Early peanut exposure may prevent allergy in high-risk children

Date: Feb-24-2015A new study involving over 600 children suggests if babies start eating

peanut products regularly and frequently before the age of 11 months, there is a

very good chance that those at high risk of peanut allergy will not develop

it.

Families with children who have peanut allergy have to be constantly vigilant about their food.

The new study - the first trial to show that consumption of a food is an

effective strategy to prevent allergy to it - appears to contradict the idea that

children should avoid eating peanuts so they do not develop peanut allergy.

The rate of food allergy has climbed steadily in recent decades. Peanut allergy

affects 1-3% of children in the US, Western Europe and Australia, and evidence has

emerged that it is also beginning to affect children in Asia and Africa.

Allergy to peanuts develops early in life. Once it develops, it is rarely

outgrown and there is no cure. Those most at risk are children with a family history

of peanut allergy, who have eczema or are allergic to eggs.

A severe reaction to peanuts is a potentially fatal condition called anaphylaxic

shock. The continual threat of this places a heavy burden on the sufferers and their

families, who have to be constantly vigilant about the food their children are

eating at home and elsewhere.

Israeli children eat peanuts early in life and have lower rates of allergy

Now a clinical trial led by King's College London in the UK and supported by the

National Institute of Allergy and Infectious Diseases (NIAID), part of the National

Institutes of Health in the US, found that introducing ​peanut products into the

diets of infants at high risk of developing peanut allergy was safe and resulted in

an over 80% percent reduction in the subsequent development of the allergy.

A report on the findings was presented at the annual meeting of the American

Academy of Allergy, Asthma and Immunology in Houston, TX, on Monday and is published

in the New England Journal of Medicine.

Trial leader Gideon Lack, a professor and head of the Department of Paediatric

Allergy at King's College London, and colleagues decided to carry out the study -

called Learning Early About Peanut Allergy (LEAP) - after observing that Jewish

children brought up in Israel have lower rates of peanut allergy than Jewish

children of similar ancestry brought up in the UK.

Unlike children in the UK, children in Israel are frequently fed peanut-containing products early in life.

The purpose of the LEAP trial was to test the idea that the very low rates of

peanut allergy in Israeli children may be due to the fact they start eating peanut

products in high quantities early in life.

LEAP is a randomized controlled trial that enrolled 640 babies aged 4-11 months

and their families through a London hospital. The children were assessed as having a

high risk of developing peanut allergy because they either had eczema or egg

allergy.

Trial results show over 80% reduction in the rate of peanut allergy

For the trial, the babies were randomly assigned to one of two groups. In one

group, the families of the babies were asked to give their infants peanut-containing

products three times a week or more. The other group was asked to avoid giving their

babies peanut-containing foods until they were 5 years old.

The researchers checked how well the families followed these requests via

questionnaires and also by testing peanut levels in their homes.

Ninety-eight percent of the children completed the study and were assessed at age 5.

The results show that less than 1% of the children who were given peanut

products and who completed the study in line with the protocol, developed peanut

allergy by the age of 5, compared with 17.3% of those who avoided peanut products in

that time.

Even if you count all the children enrolled on the study - including the 13 of

the 319 randomized to eat peanuts but who could not tolerate it from the start - the

analysis shows there appears to be a powerful protective effect from introducing peanut consumption early in life.

The overall rate of allergy in the children who were given peanut products

was 3.2% compared with 17.2% in the avoidance group. This translates to an over 80%

reduction in the rate of peanut allergy.

The researchers note that in the peanut group, early introduction of the food was

well tolerated and safe.

Importantly, the children were not given whole peanuts - because of the risk of

choking - they were given a baked snack containing 50% peanuts and fortified with

vitamins and iron that is popular in Israel.

The authors conclude that:

"The early introduction of peanuts significantly decreased the frequency of the

development of peanut allergy among children at high risk for this allergy and

modulated immune responses to peanuts."

Results question the idea that food should be avoided early in life to prevent

allergy

For many years, public health guidelines and the advice of pediatricians and

allergy experts was we should avoid giving babies products like peanuts that might

trigger allergies.

Prof. Lack says:

"This is an important clinical development and contravenes previous

guidelines. Whilst these were withdrawn in 2008 in the UK and US, our study suggests

that new guidelines may be needed to reduce the rate of peanut allergy in our

children."

He also notes that the study did not include babies showing early strong signs of

peanut allergy so they cannot say whether early peanut consumption would be a safe or

effective allergy-prevention strategy in this group. He advises:

"Parents of infants and young children with eczema and/or egg allergy

should consult with an Allergist, Paediatrician, or their General Practitioner prior

to feeding them peanut products."

The researchers are continuing with the trial. One of the questions the further

investigation is exploring is whether the protection against peanut allergy is

sustained or whether it depends on continuing to consume peanuts, as co-investigator

and first author of the study, Dr. George Du Toit explains:

"The next stage of our work, the LEAP-On study, will continue to monitor those

children who consumed peanut to see if they remain protected against allergy even if

they stop consuming peanut for 12 months."

Dr. Du Toit is consultant in Paediatric Allergy at Guy's and St. Thomas' NHS

Foundation Trust and honorary senior lecturer at King's College London.

Meanwhile, Medical News Today recently learned of a study that suggests

dishwashers may make children more prone to

allergies. In the journal Pediatrics, researchers report the

preliminary findings of an observational study where they found families who wash

their dishes by hand, rather than in a dishwasher, have children with fewer

allergies.

Written by Catharine Paddock PhD

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.