Human & Veterinary
Medicine

Adverse reactions to food represent a growing public health concern worldwide, encompassing a heterogeneous spectrum of conditions ranging from non- immune-mediated food intolerances to potentially life-threatening IgE-mediated allergic responses. This review provides a comprehensive and mechanistically oriented analysis of the principal categories of food intolerance including lactose intolerance, fructose malabsorption, and non-celiac gluten sensitivity alongside the immunological pathways underpinning celiac disease and IgE-mediated food allergies. Particular attention is given to the biochemical basis of allergenicity, the role of food processing in modifying allergenic potential, and the clinical spectrum from localized oral allergy syndrome to systemic anaphylaxis. The review also examines the epidemiology of the major regulated allergens under EU Regulation (EU) No 1169/2011, summarizes current diagnostic approaches including skin prick testing, specific IgE assays, and double-blind placebo-controlled food challenges (DBPCFC), and discusses emerging immunotherapeutic strategies such as oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT). Finally, the review addresses the practical implications of cross-reactivity phenomena, including latex-fruit syndrome and pollen-food allergy syndrome, for clinical management and dietary counselling.

Exercise induces a coordinated neuroendocrine response that is essential for maintaining homeostasis and supporting adaptation in humans. This mini-review examines the role of the hypothalamic-pituitary-adrenal (HPA) axis and cortisol in the response to exercise stress, with particular emphasis on the non-linear relationship between training load, endocrine responses, recovery, and performance. Cortisol promotes metabolic substrate availability during exercise and contributes to short-term physiological adaptation, but excessive or insufficiently recovered training may alter HPA-axis responsiveness and contribute to maladaptive outcomes. Evidence indicates that acute cortisol responses are strongly dependent on exercise intensity and duration, with responses becoming more pronounced above approximately 60% of maximal oxygen uptake (VO₂max). However, greater endocrine stress does not necessarily translate into greater adaptation, as moderate training doses may provide a more favorable balance between physiological challenge and recovery. Repeated training also modifies HPA-axis behavior, with trained individuals showing altered cortisol responses to standardized exercise and other stressors. Particular attention is given to the distinction between functional overreaching, non-functional overreaching, and overtraining syndrome. Current evidence suggests that resting cortisol concentrations alone have limited diagnostic value because of substantial biological and contextual variability. Dynamic responses to standardized exercise or endocrine stimulation may provide more informative indicators of altered HPA-axis function, although these responses remain heterogeneous. Overall, cortisol should be interpreted as a component of a broader physiological framework rather than as an isolated biomarker of training status or overtraining.