Approximately one third of parents of children with atopic dermatitis (AD) reported little or no improvement with elimination diets, and nearly 80% reintroduced the eliminated foods, based on survey data from nearly 300 parents. Although AD can be associated with an increased risk for food allergies, major allergy organizations do not currently recommend elimination diets as a treatment for AD.
A fear of drastic dietary changes often prevents families from seeking the care their children need. Many patients who have started food elimination diets on their own or as recommended by other doctors, these diets can lead to dangers such as the development of immunoglobulin E–mediated food allergies on reintroduction of eliminated foods and malnutrition. Based on a recent survey made between parents, the most commonly identified triggers were milk, tree nuts/seeds/peanuts and eggs. Of the parents who reported food triggers, 23% removed the suspected trigger food from the child’s diet completely, 20% removed suspected trigger foods from their own diets while breastfeeding, and 19% changed their infant’s formula. In the wake of the elimination diets, 38% of the parents reported no improvement in their child’s AD, 35% reported a 25% improvement, and 9% reported complete resolution. The majority (79%) reintroduced eliminated foods and reported no recurrence of AD symptoms.
The researchers were surprised by how many parents changed their child’s diet in the belief that certain foods exacerbated their child’s AD. Indeed, this perception aligns with the common concern that food allergens can trigger or worsen atopic dermatitis flares. The current study highlights the need for more awareness of the limited impact of dietary modifications on AD in the absence of confirmed food allergies. Many practitioners continue to recommend excluding foods such as gluten or dairy from the diet, but generally these are only of modest help, and although patients wish that dietary changes would fix the problem, most are left wondering why these changes didn’t help them.
Recent research has shown that by eating foods regularly, particularly those such as peanuts that seem to have more allergic potential, the body becomes tolerant, and this prevents the development of true food allergies, he said. As for additional research, many questions remain about the effects of types of foods, processing methods, and timing of introduction of foods on AD, said Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine, Chicago, in an interview.
