Factors influencing adherence in a trial of early introduction of allergenic food


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.

Publication DOI: https://doi.org/10.1016/j.jaci.2019.06.046
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences > Applied Health Research Group
College of Health & Life Sciences
Additional Information: ©2019 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Uncontrolled Keywords: adherence,allergens,breastfeeding,diet,Food allergy,infancy,randomized controlled trial,Immunology and Allergy,Immunology
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://www.sci ... 0322?via%3Dihub (Publisher URL)
PURE Output Type: Article
Published Date: 2019-12-04
Accepted Date: 2019-06-14
Authors: , Enquiring About Tolerance (EAT) study team



Version: Published Version

License: Creative Commons Attribution

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