Conclusions
The evidence supporting the role of early introduction of potential allergens in the development of oral tolerance to prevent food allergy is mounting. Although there are still questions as to the timing and also which allergens can be introduced safely and with effect, a shift from recommending avoidance of common food allergens to early consumption strategies to prevent the development of food allergy is occurring. It appears that the window of opportunity for intervention is starting to close upon reaching the milestone of sitting and is almost entirely closed upon reaching the milestone of walking. Studies such as the LEAP study have already been influential in recommendations in order to prevent the development of peanut allergy. The EAT study results, in the per protocol population, support the LEAP findings and also demonstrate a reduction in egg allergy in the early introduction group. A clinical reduction in allergy could not be demonstrated for the other food allergens in EAT, but there were trends towards the reduction of both peanut and egg and the ingestion of these allergenic foods proved nutritionally safe. Indeed, there were many favourable nutritional outcomes related to early peanut introduction and ongoing consumption in the LEAP study. These recent advances towards food allergy prevention are extremely promising, but further work is required to establish if they will be as effective for other common food allergens.
