This New York Times story covers the health claims of Hello, Peanut!, a powdered peanut product that allows parents to gradually expose their infants to peanuts, in accordance with pediatricians’ and allergists’ advice that the practice reduces the risk of children developing peanut allergies.
The recently released, updated medical advice promoting early exposure to peanuts is a complete reversal from the American Academy of Pediatrics’ previous guidelines, which said that high-risk infants should avoid peanuts up to age 3. New guidelines are based on the results of one study conducted in 628 infants at high risk for peanut allergy, which found that early introduction of peanuts significantly decreased the frequency of the development of peanut allergy and modulated immune responses to peanuts.
The story covers the science behind the change as well as a range of reactions concerning the new product and its qualified health claim. The story was strong on many points, though we wished it had better explained what a qualified health claim is, and why changing guidelines based on one study can be risky.
While the story details the study that the qualified health claim is based on, it does not help readers understand how to interpret that limited evidence.
The story cites the product’s cost: $25 for the introduction kit and and $20 for the maintenance kit, which lasts for about three weeks. The story does not indicate how many weeks that proper use entails, but the randomized trial cited by the AAP in forming their recommendations (the Learning Early about Peanut Allergy (LEAP) study) continued peanut exposure until age 5. If Hello, Peanut! was used for the same duration, the total tab would be just over $1,900, a not-insignificant expense. Other less costly alternatives to include mixing smooth peanut butter into pureed fruits and vegetables – which is suggested by the AAP in the new guidelines. Yet, this alternative is not mentioned by the NYT.
The LEAP study spurred the reversal in advice for exposing infants to peanuts, a decision that then led to the formulation and release of Hello, Peanut! as well as the qualified health claim it now carries.
The NYT story details the fact that LEAP study results indicated that by the time infants turned 5, only 1.9% of the 530 allergy-prone children who had been fed peanuts regularly since infancy had developed an allergy, compared with 13.7% of the children who had not consumed peanuts.
The story covers directions for Hello, Peanut!’s use in great detail, and also emphasizes that if a baby develops a reaction, parents should discontinue use and contact their pediatrician. The story also discusses potential harms of the product specifically in terms of unintended use. Quoted sources worry that consumers might mistake the product as a cure for peanut allergies as opposed to a preventative tactic. Feeding the product to a child with an existing peanut allergy would likely cause an allergic reaction.
The story’s initial focus is the labeling on this product — FDA approved language allows the product to claim it “may reduce the risk of developing peanut allergy.” The language also requires this caveat: “the evidence supporting this claim is limited to one study.” While the story details the study that the qualified health claim is based on, it does not help readers understand how to interpret that limited evidence. The NYT could have devoted some text to describing exactly what a qualified health claim is and why the FDA made its decision to allow it to appear on this product, as well as the weaknesses inherent in basing wide-reaching guidelines on limited evidence.
Peanut allergies can result in serious and potentially life-threatening reactions in kids who are exposed. No disease-mongering here.
The story quotes the physician-developer of the product, government officials and physician-patient advocates. While we would have liked an expert source with no direct ties to industry or advocacy, we’ll rate this Satisfactory.
The story notes that peanut butter can be diluted with water to make a soupy, infant-friendly, peanut-containing food at less cost than the packaged powder product.
The story makes clear that the product is available for purchase and goes so far as to hyperlink to its website, where people can place an order. We’d call this establishing availability – sure. But it also might go a step beyond and risk actually advertising the product under scrutiny in the story.
The main thrust of the story is the novelty of the FDA approving the claim of a health benefit with this product.
The story does not appear to be based on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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