Can allergen-introduction products solve a health crisis?

More children than ever are affected by allergies, but recent research suggests that providing babies with peanuts and dairy early reduces health risks later on.

22 October 2019
childrendairyfree-fromhealthnuts and seeds
image credit: Beyond Brands

At the end of last month, Nestlé took a minority stake in a little-known company called Before Brands. As part of the deal, the food giant gained exclusive licensing rights for Before Brands’ products outside the United States – in particular, SpoonfulOne. This range claims to help reduce allergies in children by encouraging a tolerance to the food groups associated with 90% of allergic reactions. 

"This investment enhances our growing business with a new dimension: allergy prevention," said Greg Behar, CEO of Nestlé Health Science, when the deal was announced. "The prevalence of food allergies among children is increasing; however, studies have shown that consistently exposing children at a very early age to a potential food allergen can reduce the development of an allergy to that food by up to 80%.”

While how exactly Nestlé intends to capitalise on its investment has not been explained, there’s certainly potential to not only sell SpoonfulOne directly, but also incorporate it into existing baby formula products and infant meals.

According to figures from NHS Digital, the number of children in the UK hospitalised due to food allergies has risen 76% since 2013. Official estimates suggest that up to 8% of children are affected by allergies, compared to 2% of adults.

“Today, every school class has one or two children with a food allergy, while several decades ago it was unheard of,” Paul Turner, a clinician scientist in paediatric allergy and immunology at Imperial College London, told the Sunday Times

How does SpoonfulOne work?

There is evidence that early introduction of allergens may decrease the likelihood of a child developing allergies in later life.

A study in 2015 by Learning Early About Peanut (LEAP) found an 81% lower rate of peanut allergy at 60 months of age for those who were fed peanuts before they turned 11 months compared to those who weren't.

In a similar piece of research by Enquiring About Tolerance (EAT), 1,303 exclusively breast-fed three-month-old infants were divided into two groups: one was introduced early to six allergenic foods (peanut, cooked egg, cow’s milk, sesame, whitefish, and wheat) and one was only introduced at six months – the current minimum recommended age for allergen introduction in the UK. The researchers found that the “prevalence of any food allergy was significantly lower in the early-introduction group than in the standard-introduction group.”

It should also be noted that the process was deemed ‘safe’ by the study, which resulted in no life-threatening events.

SpoonfulOne references these findings to support its approach. For children four months and up, the company produces a mix-in product purporting to contain 90% of the foods responsible for allergies – “just mix one packet into your baby’s favourite food daily.” Children six months up who have begun to consume solid food can opt instead for puffs, flavoured with maple or strawberry. 

It’s not the only company adopting this approach to allergens. Hello, Peanut focuses specifically on peanut allergies and has had its claims around allergen prevention approved by the US Food and Drug Administration. Inspired Start offers different products for babies aged four to six months that target different allergens in groups. For example, one introduces peanut, egg, tree nut, and soy; another targets wheat, sesame, shrimp and cod.

Ready, Set, Food targets peanut, egg and milk allergies specifically, with products it claims are suitable for babies aged four to 11 months. Like the other brands mentioned here, it is also keen to highlight its additive-free status, emphasising that the ingredients are natural and wholesome.

What do the dieticians say?

While the attraction of these products for parents is obvious, the big question is whether potential customers will see things like SpoonfulOne as safe and free from risk. When it comes to expert advice and government recommendations, the suggestions are decidedly conservative.

Paediatric dietitian Judy More, who runs a child nutrition consultancy in London, said that the product sounds okay for low-risk babies, but it would not be suitable for babies at a higher risk of allergies, such as those with moderate or severe eczema. “It would be better to introduce the high allergen foods one at a time so that if there is a reaction, the specific protein can be easily identified,” she adds. 

Bahee Van de Bor, a specialist paediatric dietitian, notes that the UK Department of Health recommends that high allergenic foods are introduced one at a time from six months of age, with a gap of three days in between. Only after several successful episodes of eating high allergenic foods should meals with a mixture of the high allergenic foods be offered.

“SpoonfulOne has a blend of six different high allergenic foods (plus a variety of nuts) and opposes UK advice of offering high allergenic foods one at a time,” she cautioned. “Although the supplement has been tested in 321 healthy full-term babies of age five to 12 months of age, further studies would be required to assess the safety of this approach for introducing high allergenic foods.

“There is also no advantage to offering multiple high allergenic foods in a single episode using a protein supplement as it would be extremely difficult to ‘tease’ out which food caused the allergenic reaction. This can only be established by offering allergenic foods one at a time.”

Van de Bor concluded that there may be a role for using products like SpoonfulOne “further down the weaning journey to maintain exposure and tolerance to a high allergenic protein that a baby was previously allergic,” but stresses that this should always be completed under the supervision of an allergy team.

Taking these opinions into consideration, it’s hard to see an immediate route to market for allergen-introduction products – perhaps why there don't appear to be any options available in the UK. Even in the US, where some can be purchased easily on Amazon, there are only a limited number of brands working in this area, though arguably this is down to the fairly recent reversal of official recommendations regarding allergens in infant diets.

However, the concept does appear to fit with the overall goals of Nestlé Health Science (NHS amusingly being its abbreviated name), which specialises in nutritional solutions. Just a few weeks before its investment in SpoonfulOne was announced, the wholly owned Nestlé subsidiary revealed it had acquired personalised nutrition company Persona, with an eye to introducing the brand in 32 countries throughout Europe and Asia by November. 

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