Peanut allergies have plummeted in children

Peanut allergies among children have dropped significantly over the past decade, and early introduction guidelines are likely the cause. Although food allergies can be deadly, taking steps to reduce the chances of them ever developing can lead to better health outcomes in the future.

Nuts numbers

Food allergies in children dropped by 36% over the past 10 years, a change mostly attributed to a 43% drop in peanut allergies, according to a study published in the journal Pediatrics. Eggs also overtook peanuts as the number one most common allergen among children. This shift comes 10 years after a study found that early exposure to peanut products could cut the chances of developing a peanut allergy by 80%. In 2017, the National Institute of Allergy and Infectious Diseases formally recommended and issued national guidelines for early introduction.

“Early allergen introduction works,” Dr. David Hill, the lead author of the new study, said to NPR. “For the first time in recent history, it seems like we're starting to put a brake pedal on the epidemic of food allergy in this country.” Peanut allergies occur when the “body’s immune system mistakenly identifies proteins in peanuts as harmful and releases chemicals that trigger allergic symptoms, including hives, respiratory symptoms and, sometimes, life-threatening anaphylaxis,” said CBS News. Because of this, parents were previously advised to avoid feeding their kids foods likely to trigger allergens before the age of 3.

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The current guidelines, most recently updated in 2021, call for “introducing peanuts and other major food allergens between 4 and 6 months, without prior screening or testing,” said CBS News. It “doesn’t have to be a lot of the food,” just “little tastes of peanut butter, milk-based yogurt, soy-based yogurts and tree butters,” Hill said to CBS News. “These are really good ways to allow the immune system exposure to these allergenic foods in a safe way.”

Cautious optimism

The study looked at diagnosis codes and EpiPen prescriptions for 125,000 children across almost 50 pediatric practices. It did not “examine what infants ate, so it does not show that the guidelines caused the decline,” said The New York Times. However, it has been inferred that the guidelines are likely a contributing factor because of the timing of the drop. Also, since the study only followed children up until the age of 3, “it did not capture allergy rates in older children” or determine “if the drop in allergies would last into adolescence,” said the Times.

Approximately two-thirds of food allergies in children are diagnosed by the age of 3. Still, some experts are cautious of the results. Many families have not been “fully implementing the new guidelines, in many cases due to fear that exposing an infant to peanut products might also endanger a sibling or parent who’s allergic,” said Dr. Corinne Keet, a professor of pediatrics at the University of North Carolina at Chapel Hill, to NPR. It is also “simply difficult to conduct a high-quality study about food allergy prevalence” because of the large amount of data needed.

Despite this, researchers say there is reason for optimism. “We’re talking about the prevention of a potentially deadly, life-changing diagnosis,” said Dr. Edith Bracho-Sanchez, a pediatrician at Columbia University Irving Medical Center, to the Times. “This is real-world data of how a public health recommendation can change children’s health.”