NEW YORK (Reuters Health) – Contrary to widespread recommendations, early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy, results of a study suggest.

“Our study findings raise the question of whether early introduction rather than avoidance of peanut in infancy is the better strategy for the prevention of peanut allergy,” write researchers in the November issue of the Journal of Allergy and Clinical Immunology.

In the UK, Australia and, until recently, the United States, guidelines have recommended avoiding peanuts during pregnancy, breastfeeding and early life, note Dr. George Du Toit of King’s College London and colleagues.

They analyzed the prevalence of peanut allergy and dietary histories for 5,171 Jewish children from the UK and 5,615 Jewish children from Israel. They found that children from the UK had a prevalence of peanut allergy that was 10-fold higher than that of children from Israel — 1.85% versus 0.17% (p < 0.001).

“This difference is not accounted for by differences in atopy, social class, genetic background, or peanut allergenicity,” the investigators report.

“The most obvious difference in the diet of infants in both populations occurs in the introduction of peanut,” they note, with 69% of infants eating peanuts at age 9 months compared with just 10% of those in the UK.

Israeli children aged 8 to 14 months consume a median of 7.1 grams of peanut protein per month, whereas age-matched UK children do not consume any peanut protein, Dr. Du Toit and colleagues point out.

The researchers suggest that recommendations to avoid peanut in early infancy could be behind the increase in peanut allergy in the UK, Australia and the US.

In a written statement, Dr. Jacqueline A. Pongracic, vice chair of the American Academy of Allergy, Asthma & Immunology (AAAAI) Adverse Reactions to Foods Committee cautions that while this study’s findings “provide optimism for prevention of peanut allergy in the future, randomized, controlled trials are needed to verify that early introduction of peanut is indeed effective.”

The Learning Early about Peanut Allergy (LEAP) study, a large randomized study in the UK, is currently testing the effects of early peanut exposure.

Reference:
J Allergy Clin Immunol 2008;122:978-985.