The effects of elimination diet on nutritional status in subjects with atopic dermatitis

Abstract

A food allergy is an adverse health effect arising from a specific immune response that occurs reproducibly upon exposure to a given food. In those with food allergies that are thought to cause aggravation of eczema, food avoidance is important. The objective of this study was to research the nutritional status of patients with food allergies. A total of 225 subjects diagnosed with atopic dermatitis underwent a skin prick test as well as measurement of serum immunoglobulin E. Food challenge tests were conducted using seven food items: milk, eggs, wheat, soybeans, beef, pork, and chicken. At post-food challenge visits to the test clinic, participants completed a three-day dietary record, which included two week days and one weekend day, in order to evaluate energy intake and diet quality during the challenge. We analyzed nutrient intake based on differential food allergens. Subjects with a food allergy to milk showed lower intake of Ca, Zn, and vitamin B2, and subjects with a food allergy to egg showed lower intake of vitamin A, B1, B2, niacin, and cholesterol. Subjects with a food allergy to wheat and soybean showed lower intake of Ca, P, Fe, K, Zn, vitamin B2, vitamin B6, and niacin; and subjects with a food allergy to beef, pork, and chicken showed lower intake of Fe and higher intake of K, vitamin A, B2. Subjects with atopic dermatitis were lacking in several nutrients, including vitamin A and vitamin C. A greater number of food allergies showed an association with a greater number of nutrient intake deficiencies. Allergen avoidance is the basic treatment for atopic dermatitis. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. Findings of this study suggest the necessity for enhanced nutritional education in order to provide substitute foods for patients with food allergies who practice food restriction.

Comparison of nutrient intake in adolescents and adults with and without food allergies

“…A higher intake of selenium has previously been reported in infants consuming a milk‐free diet , which may be explained by the selenium content of substitute soya products . Only one previous study of adolescents was identified in the literature, which did not show any difference in nutritional intake in 12–19 year olds .…”

“…Kim et al . demonstrated higher intakes of calcium, iron, folate and vitamin E in adults with food allergy; however, they included participants with atypical food allergies to beef, pork and chicken; the control participants had atopic dermatitis and the contribution of dietary supplements was not clear. Nachshon et al .…”

Oral Immunotherapy for Food Allergy

“…Food allergy is potentially life-threatening and has a major impact on quality of life [3,4]. Avoidance is currently the only approved therapy, and, although effective, avoidance diets can be difficult and may also put children at risk of nutritional deficiencies and impaired growth [5,6]. While at least 80% of milk-and eggallergic children are expected to achieve natural tolerance to these foods by adulthood, only 15%-20% of peanut-or tree nut-allergic individuals "outgrow" their allergies [7].…”

Management of Food Allergy

“…7,[26][27][28][29][30] A comprehensive baseline nutrition assessment includes gathering, verifying and interpreting data from anthropometric measurements, dietary history, medical history, physical examination and laboratory indices. For example, cafeterias, buffets and salad bars have inherently greater risk of cross-contact due to spillage and shared serving utensils.…”