Food and Behaviour Research

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Effect of nutrient supplementation on atopic dermatitis in children: a systematic review of probiotics, prebiotics, formula, and fatty acids.

Foolad N, Brezinski EA, Chase EP, Armstrong AW. (2013) JAMA Dermatol.  149(3) 350-5 

Web URL: View this and related abstracts via PubMed here.

Abstract:

OBJECTIVE:

To identify whether nutrient supplementation with probiotics, prebiotics, formula, or fatty acids prevents the development of atopic dermatitis (AD) or reduces the severity of AD in newborns to children younger than 3 years.

DATA SOURCES:

We searched MEDLINE, Cochrane Central Register of Controlled Trials, and LILACS (Latin American and Caribbean Health Science Literature) from January 1, 1946, to August 27, 2012, and performed an additional manual search.

STUDY SELECTION:

Randomized controlled trials and cohort studies examining nutritional supplementation in prevention and amelioration of AD among children younger than 3 years.

DATA EXTRACTION:

Of 92 articles, 21 met inclusion criteria.

DATA SYNTHESIS:

In the 21 studies, a total of 6859 participants received supplements, which included infants or mothers who were either pregnant or breastfeeding;4134 infants or mothers served as controls.

Nutritional supplementation was shown to be an effective method in preventing AD (11 of 17 studies) or decreasing its severity(5 of 6 studies).

The best evidence lies with probiotics supplementation in mothers and infants in preventing development and reducing severity of AD. Specifically, Lactobacillus rhamnosus GG was effective in long-term prevention of AD development.

γ-Linolenic acid reduced severity of AD. Supplementation with prebiotics and black currant seed oil (γ-linolenic acid and ω-3 combination) was effective in reducing the development of AD.

Conflicting findings were reported from different research groups that performed supplementation with an amino acid–based formula.

CONCLUSIONS:

Certain types of nutrient supplementation are beneficial in preventing AD development and reducing its severity. Future research elucidating the mechanisms underlying the actions of nutritional supplementation on AD is necessary.

FAB RESEARCH COMMENT:

This systematic review found good evidence that some nutritional treatments can help to reduce symptoms of atopic dermatitis (otherwise known as atopic eczema).

Benefits from controlled trials were found for supplementation with certain probiotics (lactobacillus Rhamnosus GG), or supplementation with some fatty acids (notably GLA - found in evening primrose and blackcurrant seed oils, among others)

Currently, the main standard treatment for atopic dermatitis involves topical steroid drugs, which can usually control symptoms, but have negative side effects - especially with prolonged use. Like the current review, a previous meta-analysis focusing only on studies evening primrose oil also found benefits for atopic eczema - but not for those already receiving high-dose steroid medications. (See Morse & Clough, 2006