Eczema is a common skin disease
and there are plenty of drugs on the market to combat it.
But what about diet?
Are there foods that trigger eczema,
and can dietary changes be used to treat it?
Watch to find out.
"Best Foods to Avoid for Eczema & Exclusion Diets for Eczema"
Eczema, also known as atopic dermatitis,
is a chronic inflammatory skin disease.
In fact, it’s the leading cause of healthy years of life lost
due to common skin diseases, because it’s just so common,
affecting up to a fifth of us.
And, it's not just an itchy rash;
it’s associated with other diseases too.
Yes, it can be itchy, exhausting, and embarrassing,
but in kids, it may increase risk for ADHD,
though that may just be from the sleep deprivation.
And, in adults, it may increase the risk of major depression.
And, it’s on the rise.
There are drugs for it, of course; there are always drugs.
Steroids are the first-line therapy,
but then there are immunosuppressants as well,
with more in the drug pipeline.
You know the medical profession is desperate
when they’re forced to go back to the basics
and start applying leeches to people.
Previously, I talked about the safety and efficacy
of other, more natural treatments,
but what about diet?
Our story begins in 1920, a year doctors were realizing
how good this oxygen stuff was,
though maybe not as good as injecting people with mercury,
but a researcher at Johns Hopkins reported a number of cases
in which by omitting eggs, meat, and milk from the diet,
patients’ eczema improved.
Who’s going to profit off of that though?
No wonder it took 58 years before it was put to the test.
Figuring eggs and milk were the two foods
most likely involved in eczema, they excluded them—
and chicken and beef,
since it may just be chicken and cow proteins more generally,
in a randomized double-blind controlled trial
swapping in soy milk instead, and…
70% of the patients improved.
One person got worse on the no egg, no chicken, no milk, no beef diet,
but almost everyone else got better.
So, the researchers concluded that for many kids,
avoiding those foods may induce a clinical improvement.
And interestingly, it didn’t seem to depend
on whether allergy tests showed they were allergic to milk and eggs.
Either way, they tended to get better, regardless.
You can do randomized double-blind food challenges,
where you give kids with eczema various foods in opaque capsules,
like one with egg powder, one with wheat powder, etc.
Egg was found by far to be the most offending food.
For example, in this study, where they just cut out the eggs,
dramatic improvements were documented
for both the amount of skin involvement and the severity of the eczema lesions
after removing eggs from the diet,
but in about 90% of cases, the mom had no idea
that eggs were a problem.
Why?
Because it wasn’t like they were eating scrambled eggs or something.
Almost all the egg exposure was hidden;
they were exposed to hidden egg products in packaged foods.
So, they had no idea why their eczema was so bad—
until this study, where they removed all eggs
and egg products from their diets.
Eggs are evidently the most frequent cause
of food sensitivity in children.
Out of hundreds of kids with eczema tested,
egg allergy was documented in about two-thirds of those with sensitivities.
In fact, a child having a blood reaction to egg white proteins
appears to be one of the best laboratory tests
for predicting future allergic diseases in general.
It appears to be the ovomucoid protein within egg whites
that seems to be causing most of the mischief.
About 40% of kids with eczema have some form of food allergy.
And, the more food allergies they have,
the more likely it appears they’re going to suffer
from eczema— and, make it worse.
Those who react to cows’ milk protein
are significantly more likely to suffer severe eczema,
showing the important role cows’ milk proteins may play
“in the induction and increased severity of eczema in children.”
Often, parents switch from cows’ milk to goats’ milk,
in an attempt to improve their children’s eczema.
But goats’ milk should never be given to kids
with a cows’ milk allergy,
because they often cross-react with one another,
which has been confirmed with double-blind placebo controlled food challenges.
Ass milk, on the other hand, is a different story.
Switching kids to donkey milk improved their eczema,
and, for that matter, horse’s milk might, as well.
The original randomized, double-blind, controlled trial
of diet and eczema found that cutting out
eggs, chicken, milk, and beef
significantly improved eczema in 70%
of the kids that completed the study.
Subsequent studies found similar results,
though in this case, for example,
it only seemed to work for a quarter of the kids.
But, bottom line, out of 13 studies
on avoiding milk, eggs, or both,
10 out 13 studies documented overall clinical improvement.
The economic burden of eczema
caused by just regular cows’ milk formula alone
may be hundreds of millions of dollars a year,
though eggs appear to be worse,
in terms of predicting persistence and severity of the disease.
Sensitization to egg white and cows’ milk
can occur even in breast-fed infants though.
So, presumably the source of the exposure
is the passage of egg and cow proteins
through the mother’s milk,
but you don’t know until you put it to the test.
New mothers were randomized to cut out eggs,
cows’ milk, and fish from their diet
during the first three months of breastfeeding
after giving birth or to continue their regular diet.
And indeed, the infants of mothers
who cut out the eggs, milk, and fish
were significantly less likely to have eczema by age 6 months,
though after that age, the decreased rates of eczema
in the no eggs/milk or fish group
were no longer statistically significant.
Follow those same kids out to four years, though,
and those whose moms cut out the eggs,
milk, and dairy for just three months
while breast feeding had significantly
lower eczema rates even years later.
Consuming that hypoallergenic diet during breastfeeding
cut child eczema rates in half.
Eating more plant foods may also help.
The majority of fruit and vegetable studies
suggest that higher consumption by mothers during pregnancy,
and children in early life,
results in reductions in asthma,
another allergic- type disease.
Maybe it’s the phenolic phytonutrients in plants that are helping,
supported by evidence that certain vegetarian diets
appear to alleviate the severity
of skin diseases in adults with eczema.
Though if you look at that citation,
it was a very strange diet.
They found striking benefits in terms
of reducing the severity of eczema,
and even 2 months after they went off the diet,
they were still doing better than when they started,
but the diet was just vegetable juice,
brown rice, kelp, tofu, tahini, and persimmon leaf tea,
and severely calorie-restricted.
And, just straight fasting alone can improve eczema,
as can a strictly plant-based diet,
which is not so surprising given the data
on children showing how much better
they can do cutting out eggs and dairy.
In spite of these data, dermatologists
and pediatricians have, for many years,
denied the role of food in eczema,
even though as many as 80% of kids may benefit
cutting out milk and/or eggs
regardless of what the various allergy tests show.
You can’t necessarily tell if diet is going to help,
until you yourself put it to the test in your own body.
And, that’s what parents are doing.
They’re not waiting for their pediatricians to catch up;
75% of parents with eczema-stricken kids
have tried some form of dietary exclusion,
most commonly cutting out dairy and eggs,
though only about 40% of parents
who tried it feel that it worked.
But hey, why not give it a try?
A typical recommendation you see in the medical literature is,
“Look, if you have a child with some bad eczema,
and the drugs aren’t working,
then... why don’t you try cutting out some foods?”
But, that seems to me backwards.
If foods are contributing,
why not treat the cause
and eliminate the offending foods,
and then do the drugs if diet isn’t enough.
Now, there are some pretty nutty eczema diets out there,
like the so-called “few foods” diet,
excluding everything except lamb, potatoes,
Rice Krispies, broccoli, and pears.
To my surprise, it was actually put to the test—
I told you docs were desperate!
But it failed to show a benefit.
Basically, if you don’t know where to begin,
the simplest approach may be to just cut out dairy and eggs
and see what happens.
That’s a controversial recommendation, though.
Avoiding fish, beef, eggs, and dairy
without medical supervision?
That might trigger malnutrition-related pathology.
What?!
I checked out that citation,
and it's just another article making an unsupported claim.
Now, if you exclude everything, like 99% of your diet
is rice milk, well then, obviously, that’s completely insufficient,
but for most parents, the #1 thing they add
to their child’s diet for eczema... is vegetables,
and the #1 thing they cut down on is.... junk food,
and I don’t think we have to worry,
about a junk food deficiency.