TY - JOUR
T1 - Factors influencing adherence in a trial of early introduction of allergenic food
AU - Perkin, Michael R.
AU - Bahnson, Henry T.
AU - Logan, Kirsty
AU - Marrs, Tom
AU - Radulovic, Suzana
AU - Knibb, Rebecca
AU - Craven, Joanna
AU - Flohr, Carsten
AU - Mills, E. N.
AU - Versteeg, Serge A.
AU - van Ree, Ronald
AU - Lack, Gideon
AU - Enquiring About Tolerance (EAT) study team
AU - Young, Louise
AU - Offord, Victoria
AU - DeSousa, Mary
AU - Cullen, Jason
AU - Taylor, Katherine
AU - Tseng, Anna
AU - Raji, Bunmi
AU - Byrom, Sarah
AU - Regis, Gillian
AU - Bigwood, Charlie
AU - Stedman, Charlotte
AU - Tonner, Sharon
AU - Banks, Emily
AU - Kahnum, Yasmin
AU - Babic, Rachel
AU - Stockwell, Ben
AU - Thompson, Erin
AU - Wheatley, Lorna
AU - Patkunam, Devi
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background: The Enquiring About Tolerance (EAT) study examined whether the early introduction of 6 allergenic foods from 3 months of age in exclusively breastfed infants prevented the development of food allergy. The intervention was effective in the per-protocol analysis for allergy to 1 or more foods and for egg and peanut individually, but only 42% of early introduction group (EIG) children met the per-protocol criteria. Objective: We sought to identify which factors were responsible for nonadherence in the EAT study. Methods: Factors influencing adherence within the key early introduction period in the EIG (up to 6 months of age) were divided into enrollment and postenrollment factors, and their association with nonadherence was explored. Results: In an adjusted analysis, at enrollment, increased maternal age, nonwhite ethnicity, and lower maternal quality of life were independently and significantly associated with overall nonadherence in the EIG. Enrollment eczema and enrollment serum allergen-specific IgE sensitization to 1 or more foods (≥0.1 kU/L) were not related to overall nonadherence. After enrollment, 2 factors were significantly related to EIG overall nonadherence: parent-reported IgE-type symptoms with infant allergenic food consumption by 6 months of age and reported feeding difficulties by 4 months of age. Conclusion: If early introduction of allergenic foods were to be considered a strategy to prevent food allergy, families of nonwhite ethnicity, those with older mothers, and those with infants with reported feeding difficulties or early-onset eczema would benefit from support to promote early and sustained consumption.
AB - Background: The Enquiring About Tolerance (EAT) study examined whether the early introduction of 6 allergenic foods from 3 months of age in exclusively breastfed infants prevented the development of food allergy. The intervention was effective in the per-protocol analysis for allergy to 1 or more foods and for egg and peanut individually, but only 42% of early introduction group (EIG) children met the per-protocol criteria. Objective: We sought to identify which factors were responsible for nonadherence in the EAT study. Methods: Factors influencing adherence within the key early introduction period in the EIG (up to 6 months of age) were divided into enrollment and postenrollment factors, and their association with nonadherence was explored. Results: In an adjusted analysis, at enrollment, increased maternal age, nonwhite ethnicity, and lower maternal quality of life were independently and significantly associated with overall nonadherence in the EIG. Enrollment eczema and enrollment serum allergen-specific IgE sensitization to 1 or more foods (≥0.1 kU/L) were not related to overall nonadherence. After enrollment, 2 factors were significantly related to EIG overall nonadherence: parent-reported IgE-type symptoms with infant allergenic food consumption by 6 months of age and reported feeding difficulties by 4 months of age. Conclusion: If early introduction of allergenic foods were to be considered a strategy to prevent food allergy, families of nonwhite ethnicity, those with older mothers, and those with infants with reported feeding difficulties or early-onset eczema would benefit from support to promote early and sustained consumption.
UR - http://www.scopus.com/inward/record.url?scp=85075334020&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jaci.2019.06.046
DO - https://doi.org/10.1016/j.jaci.2019.06.046
M3 - Article
C2 - 31812183
SN - 0091-6749
VL - 144
SP - 1595
EP - 1605
JO - Journal of allergy and clinical immunology
JF - Journal of allergy and clinical immunology
IS - 6
ER -