Feeding Babies Foods With Peanuts Appears To Prevent Allergies
Audio File: http://www.npr.org/blogs/thesalt/2015/02/23/388450621/feeding-babies-foods-with-peanuts-appears-to-prevent-allergies
Babies at high risk for becoming allergic to peanuts are much less likely to develop the allergy if they are regularly fed foods containing the legumes starting in their first year of life.
That's according to a big new study released Monday involving hundreds of British babies. The researchers found that those who consumed the equivalent of about 4 heaping teaspoons of peanut butter each week, starting when they were between 4 and 11 months old, were about 80 percent less likely to develop a peanut allergy by their fifth birthday.
"This is certainly good news," says Gideon Lack of King's College London, who led the study. He presented the research at the annual meeting of the American Academy of Allergy, Asthma and Immunology. It was also published in The New England Journal of Medicine.
As many as 2 million U.S. children are estimated to be allergic to peanuts — an allergy that has been increasing rapidly in the United States, Britain and other countries in recent years. While most children who are allergic to peanuts only experience relatively mild symptoms, such as hives, some have life-threatening reactions that can include trouble breathing and heart problems.
"Peanut allergy can be extremely serious," Lack says.
THE SALT
Doctors Lean Toward Introducing Allergenic Foods To Kids Early
Lack's study was launched after he noticed that Israeli kids are much less likely to have peanut allergies than are Jewish kids in Britain and the United States.
"My Israeli colleagues and friends and young parents were telling me, 'Look, we give peanuts to these children very early. Not whole peanuts, but peanut snacks,' " Lack says.
Peanut snacks called Bamba, which are made of peanut butter and corn, are wildly popular in Israel, where parents give them to their kids when they're very young. That's very different from what parents do in Britain and the United States, where fears about food allergies have prompted many parents to keep their children away from peanuts, even though the American Academy of Pediatrics revised a recommendation to do so in 2008.
"That raised the question whether early exposure would prevent these allergies" by training babies' immune systems not to overreact to peanuts, Lack says. "It's really a very fundamental change in the way we're approaching these children."
To try to find out, Lack and his colleagues got funding from the U.S. National Institutes of Health to launch a study. They found 640 babies who were at high risk for developing peanut allergies because they already had eczema or egg allergy. They asked half of the infants' parents to start feeding them Bamba, peanut butter, peanut soup or peanut in some other form before their first birthday and followed them for about five years.
"What we found was a very great reduction in the rate of peanut allergy," Lack says. About 17 percent of the kids who avoided peanuts developed peanut allergies, compared with only 3.2 percent of the kids who ate peanuts, the researchers reported.
THE SALT
Hypoallergenic Nuts: A Solution To Nut Allergies?
Based on the findings, Lack thinks most parents should start feeding their babies peanut products as early as possible — not whole peanuts or globs of peanut butter, but peanut mixed in some other food to avoid any possible choking hazard.
"We've moved, really, 180 degrees from complete avoidance to we should give peanuts to young children actively," Lack says.
Other allergy experts hailed the results as an important advance.
"This is a major study — really what we would call a landmark study," says Scott Sicherer, who advises the American Academy of Pediatrics on allergies. "There's been a huge question about why there's an increase in peanut allergy and what we can do to try to stem that increase. And this is a study that directly addresses that issue."
But Sicherer says we have to be careful, since some kids are really sensitive to peanuts.
"If you're a parent sitting at home with your child looking at them saying, 'Well, gee, they didn't eat peanut yet. Maybe I should run to the cupboard and get some peanut butter for them,' it could be a little bit dangerous because if you do that and the child has a bad allergic reaction, you would be at home and have a problem," Sicherer says.
So Sicherer says parents who have some reason to think their kids might be allergic to peanuts should get them tested first and then only try feeding them peanuts with a doctor in the room.
But other specialists say for most parents, the new findings should encourage them to start feeding their kids peanuts as early as possible.
"This is a question we get asked constantly in our clinic. When parents come in, they often have young children. They want to know what should they do. This really provides us with the answer," says Hugh Sampson, who heads the Jaffe Food Allergy Institute at Mount Sinai in New York. Sampson co-authored an editorial being published with the study.
"So now I think we're on firm ground, and we can go forward and look the parents in the eye and say, 'This is something that will be beneficial,' " Sampson says.
A key question is whether kids will have to keep eating peanuts to keep any allergy at bay. Lack is following the kids in his study to find out what happened to them after they stopped eating peanuts regularly.
***
The study's findings may encourage doctors to recommend that even toddlers deemed to be at high risk for food allergies consume peanut butter.
Feeding Babies Peanut Snacks Can Help Them Avoid Future Allergies
Landmark study puts to bed old advice on blanket avoidance.
Allergy experts say the finding is likely to lead doctors to begin recommending that toddlers consume peanut butter and other peanut snacks even if they’re deemed to be at high risk because they haveasthma, severe eczema, siblings with peanut allergies and other food allergy risks.
In the study, researchers randomly assigned 640 babies with high allergy risks who were older than 4 months to either eat a peanut-flavored puffed snack food three times a week or avoid all peanut-containing products until they reached their fifth birthday; those who were mildly allergic to peanuts based on skin-prick tests were also included in the study.
At the end of the five-year study, researchers found that fewer than 2 percent of the babies who ate the peanut snack, called Bamba, developed peanut allergies compared to nearly 14 percent of those in the peanut-avoidance group. Nearly 11 percent of those who were mildly allergic to peanuts at the beginning of the study still had allergic reactions on skin tests at the end of the study compared to 35 percent of those who had avoided peanuts.
The British and American researchers didn’t see any significant differences in allergic reactions like hives, stomach complaints and wheezing among the various groups.
“The data in paper are obviously very impressive,” says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, the federal agency that funded and helped conduct the trial. “With regards to practicality of this now, we wouldn’t recommend to parents to do anything on their own but to contact an allergist to see if this data warrants a change in their child’s diet.”
The prevalence of peanut allergies in the U.S. has skyrocketed in recent years – quadrupling from 0.4 percent in 1997 to more than 2 percent in 2010. In fact, peanut allergies, which typically begin in early childhood and are rarely outgrown, have become the leading cause of severe food-related allergic reactions and death in this country.
The American Academy of Pediatrics began recommending 15 years ago that babies with a family history of food allergies or with symptoms of allergies themselves avoid certain high-risk foods like peanuts, shellfish and nuts until they reached age 3. But the pediatrician group withdrew those recommendations in 2008 after the number of kids with peanut allergies continued to rise and after studies began hinting at benefits to introducing allergenic foods during infancy.
In one striking finding, British researchers observed that the prevalence of peanut allergies among Jewish children in London who weren’t fed peanut foods during their first year of life was 10 times higher than among Jewish Israeli children who were given Bamba, popular in Israel, when they were babies.
Fauci says the old recommendations for children to delay eating peanut foods may have contributed to the sharp rise in peanut allergies.
Current food allergy guidelines issued by Fauci’s agency state that “there is no evidence that supports delaying the introduction of solid foods to an infant beyond 4 to 6 months of age to prevent allergic diseases from developing. This includes giving an infant a food containing milk, eggs, peanut, tree nuts, soy or wheat.”
But those guidelines could be taken a step further, by encouraging parents to feed these foods to their young kids regularly to prevent allergies as a result of the new study, according to Rebecca Gruchalla, a pediatric allergist and director of the division of allergy and immunology at the University of Texas Southwestern Medical Center--Dallas. She also emphasizes that any new guidelines would have to be carefully worded to convey the complexity of food-allergy prevention in babies who already have signs of peanut allergies.
“I don’t want every parent out there to say I’m going to give my 4-month-old peanut butter,” Gruchalla says. “Kids with severe eczema, asthma or other food allergies need to be evaluated by an allergy specialist and have a skin test to see how allergic they are to peanuts.”
She says she plans to change her guidance to recommend that babies with mild peanut allergies or other food allergies have peanut snacks as a regular part of their diets based on the new study – under her close supervision – but she would also hesitate to recommend this for those with severe peanut allergies.
Babies with severe peanut allergies based on a skin test were excluded from the clinical trial, so allergists have no way of knowing whether they can safely consume peanuts.
In an editorial accompanying the study, Gruchalla and her colleague also questioned the optimal dose that babies need to avoid peanut allergies.
“Do infants need to ingest 2 grams of peanut protein (approximately eight peanuts) three times a week on a regular basis for five years, or will it suffice to consume lesser amounts on a more intermittent basis for a shorter period of time?”
No comments:
Post a Comment