Encouraging infant peanut consumption slashes allergy risk in Australian guideline investigation

01 Mar 2021 --- Allergy guidelines encouraging infant peanut consumption may have reduced the risk of infant peanut allergies by up to 16 percent in Australia, according to a study by Murdoch Children’s Research Institute (MCRI), Australia.

Dietary guidelines for parents in Australia were adjusted in 2016 to suggest that feeding infants peanuts at an early stage of life, before the age of 12 months, could help cultivate defense against peanut allergy development. 

This advice was issued following a range of randomized control trials conducted over 20 years. 

The latest MCRI findings, now published in the Journal of Allergy and Clinical Immunology, are the first to examine this advice’s impact and efficacy in family homes, say the study authors. 

Peanut allergy is one of the most common allergies worldwide, with a prevalence of up to one in 200 people in some countries.Avoidance not the answer  
Lead author of the study Victoria Soriano says further research was necessary to establish infant nutrition advice properly. 

“In the 1990s, some guidelines recommended avoiding allergenic foods until age one to three years, and avoidance of these foods in infancy became widespread,” she explains. 

By 2008, this advice started to be removed, Soriano continues. This was based on increasing evidence that delaying allergenic foods was associated with an increased food allergy risk.

“However, evidence was still insufficient for specific recommendations for what age these foods should be introduced.”

Two study comparison 
Soriano and her colleagues at MCRI compared data from the 1,933 infants enrolled in the 2018 to 2019 EarlyNuts study with the 5,276 infants recruited in the 2007 to 2011 HealthNuts study. 

The HealthNuts study laid the ground for the 2016 Australian infant feeding guidelines by showing that few infants were consuming peanuts within their first year of life despite high levels of infant allergy. 

The EarlyNuts study was then launched using an identical sampling method, analyzing a cross-section of infants in Melbourne, Australia, for dietary behavior differences. 

Around 3 percent of Australian children are allergic to peanuts.The initial findings, taken from the first 860 participants, showed a striking increase in peanut consumption among infants. The researchers highlight a three-fold increase in peanut introduction by age one in 2018, compared to the trend within timespan between 2007 to 2011.

The MCRI has now compared the differences in allergy rates between all 1,933 infants in the EarlyNuts study with those of the HealthNuts study ten years earlier. 

Direct standardization and marginal effects models were used to compare prevalence between the two cohorts. 

Findings were also adjusted for known risk factors for food allergies, such as parents’ country of birth, family history of allergy, dog ownership and number of siblings.

The adjusted peanut allergy prevalence from 2018 to 2019 was 2.6 percent compared to 3.1 percent from 2007 to 2011. This represents a 16 percent decrease overall. 

A lack of control over participants’ diets, however, makes the findings tentative, and the researchers are calling for further investigations. 

Peanut allergies still high 
Jennifer Koplin, a researcher on the study at MCRI, says that despite the decrease in peanut allergies, its prevalence continues to be high. 

Australia has the highest reported rates of childhood food allergy globally, with about 10 percent of infants and 5 percent of children under the age of five being allergic. 

“The safety of early peanut introduction at home is of significant interest to parents as well as health professionals around the world,” Koplin remarks. 

“More research must be done to look closer at these trends to help us understand how well early introduction to peanut works to prevent peanut allergies in real-life situations.”

Edited

By Louis Gore-Langton