Peanut allergy is on the rise and that has led to a lot of confusion about our children and introducing peanut butter. Now a new study shows that the majority of infants at high-risk of developing peanut allergy are protected from peanut allergy at age 5 years if they DO eat peanut frequently! The results suggest starting within the first 11 months of life.
For many years Public Health Guidelines have recommended avoiding foods in infant's diet that cause allergies such as peanut.
The Learning Early About Peanut Allergy study published today in the New England Journal of Medicine is the first study to show that consumption is an effective strategy to prevent food allergy!
Did you know that the incidence of food allergy is rising? 1.52 per cent of children in Canada have this allergy and peanut allergy more than doubled North America. We now know between 1-3 per centof children in Western Europe, the U.S., and Australia are impacted. The allergy develops early in life and is rarely out-grown. Furthermore, there is currently no cure.
The LEAP study, a randomized controlled trial, enrolled 640 children aged 4-11 months from Evelina London Children's Hospital, who were considered at high-risk of developing peanut allergy due to pre-existing severe eczema and/or egg allergy.
The goal was to determine whether peanut consumption or avoidance is the most effective strategy to prevent peanut allergy. So half of the children were asked to eat peanut-containing foods three or more times each week and the other half to avoid eating peanut until 5 years of age.
Adherence to peanut consumption or avoidance advice was assessed using a food frequency questionnaire at regular intervals during the study and by measuring peanut levels in the child's home environment.
The results showed less than 1 per cent of those consuming peanut developed peanut allergy by 5 years of age but 17.3 per cent in avoidance group developed peanut allergy. Overall there was a 80 per cent reduction of peanut allergy
Even when considering all children enrolled - including those participants who were unable to tolerate peanut consumption (13 of the 319 children who were randomised to peanut consumption had some allergic responses to peanut during the study) - a powerful protective effect against the development of peanut allergy remains: the overall prevalence of allergy in all children asked to consume peanut was 3.2 per cent versus 17.2 per cent in the avoidance group.
This represents a greater than 80 per cent reduction in the prevalence of peanut allergy. Nearly all participants enrolled on the LEAP study completed the final assessment at age 5 years (98 per cent).
Importantly, the early introduction of peanut-containing foods was found to be safe and well tolerated; infants were not fed whole peanuts which carry a risk of choking in young children.
The study was therefore able to conclude that early, sustained consumption of peanut is safe and associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants by the age of five. Deliberate avoidance of peanut in the first year of life is consequently brought into question as a strategy to prevent allergy.
The study also excluded infants showing early strong signs of having already developed peanut allergy; the safety and effectiveness of early peanut consumption in this group remains unknown and requires further study. Parents of infants and young children with eczema and/or egg allergy should consult with an allergist, pediatrician, or their general practitioner prior to feeding them peanut products, stated the authors.
