D2.308 - Diet quality and intake behaviours among alpha-gal–positive patients at a specialized allergy clinic in Sri Lanka

Alpha-gal syndrome (AGS) is an IgE-mediated delayed hypersensitivity to mammalian-derived products. This study examined dietary behaviours and diet quality among 204 patients with AGS (alpha-gal IgE ≥0.35 kUA/L for ≥6 months) attending a specialized allergy clinic in Sri Lanka.

Data were collected using structured, interviewer-administered questionnaires, including a 3-day dietary recall. Diet quality was assessed using dietary diversity score (DDS) across 12 food groups and food variety score (FVS). Analyses were performed with SPSS version 27.

Among 204 patients, 111 (54.4%) were female. The mean age was 24.5 ± 17.0 years (range 3–76). Sensitization limited to mammalian meat was reported in 61 (29.9%), most commonly pork (70%). Sensitization limited to dairy and gelatine was observed in 26 (13.7%) and 8 (3.9%), respectively. Seventy five patients (36.8%) were sensitized to two or more mammalian derived foods, while 34 (16.7%) reported additional sensitization to other foods or drugs.

Food reintroduction without medical guidance was attempted by 103 (50.5%) patients; 44 (21.6%) used antihistamines during reintroduction, whereas 57 (27.9%) avoided reintroduction altogether. Allergic episodes following reintroduction occurred in 58 (40.6%).

The mean Food Variety Score (FVS) was 10.3 ± 1.7 and the Dietary Diversity Score (DDS) was 7.8 ± 1.0. Adequate daily intake was low for fruits (64.7%), fish (56.4%), meat (50.5%), pulses (42.2%), eggs (38.7%), and milk (28.9%). Only 16.2% underwent biochemical nutritional assessment, and none received professional dietary consultation.

Overall, 99.5% expressed interest in structured dietary guidance, particularly regarding prevention of deficiencies (86.3%), identification of safe foods (66.2%), and suitable substitutes (59.8%).

Patients with AGS exhibited reduced diet quality, limited diversity, and inadequate high-quality protein intake. Unsupervised food reintroduction was common, with minimal nutritional monitoring, highlighting the gap between restrictions and professional support. Findings emphasize the need for systematic dietary assessment, individualized counseling, and biochemical monitoring to optimize management in this population.