Randomised controlled trial of early introduction of allergenic foods to induce tolerance in infants (EAT trial)
Lead Research Organisation:
Food Standards Agency
Department Name: UNLISTED
Abstract
Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.
Technical Summary
In the UK 6% of children under the age of 6 years will develop food Allergies (FA), 25% eczema, 20% asthma and 10% allergic rhinitis (AR). DH guidelines advise exclusive breast feeding (EBF) for the first 6 months and delayed introduction of allergenic foods. There is little evidence that this reduces allergic disease. Interventional trials of delayed weaning have consistently failed to reduce FA and atopy. Animal models and preliminary human data demonstrate that high dose oral tolerance to food proteins in early life prevents allergic sensitisation. Three separate studies show that prolonged EBF is a risk factor for developing atopic disease. The trebling of allergic disease since the 1970s has coincided with a two-thirds reduction in early weaning. Thus delayed weaning could promote FA and even other atopic diseases. We propose a randomized controlled study in infants to determine whether early weaning and exposure to food allergens (3 months of age) prevents the development of FA, eczema, asthma and AR. This study will provide an informed basis for future weaning practices in both atopic and normal infants.
Organisations
People |
ORCID iD |
Publications
Du Toit G
(2011)
Can food allergy be prevented? The current evidence.
in Pediatric clinics of North America
Flohr C
(2010)
Filaggrin loss-of-function mutations are associated with early-onset eczema, eczema severity and transepidermal water loss at 3 months of age.
in The British journal of dermatology
Flohr C
(2014)
Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants.
in The Journal of investigative dermatology
Lack G
(2012)
Update on risk factors for food allergy
in Journal of Allergy and Clinical Immunology
Logan K
(2020)
Early Gluten Introduction and Celiac Disease in the EAT Study: A Prespecified Analysis of the EAT Randomized Clinical Trial.
in JAMA pediatrics
Marrs T
(2019)
Dog ownership at three months of age is associated with protection against food allergy.
in Allergy
Marrs T
(2021)
Gut microbiota development during infancy: Impact of introducing allergenic foods
in Journal of Allergy and Clinical Immunology
Perkin M
(2016)
Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A population-based cross-sectional study
in Journal of Allergy and Clinical Immunology
Perkin M
(2018)
Association of Early Introduction of Solids With Infant Sleep A Secondary Analysis of a Randomized Clinical Trial
in JAMA Pediatrics
Perkin MR
(2019)
Efficacy of the Enquiring About Tolerance (EAT) study among infants at high risk of developing food allergy.
in The Journal of allergy and clinical immunology
Guideline Title | ASCIA Guidelines - infant feeding and allergy prevention |
Description | ASCIA Guidelines - infant feeding and allergy prevention |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in clinical guidelines |
Impact | ASCIA developed these revised recommendations to outline practices that may help reduce the risk of infants developing allergies, particularly early onset allergic diseases such as eczema and food allergy.These guidelines are based on current published evidence, including information published after 2010. All infants should be given allergenic solid foods including peanut butter, cooked egg, dairy and wheat products in the first year of life. This includes infants at high risk of allergy. All babies should be given foods that may cause a food allergy, including peanut, in an age appropriate form in the first 12 months, such as smooth peanut butter/paste, cooked egg, dairy and wheat products. This includes babies with severe eczema, babies with another food allergy or babies who have a first degree relative with food allergy, even though they may have a higher chance of developing food allergy. |
URL | https://www.allergy.org.au/images/pcc/ASCIA_Guidelines_infant_feeding_and_allergy_prevention.pdf |
Guideline Title | Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the NIAID-sponsored Expert Panel |
Description | Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the NIAID-sponsored Expert Panel |
Geographic Reach | North America |
Policy Influence Type | Citation in clinical guidelines |
Impact | The EAT study provided additional support for early introduction of peanut in infants who do not have severe eczema for the NIAID Addendum guidelines for the Prevention of Peanut Allergy in the United States. Although the intention-to-treat group did not show benefit, most likely because of relatively poor compliance with feeding recommendations, the children in the per-protocol group who had peanut introduced early in infancy showed a significant reduction in peanut sensitization and peanut allergy at age 3 years. The EAT study also provided support for addendum guideline 3 that infants without eczema or any food allergy have age-appropriate peanut-containing foods freely introduced in the diet together with other solid foods and in accordance with family preferences and cultural practices. |
URL | https://www.niaid.nih.gov/sites/default/files/addendum-peanut-allergy-prevention-guidelines.pdf |
Guideline Title | The Australasian Society of Clinical Immunology and Allergy infant feeding for allergy prevention guidelines |
Description | Citation in clinical guidelines - Australasia Society of Clinical Immunology and Allergy release their latest recommendations in the Medical Journal of Australia, Jan 2019 |
Geographic Reach | Australia |
Policy Influence Type | Citation in clinical guidelines |
Impact | The Australasian Society of Clinical Immunology and Allergy, the peak professional body for clinical immunology and allergy in Australia and New Zealand, develops and provides information on a wide range of immune-mediated disorders, including advice about infant feeding and allergy prevention for health professionals and families. Guidelines for infant feeding and early onset allergy prevention were published in 2016, with additional guidance published in 2017 and 2018, based on emerging evidence. Changes in management a result of the guidelines: The guidelines specifically recommend introducing solid foods at around 6 months of age and introducing peanut and egg in the first year of life in all infants to prevent allergy development. Hydrolysed formula is no longer recommended for prevention of allergic disease. A new document outlining the reasons for and the method of peanut introduction to high risk infants is available for health professionals. |
URL | https://www.ncbi.nlm.nih.gov/pubmed/30636277 |
Description | Data Analysis of the EAT Study |
Amount | £63,516 (GBP) |
Funding ID | FS101178 |
Organisation | Food Standards Agency (FSA) |
Sector | Public |
Country | United Kingdom |
Start | 10/2016 |
End | 03/2017 |
Description | Food allergy - does early introduction of food allergens reduce the risk? |
Amount | £152,000 (GBP) |
Funding ID | GN2551 |
Organisation | Action Medical Research |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 06/2017 |
End | 06/2019 |
Title | WISP online FFQ for early childhood |
Description | We are developing a unique on line parent completed food diary that is appropirate for the age group of the EAT participants. |
Type Of Material | Physiological assessment or outcome measure |
Year Produced | 2015 |
Provided To Others? | No |
Impact | On going. |
Description | 4th Food Allergy and Anaphylaxis Meeting (FAAM 2016) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Title of Presentation: Lessons from early intervention studies. Talked about results and implications of EAT study |
Year(s) Of Engagement Activity | 2016 |
Description | BBC News online |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | BBC News - 10/07/2018 Babies given solid food plus breast milk from three months sleep better than those who are solely breastfed, according to a new study. The study, by King's College, London, and St George's, University of London, surveyed 1,303 three-month-olds, and divided them into two groups. |
Year(s) Of Engagement Activity | 2018 |
URL | https://www.bbc.co.uk/news/health-44723638 |
Description | CNN News Online feature |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | CNN - 10/07/2018 Dr. Gideon Lack, senior author of the study and a professor and head of the Department of Paediatric Allergy at King's College London, the study's single most important finding was the "more than 50% reduction in the number of families reporting severe sleep disturbances in their babies." |
Year(s) Of Engagement Activity | 2018 |
URL | https://edition.cnn.com/2018/07/09/health/infant-sleep-solid-food-study/index.html |
Description | Daily Mail Newspaper article |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Daily Mail - 10/07/2018 p34 News. Ben Spencer . FEEDING babies solid food from when they are three months old could help them sleep better and improve their long-term health, a study suggests. The new study, by researchers at King's College London and St George's University of London, found solid food did in fact increase sleep time and reduced the number of times a baby woke. |
Year(s) Of Engagement Activity | 2018 |
URL | https://www.dailymail.co.uk/health/article-5933905/Babies-fed-solid-food-just-3-MONTHS.html |
Description | FSA National Science and Engineering Week event |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | Yes |
Type Of Presentation | Keynote/Invited Speaker |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | http://tna.europarchive.org/20120419000433/http://www.food.gov.uk/science/research/foodcomponentsresearch/allergyresearch/foodallergycommunicatinguncertainty The event was run as part of the National Science and Engineering Week, an annual event designed to celebrate science, engineering and technology and its importance in our lives. |
Year(s) Of Engagement Activity | 2011 |
Description | Interview for CNN |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Is food the cure for a food allergy? Food allergies are on the rise globally and researchers at Kings College London are finding a way to prevent them -- by feeding them. Extensive coverage of work including links to my biog, NEJM articles, the EAT website and NEJM article. The article was widely picked up by other media outlets and discussed widely on social channels. |
Year(s) Of Engagement Activity | 2016 |
URL | http://edition.cnn.com/2016/04/07/health/feeding-to-prevent-food-allergy/index.html?eref=edition |
Description | Interview for Scientific American journal on how to prevent food allergies - August 2019 |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Interview request following the American Academy of Pediatrics (AAP) updating its guidance in April 2019 that high-risk children (those with severe eczema or an allergy to eggs) be systematically fed "infant-safe" peanut products as early as four to six months of age to prevent this common and sometimes life-threatening allergy. Specifically wanted to know about the LEAP and EAT studies. |
Year(s) Of Engagement Activity | 2019 |
URL | https://www.scientificamerican.com/article/how-to-prevent-food-allergies/ |
Description | Interview for national news |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Guardian Newspaper article "Feeding your baby solids early may help them sleep, study suggests" |
Year(s) Of Engagement Activity | 2018 |
URL | https://www.theguardian.com/lifeandstyle/2018/jul/09/feeding-baby-solids-early-may-help-them-sleep-s... |
Description | Interview for national news |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | https://www.theguardian.com/society/2016/mar/04/early-introduction-peanuts-eggs-cuts-allergy-risk-eat-study |
Year(s) Of Engagement Activity | 2016 |
URL | https://www.theguardian.com/society/2016/mar/04/early-introduction-peanuts-eggs-cuts-allergy-risk-ea... |
Description | King's College London Allergy Academy Study Day |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | King's College London Allergy Academy: 10th food allergy study day meeting organised by the Clinical Immunology & Allergy Section of the Royal Society of Medicine. Keynote talk "EAT Study - the final results" |
Year(s) Of Engagement Activity | 2016 |
Description | NHK Japanese TV programme about food allergies |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Increased awareness of the research study Increased awareness of the research study, particularly in Japan |
Year(s) Of Engagement Activity | 2011 |
Description | Nature article on EAT study |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | http://www.nature.com/nature/journal/v479/n7374_supp/full/479S8a.html Increased awareness of the research studies |
Year(s) Of Engagement Activity | 2011 |
URL | http://www.nature.com/nature/journal/v479/n7374_supp/full/479S8a.html |
Description | New England Society of Allergy conference, Boston |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Fall 2016 New England Society of Allergy Meeting in Boston - special 60th anniversary meeting "Should Infants be Exclusively Breast Fed for 6 months?: The EAT Perspective"-named lecture for Dr. Frank Twarog Learning objectives and pre/post test questionnaires for the audience |
Year(s) Of Engagement Activity | 2016 |
Description | Radio 4 |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Interview with Prof Lack on Women's Hour on Radio4 Increase in recruitment calls |
Year(s) Of Engagement Activity | 2011 |
Description | TV interview - EAT study - 3 months may be more effective than 6 months in preventing food allergies (BBC World News, 4th December 2019) |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | BBC were interested in knowing more about the EAT study - particularly the suggestion that 3 months may be more effective than 6 months. Outcome or impact: Stimulating increased interest in research to e.g. influencing public policy; changes in public attitudes. |
Year(s) Of Engagement Activity | 2019 |
Description | The Journal of the American Medical Association article on food allergies |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | http://jama.jamanetwork.com/article.aspx?articleid=202252 Increased awareness of the research study |
Year(s) Of Engagement Activity | 2012 |
URL | http://jama.jamanetwork.com/article.aspx?articleid=202252 |
Description | The Times Newspaper article - Babies given solid food early sleep better, study claims |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Public/other audiences |
Results and Impact | Feeding babies solids from three months improves their sleep, according to a study that contradicts NHS advice. |
Year(s) Of Engagement Activity | 2018 |
URL | https://www.thetimes.co.uk/article/babies-given-solids-early-sleep-better-study-claims-pshrbrnbr |