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Article

Elimination Diets Have Little Impact on Pediatric Atopic Dermatitis, New Study Finds

Key Takeaways

  • Elimination diets showed mild improvement in only one-third of children with pediatric atopic dermatitis, despite not being recommended by major allergy organizations.
  • The study surveyed 298 parents, revealing that 58% reported no food-related exacerbation of eczema, with milk, nuts, and eggs as common triggers.
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Survey results presented at ACAAI’s annual Scientific Meeting demonstrate the limited influence of elimination diets for reducing symptoms of AD.

Child with atopic dermatitis | Image Credit: © dermnetnz.org

Image Credit: © dermnetnz.org

A recent parent survey showed that only one-third of children saw mild improvement in pediatric atopic dermatitis with the implementation of elimination diets. Although elimination diets are not recommended as an AD treatment, according to major allergy organizations, there can be a heightened risk of developing food sensitivities in some circumstances.1

The results from the study were presented at the 2024 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting in Boston, Massachusetts from October 24 to 28. The cross-sectional, IRB-approved study surveyed 298 parents of children with AD. Statistical analysis was then performed.

Nadia Makkoukdji, MD, lead author of the study, said in a statement. “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.”1

Out of nearly 300 surveyors, 58% reported that certain foods did not exacerbate their child’s eczema. Those who did experience an increase in symptoms listed foods that could potentially trigger the appearance of AD. The most frequently identified triggers include milk, tree nuts/seeds/peanuts, and eggs. Among these, 19% changed their baby’s formula, 20% stopped eating certain foods while breastfeeding and 23% completely removed the suspected trigger from their child’s diet.

After the elimination diet was implemented, 38% observed no improvement in symptoms of AD. However, 35% reported some improvement and 9% reported complete resolution of symptoms. Additionally, 79% of participants reintroduced the eliminated foods and did not see a recurrence of eczema.

Larger trials and research endeavors, such as the TRACKER study published in September,2 are recommended to further explore the effect of diet on pediatric AD. However, this study can help parents and clinicians make informed decisions about treatment options for children with eczema and other allergies.

References

1. Makkoukdji, N. Study: Parents' Understanding of Atopic Dermatitis May Influence Child's Diet. Presented at: American College of Allergy, Asthma and Immunology Annual Scientific Meeting, October 24-28, 2024; Boston, MA.

2. Miltner LA, Vonk JM, van der Velde JL, Sprikkelman AB. Eczema in early childhood increases the risk of allergic multimorbidity. Clin Transl Allergy. 2024;14(9):e12384. doi:10.1002/clt2.12384

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