Over the last two decades atopic diseases have increased in prevalence and severity in the industrialized countries. Food allergy is frequently the first manifestation of these disorders. Currently food allergy is mainly treated with elimination diets. However, this approach to control allergic inflammation by empirical elimination diets has not proved totally satisfactory. Applying therapeutic elimination diets in clinically documented allergy to a specific food has been shown to alleviate symptoms and reverse some disturbances of humoral and cell-mediated immune response. These diets are, however, associated with the risk of inadequate nutrition in infants with allergies to foods of vital importance. New approaches to the management of food allergy, such as for example immunotherapy for counteracting the hypersensitivity process and for potentiating the gut barrier mechanisms, are therefore needed. Diet remains an important element in this approach as sensitization to dietary antigens is frequently transient and is reversed to antigen-specific hyporesponsiveness. However, it represents an initial link in the development of more permanent sensitization to aeroallergens.