New studies support early exposure for allergy avoidance

Proteins are an important part of anyone’s diet, and eggs and peanuts are a palatable option for children. Food allergies can make these choices scary for parents, but new research supports early introduction of these foods as a way to actually prevent the development of food allergies.

Results of research by investigators at King’s College of London and St. George’s University of London were split into multiple published studies in the Journal of Allergy and Clinical Immunology. The consensus of the studies was that, even though it’s not yet a popular method, early introduction to goods that cause allergies—including eggs and peanuts—is an effective way to prevent the development of food allergies.

The research was done as part of the Enquiring About Tolerance (EAT) study. The study investigated more than 1300 infants at three months old from England and Wales. The infants were placed into 2 groups—1 that was introduced to allergenic foods at 3 months of age along with breastfeeding, and the other was breastfed alone for 6 months with no introduction to allergenic foods. The team found that the group that was introduced to allergenic foods early fared best, with only 19.2% of children in that group later developing food allergies compared to 34.2% of the children who did not have early introduction to allergenic foods. The results were even more significant when the results were broken into specific foods groups. According to the studies, 33.3% of the infants who were not offered peanuts early developed peanut allergies while only 14.3% in the group that ate peanuts early developed allergies to them. For eggs, 48.7% of children who did not eat eggs early developed allergies compared to 20% of children who were fed eggs early.

One flaw of the research was the overall low adherence to the feeding plans, with only 42% of the groups that was introduced to allergens foods early completing the full protocol. Still, researchers say the results were significant enough to be used to transform feeding recommendations and make early allergen introduction a part of new nutrition and feeding guidelines.

Each paper published as a part of the research had a different focus. The main study¹ shared the results of early allergenic food introduction, and how effective this method was at preventing further development of food allergies—despite low adherence to protocols. The second report² published as a part of the project addressed challenges in adhering the study that led to low adherence. Some of these specific examples included the refusal of children to eat the foods that were offered and fear by caregivers that the foods would cause a reaction.

A third³ and final part of the report focused on other factors that led to non-adherence with the study protocol. One specific example found in the report was the finding that children from non-white families, those with older mothers, infants who had early feeding problems, and babies with early-onset eczema were among those who were among the least compliant with early allergenic food experiments.

Although the research was conducted in the United Kingdom, similar ideas are being echoed in the United States. Early exposure to allergenic foods is expected to be suggested in the national diet guidelines from the US departments of Agriculture and Human Services later this year.

Reference

1. Perkin M, Logan K, Bahnson H, et al. Efficacy of the enquiring about tolerance (EAT) study among infants at high risk of developing food allergy. Journal of Allergy and Clinical Immunology. 2019;144(6):1606-1614.e2. doi:10.1016/j.jaci.2019.06.045

2. Voorheis P, Bell S, Cornelsen L, et al. Challenges experienced with early introduction and sustained consumption of allergenic foods in the enquiring about tolerance (EAT) study: a qualitative analysis. Journal of Allergy and Clinical Immunology. 2019;144(6):1615-1623. doi:10.1016/j.jaci.2019.09.004

3. Perkin M, Bahnson H, Logan K, et al. Factors influencing adherence in a trial of early introduction of allergenic food. Journal of Allergy and Clinical Immunology. 2019;144(6):1595-1605. doi:10.1016/j.jaci.2019.06.046