Prevention Strategy Benefits Persist After 1-Year Peanut Avoidance

A jar of peanut butter sits on table next to slice of bread slathered with peanut butter as well as peanuts and shells.

Findings suggest that children who have regularly consumed peanut-containing foods from infancy to age 5 as a peanut allergy prevention strategy can safely switch to consuming peanut as part of a normal diet.

The benefits of regularly consuming peanut-containing foods early in life to prevent the development of peanut allergy persist even after stopping peanut consumption for 1 year, new clinical trial findings show. The results were published online Mar. 4 in the New England Journal of Medicine.

NIAID’s LEAP-On study is an extension of the Learning Early About Peanut Allergy (LEAP) study. LEAP showed that regular peanut consumption begun in infancy and continued until 5 years of age led to an 81 percent reduction in development of peanut allergy in infants deemed at high risk because they already had severe eczema, egg allergy or both.

At the end of LEAP, participants who enrolled in LEAP-On were instructed to avoid peanut consumption for 1 year to help investigators determine whether continuous peanut consumption is required to maintain protection against development of peanut allergy. After the avoidance period, peanut allergy prevalence was determined, as it was in LEAP, by an oral food challenge. Only 4.8 percent of the children who had regularly consumed peanut-containing foods during LEAP were allergic to peanut following the year of peanut avoidance. In comparison, the prevalence of peanut allergy was 18.6 percent among those who had avoided peanut throughout LEAP and LEAP-On.

“The findings suggest that children who have regularly consumed peanut-containing foods from infancy to age 5 as a peanut allergy prevention strategy can safely switch to consuming peanut as desired as part of a normal diet,” said Dr. Daniel Rotrosen, director of NIAID’s Division of Allergy, Immunology and Transplantation. “We expect that many will continue to enjoy peanut-containing foods consumed regularly and others will maintain their non-allergic status with moderate intervals of diminished or no peanut consumption.”