The Food-Eczema Relationship

Do you have food allergies? What do you think about it? In fact, more than 10% of the world population have food allergies which may trigger eczema. Although some children may grow out of food allergies, approximately half of them have lifelong eczema during adulthood. This article will explore the impact of inflammatory and anti-inflammatory food on eczema patients.  

What types of food can trigger eczema? 

Eczema (aka. atopic dermatitis) is an inflammatory skin condition due to an overreacting immune system. Certain types of food are known to aggravate eczema. 

According to the US Food and Drug Administration, the most common food allergens include:[1]

• Cow’s milk
• Eggs
• Fish
• Crustaceans (shellfish)
• Tree nuts
• Peanuts
• Wheat
• Soybeans
• Sesame 

It is not surprising that some of you may feel uncomfortable after eating these foods, and I will tell you why!

1. Dairy Products

Among all dairy products, cow’s milk is the most common food allergen in both children and adults. Milk allergy can lead to hives, facial flushing and itching, and if serious lead to anaphylaxis, i.e. the narrowing and blockage of airways leading to breathing difficulties.  

The main reason for food allergies is due to a malfunctioning immune system. For example in milk allergy, our body identifies milk proteins as a “foreign attacker” and triggers the production of “army soldiers”, known as immunoglobulin E (IgE). [2]

The overproduction of IgE aims to attack the allergens and cause allergic-autoimmune reactions. It triggers the release of histamine which leads to skin inflammation and flare ups.

A dairy allergy can come in different forms, e.g. the difference between casein allergy and lactose intolerance. Casein allergy mainly involves the immune system and is life-threatening, but lactose intolerance occurs because the body does not produce sufficient lactase to digest lactose in milk, causing digestive issues. [3] 87% of Asians are lactose intolerant due to genetic defects in coding for lactase. 

Surprisingly, besides the commonly listed food allergens, preserved food and food with high sugar can also aggravate eczema.  

2. Preserved and processed food

Common preserved foods include sausages, kimchi, and pickled vegetables. They are high in salt content and contain many preservatives which aggravate eczema. 

Research has shown that high salt consumption can increase the inflammatory response of inflammatory proteins such as Th17 and IL-4, triggering more inflammatory reactions in the body and thus eczema flare ups and itching. [4]

Moreover, the recommended average intake of sodium per meal is around 800mg. Most individuals in the modern diet consume 5-10 times over this amount. Excess sodium intake increases the binding of glycosaminoglycans (a type of skin molecule) and facilitates mast cell production. This increases the release of inflammatory mediators which contribute to eczema. [4]

3. Food with high sugar content 

Sugar refers to the artificial sugars commonly found in snacks like candies, chocolates and sweetened drinks. Most of us are not aware, but sugar is a significant culprit behind eczema. 

When you consume sugary foods, the body produces more insulin to break down extra carbohydrates. High insulin levels cause our enzymes to break down collagen and elastin on the skin which are both essential components of healthy skin. This process called glycation creates more wrinkles and makes eczema wounds harder to heal. [5] 

Further, high sugar intake contributes to gut dysbiosis, the imbalance of microbial communities in the gut. Increased sugar intake lowers bacterial diversity and beneficial gut species. It also increases harmful bacteria called Staphylococcus Aureus (S. Aureus) which creates more  inflammatory proteins like Th2. [6] Overall, we experience more inflammation, an impaired skin barrier, and increased susceptibility to bacterial infections.

What type of food is good for eczema?

It may seem that there are a lot of restrictions on food when it comes to having food allergies. Here are two categories of everyday foods that are beneficial for eczema.

1. Food containing Flavonoids

Flavonoids are a type of plant chemicals commonly found in vegetables and fruits. One example is quercetin, it has a strong anti-inflammatory effect and prevents cell oxidation. 

Flavonoids work in two ways which help eczema:

1. As an inhibitor of mast cell secretion and suppress inflammatory proteins like nitric oxide synthase and cyclooxygenase. [7]
2. As antioxidants which reduce the oxidative stress in our body. It increases the stability of free radicals and protects the outermost layer skin cells from oxidative damage. [8]

Overall, flavonoids inhibits unnecessary inflammation and protects the skin from additional oxidative damage, meaning fewer flare-ups. 

Greens such as berries, red cabbage and kale contain a high amount of flavonoids. Coffee, tea and dark chocolate are also good sources of flavonoids. 

2. Food with Omega 3 Fatty Acids 

Omega 3 fatty acids like Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) are useful for countering skin inflammation. They alter the inflammatory transcription and cell membrane phospholipid fatty acid composition of nuclear factor kappa B (NF-KB) which reduce the production of inflammatory proteins. [9]

Salmon, Tuna, Mackerel, flaxseeds and walnuts are some common examples of high omega- 3 containing food. They are easily obtained, bought and prepared from the market which gives our body enough omega 3 fatty acid for the day. 

What are the suggested dishes for eczema patients?

It may seem that eczema patients have many constraints on food consumption. But actually, eczema patients can also have delicious and nutritious food! 

1. Pan Seared Salmon with Greens

This dish is simple to make and is suitable for many people. The ingredients can also be easily obtained from the supermarket. It is also a healthy and nutritious meal.

The greens in this dish can be represented by a variety of vegetables like tomatoes, brussels sprouts, and lettuce. Vegetables contain a high amount of soluble and insoluble fiber. This increases bowel movements and improves your digestive health which is a factor in treating eczema. 

Salmon contains a high amount of EPA and DHA which helps to improve the skin hydration barrier function, retain water content in the skin, and reduce the production of inflammatory proteins. This improves the flaky skin condition of eczema patients. 

2. Kale and Mixed Berries Smoothie

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This dish is easy to make and convenient to carry. It is quite suitable for breakfast as it allows the patient to start the day with fresh fruits and vegetables. 

Fruits like mixed berries and citrus fruits are high in vitamins and antioxidants. Antioxidants help control the inflammatory processes and skin damage. Mixed berries and kale are also high in flavonoids which reduce oxidative stress and suppress inflammation. This reduces overall eczema inflammation.

In conclusion, dairy products, preserved food and food with high sugar content can trigger eczema, especially for patients with food allergies. To better control eczema, patients can eat food that are high in omega 3 fatty acid and flavonoids as they can inhibit the production of inflammatory proteins and improve the skin barrier function. 

References

1. FDA. Food Allergies. 2022; Available from: https://www.fda.gov/food/food-labeling-nutrition/food-allergies.
2. Research, M.F.f.M.E.a. Milk allergy. 2022; Available from: https://www.mayoclinic.org/diseases-conditions/milk-allergy/symptoms-causes/syc-20375101.
3. WebMD. Lactose Intolerance vs. Diary Allergy. 2022; Available from: https://www.webmd.com/digestive-disorders/lactose-intolerance-or-dairy-allergy.
4. Li, Y., et al., Processed Food and Atopic Dermatitis: A Pooled Analysis of Three Cross-Sectional Studies in Chinese Adults. Frontiers in nutrition, 2021. 8: p. 754663-754663.
5. Today, M.N. The link between eczema, gut health, and the microbiome. 2022; Available from: https://www.medicalnewstoday.com/articles/eczema-gut-health.
6. De Pessemier, B., et al., Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms, 2021. 9(2): p. 353.
7. Choopani, R., et al., Treatment of Atopic Dermatitis From the Perspective of Traditional Persian Medicine: Presentation of a Novel Therapeutic Approach. Journal of evidence-based complementary & alternative medicine, 2017. 22(1): p. 5-11.
8. Jafarinia, M., et al., Quercetin with the potential effect on allergic diseases. Allergy, Asthma & Clinical Immunology, 2020. 16(1): p. 36.
9. Calder, P.C., Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? British journal of clinical pharmacology, 2013. 75(3): p. 645-662.