DOI QR코드

DOI QR Code

Effects of Nutrition Education Promoting Vegetable, Fruit, and Fish Intake on the Severity of Atopic Dermatitis in Children: Results from a One-year Follow Up Study

채소와 과일, 생선 섭취 강조 영양중재교육이 아토피 피부염 영유아의 중증도 변화에 미치는 효과

  • Lee, Heejin (Department of Foods and Nutrition, Kookmin University) ;
  • Ahn, Kangmo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Han, Youngshin (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Sang-Jin (Department of Foods and Nutrition, Kookmin University)
  • 이희진 (국민대학교 식품영양학과) ;
  • 안강모 (성균관대학교 의과대학 삼성서울병원 소아과) ;
  • 한영신 (성균관대학교 의과대학 삼성서울병원 소아과) ;
  • 정상진 (국민대학교 식품영양학과)
  • Received : 2013.04.19
  • Accepted : 2013.10.15
  • Published : 2013.10.31

Abstract

Atopic dermatitis (AD) is believed to be associated with the intake of antioxidant nutrients and fatty acids due to its immunological dysfunction. The purpose of this study was to examine the effects of nutrition education promoting vegetable, fruit, and fish intake on the severity of AD in children. Children with AD aged 6 months to 5 years were randomly assigned into education and control groups, and followed for 1 year. Seventy-six children completed the study (38 for control, 38 for education). The education group received education promoting the intakes of antioxidant-rich foods (vegetables, fruits) and n-3 fatty acid foods (fish). A 24-hour food recall was collected for the diet information. After education, all vegetables (p < 0.001), fruits (p < 0.01), and fish (p < 0.05) intakes per 1000 kcal increased significantly in the education group, whereas only vegetable intake increased in the control group (p < 0.001). The SCORAD index, the severity of atopic dermatitis, decreased significantly in the education group (p < 0.05). Increased consumption of dietary vitamin E was significantly associated with reduction in the SCORAD index, after adjusting for age and gender (p < 0.05). A nutritional education program to increase vegetable, fruit, and fish intake may be effective in reducing the severity of AD, and vitamin E intake may be associated with the decreased severity of AD. More controlled studies on the relationship between these intakes and severity of AD, with intensive diet and/or supplement intervention programs, are needed to obtain conclusive results.

Keywords

References

  1. Alm B, Aberg N, Erdes L, Mollborg P, Pettersson R, Norvenius SG, Goksor E, Wennergren G (2009): Early introduction of fish decreases the risk of eczema in infants. Arch Dis Child 94(1): 11-15 https://doi.org/10.1136/adc.2008.140418
  2. Arslanoglu S, Moro GE, Schmitt J, Tandoi L, Rizzardi S, Boehm G (2008): Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life. J Nutr 138(6): 1091-1095 https://doi.org/10.1093/jn/138.6.1091
  3. Boguniewicz M, Leung DY (2011): Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol 242: 23-46
  4. Chatzi L, Apostolaki G, Bibakis I, Skypala I, Bibaki-Liakou V, Tzanakis N, Kogevinas M, Cullinan P (2007): Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete. Thorax 62(8): 677-683 https://doi.org/10.1136/thx.2006.069419
  5. Devereux G, Seaton A (2005): Diet as a risk factor for atopy and asthma. J Allergy Clin Immunol 115(6): 1109-1117 https://doi.org/10.1016/j.jaci.2004.12.1139
  6. Devereux G, Turner SW, Craig LC, McNeill G, Martindale S, Harbour PJ, Helms PJ, Seaton A (2006): Low maternal vitamin E intake during pregnancy is associated with asthma in 5-yearold children. Am J Respir Crit Care Med 174(5): 499-507 https://doi.org/10.1164/rccm.200512-1946OC
  7. Eriksen BB, Kare DL (2006): Open trial of supplements of omega 3 and 6 fatty acids, vitamins and minerals in atopic dermatitis. J Dermatolog Treat 17(2): 82-85 https://doi.org/10.1080/09546630600621946
  8. Fitzsimon N, Fallon U, O'Mahony D, Loftus BG, Bury G, Murphy AW, Kelleher CC (2007): Mother's dietary patterns during pregnancy and risk of asthma symptoms in children at 3 years. Ir Med J 100(8): suppl 27-32
  9. Fogarty A, Lewis S, Weiss S, Britton J (2000): Dietary vitamin E, IgE concentrations, and atopy. Lancet 356(9241): 1573-1574 https://doi.org/10.1016/S0140-6736(00)03132-9
  10. Kremmyda LS, Vlachava M, Noakes PS, Diaper ND, Miles EA, Calder PC (2011): Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids: a systematic review. Clin Rev Allergy Immunol 41(1): 36-66 https://doi.org/10.1007/s12016-009-8186-2
  11. Kull I, Bergstrom A, Lilja G, Pershagen G, Wickman M (2006): Fish consumption during the first year of life and development of allergic diseases during childhood. Allergy 61(8): 1009-1015 https://doi.org/10.1111/j.1398-9995.2006.01115.x
  12. Kunz B (1997): Clinical validation and guidelines for the SCORAD Index: consensus report of the European task force on atopic dermatitis. Dermatology 195: 10-19
  13. Hijazi N, Abalkhail B, Seaton A (2000): Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax 55(9): 775-9 https://doi.org/10.1136/thorax.55.9.775
  14. Javanbakht MH, Keshavarz SA, Djalali M, Siassi F, Eshraghian MR, Firooz A, Seirafi H, Ehsani AH, Chamari M, Mirshafiey A (2011): Randomized controlled trial using vitamins E and D supplementation in atopic dermatitis. J Dermatolog Treat 22(3):144-150 https://doi.org/10.3109/09546630903578566
  15. Korean Nutrition Society (2010): Dietary reference intakes for Koreans
  16. Lee JH, Kim EH, Cho JB, Kim HY, Suh JM, Ahn KM, Cheong HK, Lee SI (2011): Comparison of prevalence and risk factors of atopic dermatitis by physical examination and questionnaire survey in elementary school children. Pediatr Allergy Respir Dis 21(3): 186-196 https://doi.org/10.7581/pard.2011.21.3.186
  17. Lee JS, Jo S, Lee H, Kang A, Chung SJ (2010): Associated factors of severity of atopic dermatitis in children. Korean J Community Nutr 15(6): 776-782
  18. Lee S, Ahn K, Paik HY, Chung SJ (2012): Serum immunoglobulin E (IgE) levels and dietary intake of Korean infants and young children with atopic dermatitis. Nutr Res Pract 6(5): 429-435 https://doi.org/10.4162/nrp.2012.6.5.429
  19. Li-Weber M, Giaisi M, Treiber MK, Krammer PH (2002): Vitamin E inhibits IL-4 gene expression in peripheral blood T cells. Eur J Immunol 32(9): 2401-2408 https://doi.org/10.1002/1521-4141(200209)32:9<2401::AID-IMMU2401>3.0.CO;2-S
  20. Malmberg KJ, Lenkei R, Petersson M, Ohlum T, Ichihara F, Glimelius B, Frodin JE, Masucci G, Kiessling R (2002): A shortterm dietary supplementation of high doses of vitamin E increases T helper 1 cytokine production in patients with advanced colorectal cancer. Clin Cancer Res 8(6): 1772-1778
  21. Martindale S, McNeill G, Devereux G, Campbell D, Russell G, Seaton A (2005): Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life. Am J Respir Crit Care Med 171(2): 121-128 https://doi.org/10.1164/rccm.200402-220OC
  22. Mayser P, Mayer K, Mahloudjian M, Benzing S, Kramer HJ, Schill WB, Seeger W, Grimminger F (2002): A double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acidbased lipid infusion in atopic dermatitis. J Parenter Enteral Nutr 26(3): 151-158 https://doi.org/10.1177/0148607102026003151
  23. Nja F, Nystad W, Lodrup Carlsen KC, Hetlevik O, Carlsen KH (2005): Effects of early intake of fruit or vegetables in relation to later asthma and allergic sensitization in school-age children. Acta Paediatr 94(2): 147-154 https://doi.org/10.1080/08035250410023638
  24. Oh JW, Kim KE, Pyun BY, Lee HR, Choung JT, Hong SJ, Park KS, Lee SY, Song SW, Kim CH, Ahn KM, Nam SY, Shon MH, Kim WK, Lee MH, Kwon BC, Choi SY, Lee SY, Lee HB, Lee SI, Lee JS (2003): Nationwide study for epidemiological change of atopic dermatitis in school aged children between 1995 and 2000 and kindergarten aged children in 2003 in Korea. Pediatr Allergy Respir Dis 13(4): 227-237
  25. Oh SY, Chung J, Kim MK, Kwon SO, Cho BH (2010): Antioxidant nutrient intakes and corresponding biomarkers associated with the risk of atopic dermatitis in young children. Eur J Clin Nutr 64(3): 245-252 https://doi.org/10.1038/ejcn.2009.148
  26. Seaton A, Godden DJ, Brown K (1994): Increase in asthma: a more toxic environment or a more susceptible population? Thorax 49(2): 171-174 https://doi.org/10.1136/thx.49.2.171
  27. Senkal M, Geier B, Hannemann M, Deska T, Linseisen J, Wolfram G, Adolph M (2007): Supplementation of omega-3 fatty acids in parenteral nutrition beneficially alters phospholipid fatty acid pattern. J Parenter Enteral Nutr 31(1): 12-17 https://doi.org/10.1177/014860710703100112
  28. Tamay Z, Akcay A, Ones U, Guler N, Kilic G, Zencir M (2007): Prevalence and risk factors for allergic rhinitis in primary school children. Int J Pediatr Otorhinolaryngol 71(3): 463-471 https://doi.org/10.1016/j.ijporl.2006.11.013
  29. The Korean Nutrition Society (2010): Dietary reference intakes for Koreans, first revision. The Korean Nutrition Society, Seoul
  30. Tsoureli-Nikita E, Hercogova J, Lotti T, Menchini G (2002): Evaluation of dietary intake of vitamin E in the treatment of atopic dermatitis: a study of the clinical course and evaluation of the immunoglobulin E serum levels. Int J Dermatol 41(3): 146-150 https://doi.org/10.1046/j.1365-4362.2002.01423.x
  31. Wong GW, Ko FW, Hui DS, Fok TF, Carr D, von Mutius E, Zhong NS, Chen YZ, Lai CK (2004): Factors associated with difference in prevalence of asthma in children from three cities in China: multicentre epidemiological survey. BMJ 329(7464): 486 https://doi.org/10.1136/bmj.329.7464.486

Cited by

  1. 광주광역시 광산구 보육시설 유아의 식행동과 식품알레르기 발생 현황 vol.35, pp.1, 2013, https://doi.org/10.7318/kjfc/2020.35.1.97
  2. 12세 미만 아토피 피부염 어린이의 에너지 및 영양소적정섭취 수준 평가: 2013-2015년 국민건강영양조사 자료를 바탕으로 vol.53, pp.2, 2013, https://doi.org/10.4163/jnh.2020.53.2.141
  3. Nutritional Intervention for a Korean Adolescent with Atopic Dermatitis: a Case Report vol.10, pp.4, 2013, https://doi.org/10.7762/cnr.2021.10.4.364