Food-Dependent Exercise-Induced Anaphylaxis: A Comprehensive Review

Oct. 18, 2023 by Ava Green

Food-Dependent Exercise-Induced Anaphylaxis (FDEIA)

Food allergies are a common concern for many, but have you ever heard of an allergic reaction that only occurs when certain foods are combined with exercise?

This unique phenomenon is known as Food-Dependent Exercise-Induced Anaphylaxis (FDEIA). Let's delve into this intriguing topic and understand its implications for our health.

What is FDEIA?

FDEIA is a distinct form of food allergy where symptoms arise during or after exercise, but only if specific trigger foods have been consumed beforehand. The most severe manifestation of this condition is anaphylaxis, a potentially life-threatening allergic reaction. What's fascinating about FDEIA is that patients can exercise or consume specific foods separately without any allergic reactions. However, when combined, they can trigger severe symptoms.

How is it Different from Other Allergies?

FDEIA is unique because it requires the combination of food intake and physical exertion to trigger an allergic reaction. This is different from typical exercise-induced or food-induced anaphylaxis. The exact relationship between the timing of food intake, type of exercise, and other factors like alcohol or nonsteroidal anti-inflammatory drugs (NSAIDs) is still being studied.

How is FDEIA Diagnosed?

Diagnosing FDEIA can be challenging. It primarily relies on the patient's history and provocation testing, which must be rigorously conducted in a supervised hospital environment. Positive symptoms and clinical signs during testing confirm FDEIA. However, negative outcomes do not necessarily rule out its presence.

What Triggers FDEIA?

Exercise is the primary trigger for FDEIA, followed by NSAIDs and alcohol. The intensity and duration of exercise, ranging from vigorous workouts to routine activities, can provoke FDEIA symptoms. Interestingly, there have been documented cases of anaphylaxis occurring at rest, adding complexity to the FDEIA phenomenon.

Management and Treatment

The immediate treatment for acute allergic reactions or anaphylaxis is crucial, with epinephrine being the primary medication. Patients diagnosed with FDEIA should always have access to self-injectable adrenaline and be educated on anaphylaxis action plans. They should also be advised to avoid the implicated food 4-6 hours before and 1-4 hours after exercise or intake of other cofactors like NSAIDs and alcohol.


FDEIA is a unique and complex clinical phenomenon that requires a comprehensive understanding for accurate diagnosis and effective management. While research continues to unravel its intricacies, it's essential for individuals to be aware of this condition, especially if they have a history of food allergies and experience unusual symptoms after exercising.

Source: MDPI