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

2016; Elsevier BV; Volume: 138; Issue: 4 Linguagem: Inglês

10.1016/j.jaci.2016.04.016

1097-6825

Mary Feeney, George Du Toit, Graham Roberts, Peter H. Sayre, Kaitie Lawson, Henry T. Bahnson, Michelle L. Sever, Suzana Radulovič, Marshall Plaut, Gideon Lack, Susan 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, Áine Sheridan, Tammy Amarra, Kathryn Cockerell, Sarah Lacey, Gail Harland, Charlotte Stedman, Ruth Towell, Monica Basting, Catherine Clarke, Richard Cleaver, Gemma Deutsch, Erica Harris, L. Nirenstein, Alicia Parr, Natalia Bécares, 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 L. Asare, Eduard Chani, Judith Evind, Kristina M. Harris, Noha Lim, Nariman Nasser, Audrey Plough, Jennifer Romaine, Michael Stahly, Joy Laurienzo Panza, Susan McCachren, Travis Mason, Valerie Nelson,

Food Security and Health in Diverse Populations

BackgroundEarly 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.ObjectiveWe sought to evaluate the feasibility of introducing peanut in infancy and explore effects on growth and nutritional intake up to age 60 months.MethodsIn 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.ResultsPeanut 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.ConclusionsIntroduction 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.Graphical abstract