Abstract

Background: Food hypersensitivity is frequently associated with gastrointestinal and systemic manifestations. This study aimed to evaluate the clinical, nutritional, biochemical, lifestyle characteristics, and stress levels of Lebanese adults with food hypersensitivity (cases) (n = 378) compared with controls (n = 397) (absence of food hypersensitivity). Methods: A case–control study was conducted among 775 Lebanese adults, including participants with self-reported food allergies and/or food intolerance and controls. Sociodemographic, clinical, and lifestyle data were collected. Dietary intake was assessed using validated dietary assessment tools. Biochemical parameters (n = 775), stool analyses (n = 297), and fecal calprotectin were evaluated. Results: Overall, 378 participants (48.8%) were classified as having food hypersensitivity. Dermatological, nasal, respiratory, and gastrointestinal symptoms were significantly more frequent among cases than controls (p < 0.05). Autoimmune diseases were more prevalent among cases. Daily energy and nutrient intake differed significantly between groups, with cases generally reporting lower intakes than controls. Cases exhibited substantially lower serum vitamin D, vitamin B12, and hematocrit levels. In binary logistic regression models, significant correlations were observed alongside key antioxidant and immunomodulatory micronutrients: vitamin C (OR = 0.604; 95% CI: 0.390–0.937), dietary vitamin D (OR = 0.079; 95% CI: 0.011–0.565), vitamin E (OR = 0.085; 95% CI: 0.013–0.568), and iron (OR = 0.025; 95% CI: 0.002–0.291). Conclusions: Biochemical and nutritional differences were observed despite generally adequate dietary intake. Reduced intakes of essential micronutrients, including antioxidant vitamins (vitamins C and E), vitamin D, and the essential mineral iron, emerged as primary independent predictors of food hypersensitivity. These findings highlight the core role of localized intestinal inflammation, specific dietary avoidance behaviors, and systemic immune modulation.

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