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Consuming peanuts (instead of avoiding) reduces peanut allergy

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The study

Some 640 infants participated in the trial, starting from an age of four to 11 months, and followed up until the age of five. All of the infants suffered from egg allergy, severe eczema, or both.

Initial skin prick tests to peanut protein were done to create two groups of patients - one group with children who showed signs of mild sensitivity (by the development of small wheals) to peanut protein, and one group that showed no sensitivity. Children who suffered significant allergic reactions (large wheals) were excluded.

Participants in each group were randomly allocated into one of two groups. One group consumed peanuts, and the other group avoided them.

The group that consumed peanuts did so in the form of six grams of peanut protein per week incorporated into their meals until they were five years old. The other group avoided peanuts until the same age.

The presence of peanut allergy at the age of five was determined using immune markers (such as peanut specific IgE) and wheal size following a food challenge.

Main findings

Out of the 542 children who had a negative skin-prick test initially, 1.9% who consumed peanuts were found to be allergic to them (at the age of five), compared to 13.7% of the group that avoided peanuts.

Out of the 98 children who had a positive skin-prick test initially, 10.6% who consumed peanuts were found to be allergic to them (at the age of five) compared to 35.3% of the group which avoided peanuts.

What this means for GPs

GPs should be aware that in children with atopic tendencies, consuming peanuts consistently from a young age (four to 11 months) is associated with a significantly reduced risk of developing a peanut allergy.

We should be judicious in our approach when advising parents about the risks, benefits and associations of peanut consumption, and mindful of the potential benefit demonstrated by this research.

The paper

NEJM (New England Journal of Medicine) 2015

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Readers' comments (2)

  • Most of eastern Africa could have told you this a 100 years ago. Babies in countries such as Tanzania are weaned on peanut paste. Peanut allergy is unheard of in Tanzania.

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  • There is a consensus statement about this study that has just been released by the WAO and American Association Of Allergists about risk assessment and when to consider referral to an allergist for assessment before introduction of peanuts this might be better covered in a longer article by one of the members of the LEAP study and a primary care member of the BSACI allergy group for more practical advice of what to do in general practice .We have offered to do this.

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