Early Peanut Introduction Linked โto Reduced โคAllergy Rates in US Infants, Real-World Studyโ Shows
New research provides compelling evidence that โupdated guidelines recommending early introduction of peanut products to infantsโ are associated โwith a notableโค decrease in peanut and overall food allergies across the United States.โข The study, published in Pediatrics (DOI: 10.1542/peds.2024-070516), analyzed real-world data and found a measurable decline in new diagnoses following the release of national guidelines in 2015 and โ2017.
Researchers, lead by S.J. gabryszewski and colleagues, compared โdata from before and after the guideline changes. They observed a drop in theโข cumulative incidence of peanut allergy fromโค 0.79% to 0.45% – a roughly 45%โ reduction in risk (Hazard Ratio [HR] 0.55, p โ< 0.0001). The incidence of any IgE-mediated โfood allergy also decreased, falling from 1.46% to 0.93%, representing a 37% reduction in risk (HR 0.63, pโค < 0.0001).
However, โthe benefits โweren’t global. Children with pre-existing atopicโ dermatitis (a known risk factor for food allergies) didโ not experience a significant reductionโ in peanut allergy risk. โขInterestingly, whileโ cow’s milk allergy rates declined, egg โฃallergy rates remained stable and even surpassed peanut allergy as โคthe most commonly identifiedโ food allergen after the guidelines were implemented.
The study also noted a concurrent increase in the diagnosis of โคatopic dermatitis (p < 0.0001), which researchers suggest may reflect โimproved identification of at-risk infants by pediatricians. Demographic shifts were โalso observed, with fewer Black, Asian/Pacific Islander, and Hispanicโ children beingโ diagnosed with food allergies inโ the post-guideline period.
An interrupted โคtime series analysis confirmed a significant decline in any food allergy diagnosis, though the reduction for peanut allergy alone did not โreach statistical significance.
The authors emphasize that thisโ observationalโค study demonstrates โขanโ association between the guidelines and reduced allergy rates, but โขdoes not prove direct causation. They also point โฃout โขthat the observed reductions were more modest thanโข the 81% decrease seen in the controlled LEAP trial, suggesting room for enhancement in how the guidelines are implemented in practice. Furthermore, the study period concluded before the potential impact ofโค the 2021 guidelines could be evaluated.
“Theโ present study is one of the first to provide methodologically robust, โขreal-world evidence suggesting the public healthโข benefitsโฆmay be occurring,” the researchers conclude. โคTheyโค believe the findings support the guidelines as a “valuable step towards a healthy and allergy-free childhood.”
