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Adverse reactions to food are common in the general population. Distinguishing between food allergies and food intolerance is necessary in order to avoid unnecessary dietary restrictions. These may adversely affect nutrition, social interaction and quality of life. Recognition of risk factors for the development of food allergies can help facilitate an early diagnosis and seek to prevent life-threatening reactions to food. Accurate recognition of clinical manifestations, followed by the appropriate use and interpretation of tests, helps improve diagnosis. The management of food allergies to optimize prevention, and the diagnosis and management of these conditions, is an area that is controversial and still developing. This review focuses on the epidemiology, pathogenesis, diagnosis and management of food allergy.