Graham RobertsDoctors in Southampton are part of a team of researchers who have found that introducing peanut into an infant's diet within the first 11 months of life can prevent peanut allergy in those at high risk.
The Learning Early About Peanut Allergy (LEAP) study, led by Professor Gideon Lack of King’s College London, is the first to show consumption is an effective strategy to prevent food allergy.
Peanut allergy, which affects one in 50 school age children in the UK, has more than doubled in the UK and North America over the past 10 years and is one of the most common food allergies.
It develops early in life and can cause a severe and potentially life-threatening allergic reaction in sufferers which is known as anaphylaxis. The allergy is rarely outgrown and there is currently no cure.
The LEAP study enrolled 640 children aged four to 11 months who were considered at high risk of developing peanut allergy due to pre-existing severe eczema and/or egg allergy, with half asked to eat peanut-containing foods three or more times a week and the other half to avoid eating peanut until five years of age.
The results, published in the New England Journal of Medicine, showed less than 1% of children who consumed peanut and completed the study developed peanut allergy by five years of age compared to 17.3% in the avoidance group.
The overall prevalence of allergy in all children asked to consume peanut – including those participants who were unable to tolerate peanut consumption – was 3.2% versus 17.2% in the avoidance group, which represents a reduction of more than 80% in the prevalence of peanut allergy.
Professor Graham Roberts, a consultant in paediatric allergy and respiratory medicine at Southampton Children’s Hospital and part of the research team, said: “For many years, guidelines and paediatricians have recommended that infants avoid peanut.
“However, this study shows that early, sustained consumption of peanut is safe and results in a substantial and significant reduction in the development of peanut allergy in high-risk infants by five years of age.
“As a result, this questions whether children should be deliberately avoiding peanut in the first year of life to prevent allergy.”
Prof Lack, head of the department of paediatric allergy at King’s College, presented the findings at the American Academy of Allergy, Asthma and Immunology meeting (AAAAI).
He said: “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.”
However, as the study excluded infants showing early strong signs of having already developed peanut allergy, Prof Lack said 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, paediatrician, or their GP prior to feeding them peanut products,” he added.
Dr George Du Toit, co-investigator of the study, said: “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. The LEAP-On study will help establish if the protection provided against the development of peanut allergy is sustained and not dependent on ongoing peanut ingestion.”
Prof Roberts, who is also a professor of allergy and respiratory medicine at the University of Southampton, is currently co-leading the European-wide Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM) research project which, locally, will discover how children born in Hampshire develop food allergies and asthma.
Posted on Tuesday 24 February 2015