Early peanut eating and allergy protection into adolescence
What it found
Eating peanut from infancy to age 5 kept protecting against peanut allergy at age 12, even after years of eating as much or as little as desired.
This was found in a long-term follow-up of children.
What they found
Studies in people
Allergy rates at age 12
At 144 months, 15.4% (38 of 246) of those who originally avoided peanut had a peanut allergy. Only 4.4% (11 of 251) of those who ate peanut early on were allergic. This means early eating cut the allergy rate by 71%.
Protection despite avoidance periods
Many children in both groups went long stretches without eating any peanut between ages 6 and 12. Even so, the group that ate peanut as babies stayed protected.
Immune markers in blood
The early-eating group had lower levels of Ara h2-specific IgE, a marker linked to severe reactions. Their average level was 0.03 kU/l compared with 0.06 kU/l in the avoidance group. They also had higher levels of peanut-specific IgG4, a marker linked to protection: 535.5 micrograms per litre versus 209.3 micrograms per litre.
Skin-prick test results
When tested on the skin, the early-eating group had smaller reaction bumps. Their average bump size was 1.4 mm compared with 2.8 mm in the avoidance group.
Safety during testing
Unwanted reactions during the study were rare. One child stayed overnight in hospital for vomiting, and two children needed epinephrine during the food challenge tests.
What the authors conclude
- They conclude that eating peanut from infancy to age 5 gave lasting protection against peanut allergy well into the teenage years.
- Their findings show this protection held up no matter how much or how little peanut the children chose to eat later on.
- The authors say this proves that true, long-lasting tolerance to a food allergen can be built through early introduction.
How it was done
Peanut allergy affects 1 to 2% of people in the Western world and is usually lifelong. Earlier trials showed that feeding peanut to high-risk infants prevented allergy up to age 5, but scientists did not yet know if that protection would last into the teenage years.
Researchers followed 508 children from an earlier trial until they were about 12 years old (144 months). The children had originally been told either to eat peanut regularly or to avoid it completely from infancy until age 5. After that, everyone could eat or avoid peanut as they wished for several years before being tested for allergy again.
What it can’t tell you
- This trial only included infants who already had eczema or egg allergy, so the results might not apply to all children.
- Because the original eating group still tended to eat more peanut later on, it is hard to separate the effect of early eating from the effect of eating more overall.
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 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error