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Food allergy affects up to 10% of the population. The identification of modifiable risk factors including skin barrier dysfunction, vitamin D deficiency, microbiome, and route and timing of allergen exposure is leading to effective prevention strategies, and some of which are now included in public health guidelines. An increasing understanding of the pathophysiology has improved diagnostic options and revealed novel manifestations such as delayed anaphylaxis to mammalian meat related to sensitization to a sugar moiety triggered by tick