Daily Gleaner | Life – Other Article published: Apr 15, 2006
Faulty fat metabolism may aggravate eczema
NUTRITION AND WELLNESS
Dry itchy skin and red scaly patches which become inflamed and cracked can be a chronic condition for those suffering with eczema.
It is one of the most common forms of dermatitis and appears to affect over 15 million North Americans with over a third of cases being found in infants under the age of one, and almost 90 per cent of the patients showing symptoms before their fifth birthday.
Although the cause is unclear, it maybe related to a malfunction in the immune system and is often triggered by hereditary or environmental factors which can range from stress, allergic reactions, irritants found in household cleaners and extremely high or low temperatures.
There are several approaches through food for managing this form of dermatitis.
Certain food proteins may trigger an allergic reaction which aggravates the eczema. Researchers estimate that almost a third of the cases of children's eczema can be linked to an allergy. Common food allergens include wheat, dairy, egg and fish and allergy testing should be done to confirm a reaction.
Another option is doing an elimination and challenge diet. The premise is simple; you take all possible offending foods out of the diet, for a two to three week period, with the hope that the symptoms subside. During this elimination phase, one should avoid all wheat, dairy, egg, fish, soy, citrus fruits, nuts, shellfish, corn and sulphites. It doesn't leave many options, but it is only for a two to three-week period.
Then you re-introduce them one at a time in a controlled manner so that you can determine your body's reaction to the food. This approach may seem simple on paper, but is challenging, especially if you're dealing with a child.
Another aspect to consider is fatty acid metabolism. Linoleic acid is a type of fat, which is easily found in vegetable oils, and our body will naturally convert it into another fat called gamma-linolenic acid (GLA). GLA plays an instrumental role in promoting the development of healthy skin, hair and nails. Individuals suffering from eczema may have difficulty in this fat conversion, and therefore lack the beneficial form of GLA.
In order to optimize the creation of this healthy fat, it is encouraged to limit the total amount of saturated fat and highly processed oils. Choose leaner cuts of meat, low-fat dairy products, and also limit the amount of hydrogenated fats in our diet which would include processed baking such as cakes, cookies and muffins, and select a non-hydrogenated margarine and use sparingly.
Another option is finding a direct dietary source of GLA rather than relying on our body's conversion. Evening primrose oil is one of the better choices. There is no conclusive verdict on this supplementation, but some studies found it to be beneficial. The dosage is 3-4 grams per day twice a day, while children would only need half this amount. You always want to purchase a product which has been standardized to contain nine per cent GLA. It may take up to four weeks before an improvement is noticed.
Strengthening our overall immune system may help also reduce the severity and frequency of flare-ups and there are several approaches. Probiotics may be useful, especially if there have been repeated antibiotic use, since they help restore the natural flora in the bowel. This can be especially useful if the eczema is allergy-related.
Zinc may play a role as well since a deficiency of this mineral can affect our immune system. Zinc can be found easily in red meat, poultry, shellfish and whole grains, but this mineral may become a concern when you have a picky eater.
Breast milk is also known to offer some protection for infants against dermatitis since the breast milk can strengthen a baby's immune system.
There are several options available and what works for one person may be completely different for another.
Most parents don’t realize how often baby eczema is triggered by food allergies – indeed, how often it is the first sign of food allergies. In one study, about 40 percent of babies with eczema had proven food allergies1. And the more impressive the rash appears, the more likely there is a food allergy involved. For the third of babies with the worst eczema, more than 96 percent have a proven food allergy connection2. Babies with eczema often have different ratios of beneficial bacteria in their guts, compared with other healthy babies; perhaps these bacteria are part of the allergy-eczema link. In an April 2005 study, researchers investigated whether giving babies probiotics (beneficial bacteria) could improve their eczema. There were 230 babies in the study, ranging in age from 6 weeks to just under one year old. All of the babies in the study were suspected of having a cow’s milk allergy. All of the babies were switched to cow’s-milk-free diets (and their nursing moms to cow’s-milk-free diets). All of the babies were treated with topical medicines. Some of the babies also received daily supplements of probiotics; the rest received placebo capsules. The people evaluating the babies’ symptoms didn’t know which babies belonged to which group. The results of the study were published in the April 2005 Allergy3. All of the babies in the study improved, by an average of 65 percent. But those babies with either a positive skin test or blood test for food allergy enjoyed a 32 percent greater improvement if they got the probiotic Lactobacillus GG (LGG) supplement than if they got the placebo capsules. More research is needed to clarify the role of LGG, and of probiotics in general, in the treatment of eczema in babies and in older children, but this study suggests that the use of probiotics is promising. I’m especially pleased to see positive results for this gentle treatment shortly after the FDA issued its strong warning against the use of some of the harsh topical creams and ointments in children under age two.
Probiotics in the management of atopic eczema.
Department of Paediatrics, University of Turku, Finland.
BACKGROUND: Over the last two decades the incidence of allergic diseases has increased in industrialized countries, and consequently new approaches have to be explored. OBJECTIVE: The potential of probiotics to control allergic inflammation at an early age was assessed in a randomized double-blind placebo-controlled study. METHODS: A total of 27 infants, mean age 4.6 months, who manifested atopic eczema during exclusive breast-feeding and who have had no exposure to any infant or substitute formula were weaned to probiotic-supplemented, Bifidobacterium lactis Bb-12 or Lactobacillus strain GG (ATCC 53103), extensively hydrolysed whey formulas or to the same formula without probiotics. The extent and severity of atopic eczema, the growth and nutrition of infants, and concentrations of circulating cytokines/chemokines and soluble cell surface adhesion molecules in serum and methyl-histamine and eosinophilic protein X in urine were determined. RESULTS: The SCORAD score reflecting the extent and severity of atopic eczema was 16 (7-25) during breast-feeding, median (interquartile range). After 2 months, a significant improvement in skin condition occurred in patients given probiotic-supplemented formulas, as compared to the unsupplemented group; chi(2) = 12.27, P = 0.002. SCORAD decreased in the Bifidobacterium lactis Bb-12 group to 0 (0-3.8), and in the Lactobacillus GG group to 1 (0.1-8.7), vs unsupplemented 13.4 (4.5-18.2), median (interquartile range), in parallel with a reduction in the concentration of soluble CD4 in serum and eosinophilic protein X in urine. CONCLUSION: The results provide the first clinical demonstration of specific probiotic strains modifying the changes related to allergic inflammation. The data further indicate that probiotics may counteract inflammatory responses beyond the intestinal milieu. The combined effects of these probiotic strains will guide infants through the weaning period, when sensitization to newly encountered antigens is initiated. The probiotic approach may thus offer a new direction in the search for future foods for allergy treatment and prevention strategies.
PMID: 11069570 [PubMed – indexed for MEDLINE]