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Published on: August 7, 2017
Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
Judy Shan1, Morgan Ye2, Sheng-Pei Wang2
1School of Medicine, University of California, San Francisco, California, USA.
Insights
High dietary sugar intake in children is linked to increased odds of atopic dermatitis (AD) by age 13. Reducing nonmilk sugars may be a low-risk intervention for managing childhood eczema.
Area of Science:
- Pediatric dermatology
- Nutritional science
- Epidemiology
Background:
- Dietary factors in childhood atopic dermatitis (AD) are understudied.
- Understanding these associations may offer cost-effective, low-risk management strategies for AD.
- Previous research has not fully explored the link between sugar intake and AD prevalence or severity.
Purpose of the Study:
- To investigate the association between dietary sugar intake and the period prevalence and severity of atopic dermatitis (AD) in a longitudinal pediatric cohort.
- To determine if specific types of dietary sugar are more strongly associated with AD.
- To explore potential dietary interventions for AD management.
Main Methods:
- A longitudinal cohort study design was employed using data from the Avon Longitudinal Study of Parents and Children.
- Food frequency questionnaires assessed dietary carbohydrate and sugar intake at multiple time points (ages 1-13 years).
- Logistic regression models, adjusted for numerous covariates, analyzed the association between dietary sugar (as a proportion of total caloric intake) and AD prevalence/severity.
Main Results:
- No significant associations between dietary sugar and AD were found at ages 1, 3, 5, and 7 years.
- At age 13, a 10% increase in dietary sugar intake was associated with a 22% increase in the odds of AD.
- A dose-response relationship was observed with disease severity, and the association was specifically linked to nonmilk extrinsic sugars.
Conclusions:
- Increased dietary sugar intake, particularly nonmilk extrinsic sugars, is associated with higher odds of atopic dermatitis (AD) in late childhood.
- Reducing nonmilk sugar consumption could be a viable, low-risk intervention for managing AD in children.
- Further research into sugar reduction as an AD intervention is warranted.
Importance:
The association of diet with atopic dermatitis (AD) in children is understudied and may present an opportunity to optimize AD management in a cost-effective and low-risk manner.
Objective:
The aim of this study was to determine the extent to which dietary sugar is associated with AD period prevalence and severity in a longitudinal pediatric cohort.
Design Setting And Participants:
This was a longitudinal cohort study of children from the Avon Longitudinal Study of Parents and Children with food frequency questionnaire data to estimate dietary carbohydrate and sugar at 1, 3, 5, 7, 10, and 13 years.
Exposure:
The exposure was dietary sugar as a proportion of total caloric intake.
Main Outcome And Measure:
The primary outcome was AD based on a maternal- or self-reported questionnaire that asked about disease activity and severity over the past 12 months. Logistic regression models adjusted for sex, race, maternal delivery age, highest parental education level, social class assessed through parental occupation, body mass index, total caloric intake, and maternal history of AD.
Results:
The study population included 5372 unique participants, 50% of whom were female, and 20-30% of whom reported AD at any time point. No significant associations were found at ages 1, 3, 5, and 7 years. At age 13 years, logistic regression revealed that a 10% increase in dietary sugar as a proportion of total caloric intake was associated with a 22% (95% confidence interval = 7-40%) increase in odds of AD overall. There was a dose-response relationship with disease severity: there was a 19% (95% confidence interval = 0-42%) increase in the odds of mild AD and 32% (95% confidence interval = 5-86%) increase in the odds of moderate-severe AD. When examining subtypes of dietary sugar, the effect was limited to nonmilk extrinsic sugars.
Conclusions And Relevance:
Given the known health benefits, reduction of nonmilk sugars could be studied as a cost-effective and low-risk intervention for AD in late childhood and early adolescence.
