Avoiding Peanuts Increases Allergy Risk

Avoiding Peanuts Increases Peanut Allergy Risk

Peanut butter and jelly sandwiches on whole wheat, peanut butter crackers, apples and peanut butter – these are favorite snacks for kids, and healthy, too, thanks to the protein in peanut butter.

 

But due to the growing prevalence of peanut allergy, many day care centers, schools, and even airlines are outright banning peanut products.

 

And this isn’t just an issue in the U.S. Peanut allergy is increasing in other Western nations and Africa and Asia. So what’s a concerned parent to do?

 

“Early sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants”

 

A recent study published in the New England Journal of Medicine by researchers at King’s College, London, found that introducing peanuts into the diets of infants who had a high risk of developing peanut allergy led to an 81% reduction in later development of the allergy. The study was conducted in conjunction with the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH).

 

Researchers studied 640 infants, between four and 11 months old, who had been diagnosed with severe eczema, egg allergy, or both. The infants were given a skin-prick test to determine whether they were already allergic to peanuts and split into two groups based on the results. 530 children had a negative response, and 98 children had mild-to-moderate reactions, signifying a developing allergy.

 

Half of each group – the negative skin-prick group and the reactive group – was then instructed to avoid peanuts. The other half was instructed to consume 6 grams of peanut protein, in three or more meals per week, in the form of peanut butter or a puffed peanut-flavored snack called Bamba.

 

When the children reached 5 years of age, in the larger, negative skin-prick group, 13.7% of those who avoided peanut protein developed the allergy compared to just 1.9% of those who consumed peanut products. In the smaller group, 35.3% of those who avoided peanut protein developed the allergy compared to just 10.6 of those who consumed peanut products.

 

The researchers then assessed peanut allergy in the 5 year olds with a supervised, oral food test with a peanut. Results showed an 81% reduction of peanut allergy in children who consumed peanuts continuously from an early age compared to children who avoided peanut products.

 

The authors wrote that while “clinical practice guidelines from the United Kingdom in 1998 and from the United States in 2000 recommended the exclusion of allergenic foods fro the diets of infants at high risk for allergy,” the study shows that “early sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants” and “raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy.”

 

The Bottom Line

It seems like more kids have food allergies ever before. The authors of this study note that the prevalence of peanut allergy has doubled over the past 10 years, and another study estimates that more than a third of children in the U.S. are food sensitized.

 

Part of the reason may be due to early years in life when the gut is determining who is friend and foe. If the microbial balance gets perturbed early on, that can cause problems later in life, including allergies and asthma. And a more recent study showed that infants who have less microbiota variety in their gut at three months may be at greater risk of sensitization to foods such as peanuts, milk, or egg by age one.

 

This study has important implications for how we treat allergies. Does this mean we should simply start exposing ourselves and others to known allergens? Of course not – that would be dangerous! But by staying informed about the latest research, it allows us to approach our doctors and ask about the potential benefits of allergen immunotherapy or exposure therapy, especially if they haven’t been brought up before.

 

It also argues for adopting dietary and lifestyle practices that promote bacterial richness in children while they are young, from breastfeeding as infants and getting good bacteria from mom, to bringing a pet dog into the household.

 

Childhood may not be completely free of worries, especially for parents, but we can sure try to cut down on a few!

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