Imperial College London study: Feeding babies egg and peanut may prevent food allergy, study suggests

25 Sep

More children seem to have peanut allergies. Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.

Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it…

One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand….

Kids With Food Allergies has some excellent resources.

Kate Wighton wrote in Feeding babies egg and peanut may prevent food allergy:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

In the research, which is the largest analysis of evidence on the effect of feeding allergenic foods to babies, scientists from Imperial College London analysed data from 146 studies. In total the studies involved more than 200,000 children.

The study, which was commissioned by the UK Food Standards Agency, also found feeding children peanut, between the ages of four and eleven months, may reduce risk of developing peanut allergy. In addition, the team analysed milk, fish (including shellfish), tree nuts (such as almonds) and wheat, but didn’t find enough evidence to show introducing these foods at a young age reduces allergy risk.

The research is published today in the Journal of the American Medical Association.

Although previous studies have found feeding children peanut and egg may reduce allergy risk, other studies have found no effect.

Dr Robert Boyle, lead author of the research from the Department of Medicine at Imperial, said: “This new analysis pools all existing data, and suggests introducing egg and peanut at an early age may prevent the development of egg and peanut allergy, the two most common childhood food allergies.

“Until now we have not been advising parents to give these foods to young babies, and have even advised parents to delay giving allergenic foods such as egg, peanut, fish and wheat to their infant.”

Allergies to foods, such as nuts, egg, milk or wheat, affect around one in 20 children in the UK. They are caused by the immune system malfunctioning and over-reacting to these harmless foods. This triggers symptoms such as rashes, swelling, vomiting and wheezing.

“The number of children diagnosed with food allergies is thought to be on the rise”, added Dr Vanessa Garcia-Larsen, a co-author on the study from the National Heart and Lung Institute at Imperial. “There are indications that food allergies in children have become much more common over the last 30 years.

The number of patients coming into our clinics has increased year-on-year, and allergy clinics across the country have seen the same pattern.”

She added that the reasons behind this rise are still unclear – doctors may be better at recognising food allergy, or there may be environmental factors involved.

In the new study, called a meta-analysis, the team initially analysed 16,289 research papers on allergies and other immune system problems. Out of these, 146 were used for data analysis of when to feed babies allergenic foods such as egg, peanut, wheat and fish.

The results showed that children who started eating egg between the ages of four and six months had a 40 per cent reduced risk of egg allergy compared to children who tried egg later in life.

Children who ate peanut between the ages of four and eleven months had a 70 per cent reduced peanut allergy risk compared to children who ate the food at a later stage. However, the authors cautioned that these percentages are estimates based on a small number of studies……                                                         


Feeding babies egg and peanut may prevent food allergy, study suggests

Date:        September 20, 2016

Source:    Imperial College London


Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

Journal Reference:

  1. Despo Ierodiakonou et al. Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune DiseaseA Systematic Review and Meta-analysis. JAMA, 2016 DOI: 10.1001/jama.2016.12623

Here is the citation from the Journal of the American Medical Association:

September 20, 2016, Vol 316, No. 11 >

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Original Investigation|September 20, 2016

Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease A Systematic Review and Meta-analysis

Despo Ierodiakonou, MD, PhD1,2; Vanessa Garcia-Larsen, PhD2; Andrew Logan, PhD1; Annabel Groome, BSc1; Sergio Cunha, MD2; Jennifer Chivinge, BSc1; Zoe Robinson, BSc1; Natalie Geoghegan, BSc1; Katharine Jarrold, BSc1; Tim Reeves, BSc2; Nara Tagiyeva-Milne, PhD3; Ulugbek Nurmatov, MD, PhD4; Marialena Trivella, DPhil5; Jo Leonardi-Bee, PhD6; Robert J. Boyle, MD, PhD1

[+] Author Affiliations

JAMA. 2016;316(11):1181-1192. doi:10.1001/jama.2016.12623.

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Supplemental Content





Importance  Timing of introduction of allergenic foods to the infant diet may influence the risk of allergic or autoimmune disease, but the evidence for this has not been comprehensively synthesized.

Objective  To systematically review and meta-analyze evidence that timing of allergenic food introduction during infancy influences risk of allergic or autoimmune disease.

Data Sources  MEDLINE, EMBASE, Web of Science, CENTRAL, and LILACS databases were searched between January 1946 and March 2016.

Study Selection  Intervention trials and observational studies that evaluated timing of allergenic food introduction during the first year of life and reported allergic or autoimmune disease or allergic sensitization were included.

Data Extraction and Synthesis  Data were extracted in duplicate and synthesized for meta-analysis using generic inverse variance or Mantel-Haenszel methods with a random-effects model. GRADE was used to assess the certainty of evidence.

Main Outcomes and Measures  Wheeze, eczema, allergic rhinitis, food allergy, allergic sensitization, type 1 diabetes mellitus, celiac disease, inflammatory bowel disease, autoimmune thyroid disease, and juvenile rheumatoid arthritis.

Results  Of 16 289 original titles screened, data were extracted from 204 titles reporting 146 studies. There was moderate-certainty evidence from 5 trials (1915 participants) that early egg introduction at 4 to 6 months was associated with reduced egg allergy (risk ratio [RR], 0.56; 95% CI, 0.36-0.87; I2 = 36%; P = .009). Absolute risk reduction for a population with 5.4% incidence of egg allergy was 24 cases (95% CI, 7-35 cases) per 1000 population. There was moderate-certainty evidence from 2 trials (1550 participants) that early peanut introduction at 4 to 11 months was associated with reduced peanut allergy (RR, 0.29; 95% CI, 0.11-0.74; I2 = 66%; P = .009). Absolute risk reduction for a population with 2.5% incidence of peanut allergy was 18 cases (95% CI, 6-22 cases) per 1000 population. Certainty of evidence was downgraded because of imprecision of effect estimates and indirectness of the populations and interventions studied. Timing of egg or peanut introduction was not associated with risk of allergy to other foods. There was low- to very low-certainty evidence that early fish introduction was associated with reduced allergic sensitization and rhinitis. There was high-certainty evidence that timing of gluten introduction was not associated with celiac disease risk, and timing of allergenic food introduction was not associated with other outcomes.

Conclusions and Relevance  In this systematic review, early egg or peanut introduction to the infant diet was associated with lower risk of developing egg or peanut allergy. These findings must be considered in the context of limitations in the primary studies.                                                                                           

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children


Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

USDA’s Accomodating Children With Special Dietary Needs

Child and Teen Checkup Fact Sheet

Video: What to Expect From A Child’s Physical Exam

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