{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:30:52Z","timestamp":1789500652125,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Recovery and Resilience Plan (NRRP)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Allergen-free diets are a specific and effective anti-inflammatory therapy for eosinophilic esophagitis. They should be carried out by a multidisciplinary team to reduce side effects and improve adherence. According to recent guidelines and expert opinions, empirical diets with a reduced number of eliminated food categories and a step-up approach are the most encouraged strategy to reduce the number of endoscopies to identify food trigger(s) and maximize clinical results and adherence. Despite the fact that allergy testing-based diets are not recommended at a population level, geographical sensitization patterns may play a role in some patients in specific areas, such as in Southern and Central Europe.<\/jats:p>","DOI":"10.3390\/nu15102409","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T02:28:42Z","timestamp":1684722522000},"page":"2409","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Dietary Strategies in Adult Patients with Eosinophilic Esophagitis: A State-of-the-Art Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1314-361X","authenticated-orcid":false,"given":"Carlo Maria","family":"Rossi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy"},{"name":"First Department of Internal Medicine, Fondazione IRCCS San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Vincenzo","family":"Lenti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy"},{"name":"First Department of Internal Medicine, Fondazione IRCCS San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Merli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy"},{"name":"First Department of Internal Medicine, Fondazione IRCCS San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5752-6199","authenticated-orcid":false,"given":"Hellas","family":"Cena","sequence":"additional","affiliation":[{"name":"Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experiemental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy"},{"name":"Clinical Nutrition Unit, Department of General Medicine, Istituti Scientifici Maugeri IRCCS, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0302-8645","authenticated-orcid":false,"given":"Antonio","family":"Di Sabatino","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy"},{"name":"First Department of Internal Medicine, Fondazione IRCCS San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1053\/j.gastro.2017.06.067","article-title":"Epidemiology and Natural History of Eosinophilic Esophagitis","volume":"154","author":"Dellon","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1002\/ueg2.12273","article-title":"Eosinophilic oesophagitis in Denmark: Population-based incidence and prevalence in a nationwide study from 2008 to 2018","volume":"10","author":"Allin","year":"2022","journal-title":"United Eur. 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Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/0016-5085(95)90637-1","article-title":"Eosinophilic esophagitis attributed to gastroesophageal reflux: Improvement with an amino acid-based formula","volume":"109","author":"Kelly","year":"1995","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1177\/2050640616689525","article-title":"Guidelines on eosinophilic esophagitis: Evidence-based statements and recommendations for diagnosis and management in children and adults","volume":"5","author":"Lucendo","year":"2017","journal-title":"United Eur. Gastroenterol. 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Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jaci.2018.02.028","article-title":"Dietary therapy for eosinophilic esophagitis","volume":"142","author":"Lucendo","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Visaggi, P., Mariani, L., Pardi, V., Rosi, E.M., Pugno, C., Bellini, M., Zingone, F., Ghisa, M., Marabotto, E., and Giannini, E.G. (2021). Dietary Management of Eosinophilic Esophagitis: Tailoring the Approach. Nutrients, 13.","DOI":"10.3390\/nu13051630"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Pitsios, C., Vassilopoulou, E., Pantavou, K., Terreehorst, I., Nowak-Wegzryn, A., Cianferoni, A., Tsigkrelis, G.P., Papachristodoulou, M., Bonovas, S., and Nikolopoulos, G.K. (2022). Allergy-Test-Based Elimination Diets for the Treatment of Eosinophilic Esophagitis: A Systematic Review of Their Efficacy. J. Clin. Med., 11.","DOI":"10.2139\/ssrn.4042682"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.anai.2020.03.020","article-title":"AGA institute and the joint task force on allergy-immunology practice parameters clinical guidelines for the management of eosinophilic esophagitis","volume":"124","author":"Hirano","year":"2020","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.cgh.2006.05.026","article-title":"Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis","volume":"4","author":"Kagalwalla","year":"2006","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1053\/j.gastro.2012.03.001","article-title":"Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors","volume":"142","author":"Gonsalves","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jaci.2012.12.664","article-title":"Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: A prospective study on the food cause of the disease","volume":"13","author":"Lucendo","year":"2013","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/apt.13676","article-title":"Allergy tests do not predict food triggers in adult patients with eosinophilic oesophagitis. A comprehensive prospective study using five modalities","volume":"44","author":"Philpott","year":"2016","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/dote.12175","article-title":"Practical approach to implementing dietary therapy in adults with eosinophilic esophagitis: The Chicago experience","volume":"28","author":"Doerfler","year":"2015","journal-title":"Dis. Esophagus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/j.jaci.2017.08.038","article-title":"Step-up empiric elimination diet for pediatric and adult eosinophilic esophagitis: The 2-4-6 study","volume":"141","author":"Arias","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/j.jaci.2014.07.023","article-title":"Four-food group elimination diet for adult eosinophilic esophagitis: A prospective multicenter study","volume":"134","author":"Arias","year":"2014","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1097\/MPG.0000000000002215","article-title":"Pediatric Eosinophilic Esophagitis: Results of the European Retrospective Pediatric Eosinophilic Esophagitis Registry (RetroPEER)","volume":"68","author":"Hoofien","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1111\/all.12257","article-title":"Birch pollen sensitization with cross-reactivity to food allergens predominates in adults with eosinophilic esophagitis","volume":"68","author":"Versteeg","year":"2013","journal-title":"Allergy"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12948-022-00174-z","article-title":"High prevalence of sensitization to non-specific lipid transfer protein in adult patients with primary eosinophilic gastrointestinal disorders in Italy: A single center series","volume":"20","author":"Rossi","year":"2022","journal-title":"Clin. Mol. Allergy"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.5415\/apallergy.2021.11.e44","article-title":"Eosinophilic esophagitis induced by sublingual immunotherapy with cedar pollen: A case report","volume":"1","author":"Suto","year":"2021","journal-title":"Asia Pac. 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