Scientific Study

Background: Randomized controlled trials have demonstrated that early introduction of allergenic foods, such as peanut and egg, can reduce food allergy in high-risk children. Many international guidelines recommend introduction in the first year of life and accordingly, the Swedish National Food agency released updated guidelines in June 2019. Objective: To examine if the age at introduction and consumption frequency of allergenic foods have changed since the release of revised national guidelines on the introduction of solid foods in Sweden. Methods: Children born between June 2016 and December 2018 (n=1925) were compared to children born between June 2019 and April 2021 (n=1761) using data from the NorthPop Birth Cohort study. Data on food introduction, eczema and food allergy were prospectively collected until age 18 months using web-based questionnaires. IgE sensitization was assessed at 18 months of age. Results: The proportion who had introduced egg, legume, soy protein, peanut, almond and cashew nut during the first year of life increased after the implementation of revised national guidelines. The most significant change was seen for legume (55.2% to 69.8% aOR 1.90 (95% CI: 1.62-2.24) and peanut (29.2% to 43.2% aOR 1.87 (95% CI: 1.55-2.24) and the consumption frequency had also increased. No differences in the prevalence of eczema, food allergy or sensitization to the foods of interest were found. Conclusion: Since the release of revised guidelines, infants in the general population introduce and consume a variety of allergenic foods earlier and more frequently, while early manifestations of allergic disease remained unchanged.

https://doi.org/10.1016/j.jaci.2023.08.037