Fig. 1

Layers and multiplication factors relating to risk in severe food allergy: 1. Dose of antigen, which can be altered by concealment factors, 2. Age—most deaths from food allergy are in the young, but older patients tend to have more severe reactions with nut allergy, 3. Timely effective treatment, 4. Co-existent allergic burden, and 5. Metabolic/Pharmacologic factors including: capacity to catabolize allergic mediators, exercise, illness, ethanol and medications.