A structured food list for dietary assessment in patients with lipid transfer protein syndrome

Abstract

Lipid transfer proteins (LTPs) are widely distributed plant defense proteins and represent one of the most frequent causes of plant food allergy in Mediterranean countries. Due to their resistance to heat and enzymatic digestion, foods containing LTPs may induce immediate allergic reactions ranging from mild local symptoms to severe systemic reactions, including anaphylaxis. Sensitization to peach lipid transfer protein (Pru p 3) is considered the primary sensitizer in Southern Europe and is frequently associated with reactions to multiple plant-derived foods.
In clinical practice, one of the main challenges in the management of patients with LTP syndrome is the accurate identification of foods that truly trigger allergic reactions, those that are well tolerated, and those that are unnecessarily avoided due to fear or positive sensitization tests without clinical relevance.
The aim of this position paper is to describe the development and clinical use of a structured, patient-completed food list designed to facilitate dietary assessment and clinical history-taking in patients with LTP syndrome.
The proposed tool records foods that are consumed and tolerated, foods associated with allergic reactions, foods avoided due to fear or medical advice, foods excluded for nonallergic reasons, and foods with positive skin test results. Foods are organized according to plant-derived food groups and associated plant allergen families.
Based on our clinical experience in a specialized allergy consultation focused on LTP syndrome, the systematic use of this structured food list facilitates dietary history-taking, supports clinical decision-making, and may help reduce unnecessary dietary restrictions during patient follow-up.