Friday Favorites: Best Foods to Avoid for Eczema & Exclusion Diets for Eczema

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Randomized, double-blind, controlled trials suggest that excluding certain foods, such as eggs and chicken, can significantly improve atopic dermatitis. 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.

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.

Eczema, also known as atopic dermatitis, “is a chronic inflammatory skin disease”; in fact, the leading cause of healthy years of life lost due to common skin diseases, because it’s just so common—affecting about 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, may increase risk for ADHD—though that may just be from the sleep deprivation. And, in adults, 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, “[b]y omitting eggs, meat[s], 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 conclude 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 that 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 like give kids with eczema various foods in opaque capsules—like one with egg powder, one with wheat powder, etc. And 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 like 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 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 white 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 cow’s milk protein are significantly more likely to suffer severe eczema, showing the important role cow’s milk proteins may play “in the induction and increased severity of eczema in children.”

Often, parents switch from cow’s milk to goat’s milk, in an attempt to improve their children’s eczema. But goat’s milk should never be given to kids with a cow’s 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: “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 Gabriele Masaspina, Nestor Arellano, Iconic, Herman Susanto and Harden Dwi Lester from The Noun Project.

Image credits: Kai Schreiber and psyberartist. Images have 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.

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.

Eczema, also known as atopic dermatitis, “is a chronic inflammatory skin disease”; in fact, the leading cause of healthy years of life lost due to common skin diseases, because it’s just so common—affecting about 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, may increase risk for ADHD—though that may just be from the sleep deprivation. And, in adults, 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, “[b]y omitting eggs, meat[s], 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 conclude 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 that 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 like give kids with eczema various foods in opaque capsules—like one with egg powder, one with wheat powder, etc. And 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 like 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 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 white 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 cow’s milk protein are significantly more likely to suffer severe eczema, showing the important role cow’s milk proteins may play “in the induction and increased severity of eczema in children.”

Often, parents switch from cow’s milk to goat’s milk, in an attempt to improve their children’s eczema. But goat’s milk should never be given to kids with a cow’s 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: “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 Gabriele Masaspina, Nestor Arellano, Iconic, Herman Susanto and Harden Dwi Lester from The Noun Project.

Image credits: Kai Schreiber and psyberartist. Images have been modified.

Motion graphics by Avocado Video.

Doctor's Note

For even more on eczema, see:

Other videos on skin health include:

The original videos aired on December 1 and 4, 2017

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