Early peanut eating and lasting tolerance to peanut
What it found
In children who ate peanut from infancy to age 5, peanut allergy was much less common at age 12 than in those who avoided peanut early on.
This was a follow-up of a randomised trial in people.
What they found
Studies in people
Peanut allergy at age 12
Peanut allergy was more common in the original peanut avoidance group (15.4%) than in the peanut consumption group (4.4%). This was a 71% reduction in peanut allergy.
Allergy in skin test groups
Among those who started with a negative skin prick test, 12.7% of the avoidance group and 2.8% of the consumption group had peanut allergy at age 12. Among those who started with a positive skin prick test, the figures were 29.3% and 13.2%.
Peanut consumption later
In the 4 weeks before the age 12 check, the peanut consumption group ate more peanut on average (2.9 g per week) than the avoidance group (0.2 g per week). But both groups often ate little or no peanut for long stretches.
Immune markers
At age 12, the peanut consumption group had smaller skin prick test reactions and lower levels of Ara h2-specific IgE (0.03 vs 0.06 kU/l) than the avoidance group. They also had higher levels of peanut-specific IgG4 (535.5 vs 209.3 μg/l).
Safety
Adverse events were uncommon. One child was hospitalised overnight for vomiting, and epinephrine was given twice during food challenges.
What the authors conclude
“Peanut consumption, starting in infancy and continuing to age 5 years, provided lasting tolerance to peanut into adolescence irrespective of subsequent peanut consumption, demonstrating that long-term prevention and tolerance can be achieved in food allergy.”
Also in their conclusions
- They conclude that peanut consumption starting in infancy and continuing to age 5 provided lasting tolerance to peanut into adolescence, regardless of later peanut eating.
- They say this shows that long-term prevention and tolerance can be achieved in food allergy.
How it was done
Peanut allergy is usually life-long and prevention is a public health priority. The authors wanted to see if the protection from early peanut eating would last into adolescence.
They followed up 508 of the original 640 children from a randomised trial that had tested peanut consumption from infancy to age 5. At about 144 months (12 years) of age, they checked who had peanut allergy after years of eating or avoiding peanut as they wished.
What it can’t tell you
- This trial was in children at high risk of allergy, so the results may not apply to all children.
- The trial cannot show whether the same approach would work for other allergenic foods.
Who paid
- Funding
- Funded by NIAID NIH HHS (from the PubMed record).
- Authors work at
- King's College London, London; Guy's and St Thomas' NHS Foundation Trust, London; University of California, San Francisco
The paper
- Title
- Follow-up to Adolescence after Early Peanut Introduction for Allergy Prevention
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Du Toit G, Huffaker MF, Radulovic S, et al (2024). Follow-up to Adolescence after Early Peanut Introduction for Allergy Prevention. NEJM evidence. doi:10.1056/EVIDoa2300311Free full textPubMed 38804779DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error