Early peanut exposure reduces allergy risk by 71%

Peanut allergies affect millions of people across the globe, with symptoms ranging from mild itching to, in the most severe cases, cardiac arrest. As a result of this, researchers have been working on potential preventative measures and cures, with varying levels of success. But new research suggests that early exposure to peanuts could be the key to prevention.

Does early exposure to peanuts reduce allergy risk?​

A recent study, carried out by King’s College London, has shown that the early introduction of peanuts into an infants’ diet could significantly reduce the likelihood of developing a peanut allergy in adolescence.

The long-term LEAP Trio Trial confirmed the hypothesis that early and regular peanut consumption lowers the risk of developing an allergy, when compared with avoidance. Furthermore, the study found that feeding children peanuts regularly from as young as four months, up to the age of five years, reduces the rate of peanut allergy in adolescence by 71%, even if the child then avoided eating peanuts after that period.

The new findings provide strong evidence to suggest that introducing peanuts into babies’ diets early will achieve long-term prevention of a peanut allergy.

“Decades of advice to avoid peanuts has made parents fearful of introducing peanuts at an early age,” explains Professor Gideon Lack from King’s College London. “The evidence is clear that the early introduction of peanuts in infancy induces long-term tolerance and protects children from allergies well into adolescence. This simple intervention will make a remarkable difference to future generations and see peanut allergies plummet.”

How was the peanut-allergy exposure study conducted?​

Published in the NEJM Evidence, the LEAP-Trio study builds on the results of the Learning Early About Peanut Allergy (LEAP) clinical trial. In the previous trial, half of the participants were asked to regularly consume peanuts from infancy until the age of five, while the other half were asked to avoid peanuts during that period. Researchers found that early introduction of peanuts reduced the risk of peanut allergy at age five by 81%.

The research team then followed both groups from the age of six to the age of 12. During that period, children could choose to eat peanuts in whatever amount and frequency they wanted.

Results showed that 15.4% of participants from the early childhood peanut-avoidance group had developed a peanut allergy by the age of 12. However, just 4.4% of participants from the early childhood peanut-consumption group had developed a peanut allergy by the age of 12. This indicates that regular, early peanut consumption reduces the risk of developing a peanut allergy in adolescence by 71% compared to early peanut avoidance.

“This is a safe and highly effective intervention which can be implemented as early as four months of age,” says Professor George Du Toit, co-lead investigator from King’s College London. “The infant needs to be developmentally ready to start weaning and peanuts should be introduced as a soft pureed paste or as peanut puffs.”

Additionally, while participants in the peanut-consumption group ate more peanuts than the other participants, the frequency and number of peanuts consumed varied widely, and included periods of not eating them at all. This shows that the protective effect of early peanut consumption lasts into adulthood, without the need to consistently eat them.

“Early consumption of peanuts will prevent more than 100,000 new cases of peanut allergy every year worldwide,” concludes Professor Lack.

Why finding a treatment for food allergies is so important​

Food allergies​ affect an estimated 2.5% of the world’s population. At the lower end of the spectrum, an allergic reaction can present mild symptoms to the sufferer, such as skin irritation or sneezing. However, at their most severe, a food-related allergic reaction can cause a threat to life through anaphylaxis, a whole-body response that can impair breathing, cause a dramatic drop in blood pressure and affect the heart rate. Anaphylaxis can come on within minutes of exposure to a trigger food.

“Allergic diseases, as a whole, including asthma, allergic rhinitis, skin allergies and food allergies make up one of the most common groups of chronic diseases in the EU. The prevalence of allergic disease has been growing in Europe for more than 50 years,” a spokesperson for the European Commission told FoodNavigator.

“Today, they affect over 150 million Europeans. Moreover, allergies are the most common non-communicable disease in children and represent the main cause of children's emergency visits and hospitalisations.”

Food-allergy numbers are on the rise​

The findings are significant, because according to the World Allergy Organization (WAO), the prevalence of food allergies has been increasing, leading to what is being termed the ‘second wave of the allergy epidemic’. The ‘first wave of the allergy epidemic’ referred to the dramatic rise in the numbers of asthma, allergic rhinitis and eczema sufferers.

“It is a significant public health issue and a considerable financial burden on affected individuals who require ongoing medical care,” notes the WAO.

Source: Follow-up to Adolescence after Early Peanut Introduction for Allergy Prevention
Published online: 28 May 2024
DOI: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300311
Authors: George Du Toit, Michelle F. Huffaker, Suzana Radulovic, Mary Feeney et al.