required
• Awareness of relevant co-factors and non-dietary triggers (for example, exercise, alcohol, NSAIDs) and knowledge of medications used for treatment

Skills

• Take and interpret a clinical history, including: diet, anthropometry (including growth in children and weight changes in adults), symptoms, triggers, medical, family, ethnicity, atopy, co-factors and social factors
• Determine the likelihood of a food/food compound triggering food-related symptoms
• Apply diagnostic information to guide prescription, implementation and evaluation of an appropriate, nutritionally sound individualised exclusion diet; considering the impact on quality of life
• Provide education, including label reading and making food substitutions, to ensure nutritional adequacy
• Provide nutrition advice in the paediatric population (role specific), appropriate for age and stage; including breastfeeding, maternal diet manipulation, infant formulae. Advise on suitable milk substitutes for infants and children including their indications and contra‑indications

Activities entry level APDs would conduct 

• Management of patients with simple nutrition needs (for example, single food allergy, no growth compromise, no co-morbidities), within the multidisciplinary team, including consultation with an appropriate medical practitioner.

Activities APDs working at a higher level would conduct 

• Management of patients with complex nutrition needs (for example, multiple food allergies, growth compromise, co-morbidities), within the multidisciplinary team, including consultation with an appropriate medical practitioner
• Research contributing to the evidence base in nutrition and adverse food reactions

Activities dietitians working in this area of practice do not usually undertake 

• Diagnose immune mediated adverse food reactions (for example, food allergy, coeliac disease)
• Provide medical management, including conducting supervised food allergen challenges

For more, download the full role statement.The full statement includes a list of document references.