Peanut allergy prevention strategy does not impact growth or nutrition

Published Online: June 10, 2016

The primary results of the LEAP trial, published in 2015 showed that consumption of peanut from infancy led to an 81 percent relative reduction in subsequent development of the allergy compared to avoiding peanut altogether. Although an effective strategy for the prevention of peanut allergy in high-risk infants, regular peanut consumption from infancy and throughout early childhood could have unexpected consequences for growth and nutrition.

In a recent paper published in The Journal of Allergy and Clinical Immunology (JACI) Feeney and colleagues report secondary results from the LEAP Study.

The original LEAP trial randomly assigned 640 infants aged 4 to 11 months to regularly consume at least 6g peanut protein per week or to avoid peanut until 5 years of age. In this publication, the researchers report on the feasibility of regular consumption of peanut products from infancy and whether this dietary intervention would have any adverse effects on infant and child growth and nutrition. Adherence to peanut consumption or avoidance advice was assessed by dietary questionnaires; nutritional intake assessed from three day prospective food diaries and growth evaluated from anthropometric measurements (weight, height, body mass index, waist circumference and skinfold thickness) recorded at regular clinic visits.

The study found that peanut consumers easily achieved the recommended weekly peanut intake, consuming 7.5 grams weekly on average. Importantly, the introduction of peanut in breast-feeding infants did not affect the duration of breast-feeding. They did not observe any differences for measures of infant and child growth between the peanut consumers and avoiders at any point during the study, even when comparing the subgroup of children with the highest peanut intakes with those who avoided peanut. There were no differences in energy (calorie) and protein intakes, although consumers had higher fat intakes and avoiders had higher carbohydrate intakes; these differences were greatest for the subgroup of children with the highest peanut intakes. Sodium (salt) intakes were above recommended intakes in both groups, there were no differences between intakes for consumers compared to avoiders. There were also no differences for intakes of micronutrients such as calcium, iron, zinc and vitamin D. The children in the consumption group made some different food choices to the avoiders. Peanut products appeared to be eaten instead of foods such as crisps and savoury snacks, high fibre bread, fruit juice & smoothies and spreads.

Introduction of peanut proved feasible in infants at high risk of peanut allergy and did not affect the duration of breast-feeding nor impact negatively on growth or nutrition. Energy balance was achieved in both groups through variations in intakes from fat and carbohydrate while protein homeostasis was maintained.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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