Randomized Controlled Trial of Early Regular Egg Intake to Prevent Egg Allergy

J Allergy Clin Immunol. 2017 May;139(5):1600-1607.e2. doi: 10.1016/j.jaci.2016.06.052. Epub 2016 Aug 20.

Abstract

Background: The ideal age to introduce egg into the infant diet has been debated for the past 2 decades in the context of rising rates of egg allergy.

Objective: We sought to determine whether regular consumption of egg protein from age 4 to 6 months reduces the risk of IgE-mediated egg allergy in infants with hereditary risk, but without eczema.

Methods: Infants aged 4 to 6 months were randomly allocated to receive daily pasteurized raw whole egg powder (n = 407) or a color-matched rice powder (n = 413) to age 10 months. All infants followed an egg-free diet and cooked egg was introduced to both groups at age 10 months. The primary outcome was IgE-mediated egg allergy defined by a positive pasteurized raw egg challenge and egg sensitization at age 12 months.

Results: There was no difference between groups in the percentage of infants with IgE-mediated egg allergy (egg 7.0% vs control 10.3%; adjusted relative risk, 0.75; 95% CI, 0.48-1.17; P = .20). A higher proportion of participants in the egg group stopped taking the study powder because of a confirmed allergic reaction (25 of 407 [6.1%] compared with 6 of 413 [1.5%]). Egg-specific IgG4 levels were substantially higher in the egg group at 12 months (median, 1.22 mgA/L vs control 0.07 mgA/L; P < .0001).

Conclusions: We found no evidence that regular egg intake from age 4 to 6 months substantially alters the risk of egg allergy by age 1 year in infants who are at hereditary risk of allergic disease and had no eczema symptoms at study entry.

Keywords: Allergy prevention; complementary feeding; egg; food allergy; hereditary risk; oral tolerance; randomized controlled trial.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Egg Hypersensitivity / blood
  • Egg Hypersensitivity / diagnosis
  • Egg Hypersensitivity / immunology
  • Egg Hypersensitivity / prevention & control*
  • Egg Proteins / administration & dosage*
  • Egg Proteins / adverse effects
  • Egg Proteins / immunology
  • Eggs / adverse effects
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Infant
  • Male
  • Risk Factors

Substances

  • Egg Proteins
  • Immunoglobulin E