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Adequate patient education and counseling are crucial as modified diets may be beneficial for a subset of antihistamine refractory CSU patients, and no modality currently exists to identify these patients. Elimination of food items based exclusively on patient history may lead to unnecessary restrictions in most cases resulting in nutritional deficiencies and impaired quality of life. Several dietary strategies have been tried till date with varying rates of success and evidence. This review highlights the various dietary strategies along with their levels of evidence, which may help the treating dermatologists and physicians to counsel CSU patients and make evidence\u2010based treatment decisions. There is grade A recommendation for the elimination of food additives (artificial pseudoallergens), personalized diets, vitamin D supplementation, Diamine oxidase supplementation and probiotics (in children), grade B recommendation for dietary elimination of red meat, fish and their products, natural pseudoallergens (fruits, vegetables, and spices), and low\u2010histamine diet, while dietary elimination of gluten (with concomitant celiac disease) has grade C recommendation. Notably, elimination diets should be continued for at least 3 consecutive weeks to assess their effectiveness.<\/jats:p>","DOI":"10.1111\/ijd.15988","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T13:40:08Z","timestamp":1637934008000},"page":"143-153","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Dietary strategies for chronic spontaneous urticaria: an evidence\u2010based review"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-083X","authenticated-orcid":false,"given":"Indrashis","family":"Podder","sequence":"first","affiliation":[{"name":"Department of Dermatology Venereology and Leprosy College of Medicine and Sagore Dutta Hospital  Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Dermatology Indira Gandhi Government Medical College  Nagpur Maharastra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0841-9597","authenticated-orcid":false,"given":"Anupam","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Dermatology KPC Medical College and Hospital  Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13397"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.04.013"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.01.023"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2011.1285"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13716"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3015"},{"key":"e_1_2_9_8_1","first-page":"548","article-title":"Strength of recommendation taxonomy (SORT): a patient\u2010centered approach to grading evidence in the medical literature","volume":"69","author":"Ebell MH","year":"2004","journal-title":"Am Fam Physician"},{"key":"e_1_2_9_9_1","first-page":"644","article-title":"[OCEBM levels of evidence system]","volume":"68","author":"Durieux N","year":"2013","journal-title":"Rev Med Liege"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.5826\/dpc.1001a04"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6703052"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2009.00912.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12653"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.13683"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ab.2007.01.023"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.03.031"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2018.3970"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000440653"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871530318666171129211350"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2009.03694.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62298-3"},{"key":"e_1_2_9_22_1","first-page":"339","article-title":"Is Anisakis simplex responsible for chronic urticaria?","volume":"24","author":"L\u00f3pez\u2010S\u00e1ez MP","year":"2003","journal-title":"Allergy Asthma Proc"},{"key":"e_1_2_9_23_1","first-page":"33","article-title":"Preliminary data of the effect of a temporary diet without fish in a randomised clinical trial of Anisakis simplex sensitisation\u2010associated chronic urticaria","volume":"66","author":"Daschner A","year":"2011","journal-title":"Allergy"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.10.003"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2011.06.003"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2009.01066.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"crossref","first-page":"484","DOI":"10.2340\/0001555575484487","article-title":"Pseudoallergen\u2010free diet in the treatment of chronic urticaria. 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