Early Introduction to Peanuts May Prevent Allergy

An early introduction to peanuts may help prevent nut allergies among children, according to a new study published in The New England Journal of Medicine.

Peanut allergy prevalence has doubled in Western countries in the past decade, and peanuts are the leading cause of death from a food allergy, the researchers noted.

The researchers examined 640 babies who were considered at high risk for a nut allergy due to their severe eczema and/or egg allergies. The 4- to 11-month-old children were tested for peanut allergies using a skin-prick test and randomly assigned to either consume peanuts or avoid them until 5 years of age.

One of the most common peanut sources consumed among the peanut-eating children in this study was Bamba, which is made from peanut butter and puffed maize.

Among the 530 babies who tested negative for a peanut allergy, 13.7% of those in the peanut-avoidance group had a peanut allergy and only 1.9% of those who consumed peanuts had an allergy by 5 years of age. This means there was an 86.1% relative reduction in the prevalence of a peanut allergy, according to the researchers.

For the 98 babies who had initially tested positive for a peanut allergy, 35.3% of the avoidance group and 10.6% of the peanut consumption group had a peanut allergy by 5 years of age. These results translated to a 70% relative reduction in the prevalence of a peanut allergy, according to the study.

There were no deaths related to the study, and rates of hospitalization and serious adverse events did not differ between the peanut-eating and peanut-avoiding groups.

The researchers’ hypothesis that early consumption of peanuts may help prevent allergies was driven by their finding that Israeli children tended to have lower prevalence of nut allergies than Jewish children in the United Kingdom. They found that peanut-based foods were often introduced into Israeli infants’ diets around 7 months of age, whereas children in the United Kingdom typically did not eat peanuts until after their first birthday.

The American Academy of Pediatrics had in 2000 counseled that breast-feeding mothers should avoid eating peanuts, but in 2008, these recommendations were withdrawn, the researchers noted. However, the debate has been ongoing as to whether early exposure or avoidance would help prevent a nut allergy.

“Peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption, which raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy,” the researchers concluded.