Background: Food allergies are a significant public health issue and the only effective management option currently available is strict avoidance of all foods containing the allergen. In view of the practical impossibility to limit risks to zero, quantitative allergen risk assessment and management strategies are needed. Objective: To develop appropriate methods for informing population-based risk assessments and risk management programs to benefit all stakeholders, but particularly food allergic individuals. Methods: Individual thresholds for food allergens (maximum tolerable doses and minimum eliciting doses) can ideally be established through double-blind, placebo-controlled food challenges (DBPCFCs). If DBPCFC data is not available, data from widely used “open” food challenges (OFCs) using pre-defined objective criteria can also provide useful data regarding minimum eliciting doses. For more than 20 years, the Netherlands Organisation for Applied Scientific Research (TNO) and The Food Allergy Research and Resource Program (FARRP) at the University of Nebraska-Lincoln have been
collecting individual maximum tolerable doses and minimum eliciting doses that produce objective symptoms from published and unpublished clinical data to better refine knowledge regarding the sensitivity of the population to food allergens. Results: In this paper we provide in depth insights into the methodology applied by TNO and FARRP to derive individual maximum tolerable doses and minimum eliciting doses for objective symptoms from clinical food challenge data. Over 90 examples for determining the individual allergic thresholds are presented. Conclusion: With the methodology presented in this paper, we aim to stimulate harmonization and transparency in quantitative food allergen risk assessment and risk management programs, encouraging their wider adoption.