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Impact of peanut consumption in the LEAP Study: Feasibility, growth, and nutrition
Mary Feeney1, George Du Toit1, Graham Roberts2
1Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
Insights
Introducing peanut early is feasible for high-risk infants and does not negatively impact growth or nutrition. This strategy effectively prevents peanut allergy without altering breastfeeding duration.
Area of Science:
- Allergy and Immunology
- Pediatric Nutrition
- Clinical Trials
Background:
- Early peanut introduction is a proven peanut allergy prevention strategy for high-risk infants.
- However, its feasibility and impact on infant growth and nutrition remain unclear.
Purpose of the Study:
- To assess the feasibility of introducing peanut products in infancy.
- To explore the effects of early peanut consumption on infant growth and nutritional intake up to 60 months.
Main Methods:
- The study involved 640 atopic infants (4-11 months) randomly assigned to consume (6g/week) or avoid peanut until 60 months.
- Peanut intake, feeding practices, dietary intake (food diaries), and anthropometry were monitored.
Main Results:
- Peanut consumption was feasible and sustained, with median intake of 7.5g/week in the consumption group.
- No significant differences in growth, energy intake, or breastfeeding duration were observed between groups.
- Dietary differences emerged: peanut consumers had higher fat intake, while avoiders had higher carbohydrate intake.
Conclusions:
- Early peanut introduction is feasible for high-risk infants, showing no adverse effects on breastfeeding, growth, or overall nutrition.
- Infants achieved energy balance through compensatory fat and carbohydrate intake adjustments.
- This supports early peanut consumption as a safe and effective allergy prevention strategy.
Background:
Early introduction of peanut is an effective strategy to prevent peanut allergy in high-risk infants; however, feasibility and effects on growth and nutritional intake are unknown.
Objective:
We sought to evaluate the feasibility of introducing peanut in infancy and explore effects on growth and nutritional intake up to age 60 months.
Methods:
In the Learning Early About Peanut Allergy trial, 640 atopic infants aged 4 to 11 months were randomly assigned to consume (6 g peanut protein per week) or avoid peanut until age 60 months. Peanut consumption and early feeding practices were assessed by questionnaire. Dietary intake was evaluated with prospective food diaries. Anthropometric measurements were taken at all study visits.
Results:
Peanut was successfully introduced and consumed until 60 months, with median peanut protein intake of 7.5 g/wk (interquartile range, 6.0-9.0 g/wk) in the consumption group compared with 0 g in the avoidance group. Introduction of peanut in breast-feeding infants did not affect the duration of breast-feeding. There were no differences in anthropometric measurements or energy intakes between groups at any visits. Regular peanut consumption led to differences in dietary intakes. Consumers had higher intakes of fat and avoiders had higher carbohydrate intakes; differences were greatest at the upper quartiles of peanut consumption. Protein intakes remained consistent between groups.
Conclusions:
Introduction of peanut proved feasible in infants at high risk of peanut allergy and did not affect the duration of breast-feeding nor impact negatively on growth or nutrition. Energy balance was achieved in both groups through variations in intakes from fat and carbohydrate while protein homeostasis was maintained.
