Peanut exposure during pregnancy,breastfeeding and complementary feeding: perceptions of practices in four countries

Food allergy is an increasing problem worldwide. Allergy to peanuts is a particular concern, given that this is rarely outgrown and may be associated with life‐threatening anaphylaxis. However, it is unclear what factors are responsible for a perceived increase in prevalence rates. One matter on which scientists agree, however, is that exposure to peanuts early in life is significant – although whether early exposure protects or sensitizes to allergy is unclear. There is no significant research that currently records differences in early life exposure either within or between populations. This exploratory study makes a first step in this direction using focus groups conducted in four countries with disparate ‘peanut experiences’ to characterize early exposure in these. The ultimate aim is to help in the development of a survey instrument to attain nationally representative samples of consumers and hence to use the results from this to compare with allergy prevalence data collected in other parts of the European Union‐funded ‘EuroPrevall’ project. The results in this study not only reveal considerable similarities across countries (e.g. in terms of lack of knowledge of guidelines; lack of changes in feeding behaviour during/after pregnancy, feelings that diet variety in children is important) but also one or two interesting and potentially important differences, such as increased consumption in Bulgarian (and some Spanish) breastfeeding mothers because of the ability of peanuts to facilitate lactation. Study limitations and future study intentions are also discussed.     

A characterization of peanut consumption in four countries: results from focus groups and their implications for peanut allergy prevalence

Rates of peanut allergy in the Western world have increased over the last 30 years, although it is unclear why. While eating behaviours are likely to be connected to allergy prevalence, the precise relevant factors are uncertain. This study aimed to investigate dietary differences and changes in dietary habits in peanut consumption (in apparent and hidden forms) in four different countries (Bulgaria, Poland, Spain, UK), specifically chosen because of their different ‘peanut experiences’. Focus groups revealed a common perception that dietary habits have become less healthy, with more consumption of processed foods and an increase in snacking. In addition, ethnic cuisine was perceived to have had an important impact on European eating habits, while participants identified an increase in consumption of more ‘exotic’ forms of peanuts and their products. These findings point to an increase in exposure to peanuts, particularly in hidden forms, that superficially parallels increased prevalence rates. However, it was also clear that participants lacked knowledge about the composition of food and non‐food products. The dietary trends identified here thus warrant further quantitative investigation, particularly in the context of differential national patterns of allergy prevalence – data on which is currently being gathered within the EC‐funded EuroPrevall project.