Study: Parents’ understanding of atopic dermatitis may influence child’s diet

BOSTON (Oct. 24, 2024) – Parents of children with atopic dermatitis (AD, also called eczema) know that the allergic condition can mean a heightened risk of developing food allergies. The desire to prevent food allergies causes some parents to consider elimination diets, cutting out certain foods from their child’s diet. A new study being presented at this year’s American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Boston showed that elimination diets in the case of atopic dermatitis only mildly improved AD lesions in one-third of the study participants.

“Elimination diets aren’t recommended as a treatment for AD, according to guidelines from major allergy organizations,” says pediatric resident Nadia Makkoukdji, MD, lead author of the study. “For our study, parents of infants and children with AD completed a survey in a number of sites in a single health care system including the emergency department, allergy, dermatology and general pediatrics clinic to gauge their perceptions of the effects of elimination diets on development of food allergies.”

298 parents completed the survey. 42% reported that certain foods exacerbate their child’s eczema. The foods most frequently identified as triggers were milk (32%), tree nuts/seeds/peanuts (16%,) and eggs (11%).

Among those who identified food triggers:

• 19%  changed their baby's formula
• 20% eliminated certain foods from their diet while breastfeeding and
• 23% completely removed the suspected foods from their child's diet.

Regarding the elimination diet's effectiveness, 38% observed no improvement in AD, 35% reported 25% improvement, and 9% noted complete resolution. Additionally, 79% of responders reintroduced the eliminated foods without recurrence of eczema symptoms. The authors concluded that parents' understanding of AD and its dietary links significantly influenced their children's diets.

Abstract Title: A SURVEY OF PARENTAL ECZEMA PERCEPTIONS AND ITS RELATIONSHIP TO DIETARY INTAKE IN SOUTH FLORIDA (Full abstract below)

Presenter: Nadia Makkoukdji, MD

For more information about food allergies, or to find an allergist in your area, visit AllergyandAsthmaRelief.org. The ACAAI Annual Scientific Meeting is Nov. 9-13. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI24.

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A SURVEY OF PARENTAL ECZEMA PERCEPTIONS AND ITS RELATIONSHIP TO DIETARY INTAKE IN SOUTH FLORIDA
N. Makkoukdji^*, J. Gebbia, A. Cruz, G. Kleiner, F. Bellodi-Schmidt, M. Gans, Miami, FL.

Introduction: Children diagnosed with atopic dermatitis (AD) face a heightened risk of developing food allergies; however, food elimination diets are not recommended as a treatment in patients orally tolerating foods per ACAAI/AAAAI/AAD 2023 Practice Parameters. 

Methods: We conducted a single health care system cross-sectional Institutional Review Board approved survey study in a single academic center. Parents of children with an AD diagnosis were invited to complete the survey in the emergency department, allergist, dermatology and general pediatrics clinic. Statistical analysis was performed. 

Results: 298 parents completed the survey. 58% (119/205) reported certain foods did not exacerbate their child’s eczema. The foods most frequently identified as triggers were milk (32%, 61/193), tree nuts/seeds/peanuts (16%, 31/193) and eggs (11%, 22/193). Among those who identified food triggers, 19% (36/193) changed their baby's formula, 20% (39/193) eliminated certain foods from their diet while breastfeeding, and 23% (44/193) completely removed the suspected foods from their child's diet. Regarding the elimination diet's effectiveness, 38% (33/87) observed no improvement in AD, 35% (30/87) reported 25% improvement, and 9% (8/87) noted complete resolution. Additionally, 79% of responders (33/42) reintroduced the eliminated foods without recurrence of eczema symptoms.

Conclusion: In this survey, parents' understanding of AD and its dietary links significantly influenced their children's diets. Despite elimination diets, only one-third of respondents saw mild improvement in AD lesions. Larger studies are needed to confirm these findings and further explore diet's role in AD.