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BETHESDA, Md. — Peanuts are one of the top food allergies among children. However, new research is now shedding light on how to change that. Researchers say feeding children peanut products regularly from infancy until the age of five effectively reduces the rate of peanut allergies during adolescence by a staggering 71%. This was the case even when the children ate or avoided peanut products for several years.
“Today’s findings should reinforce parents’ and caregivers’ confidence that feeding their young children peanut products beginning in infancy according to established guidelines can provide lasting protection from peanut allergy,” says National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) Director Jeanne Marrazzo, M.D., M.P.H, in a media release. “If widely implemented, this safe, simple strategy could prevent tens of thousands of cases of peanut allergy among the 3.6 million children born in the United States each year.”
The findings published in the journal NEJM Evidence come from the LEAP-Trio study, which expands on the results of the Learning Early About Peanut Allergy (LEAP) clinical trial and the subsequent LEAP-On study, which are both sponsored and co-funded by NIAID. During the LEAP trial, half of the participants regularly consumed peanut products from infancy until age five, while the other half avoided peanuts during that timeframe.
Interestingly, the team found that early introduction of peanut products reduced the risk of peanut allergy at age five by a whopping 81%. Children who participated in LEAP-On were asked to avoid eating peanut products from ages five to six. Researchers found that most children from the original peanut-consumption group still had protection from the allergy at age six.
How did researchers make this discovery?
This LEAP-Trio study was designed to test whether the protection gained from early consumption of peanut products could stretch all the way until adolescence. This also factored in whether the children could choose to eat peanuts whenever they wanted. Kids who were already allergic to peanuts at six years-old were advised to keep avoiding them.
The study included 508 out of the 640 original LEAP trial participants, so almost 80% participated. On average, they were 13 years-old at the time of enrollment. The trial was split almost perfectly even, with 255 participants in the LEAP peanut-consumption group and 253 in the LEAP peanut-avoidance group.
To conduct the assessments, researchers used an oral food challenge. It involved giving participants a slowly increasing amount of peanuts in a controlled environment, with researchers observing if the teens could safely consume at least five grams of peanuts — the equivalent of over 20 peanuts. The team also surveyed participants about their recent peanut-eating habits. Additionally, they verified these self-reports through measurements of peanut dust from the participants’ beds, which is a technique previously validated by LEAP investigators.
The team found that 38 of 246 (15.4%) participants from the early childhood peanut-avoidance group and 11 of 251 (4.4%) had a peanut allergy at age 12 or older. These findings show that consistent consumption and early introduction to peanuts can reduce the risk of peanut allergies in the adolescent years.
Further, the researchers found that although participants in the LEAP peanut-consumption group ate more peanut products throughout childhood than the other participants as a whole, the frequency and amount of peanuts consumed varied greatly in both groups and included periods of not eating peanut products at all. This sheds light on how early peanut consumption can confer such benefits without needing to actually eat peanuts on a regular basis.
A dietitian's take
As a dietitian, I have followed this area of research for some time now. Pinpointing the reason behind the development of food allergies is quite the task, and as such, there's still a lot that's left to be learned. Many people grow up with food allergies that they then outgrow by adolescence or adulthood. However, there are adults who develop a new allergy to something they've eaten all their lives on a random day.
The exact underlying reasons remain unknown. Shellfish is a common new-onset food allergy in adulthood, and sometimes, kids can develop nut allergies at ages four or five without having experienced any negative symptoms from eating them before then. There are lots of nuances to food allergies and also areas of knowledge yet to be discovered. However, there is pretty consistent evidence showing that early introduction to peanuts can help increase the chances of not having an allergy as an adult. More and more pediatric health guidelines are leaning toward adopting this practice because of it.
