Beneficial Effect of Diet Intervention on School Children with Atopic Dermatitis

Article information

Korean J Health Promot. 2016;16(1):32-36

Publication date (electronic) : 2016 January 20

doi : https://doi.org/10.15384/kjhp.2016.16.1.32

Jae Hyuck Lee ¹, Seung Wan Hong ¹, Sung-Ae Kim ², Hee Joung Choi ³, Mi Kyung Kim ⁴, Young-Sung Suh ¹^,

¹Department of Family Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea

²Department of Dermatology, Keimyung University Dongsan Medical Center, Daegu, Korea

³Department of Pediatrics, Keimyung University Dongsan Medical Center, Daegu, Korea

⁴Department of Endocrinology, Keimyung University Dongsan Medical Center, Daegu, Korea

Corresponding author: Young-Sung Suh, MD, PhD Department of Family Medicine, Keimyung University Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea Tel: +82-53-250-7263, Fax: +82-53-250-7071 E-mail: ysseo@dsmc.or.kr

Received 2015 September 18; Accepted 2016 February 18.

Abstract

Background

Atopic dermatitis (AD) is one of the most common skin disorders affecting infants and children. Food allergy is a strong risk factor for the development of AD. This study was designed to evaluate the improvement of symptoms among AD patients in the late childhood while they take the customized (organic, balanced, non-allergic, diverse vegetable, little saturated fat and trans fat free) diet.

Methods

Nineteen children with AD who agreed to the written consent were enrolled in the study from October to December, 2014. We supplied them with the customized diet for 8 weeks. Clinical evaluations, blood tests and nutritional status were conducted at baseline, at 4th and at 8th week. Eczema area and severity index (EASI) and Scoring atopic dermatitis (SCORAD) were used to determine the severity of AD.

Results

The mean age of 19 patients was 8.5±1.54 years. EASI and SCORD index were decreased after diet intervention (2.6±3.06 [standard deviation] vs. 2.0±2.93 P＝0.026, 24.9±10.76 vs. 20.0±12.65 P＝0.009). Pruritus scores using visual analogue scale, rated by patients and hemoglobin revealed statistically significant improvement after diet intervention.

Conclusions

The customized diet helps to improve the symptoms of atopic dermatitis and the nutritional indicators. Additional long-term and large-scale studies are required as well as the development of various diets.

Keywords: Dermatitis; Atopic; Eczema; Diet; Severity of illness index

Table 1.

General characteristics of all participants^a

Table 2.

Comparing EASI and subscales before and after diet intervention^a

Table 3.

Comparing SCORAD index and subscales before and after diet intervention^a

Table 4.

Comparing blood tests before and after diet inter vention^a

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Table 1.

General characteristics of all participants^a

	0 wk	4 wk	8 wk	P^b
Height, cm	131.6±11.42	131.7±11.46	132.2±11.41	0.049
Weight, kg	30.1±2.62	30.9±2.53	30.8±2.48	0.822
Body mass index, kg/m²	17.3±3.43	17.3±3.15	17.2±3.06	0.347
Fat, kg	7.1±6.24	7.8±6.03	7.2±5.70	0.003
Fat free mass, kg	23.7±5.51	23.0±5.30	23.7±5.38	0.003
Body fat, %	20.5±8.07	23.0±7.64	21.02±7.24	0.001

Values are presented as Mean±SD unless otherwise indicated.

P-value was calculated by repeated-measures ANOVA.

Table 2.

Comparing EASI and subscales before and after diet intervention^a

	0 wk	4 wk	8 wk	P^b
EASI scale	2.6±3.06	1.6±2.05	2.0±2.93	0.026
Head and Neck	0.17±0.32	0.08±0.15	0.13±0.25	0.288
Upper limbs	0.50±0.59	0.31±0.35	0.45±0.65	0.105
Trunk	0.47±1.09	0.27±0.71	0.31±0.66	0.567
Lower limbs	1.5±2.46	0.88±1.76	1.1±1.81	0.008

Abbreviation: EASI, eczema area severity index.

Values are presented as Mean±SD unless otherwise indicated.

P-value was calculated by repeated-measures ANOVA.

Table 3.

Comparing SCORAD index and subscales before and after diet intervention^a

	0 wk	4 wk	8 wk	P^b
SCORAD Index	24.9±10.76	19.1±9.93	20.0±12.65	0.009
Area	7.1±9.38	6.6±7.58	7.1±13.97	0.873
Erythema	1.2±0.54	1.0±0.75	1.2±0.86	0.461
Excoriation	0.95±0.71	0.53±0.51	0.42±0.51	0.002
Edema/Papulation	n 0.95±0.52	0.11±0.32	0.42±0.51	＜0.001
Oozing/crusting	0.42±0.69	0.89±0.57	0.84±0.50	0.005
Lichenification	0.53±0.51	0.26±0.45	0.32±0.48	0.075
Xerosis	1.1±0.57	1.0±0.62	0.74±0.45	0.128
Itching sensation	4.4±1.79	3.3±2.04	3.6±2.01	0.018
Sleep disturbance	1.2±1.76	1.8±1.74	1.2±1.70	0.236

Abbreviation: SCORAD, scoring atopic dermatitis.

Values are presented as Mean±SD unless otherwise indicated.

P-value was calculated by repeated-measures ANOVA.

Table 4.

Comparing blood tests before and after diet inter vention^a

	0 wk	8 wk	P^b
WBC, Thous/uL	7.5±2.20	6.6±2.11	0.112
Eosinophil, %	4.1±3.07	3.6±2.62	0.467
Hb, g/dL	13.1±0.78	13.6±0.69	＜0.001
Hct, %	38.2±1.81	40.7±2.51	＜0.001
Platelet, Thous/uL	304.3±55.83	288.6±80.73	0.298
Total protein, g/dL	7.1±0.45	7.5±0.51	0.005
Albumin, g/dL	4.6±0.51	4.8±0.42	0.104
AST, U/L	29.3±8.31	30.1±5.38	0.624
ALT, U/L	18.2±22.23	13.7±7.50	0.222
GTP, U/L	11.6±6.06	11.2±3.82	0.607
ALP, U/L	264.8±73.26	244.3±48.44	0.176
Iron, ug/dL	72.3±21.10	80.2±25.50	0.294
TIBC, ug/dL	361.4±39.88	346.6±36.85	0.007
transferrin sat, %	20.0±5.57	23.5±7.95	0.115
Ferritin, ng/mL	56.6±31.50	57.4±37.47	0.887

Abbreviation: WBC, white blood cell; Hb, hemoglobin; Hct, hem atocrit; AST, aspartate aminotransferase; ALT, alanine aminotrans ferase; GTP, gamma-glutamyl transferase; ALP, alkaline phospha tase; TIBC, total iron-binding capacity.

Values are presented as Mean±SD unless otherwise indicated.

P-value was calculated by paired t-test.