Food hypersensitivity (FHS) is the umbrella term used for food allergies that involve the immune system and food intolerances that do not involve the immune system. FHS has a huge impact on quality of life and any dietary advice given should aim to minimise this effect. Despite many advances made in diagnosing and managing patients with FHS, the cornerstone of management still remains avoidance of the relevant food. However, a commonly-presenting dilemma in clinical practice is deciding to what extent the food(s) should be avoided. The level of avoidance required is currently based on the type of FHS the patient has, characteristics of the particular food protein and the natural history of the particular FHS. In addition to management of other FHS, management of cow's milk allergy requires the healthcare professional to choose the appropriate formula. Information required by the patient also includes understanding food labels and issues surrounding cross-contamination. In order to ensure that the diet is nutritionally sound, advice should be given about suitable food choices and following a healthy balanced diet, whilst taking into account the dietary restrictions. Practical issues that need to be addressed include going on holiday, travelling and eating away from home. The dietitian plays a crucial role in this process. At present, there are no standardised documents or protocols for the management of FHS and practices differ within and between countries. If adrenaline auto-injectors are prescribed, correct administration should be demonstrated and reviewed on an ongoing basis.

Testing for food allergy/intolerance is a rapidly expanding market. We present an exploration of the efforts of one of the market leading companies in this sector to promote and justify their product in the face of considerable opposition from conventional medicine, as well as a range of alliances with patient groups, so-called ‘lifestyle gurus’ and their customers. In extracting the latent value of an immunoglobin called IgG, testing companies engage with and extend entrepreneurial patienthood and new forms of pastoral expertise in their efforts to identify and manage a group of low-level chronic conditions that resonate with contemporary social unease about the hazards of modernity. Rather than foregrounding novelty and hope, we found that a great deal of emphasis was placed upon establishing conventionality with business practice and scientific method, and relief from the past. We also found that the local circuits and networks of engagement, in which the company operated to secure their reputation and extend their market, were vitally important. We end by reflecting upon the implications of our analysis for contemporary scholarship on biocapitalism.

The diversity of the human genome leads to many functional differences between individuals. The present review focuses on genetic variations, both rare and common, that are of relevance to digestion of the sugars and starches that form a major part of human diets, and considers these in relation to the evolution of our species. For example, intolerances of dietary saccharides are not usually life-threatening because symptoms can be avoided by removal of the offending sugar from the diet, and deficiencies of the relevant enzymes are in some cases found at relatively high frequencies in certain populations. This is of evolutionary interest in relation to changes in the human diet, and the lactase-persistence polymorphism, in particular, provides an interesting model. More of the world's adult population are lactase-deficient than have high lactase. The other deficiencies are however much more rare, but the significance of variant alleles at these loci, and also heterozygosity for deficiency alleles, to human nutrition and health is an area that is relatively unexplored.