*May 28, 2024*
A recent study sponsored and co-funded by the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) has revealed that regularly feeding children peanut products from infancy to age 5 reduces the incidence of peanut allergy in adolescence by 71%, regardless of their peanut consumption habits in later childhood. These findings, published today in the journal *NEJM Evidence*, confirm that early introduction of allergens can lead to long-term allergy prevention.
"Today's findings should bolster parents’ and caregivers’ confidence that starting peanut products in infancy, following established guidelines, can offer lasting protection against peanut allergy," said NIAID Director Jeanne Marrazzo, M.D., M.P.H. "If widely adopted, this straightforward and safe approach could prevent tens of thousands of peanut allergy cases among the 3.6 million children born annually in the United States."
These results stem from the LEAP-Trio study, which builds on the foundational Learning Early About Peanut Allergy (LEAP) trial and the subsequent LEAP-On study, both also sponsored by NIAID.
In the LEAP trial, participants either regularly consumed peanut products from infancy until age 5 or avoided them entirely. This early introduction led to an 81% reduction in peanut allergy risk by age 5. The LEAP-On study then required participants to avoid peanuts from ages 5 to 6, revealing that the protective effect persisted even after a year of avoidance.
The LEAP-Trio study aimed to determine if this protection would last into adolescence under free-choice conditions. Children who were allergic to peanuts at age 6 continued to avoid them.
The study enrolled 508 of the original 640 LEAP participants—about 80%—with an average age of 13 at enrollment. This included 255 participants from the original peanut-consumption group and 253 from the peanut-avoidance group.
Researchers assessed peanut allergy in adolescents primarily through an oral food challenge, where participants consumed increasing amounts of peanut in a controlled environment to see if they could tolerate at least 5 grams (more than 20 peanuts). They also collected data on peanut consumption habits and verified these reports by measuring peanut dust in the participants' beds.
Findings showed that 15.4% of those in the early childhood peanut-avoidance group had a peanut allergy at age 12 or older, compared to only 4.4% from the early childhood peanut-consumption group. These figures translate to 38 out of 246 participants in the avoidance group and 11 out of 251 in the consumption group, indicating a 71% reduction in peanut allergy risk for those who consumed peanuts early in life.
Interestingly, the study also found that while the peanut-consumption group generally ate more peanuts throughout childhood, the frequency and amount varied widely, including periods of avoidance. This variation suggests that the early protective effect of peanut consumption can last even without consistent peanut intake through childhood and early adolescence.
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