Nutrition for Eczema: Atopic Dermatitis
  • December 14, 2021
  • by Jennifer Brand, MPH, MS, CNS

Atopic Dermatitis (AD) Facts (1)

Atopic dermatitis (AD) is a chronic inflammatory type of eczema. It affects 15% to 20% of children and 1% to 3% of adults, and is the most common skin condition in children, often appearing by age 5. There can be a significant burden for those struggling with AD, as well as for their families.  

Symptoms can include itchy, flaky, dry, weepy, painful, red, and inflamed skin rashes. Approximately 10% to 30% of children with AD will continue to have symptoms into adulthood.  

The incidence of AD has increased significantly (2 to 3 fold) in industrialized countries since the 1970s.  

AD is an immune-mediated condition. It is associated with other inflammatory health issues, including asthma, environmental allergies, and food allergies (the atopic triad or atopic march). Comorbidities include attention-deficit disorder, hyperactivity disorder, speech disorders, anxiety, depression, headaches, anemia, epilepsy, obesity, other risk factors for cardiovascular disease, and low bone mineral density.

Risk Factors for Atopic Dermatitis (AD) (2)

  • Immune system dysfunction and underlying inflammation
  • Genetic predisposition, family, and maternal history
  • Food allergy Impaired skin barrier function
  • Environmental factors and exposures
  • Decreased microbial exposure in early childhood

Good Nutrition for Atopic Dermatitis (3-7)

Dietary recommendations should be individualized, diagnosed food allergies must be taken into account, and foods should not be restricted unnecessarily. (3)

In infancy and early childhood, common food allergens include cow dairy, chicken eggs, wheat and gluten, soy, tree nuts, and peanuts. In older children, adolescents, and adults, pollen-related food allergies should be considered as well. (4,5,6)

A maternal and childhood anti-inflammatory diet rich in vegetables, fruits, fish and other omega 3 rich foods (i.e., flax and chia seeds), vitamin D, and other nutrients required to build and repair healthy skin is recommended. Identified food allergens should be avoided. (3,7)

Key Nutrients (8 - 23)

Nutrition is an essential factor in skin health. Evidence of this is seen where malnutrition or deficiencies of specific nutrients have a negative impact on wound healing after injury and surgery. (8)

Antioxidants

Because AD is an inflammatory skin disease, diets rich in anti-inflammatory and antioxidant foods may decrease inflammation, improve antioxidant status, and thus positively affect skin health. (9,10,11,12)

Vitamin A  

Vitamin A is highly associated with epithelial tissue (layer of cells that covers the inner and outer surfaces of the body) throughout the body, including the skin. Low vitamin A status may contribute to AD and other skin problems (like keratosis pilaris). (12)

Vitamin E  

Vitamin E protects cell membranes (including those of skin cells). It has been used topically to decrease scarring and reduce itching. (12,13)  

Vitamin D  

Vitamin D has an important role in immune system health, and deficiency can lead to increased risk and severity of AD. Children of mothers with low vitamin D status during pregnancy have an increased prevalence of AD. (14)

Glutathione: Vitamin B2 & Selenium

Vitamin B2 (Riboflavin) is needed to make glutathione, the body's master antioxidant. Low glutathione is found in people with AD. (15,16). The mineral selenium is needed for glutathione production as well. Selenium can help decrease inflammation and oxidative stress, which contribute to AD and its severity. (17)

Collagen: Vitamin B6, Vitamin C, Amino Acids, Iron, Copper & Magnesium

Vitamin C is an antioxidant nutrient essential for the synthesis of collagen, the most abundant protein in the body. Collagen has an important role in giving structure to the skin. (12,18) Iron, amino acids, vitamin B6 (8,18,19), copper, and magnesium play important roles in collagen production. Additionally, magnesium functions as an enzyme cofactor for protein synthesis. (20,21)

Zinc  

Low zinc levels (serum, hair, and red blood cell) are found in people with AD. (22)

Omega 3 & Omega 6 – Fatty Acids

Essential fatty acids are required for cell membrane structure and integrity. Additionally, omega 3 fatty acids EPA and DHA can improve AD symptoms because of their anti-inflammatory effects. Supplementing fish oil during pregnancy can reduce the severity of AD during the first year of life (23,24). The incidence of AD is higher in infants consuming breast milk that is low in omega 3 fatty acids and high in saturated fats (24).

Protein and carbohydrates

Protein deficiency can negatively impact various factors necessary for building, repairing, and maintaining healthy skin. Carbohydrates are a source of glucose, and provide energy to create new tissues, including the skin. (8)

Food Sources & Supplementation

A food-first approach to addressing AD is recommended. You can't out supplement a diet that is lacking in the first place; thus, nutrient supplementation can be considered secondary and supportive. Nutrient testing can be conducted where appropriate to help determine the best supplements and dosing. Work with your nutrition professional to create a customized plan. You may refer to the American Nutrition Association’s Practitioner Finder to locate a practitioner who specializes in skin health.

Nutrient 

Foods 

Vitamin A 

Beef liver, cod liver oil, eggs, butter, sweet potato, carrots, cantaloupe, mango, broccoli, kale, collards 

Vitamin E 

Sunflower oil, olive oil, sunflower seeds, almonds, hazelnuts, pecans, dried apricots, avocado, fish, broccoli, Swiss chard, spinach, blackberries 

Vitamin D 

Salmon, mackerel, sardines, egg yolk 

Vitamin B2 

Eggs, halibut, chicken, beef, broccoli, almonds, asparagus, spinach 

Vitamin B6 

Salmon, potatoes, turkey, avocado, chicken, spinach, bananas, hazelnuts 

Selenium 

Brazil nuts, tuna, oysters, clams, halibut, shrimp, pork, chicken, beef, brown rice, sunflower seeds 

Vitamin C 

Strawberries, kiwi, oranges, sweet red peppers, broccoli, grapefruit, Brussels sprouts, tomatoes, bananas, apples, spinach 

Zinc 

Oysters, beef, crab, turkey, pork, chicken, soybeans, pine nuts, cashews, sunflower seeds, pecans, Brazil nuts, chickpeas, almonds, beans 

Omega 3 fatty acids  

Flaxseed oil, flaxseed, chia seeds, walnuts, walnut oil, herring, salmon, sardines, oysters, trout, tuna, crab 

Omega 6 fatty acids  

Sunflower seeds, sunflower oil, safflower oil, pine nuts, pecans, Brazil nuts, sesame oil 

Protein 

Animal foods (chicken, beef, fish, and eggs) contain all essential and conditionally essential amino acids and are complete proteins.  

Plant proteins include beans, soy products (tofu, tempeh, soybeans), lentils, nuts and seeds, quinoa, spirulina. 

Carbohydrates 

Brown rice, quinoa, millet, amaranth, buckwheat, teff, starchy vegetables (root vegetables/vegetables that grow beneath the ground such as potatoes, sweet potatoes, and carrots) 

Copper 

Beef liver, oysters, crab, clams, cashews, sunflower seeds, hazelnuts, almonds, lentils, mushrooms, dark chocolate  

Magnesium 

Brazil nuts, oat bran, brown rice, cashews, mackerel, spinach, almonds, Swiss chard, lima beans, avocado, hazelnuts, molasses, bananas 

Iron 

Iron (heme iron is found in animal products and nonheme iron is found in some plant foods): Beef, chicken liver, oysters, clams, tuna, mussels, raisins, prunes, potato with skin, quinoa, spinach, lentils, tofu, hazelnuts, cashews

References

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