Pollen Food Syndrome (PFS): A common food allergy in children and adults with increasing prevalence

Written by Annette Weaver, Clinical Dietetic Advisor, Allergy UK.

This article, authored by Annette Weaver, Clinical Dietetic Advisor at Allergy UK, provides a comprehensive overview of Pollen Food Syndrome (PFS)—a common but often misunderstood allergy that affects both children and adults. It explains how PFS, also known as Oral Allergy Syndrome, arises from cross-reactivity between pollen allergens and certain raw plant foods, which can trigger symptoms ranging from mild oral discomfort to, in rare cases, severe allergic reactions.

Within the article, readers will find valuable insights on PFS prevalence, symptoms, and the specific types of food that can elicit reactions. It also covers key diagnostic criteria from the British Society for Allergy & Clinical Immunology (BSACI) and offers practical guidance for managing PFS in everyday life. Information on co-occurring conditions, such as allergic rhinitis, and the impact of environmental factors on PFS is also included.

This resource is ideal for individuals living with PFS, healthcare providers, and anyone looking to better understand this increasingly common condition. Download the article to explore these topics in more depth and learn about effective management strategies for living well with PFS.

Key points:

  • PFS is a common food allergy in school age children and adults with onset occurring after sensitisation to pollen.
  • Prevalence is increasing alongside rising cases and severity of seasonal allergic rhinitis (SAR) and, in the UK, is particularly associated with birch pollen allergy.
  • PFS presents with immediate reactions to raw/uncooked plant foods that contain proteins similar to pollen allergens. Important exceptions are soya and nuts which may still elicit reactions after processing/cooking.
  • Most cases of PFS are mild and can be diagnosed and managed in primary care without the need for allergy testing.
  • A small proportion of cases present with severe or unusual symptoms and require specialist input and further investigation.
  • Conditions that might present with similar symptoms to PFS and should be excluded when making a diagnosis are latex fruit syndrome, Lipid Transfer Protein (nsLTP) allergy and primary food allergies to plant foods such as nuts and kiwi.
  • PFS can cause anxiety and unnecessary food eliminations. Referral to a qualified dietitian should be considered.
  • Psychological needs of people affected by PFS and SAR needs to be considered.
  • The British Society for Allergy & Clinical Immunology (BSACI) have published UK-specific guidelines for the diagnosis and management of PFS and a leaflet for GPs with advice on diagnosis and management
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What is Pollen Food Syndrome?

Pollen Food Syndrome (PFS), also known as Oral Allergy Syndrome is a type of hypersensitivity reaction that affects many people,...