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



We sought to evaluate the feasibility of introducing peanut in infancy and explore effects on growth and nutritional intake up to age 60 months.



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.



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.



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.
Department 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.
Mary
M
Feeney
Department 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.
George
G
Du Toit
University of Southampton and NIHR Respiratory Biomedical Research Unit, Southampton and David Hide Centre, Isle of Wight, United Kingdom.
Graham
G
Roberts
Immune Tolerance Network and Division of Hematology-Oncology, Department of Medicine, University of California, San Francisco.
Peter H
PH
Sayre
Rho Federal Systems Division, Chapel Hill, NC.
Kaitie
K
Lawson
Rho Federal Systems Division, Chapel Hill, NC.
Henry T
HT
Bahnson
Rho Federal Systems Division, Chapel Hill, NC.
Michelle L
ML
Sever
Department 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.
Suzana
S
Radulovic
National Institute of Allergy and Infectious Diseases, Bethesda, MD.
Marshall
M
Plaut
Department 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.
Gideon
G
Lack
D000886:Anthropometry; D010367:Arachis; D001942:Breast Feeding; D004032:Diet; D015930:Diet Records; D005260:Female; D048788:Growth and Development / Q000502:physiology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D015596:Nutrition Assessment; D009747:Nutritional Physiological Phenomena; D021183:Peanut Hypersensitivity / Q000517:prevention & control*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
Food allergy; allergy prevention; breast-feeding; growth; infant feeding; nutrition; peanut; prospective food diary; protein homeostasis