Impact of peanut consumption in the LEAP Study: Feasibility, growth, and nutrition

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• 作者：Mary Feeney ; MSc ; RD^a ; ^b ; ^&lowast ; ; George Du Toit ; MBBCh ; FRCPCH^a ; ^b ; ^&lowast ; ; Graham Roberts ; DM^c ; ^d ; Peter H. Sayre ; MD ; PhD^e ; Kaitie Lawson ; MS^f ; Henry T. Bahnson ; MPH^f ; Michelle L. Sever ; MSPH ; PhD^f ; Suzana Radulovic ; MD^a ; ^b ; Marshall Plaut ; MD^g ; Gideon Lack ; MBBCh ; FRCPCH^a ; ^b ; ^{gideon.lack@kcl.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; for the Immune Tolerance Network LEAP Study TeamSusan Chan ; Adam Fox ; Mable Abraham ; Muhsinah Adam ; Lyn Clough ; Louise Coverdale ; Helen Fisher ; Fiona Henley ; Saadia Hussain ; Victoria Johnston ; Amy Nixon ; Una O'Dwyer-Leeson ; Aine Sheridan ; Tammy Amarra ; Kathryn Cockerell ; Sarah Lacey ; Gail Harland ; Charlotte Stedman ; Ruth Towell ; Monica Basting ; Catherine Clarke ; Richard Cleaver ; Gemma Deutsch ; Erica Harris ; Lori Nirenstein ; Alicia Parr ; Natalia Becares ; Matthew Crossley ; Natalia do Couto Francisco ; Kerry Richards ; Deeviya Patel ; Ewa Pietraszewicz ; Alick Stephens ; Asha Sudra ; Rianne Wester ; Alastair Wilson ; Celine Wu ; Jenna Heath ; Kathryn Hersee ; Devi Patkunam ; Michael Adamkiewicz ; Adam Asare ; Eduard Chani ; Judith Evind ; Kristina Harris ; Noha Lim ; Nariman Nasser ; Audrey Plough ; Jennifer Romaine ; Michael Stahly ; Joy Laurienzo Panza ; Susan McCachren ; Travis Mason ; Valerie Nelson
• 关键词：Food allergy ; allergy prevention ; peanut ; infant feeding ; breast-feeding ; nutrition ; growth ; prospective food diary ; protein homeostasis
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：138
• 期：4
• 页码：1108-1118
• 全文大小：1444 K

文摘

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.