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Nutritional Concerns for Acne 1.5

Photo by Jan Koetsier on Pexels.com

Being that I mentioned in my first post between the activity of hormones and acne I wanted to explore what the research can tell us about where or if nutrition can fit into the scheme of things. One common theme is that hormones are thought to play a major role in acne for both men and women. If I learned anything from looking at the research is that thinking about hormone and acne with adolescent means more than endogenous hormones but the effect of other “hormones”. Hormones essentially mean a substance/biochemical substance that can affect DNA transcription activation or deactivation of specific proteins.

The first thing I saw was the relationship between hormones (from the cow) in dairy and the stimulation of pilosebaceous units. The interesting is that there is no conclusive evidence that says consuming milk and dairy cause acne but there is evidence that there is a strong relation between dairy products and stimulation of the pilosebaceous unit. This creates the optimal environment for acne bacteria to grow. This is not specific to whole milk either, as skim milk can also cause similar results. Read more about this research paper here. The interesting thing is that there is no set amount of how much milk to be consumed will cause certain acne severity. Another example how taking small steps to changing your own diet can be more beneficial than drastic changes.

Another interesting thing to note was the importance of Vitamin A and D, both fat soluble vitamins. Being that they are fatty friendly (lipophilic), they can get into cells easy and have effects on DNA transcription (the membranes of our cells are made up of fats/lipids). A quick science lesson is when you try to mix oil and water. Oil easily mixes with oil and water easily mixes with water but they don’t mix together well. Since our cell membranes are fat mostly, fat soluble vitamins can easily cross this membrane. The good news is that Vitmain A and D have been shown to help different causes of acne and other skin conditions. Read more about this research paper here. The same study also validates that androgenic hormones (hormones produced in puberty) stimulate the sebaceous glands similarly to growth factors. This study also touches on how insulin (another type of growth hormone like substance) can influence sebaceous gland production. This goes hand in hand with the mentions of how glycemic index conscious diets can help with acne. More about insulin like growth factor (IGF) in this research paper.

To be completely honest, I was just about to say “yeah hormones and puberty cause acne, lots of people experience this”, but glad I didn’t. Turns out I was wrong in thinking hormones was a plug and play idea. It’s a lot more complicated and interesting. One thing of note is that endogenous hormones (made in body) usually have an on and off switch. By consuming hormones, this can start processes in the body that promote growth and inflammation (especially acne).

This is where the rage came with organic, non-gmo, steroid/hormone free products. When looking at the research, the main takeaway is that having a balance of nutritionally dense food will give your body what it needs to work properly. Maybe sometimes the “boost” your body needs is to have more vitamin D or zinc due to previous deficiency, but if your body starts showing symptoms of overdosing (like GI symptoms) then its safe to cut back a little bit and feel out your nutrition. With anything its about empowering you to make the most informed decisions about food that can increase your quality of life. I will end with make sure you check in with your physician and registered dietician when making changes to a diet or unsure of starting something new nutritionally.

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Nutritional Concerns for Acne 1.4

Picture is from https://www.soupersage.com/food-groups-nutrition/nuts-high-in-zinc

For this section we will be talking about zinc. The picture above shows one of the best sources of zinc: Walnuts. Other types of nuts and seeds hold lots of zinc in them per gram. Here are recommended intakes for zinc. So why is zinc important in acne? Some sources say that it may help decrease sebum production and have anti-inflammatory and antibacterial effects. All of these are helpful with acne. Read more about this abstract here.  

There have are more articles that reinforce this idea as an alternative treatment to traditional washes and creams. Read more about this in this abstract. However there is an abstract saying low zinc levels are correlated with severity of acne, however these results were not significant. Here is the abstract.

This typically means that it has shown to help but may not help with everyone and is not a causal effect. A causal effect means low zinc does not cause severity of symptoms but is correlated, meaning they happen at the same time. The good news is that zinc does help with many other diseases along with acne. In fact, oral zinc has been shown to be more anti-inflammatory and help more with inflammatory acne. Here is the research paper on this. I personally prefer the research paper over the abstracts do to more amount of resources provided as sources. The research paper not only says “do this and it will help you” it does note undesirable side effects like Gastrointestinal symptoms. Here is another research that has found similar findings.

 With research it is always making sense of what it means and how it can be applied. One of the ways I use this is by adding a handful of walnuts and pecans into my morning oats. Another thing about zinc is that there are some foods that are fortified with it such as some cereals. Although zinc isn’t a magic substance that will cure acne, it may be helpful for you to substitute items or add a couple of walnuts into your meals. Zinc is also essential for immune function, wound healing, and helping with age-related macular degeneration. I will also like to say that there are health risks for excessive zinc such as GI symptoms (nausea, cramps, diarrhea) and can have unwanted interactions with medications. Read more about the recommendations here.

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Nutritional Concerns for Acne 1.3

Photo by micheile.com || visual stories on Pexels.com

Welcome back to the continuation of nutritional concerns for acne. This post will be going over dairy products and glycemic load. The picture above adds a little bit of what we will be talking about today. Dissecting it shows that their is some dairy and foods generally low on the glycemic index (berries and oats). I have mentioned glycemic load in a previous post, and we will go more into how glycemic load can help for acne. First lets go over the effects of dairy intake on acne.

Dairy

Acne usually happens during adolescence, and it has been found that those consuming dairy products had a positive association with acne severity. This included anything from whole to skim milk and other dairy products such as cheeses. Read more about this article here. I would like add a grain of salt to this study. Although, I love research, it can be very narrow, and the takeaways can be more nuanced. Notice that this article was published in 2005. The conclusions it makes is that the hormones and molecules in milk are thought to cause the increase in acne.

The thought process behind this is that if you remove these hormones and bio actives from the milk then the association might not be true anymore. Unfortunately, there is no study that looks into this. What does this mean though? This means that the regular cheeses and milk has a good chance of showing up as acne severity in adolescents. What this does not mean is that alternative milk products without hormones such as oat, almond, or even claims of Fairlife is associated with severity of acne. The best option is to try it for yourself or someone who is experiencing acne. I would love to hear from you for any experience you might have. Of note, there have been more recent studies that do not show an association between acne severity and yogurts/cheese. Here is one of these articles. Unfortunately, this is not an end all be all scenario as the inconsistencies in the testing and lack of standardizations leave studies ambiguous. Read more about this in this article. What this means for you? If drinking milk is part of your diet, then be aware that it may cause acne and finding substitution looks like a fair way to get your milk intake without experiencing symptoms of acne. The biggest consensus is that drinking dairy milk is associated with increased acne severity with adolescence.

Glycemic load/index

Glycemic load was one of the first things I learned and remains relevant for acne. The difference between glycemic index and load can be cumbersome but let me explain. The scores of glycemic index (GI) and glycemic load (GL) indicate an increased sugar content. GI can indicate foods that cause glucose spikes based on the complexity of the sugars in the food.

This is why most processed foods have a high glycemic index number, as the sugars can readily spike blood glucose. Glycemic load is the actual effect of the food in the body. A great example of this is watermelon, its high on the glycemic index because of the available simple sugars, BUT its glycemic load is low because the real-life impact of its effect on blood sugar is low. Read about this example here. For simplicity, either one or both can be used to help combat its effects on acne.

One of the studies I looked at describes a low glycemic load diet can help with acne. The interesting thing with this article was that it was used for non-Westernized populations. Read more about this article here. There are also other studies out there that determine there are more factors at play than just simply adjusting the foods we eat through GI/GL guidelines for acne. Here is the article that explains this. Furthermore, other studies say that maintaining high GI/GL carbohydrate diet influence a more favorable lipid profile or insulin response.

The big takeaway from how practicing a high glycemic load/index diet for acne severity seems to be associated with the indirect effects of the diet. Glycemic load/index is usually used for individuals trying to control their blood sugars. Uncontrolled blood sugars are related to diabetes which can promote inflammatory mechanisms (acne possibly being one of them). This also effects the lipid content of the body (explained in my previous blogs). I think that practicing a diet high on the glycemic index/load is helpful for those concerned with developing diabetes. Remember to always consult your physician or registered dietician when making drastic changes to your diet. Thanks for reading!

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Nutritional Concerns for Acne 1.2

Taken from the Lancet: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(22)00047-X/fulltext

This one will be a quick post as they kind of go hand in hand. It is about how acne is associated with excess body weight and western diets. The picture above shows factors that effect obesity in children and adolescents. Notice that food culture effects almost all the areas from individual to public policy. So then how can we use this information to help combat acne?

One of the more specific factors associated with increased weight and acne is diabetes and carbohydrate control. Tow of the nutritional terms I will use are glycemic index and glycemic load. Glycemic index is a foods ability to raise blood glucose level via pure glucose 2 hours of food consumption, whereas glycemic load is the food’s ability to raise blood glucose levels via the carbohydrates in the food. In a nutshell, foods low on the glycemic index and have low glycemic load mean they spike your blood sugars.

Lots of spike in blood sugar can lead to the development of obesity and associated type 2 diabetes. This is because our bodies start to become insensitive to the insulin being produced (reduced glucose uptake) AND our body turns the extra glucose in our blood into fat. It has been shown that individuals that ate foods with a high glycemic index and load had decreased lesions and severity of acne secondary to less inflammatory response. Read about this in this research paper.

I will also say that the association of between body mass index may be unclear but still holds an association that overweight and obesity have with increased acne. Read more about this in this article. In one of our previous posts, we determined that the western diet leads to an increased inflammatory response. Remember that an increased inflammatory response is one of the proposed mechanisms for acne. Therefore, the western diet should have a positive correlation in acne. One of the interesting things is that the studies I have been posting here are all from America (Western Diet).

One of the reasons to this is that Western diets are deficient in omega-3s (common in salmon). Interestingly, its not the amount of omega-3s in your body that matters but its ratio compared to other fats that determine its health derivative, in the western diet the omega-6: omega-3 ratio can be from 10:1 to 20:1. In fact, when individuals shifted to a non-western diet their acne resolved. Read more about this here. One of the other proposed mechanisms that Western diet promotes acne is through hormonal signaling. Basically, one study proposes that the western diet increases inflammation by pushing the a certain group of T-cells in our body to increase activity of the sebaceous follicles. Read more about this in this research paper.

Excess body weight and the practice of western diets have a high correlation with increased acne incidence and severity. This is suggested being the change of losing weight and stopping western diet practices has provided great results against acne. It is of note that severely decreasing macro and micronutrients should be adjusted and maintained by a registered dietician, but the exchange of foods low in glycemic index and load can be substituted for safely for those higher on the scale. This is especially true being that foods on the high end provide more nutrient density than those on the low end. Also, switching to something such as a Mediterranean diet should be adjusted to an individual’s needs, allergies, and current nutritional requirements.

The goal for this post is to take something you learned and make small substitutions in your own dietary intake. See in you in the next one.

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Nutritional Concerns for Acne 1.1

Photo by cottonbro on Pexels.com

Acne, we all know someone who has been affected by it one way or another. Can nutrition help? Most likely. Today we start our journey to seeing how using nutrition can help reduce symptoms of acne.

First things first, how do we get Acne? Well, there are many ways to get acne but the majority of these ways stem from a few simple root causes. The first one I will talk about is sebum production. Sebum glands produce sebum with many roles. One thing I learned is that sebum’s role depends on species. However, the sebum in humans are used to protect us from harmful light, protection from microbes, delivery of antioxidants to the skin, and work against inflammation.

Sounds like a good product right? It is, the problem happens when our glands make too much of it. As I expressed in my last blog post, too much of anything can be extremely harmful to the body regardless of how helpful it may be. Lots of the basis I will be explaining are touched on in this article.

Alterations in sebum also produce what we see as acne. When sebum concentration are altered and the backbone of sebum is modified, Acne vulgaris is able to colonize the glands. The alteration of the healthy omega-3 (found in fatty fish) that leads to decreased concentration in sebum leads to what we know as comedones aka white-heads. Read more about this here.

Another alteration of the sebum happens with too much squalene (peroxidase) activation. Squalene is an scavenges for oxygen species. It is this oxidation that can start comedone formation that makes a favorable environment for bacteria to grow and develop. Read more about squalene here. What ends up happening is the a pimple develops creating the inflammation, redness, pain, and associated “head” (white, black, or without if deep enough). It has also been shown that a decrease in vitamin E (the helpful for the cell membrane) is associated with increased squalene peroxidase activity. Read more about this here.

One more major component to acne is hormones. There is a reason why most acne occurs in adolescence and that is because of hormones. Sebaceous glands do have some background in being hormone regulated. This means that the regulation of sebum production and ratio has a chance to help with symptoms in adolescence.

Now that we know what essentially happens with acne, we can go over how nutrition can help. We will talk about ways to moderate the sebum production. Moderation of the production will help move the production of sebum from overproduction to normal production. Another tactic we can use to help with acne is through regulating the lipid/fatty content of the sebum and bringing this to a healthy ratio. I would also like to say that although nutrition can help, maintaining an adequate skincare routine will work wonders for reducing acne symptoms. If you or someone you know is experiencing acne symptoms that are not controlled with nutrition or exercise, please reach out to your physician for further considerations. See you in the next posts.

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Atopic Dermatitis and Nutrition 1.6

Photo by mali maeder on Pexels.com

This is a picture of an avocado, a great source of monounsaturated fatty acids.

Fatty acids

Today we will be talking about atopic dermatitis and fatty acids. This will be the last topic on Atopic dermatitis… for now. Interesting thing of note is that the post before this (Vitamin D) and this topic are controversial for helping with decreasing symptomatology of atopic dermatitis. Today’s looks at fatty acids in helping with atopic dermatitis.

As a recap, the healthy fatty acids are mono- and polyunsaturated fatty acids. These are what are found in avocados and fatty fish (salmon) respectively. The theory behind why supplementation will with symptoms starts with cell membranes. Cell membranes and precursors of immunomodulators (see my last two post on a brief introduction to immunomodulators) are some end products for fatty acids. Therefore, the dysfunction of these can cause symptoms of atopic dermatitis.

The supplementation of mono- and polyunsaturated fatty acids may even be helpful for breastfeeding mothers and their less than 1 year old children as it there has been some evidence to support a decrease in atopic dermatitis in this patient population. Read more about this in this research paper. Another research paper on this here shows that when moms have healthy fats in their breastmilk for their infants, these infants had less reported eczema and less atopic dermatitis as a result of adequate immunomodulation (seen with appropriate IgE levels). Unfortunately (like vitamin D and atopic dermatitis), there have been benefits seen but with no standardization leading to dosage for treatment.

Another subset of the population that may be predisposed to atopic dermatitis in relation to fatty acids is those with a defect in the enzyme converting linoleic acid to its metabolites. Read about this abstract here. Another abstract on this here.

I would like to reiterate that abstracts provide a direction for research but are more like theories that need to be proven. For those interested, here is a research paper showing the many interactions of what effects atomic dermatitis and the role of fatty acids. Basically, what it says is that atopic dermatitis is most likely caused by a dysfunction of cellular membranes leading to disruption of epithelial layers that expose the immune system to environmental allergens that would otherwise be blocked. This is what predisposes the body to an inflammatory response seen as common symptoms of eczema and pruritis (itching).

The take home I want to provide is free fatty acids might not help deter symptoms of atopic dermatitis for most populations, but this doesn’t mean you should not try it. I don’t think increasing intake of healthy free fatty acids to an unhealthy amount is appropriate (anything taken too much is inappropriate), but I do think that most of the population can benefit from substituting unhealthy fatty acids with healthy fatty acids. There are many more positive outcomes that have shown to be associated with free fatty acid consumption, of importance is the beneficial cardiovascular effects. Another note is that everyone is an individual and you may be one where this diet could help. If so then you could be a potential for a case study. A case study is a study that helps the medical community learn something new about the disease and how to treat it. Thanks for reading.

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Atopic Dermatitis and Nutrition 1.5

Photo by Jill Wellington on Pexels.com

This post will be focusing on Vitamin D in helping with symptoms of atopic dermatitis. The picture above shows our bodies most conducive way of receiving Vitamin D: the sun. Don’t forget your sunscreen! It doesn’t lower Vitamin D absorption as much as you think. As previously discussed in the post about keloids, Vitamin D plays a role in wound healing and inflammation. The big thing for Vitamin D in its role in keloids is by controlling the growth of fibroblasts. Vitamin D’s role in atopic dermatitis is theorized to be associated with skin infections via its role in adaptive immunity. Adaptive immunity is when the body builds a response to what it experiences in the environment AFTER birth. Here is the link to this abstract.

To further this, a low Vitamin D level has the potential to predispose to a lack of immunomodulation (low antibody/receptor availability) and lack of cell differentiation (being that Vitamin D effects gene transcription). These lack of variance in receptors can play a role in antimicrobial peptide lack of variation. The problem with this research is that the actual role of Vitamin D produces inconsistent results. Read more about this in this research article.

All-in-all, many of these studies show that maintaining an adequate level of Vitamin D is important to maintaining healthy skin through barrier function and antimicrobial function. Read more about this in this research articled. The action of Vitamin D in this is still being discussed/research to determine a standardized way to identify how much Vitamin D can help with atopic dermatitis given which symptoms in what type of scenario. Besides its importance for the skin, hypovitaminosis D (low vitamin D) has other factors of worry such as decreased bone density in post-menopausal women and other bodily regulatory areas. My call to action for this post is to work in sources of vitamin D to prevent severity of disease pathogenesis. Thanks for reading and I look forward to having you in the next blog post.

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Atopic Dermatitis and Nutrition 1.4

This was taken from https://www.yakultusa.com/

Vegetarian diets

Welcome back! Lets continue our exploration of management of atopic dermatitis with looks into vegetarian diets and prebiotics/probiotics. The picture above is one of my most memorable forms of probiotics: Yakult. In terms of the vegetarian diets there really was not much to find from a research level but there were some abstracts that can help guide the conversation. I will premise saying that strictly going vegetarian should be followed by a registered dietician to make sure that certain micronutrients are retained through your nutritional input.

One of the abstracts used a SCORAD index to gauge the severity of atopic dermatitis symptoms through a vegetarian diet. The problem with this abstract is there was not a large amount of population being tested and they were individuals whose symptoms were not controlled with traditional remedies (such as topical steroids). It did look into adult patients and the pathology behind the SCORAD was a reduction in inflammation (via eosinophils, neutrophils, and PGE2). Eosinophils are what was described in the previous section as part of the type I hypersensitivity. PGE2 is released by inflammation and is one of the elements inhibited by the use of NSAIDs (ibuprofen/Advil, Tylenol, aspirin). Read more about this abstract here.

The SCORAD stands for scoring atopic dermatitis that looks at the extent and intensity of the lesions. Another abstract described this as decreased secondary to a vegetarian diet, kind of. They classified the diets tested here as undernutrition without malnutrition which basically means remaining in a caloric deficit while having micronutrient needs met. They noted that the diet caused a decrease in body weight and inflammation which led to a reduction in AD symptoms. There was a low amount of people in this abstract (14 females and 5 males) which limits its usefulness but it does touch on aspects we have mentioned previously. Read this abstract here.

I would also like to point out that there are multiple types of vegetarian diets. There is lacto-, ovo-, pesci-vegetarian to name a few. One interesting correlation found in an abstract shows that a three month regimen of a lacto-ovo-vegetarian diet provided benefits of increased IgA (your gut immune globulin that is protective) and a decreased in IgE expression as an indirect based on the gut microbiome change. Although not directly influencing the symptoms of atopic dermatitis, it is good to note when trying this diet out and seeing how it effects your personally. Read about this abstract here.

With this said lets go ahead and jump into our next section.

Prebiotics and probiotics

Let’s start off with providing the difference between the two. Prebiotics is food for the healthy gut bacteria and probiotics is actual good gut bacteria. So, when you ingest probiotics, you are ingesting live strains of the good gut bacteria that help your digestive tract. So, when can you start using probiotics to start developing good gut microbiota? Anytime.

One study reviewed many papers to find that probiotics may protect neonates (in both pre- and post- periods). An interesting thing about neonates is that their microbiome isn’t really established until within the first year of life and is unique to the mother’s microbiome. Establishing a healthy scaffold to grow from is the direction of meaning this paper was getting at. Read more about this here. Other articles I saw were abstracts that emphasized a benefit to infants receiving probiotics for protection from atopic dermatitis/eczema. Then the question is what about the other populations?

The only other paper I could find was an abstract that basically said there’s more to learn about the microbiome and although it can help, we just don’t know enough yet. Unfortunately, that’s just how it goes sometimes with directions for research. Here’s the abstract for this here. There was even a research paper that went into many mechanisms and reasons why it would help but did not make a legitimate statement that if you do this good things will happen for your atopic dermatitis symptoms. Here is the research paper if you want to learn more.

So how can we use this information? One of the oaths we take when getting into medical school is the hypocritic oath which has the famous line of doing no harm. With that said I can’t confidently recommend when you implement prebiotics and probiotics that your symptoms will change. That being said, the research is there that checks lots of boxes and could still be a staple in providing for a healthy nutritional gut microbiome. There are plenty of research out there boasting the benefit of health of microbiome and great health outcomes. Heck, this is the go-to for some people with C. diff after antibiotics won’t help anymore.

With anything make sure to seek regular checkups with your physician and registered dietician to make sure that you are hitting all the marks when starting a drastic transformation in adjusting your nutritional needs. This is very particular for implementing vegetarian diets. Have you or someone you know tried these tricks out and it helped or hurt them? Again, these are seen here as ways nutrition can help with atopic dermatitis but are also a good wedge into building the knowledge of build healthy habits in eating.

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Atopic Dermatitis and Nutrition 1.3

This is from https://www.therealisticmama.com/food-allergy-snack-alternatives/

Eliminating allergy causing foods

Remember earlier that I mentioned atopic dermatitis is associated with allergies? Well, food allergies is a common association with atopic dermatitis. Food allergies have been shown to be highly associated with atopic dermatitis and can be avoidable and replaced with alternatives that can work to provide a healthy nutritional substitute. Before I get into the research, I want to touch on what an allergic reaction means to our bodies.

Fair warning, there are many different mechanisms our body uses as an allergic reaction but the one I will mention here is common and specific for food allergies. Food allergies are categorized as a type I hypersensitivity reaction. This means that the pathways are mostly associated with IgE. The other component I would like to explain are peptides and chemical structures. Think of these as a key to a door or mailbox. Each key has its own specific shape that is very specific to the lock “combination” it is used to open; it is also unique in that other keys will not work to open that lock (or shouldn’t).

Foods have specific chemical structures or peptides that are unique also. At the first encounter, our bodies recognize these foods through the chemical structure or peptides through macrophages. Macrophages hold the lock that bind to the certain chemical structure/peptides of the food. These are called Pattern Recognition Receptors (as they recognize patterns) and they are as old; I am talking Homosapien or older type of old. They also are made with a somewhat variant structure: meaning our bodies make them unique.

When these pattern recognition receptors match with a food allergen (chemical structure/peptide), it signals to the body that whatever this allergen/chemical structure/peptide belongs to is bad news and that they need to get rid of it FAST. So what does it do? The macrophage tells the immune cells to remember the pattern and when they do to secrete tons of IgE. The next time your body see’s the allergen/chemical structure/peptide it starts the hypersensitivity reaction that causes all the symptoms of allergy. Which can be as small as some sniffles or as deadly as anaphylactic shock. Those of you who carry around an EpiPen know what I’m talking about.

When your body see’s the food allergen again, the IgE made by the memory immune cells (B cells) bind to the mast cells, and the mast cells release a cocktail of chemicals (cytokines and chemokines) that tell all your inflammatory cells to come to wherever it is and start the inflammation process. This is what causes most of the symptoms. Now to the research. The most common food allergens triggering atopic dermatitis are milk/milk products, peanuts, eggs, soy, wheat, seafood, and shellfish. These are from this research article. This article looks at dietary elimination and its success of reducing symptoms in children but brings up the great point of nutritional deficiencies. Read more about this research here. This research paper also goes over the general overview of what I discussed in the previous paragraphs. My PSA is ALWAYS consult with an registered dietician or physician when your are planning to make drastic changes in your diet to make sure your nutritional needs are met.

When looking at young children and newborns, the amount of IgE can almost be a major risk factor for developing atopic dermatitis/eczema, allergic rhinitis, and asthma. Read about this here. If you are over 14 years old and think that maybe these don’t apply to you, there is still research that shows that the hypersensitivity reaction I mentioned from food allergies is associated with persistent eczema especially during times of food allergen reaction. These were associated with seafood, fungi, and celery in this article.

You may be thinking of the “random” occurrence of food in the last article I provided. Funny thing about allergies and the immune system is that it can mistake certain food allergens/chemical structures/peptides for one another. This wasn’t mentioned in the article but a proposed mechanism that is plausible is that the fungus in the seafood has a similar chemical structure that very much resembles celery to the point that your body confuses the two. This does happen and can be confusing at first but the result to helping symptoms is replacing the foods with one that your body is not sensitive to. Just to put more research out there, a reaction to peanuts shows a very similar reaction as mentioned with the celery in patients 14 years old and older. Again, there is an association with allergic rhinitis and asthma. Read more about this here.

Being that this topic had tons of information I will postpone vegetarian diets to my next posts to ease the reading time of this post. The take aways I hope you get out of this post is that if you are suffering (or know someone) with atopic dermatitis (or even associated allergic rhinitis or asthma) consider substituting foods with alternatives to find out what you are allergic to. I would only recommend this if symptoms were not bad. The best results from finding out what you are allergic to and working to create a diet that fulfills your bodies nutritional requirements is by visiting an allergists/immunologist and working in tandem with a registered dietician.

I would recommend some healthy food substitutes to try but being that the spectrum is so broad, I will only mention a few that we covered. Some healthy substitutes to shellfish could be salmon (as it also has good omega 3) or other healthy fat fish. If seafood is a major part of your diet, there are vegetarian options such as combining complementary proteins in beans or by eating complete proteins such as quinoa or tofu. For peanuts maybe you can try replacing this with some other type of nuts such as cashews or almonds as they have a different sort of upbringing and classification than a peanut. They make butters for these as well. Please see the featured image for more ideas. Stay tuned for the next post where I will touch on vegetarian diets and hopefully get to gut health.

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Atopic Dermatitis and Nutrition 1.2

This picture was taken from https://www.kunkelplasticsurgery.com/body-contour/body-mass-index-bmi-and-surgery

Body weight (BMI/abdominal obesity)

Our first section we will talk about is BMI. Studies have shown that an increase individuals classified as overweight or obese had a higher prevalence of atopic dermatitis. Read about this study here. A quick note about this study is that it uses cross-sectional data and prevalence. Prevalence is the amount of people with the disease in the population within a certain time frame (annually). This means if one person in a population of 10 has obesity/overweightness and develops atopic dermatitis, the prevalence is 1/10. If that person is still alive come next year and another person that is obese/overweight develops atopic dermatitis, then the prevalence becomes 2/10. Cross-sectional looks at a snapshot at a point in time so there could be other factors effecting the results. The power in the paper is the number of studies but as with all research, there is a grain of salt and always more to learn.

Just because increased bodyweight/BMI is associated with atopic dermatitis, it does not always mean all signs and symptoms are equal. There is no association with the severity of eczema with increased bodyweight/BMI, only the prevalence is associated. Read about this study here. Another thing to be aware off is the associated symptoms such as asthma, as increased BMI has shown to be associated with shown in this study. This study focusses on the prevalence of atopic dermatitis and obesity in women. Read about this study here.

So does reducing weight help? The answer is yes. Reducing weight has been shown to reduce symptoms of atopic dermatitis due to adipokine. Of note, BMI and adiponectin level are related but there is no relation to adipokine levels and AD severity. A decrease in Adiponectin is associated with obesity, insulin sensitivity, and metabolic syndrome AND even associated with asthma. Increased adiponectin has been shown to be anti-inflammatory. Read all about this in this study.

So how can we use this information? Although the mechanisms are not well understood, lowering weight can help with atopic dermatitis symptoms. The basics to handling weight is by decreasing calorie intake, more exercise at increasing intensity gradually, and making sure your foods are nutrient dense. This can work along with many of the tips and tricks that I bring up during these blogs.

Avoiding western dietary pattern

Some terms I mentioned in the last section were adiponectin associated with obesity, insulin sensitivity, and metabolic syndrome. The interesting thing is that these are common diseases in western societies. There are many suggested correlations with degenerative diseases, obesity, cardiovascular disease, and low-grade inflammatory diseases associated with the western dietary pattern. It has even been shown to reach generational impacts via epigenetics and lifestyle choices. All of these are in this study here.

Tying this in with weight-loss: if obesity/overweight is associated with prevalence of atopic dermatitis and if a western diet is associated with obesity/overweight and inflammation, then decreasing the practice of a western dietary pattern can decrease atopic dermatitis symptoms. There are even studies that have shown that pregnant women on the Mediterranean diet had decreased atopic dermatitis in children. Read about this related study here. So remember that avoiding a western dietary pattern and changing to a healthier one can help mitigate atopic dermatitis symptoms in adults/adolescents and children respectively.

My call to action for this post is if anyone had noticed change in weight or diet and atopic dermatitis symptoms? I always find it interesting that inflammation seems to play a big part of symptoms of the skin issues we have discussed in this blog till now. The next blog will continue the conversation. Look forward to seeing you there.