Exclusion Diets for Eczema

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Infants of mothers randomized to cut out eggs, milk, and fish were significantly less likely to have eczema even years later.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

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: “Ten [out of 13] studies documented overall clinical improvement.”

The economic burden of eczema caused by just regular cow’s 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 cow’s milk can occur even in breastfed infants, though. And 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, cow’s 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 six months—though after that age, the decreased rates of eczema in the no eggs, milk, or fish group was 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 breastfeeding had significantly lower eczema rates, even years later. Consuming that hypoallergenic diet during breastfeeding cut childhood 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 result[s] 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 two 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 showed. 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 like, “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 food” diet, excluding everything except like “lamb, potatoes,…Rice Crispies,…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 egg[s],” 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.

Please consider volunteering to help out on the site.

Icons created by Iconic, Herman Susanto and Harden Dwi Lester from The Noun Project

Image credit: psyberartist. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

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: “Ten [out of 13] studies documented overall clinical improvement.”

The economic burden of eczema caused by just regular cow’s 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 cow’s milk can occur even in breastfed infants, though. And 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, cow’s 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 six months—though after that age, the decreased rates of eczema in the no eggs, milk, or fish group was 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 breastfeeding had significantly lower eczema rates, even years later. Consuming that hypoallergenic diet during breastfeeding cut childhood 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 result[s] 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 two 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 showed. 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 like, “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 food” diet, excluding everything except like “lamb, potatoes,…Rice Crispies,…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 egg[s],” 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.

Please consider volunteering to help out on the site.

Icons created by Iconic, Herman Susanto and Harden Dwi Lester from The Noun Project

Image credit: psyberartist. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

I talk about the original randomized, double-blind, controlled trial of diet and eczema in my video Best Foods to Avoid for Eczema.

Nonsteroidal topical treatments are covered in my videos Eczema Treatment with Coconut Oil, Mineral Oil vs. Vaseline and Eczema Treatment with Evening Primrose Oil, Borage Oil vs. Hempseed Oil.

For other videos on skin health, see:

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