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Erin Sheridan

NFS 561 Week 7


Discussion Question Assignment for Allergies Unit
Question #1: What did the LEAP study find regarding the impact of early vs. late introduction of peanuts with
allergy development?
The increasing incidents of peanut allergies in the United States has been a topic of concern for both
parents and health professionals. The allergy is often severe, causing anaphylaxis and even death, and is rarely
outgrown. Naturally, parents and health professionals have been wondering what can be done to reduce the incidents
of peanut allergy development. One popular theory is the timing of introduction. However, theres been some
controversy about when to introduce this highly allergic food.
From 2000 to 2008, the American Academy of Pediatrics recommended delaying peanut introduction until
1 year of age in low-risk children, and 3 years in high-risk children. However, the AAP retracted this guideline in
2008, acknowledging that there is not enough research on the topic to support this recommendation1. Since then,
much of the research has found the opposite recommendation to be more useful in reducing peanut allergy
development.
In 2015, the LEAP study concluded that early of introduction of peanut foods may reduce likelihood of
allergy development in infants that are at high risk. The study divided infants who were 4-11 months old into two
groups. One group consumed at least 6 grams of peanut protein per week until age 5, while the other group
completely avoided peanut foods until age 5. Peanut-specific IgE levels were measured at 12, 30, and 60 months of
age for both groups. Over the course of the study, peanut-specific IgE levels increased in both groups, but the levels
were higher in the avoidance group.
The study found that at 60 months of age (5 years), 13.7% of children in the avoidance group had an
allergy to peanuts, and only 1.9% of the consumption group had the allergy. This difference is statistically
significant and suggests that peanut avoidance may not be a useful strategy in preventing the allergy. Early
introductions of peanut foods may be a more effective way to prevent the allergy development2.
A continuation of the LEAP study, called the LEAP-On study, was published in 2016. It evaluated the same
participants during their 6th year of life. Regardless of which group they were assigned, all participants avoided
peanut foods for 12 months. At 72 months of age (6 years), the avoidance group saw a significant increase in the
prevalence of peanut allergies, whereas the consumption group did not see a significant change. The avoidance
group also continued to have higher serum levels of peanut-specific IgE. This would suggest that the early
introduction to peanuts continues to have a protective effect against development of the allergy3.
Another topic of interest is maternal peanut consumption during pregnancy and lactation. The research
suggests that peanut avoidance during pregnancy and lactation is not necessary in mothers who do not have the
allergy themselves, as it has no impact on allergy development4. Maternal peanut consumption during pregnancy
might actually reduce the infants risk of developing the allergy5.
References:
1. McCarthy C. Peanut Allergies: What You Should Know About the Latest Research. HealthyChildren.org.
https://healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Peanut-Allergies-What-YouShould-Know-About-the-Latest-Research.aspx. Published May 24, 2016. Accessed December 14, 2016.
2. Toit GD, Roberts G, Sayre PH, et al. Randomized Trial of Peanut Consumption in Infants at Risk for Peanut
Allergy. The New England journal of medicine. 2015;372(9):803-813. doi:10.1056/NEJMoa1414850.
3. Toit GD, Sayre PH, Roberts G, et al. Effect of Avoidance on Peanut Allergy after Early Peanut
Consumption. New England Journal of Medicine. 2016;374(15):1435-1443. doi:10.1056/nejmoa1514209.

4.
5.

Jrvinen KM, Westfall J, De Jesus M, et al. Role of Maternal Dietary Peanut Exposure in Development of Food
Allergy and Oral Tolerance. Hogan SP, ed. PLoS ONE. 2015;10(12):e0143855.
doi:10.1371/journal.pone.0143855.
Maslova E, Granstrom C, Hansen S, et al. Peanut and tree nut consumption during pregnancy and allergic
disease in childrenshould mothers decrease their intake? Longitudinal evidence from the Danish National
Birth Cohort. J Allergy Clin Immunol. 2012;130(3):724-732.

Erin Sheridan Timing of Peanut Introduction in Infants


The increasing incidents of peanut allergies in the United States has been a topic of concern recently. The allergy is
often severe, causing anaphylaxis and even death, and is rarely outgrown. Naturally, parents and health professionals
have been wondering what can be done to reduce the incidents of peanut allergy development. One popular theory is
the timing of introduction.
From 2000 to 2008, the American Academy of Pediatrics recommended delaying peanut introduction until
1 year of age in low-risk children, and 3 years in high-risk children. However, the AAP retracted this guideline in
2008, acknowledging that there is not enough research on the topic to support this recommendation1. Since then,
much of the research has found the opposite recommendation to be more useful in reducing peanut allergy
development.
In 2015, the LEAP study concluded that early of introduction of peanut foods may reduce likelihood of
allergy development in infants that are at high risk. The study divided infants who were 4-11 months old into two
groups. One group consumed at least 6 grams of peanut protein per week until age 5, while the other group
completely avoided peanut foods until age 5. The study found that at 60 months of age (5 years), 13.7% of children
in the avoidance group had an allergy to peanuts, and only 1.9% of the consumption group had the allergy. This
difference is statistically significant and suggests that peanut avoidance may not be a useful strategy in preventing
the allergy. Early introductions of peanut foods may be a more effective way to prevent the allergy development 2.
A continuation of the LEAP study, called the LEAP-On study, evaluated the same participants during their
6 year of life. Regardless of which group they were assigned, all participants avoided peanut foods for 12 months.
At 72 months of age (6 years), the avoidance group saw a significant increase in the prevalence of peanut allergies,
whereas the consumption group did not see a significant change. This would suggest that the early introduction to
peanuts continues to have a protective effect against development of the allergy3.
th

Another topic of interest is maternal peanut consumption during pregnancy and lactation. The research
suggests that peanut avoidance during pregnancy and lactation is not necessary in mothers who do not have the
allergy themselves, as it has no impact on allergy development4. Maternal peanut consumption during pregnancy
might actually reduce the infants risk of developing the allergy5.