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Thursday, 27 July 2017

Food and Eczema

.... are you on a see-food diet or no-food diet?

"I don't eat meat, I don't eat seafood, I don't take processed food but I still get the rashes! Why?"

There is something about Asian and food. We love food. But we blame most if not everything to the food that we ate.

Dark ugly scar? Perhaps the soy sauce?
Good grades at school? Maybe the blackbean soup that the mother took years ago during pregnancy.

More so with skin conditions.

Itch? Maybe it's from the silverfish that I took this morning.
Rashes? Could it be the prawn that I took last night? Or the gluten in the bread?

So here's a summary of what science says about your diet and eczema. (7 Cochrane Reviews)

Supplements and eczema

Fish oil, zinc sulphate, selenium, vitamin E, vitamin D, pytidoxine, sea buckthorn seed oil, hempseed oil, sunflower oil, docosahexaenoic acid -- too little evidence to say it is beneficial.

Why too little evidence?  Give for example vitamin D supplements, in one randomised controlled trial with 1600IU a day for 2 months says it improved, but another randomised controlled trial using 4000 IU daily for 2 months says no difference.

Primrose and borage oils

Yes, it is anti-inflammatory, theoretically it could be helpful. Unfortunately there were 27 studies with 1596 people involved took it and it makes no difference.

Prebiotics and probiotics

Now there are postulation that your eczema maybe related to food sensitisation and those bacteria in your gut may play a role. In case you are not sure, probiotics are supposed to be  "good bacteria" for your gut and prebiotics are the "fertiliser" for the probiotics to grow.

There are a lot of studies into these and looks like taking probiotics during pregnancy and after may help. For prebiotics, it is probably only helpful after delivery for children of up to 7 years old.

Diet restriction

Many patients say that when they take certain food, their eczema flares up. 6 studies asked the patients not to take egg and milk, another 1 asked to restrict their food to a few simple diet, and another 2 studies on elemental diet. Looks like there is significant benefit. One study that asked patient with positive egg-specific IgE to avoid eggs in their diet does see an improvement in their eczema severity. So what does this tells us?

Diet restriction is only good for those with food allergy. And therefore it is not necessary at all for everyone with eczema (but without food allergy) to practise diet restriction. Furthermore limiting yourself or your children's diet may pose a risk of nutritional deficiency, not to mention reducing our happiness because we all love food!

How to know if you have food allergy?

These are the things that your doctor may use
  • Food diary
  • Skin prick test
  • Serum IgE testing
  • Oral food challenges
Ask if you are not sure.

The mother's food

Many pregnant mothers and breastfeeding mothers are worried their food may affect their babies. 5 studies of 952 people in total says that avoiding certain food during pregnancy, breastfeeding or even both does not prevent eczema in babies up to 18 months old. And they notice that mother who practise diet restriction has an average lower weight gain during pregnancy and lower birth weight of the babies. Also there is actually increased rate of preterm birth!

In other words, there is a strong evidence that mothers should not restrict their diet during pregnancy or breastfeeding. Such practise brings more harm than good!

Breastfeeding and eczema

What about breastfeeding? Isn't it known to help eczema? The evidence from 18 studies say breastfeeding exclusively for 4 months if not using hydrolyzed formula (rather than formula milk) helps those babies at high risk. These are the babies with family members of atopy. However, for those people without family members with atopy, breastfeeding or formula milk doesn't matter really.

Confused over what food to take or not to take when you have eczema? Hope what I've put up here helps!
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