Allergies fall after children given eggs and peanuts

Foods ‘introduced to the infant diet before the age of 12 months’ can help build up tolerance, study suggests

The rapid rise in food allergies is slowing after parents were advised to give eggs and peanuts to young children to build up tolerance, a study suggests.
Analysis from Imperial College London has found that, although allergy cases doubled between 2008 and 2018, they have largely plateaued since 2014.
Researchers say incidence of new cases may have slowed owing to changes in infant feeding guidelines, which no longer recommend delaying the introduction of foods such as peanuts, although they said more evidence is needed to confirm the hypothesis.
The estimated number of new cases of probable food allergy in the UK doubled between from 76 cases per 100,000 people in 2008 to 160 cases per 100,000, but most of the increase occurred up to 2014 before levelling off.
Prof Jenny Quint, from the School of Public Health at Imperial College London, said: “Our work shows that using large health datasets can help us to cut through the noise and see changing trends in allergies in the UK, and ultimately whether interventions are having an impact.”
In 1998, the Committee on Toxicity, which advises the Food Standards Agency (FSA), carried out a review and concluded that children under three should not be given peanuts. The FSA also advised against youngsters eating runny yolks.
The advice frightened parents into removing nuts and eggs from their children’s diet, meaning children’s immune systems were not primed, which caused a rise in deadly anaphylaxis.
Following the guidance, the prevalence of food allergies increased dramatically.
However, in the past 15 years, multiple studies have shown that the early introduction of peanut and egg may help prevent development of allergies.
By 2015, world-leading allergy doctors had issued a consensus statement advising the introduction of problem foods early, and in 2018, the government’s Scientific Advisory Committee on Nutrition changed advice, warning that the deliberate exclusion of peanuts and hens eggs could increase allergies.
For the new study, Imperial used anonymised data from GP practices in Britain covering 13 million patients, to search for instances of food allergy between 2008 and 2018.
They found that overall prevalence in Britain rose from 0.4 per cent to 1.1 per cent in the 10 years between 2008 and 2018.
Children under five were most affected with one in 25 (4 per cent) suffering a food allergy compared to 1per cent of adults.
However, the rising trend levelled off around the same time that allergists were recommending that triggering foods be introduced early.
Writing in The Lancet Public Health, the authors conclude: “The apparent plateauing of incidence observed since 2014 for many age groups is noteworthy and requires confirmation.
“One of the biggest changes in public policy with respect to food allergy has come from a series of UK primary prevention trials.
“These trials showed that the introduction of potential food allergens into the infant diet before the age of 12 months substantially reduces the risk of food allergy, at least for peanut and egg.
“Whether the resulting changes in public policy have contributed to any reduction in incidence is currently unclear.”
A study published by King’s College London in May, found that feeding peanuts to children lowers the risk of developing an allergy by 71 per cent.
Experts at King’s said that decades of poor advice, warning against introducing peanuts early in life, had made parents fearful and fuelled the rise in allergies.
They predicted that peanut allergies would “plummet” if parents included the food in their babies’ diet from infancy,  preventing 10,000 cases in Britain each year.
Dr Paul Turner, professor of paediatric allergy at the National Heart & Lung Institute at Imperial College London, who led the research, said: “This new analysis paints an important, if mixed, picture of food allergy in the UK.
“The good news is that while the prevalence of food allergy has increased, the numbers of new cases occurring each year look to have plateaued.”
Food allergy occurs when the immune system overreacts to certain foods, such as cow’s milk, peanuts, eggs or shellfish.
In severe cases it can lead to anaphylaxis, which can cause swelling of the airways, breathing difficulties, and cardiac arrest if not treated urgently.
Dr Turner added: “Food allergy can have a huge impact on people’s lives, and in some tragic cases, can cut lives short.
“By better understanding the prevalence of food allergy in the UK and working with affected people, their families, scientists and clinicians, we are working together to reduce that impact.”
Commenting on the study, Amena Warner, head of clinical services at Allergy UK, says “There has been a lot of data over the years which looks at rates of food allergies and related anaphylaxis episodes at hospital admission level.
“However, there has been limited robust data on the incidence and prevalence of food allergies which paints a complete picture of the burden of food allergy, so the data from this study is long overdue and very welcomed.
“We welcome any action that arises as a result of this important study, to improve allergy care for those living with food allergy.”
The work was funded by the UK Food Standards Agency and the UK Medical Research Council.
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