A new FDA ruling states the FDA will “acknowledge” and “exercise enforcement discretion” (meaning, not oppose) a qualified health claim associating the early introduction of peanuts into diets of young children with egg allergies or severe eczema as a way to reduce their risk for peanut allergy. The claim, which food manufacturers are allowed to use ASAP states, “For most infants with severe eczema and/or egg allergy who are already eating solid foods, introducing foods containing ground peanuts between 4 and 1 months of age and continuing consumption may reduce the risk of developing peanut allergy by 5 years of age. FDA has determined, however, that the evidence supporting this claim is limited to one study. If your infant has severe eczema and/or egg allergy, check with your infant’s healthcare provider before feeding foods containing ground peanuts.
This decision by the FDA is based on one randomized trial of peanut intake in infants at risk for peanut allergy published in the New England Journal of Medicine 1, the increasing prevalence of peanut allergy in US children based on epidemiologic evidence and pediatric authorities’ recommendations based on the 2017 Addendum Guidelines for the Prevention of Peanut Allergy in the United States. 2
In reality, a health claim is not really necessary. Opponents to the claim point out that the claim was due to a petition started by Assured Bites, Inc., who is the maker of Hello Peanut Products. The FDA often allows qualified health claims because food manufacturers want them for marketing and puts pressure on Congress to coerce the FDA to allow them.
The problem with a qualified health claim is that the qualifications get skewed in the marketing. Hello Peanut products may appear to parents to be better than less costly peanut products.
The seven most common food allergens are cow’s milk, eggs, peanuts, seafood, soy, tree nuts, and wheat with peanuts being the leading cause of severe food reaction and anaphylaxis. 3 Tree nuts include almonds, beechnuts, Brazil nuts, cashews, chestnuts, coconut, filberts, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts. 3 Signs and symptoms of food allergy may include but are not limited to: hives, eczema, itchy or swollen tongue, nausea, vomiting or diarrhea, stomach pain, shortness of breath, nasal congestion or runny nose and difficulty swallowing or breathing. 4
If your child suffers from severe eczema and/or egg allergy and is at risk for peanut allergy, talk to your pediatrician about the right time to start him or her on peanuts or peanut products. If your child is allergic to peanuts, all products containing peanuts must be strictly avoided. If the green light is given, don’t be fooled by the new health claim. Whatever peanut butter you have in the pantry at the time is likely just fine.
Submitted by Lisa Andrews, MEd, RD, LD
- Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy
George Du Toit, M.B., B.Ch., Graham Roberts, D.M., Peter H. Sayre, M.D., Ph.D., Henry T. Bahnson, M.P.H., Suzana Radulovic, M.D., Alexandra F. Santos, M.D., Helen A. Brough, M.B., B.S., Deborah Phippard, Ph.D., Monica Basting, M.A., Mary Feeney, M.Sc., R.D., Victor Turcanu, M.D., Ph.D., Michelle L. Sever, M.S.P.H., Ph.D., Margarita Gomez Lorenzo, M.D., Marshall Plaut, M.D., and Gideon Lack, M.B., B.Ch., for the LEAP Study Team* N Engl J Med 2015; 372:803-813February 26, 2015