Early introduction of allergenic foods and the prevention of food allergy in infancy

In summary

Food allergies affect around 6% of children in high-income countries. Traditionally, guidelines recommended delaying the introduction of allergenic foods.

However, the EAT (Enquiring About Tolerance) study - led by Dr Michael Perkin at City St George’s - found that introducing allergens early in life significantly reduced the risk of developing food allergies, particularly peanut and egg allergies.

What did we explore and how?

Between 2008 and 2015, Dr Michael Perkin and colleagues at City St George’s, University of London, conducted the EAT study, the largest published clinical trial at the time on early allergenic food introduction.

The study enrolled over 1,300 exclusively breastfed infants to test whether introducing six common allergens - peanut, cooked hen’s egg, cow’s milk, sesame, white fish, and wheat - from three months of age could prevent the development of food allergies.

This research was motivated by earlier observational findings, such as the notably low rate of peanut allergies among Israeli infants, where early introduction of peanut is common, compared to higher rates in North London Jewish infants.

While achieving the recommended intake levels was challenging, the study demonstrated a strong protective effect when foods were introduced early and consumed in sufficient amounts.

Benefits and influence of this research

• Food allergy prevention: Early introduction of allergens led to a 100% reduction in peanut allergy and 75% reduction in egg allergy when properly adhered to.
• Additional health benefits: The early introduction group also experienced fewer serious sleep problems and a lower incidence of coeliac disease in infants who consumed wheat early.
• Health equity considerations: The study identified that Black, Asian, and Minority Ethnic (BAME) families, who are at a higher risk of food allergies, were significantly less likely to follow early introduction protocols—highlighting the need for tailored support and public health outreach.
• Policy impact: The findings continue to shape national and international infant feeding guidelines and provide critical insights into allergy development and prevention.

The EAT study has produced a wealth of data that continues to inform infant feeding guidelines and insights into how allergies develop and their potential prevention.