Study of Nutritional Status, Dietary Patterns, and Dietary Quality of Atopic Dermatitis Patients

아토피 피부염 환자의 영양상태.식이형태 및 식사의 질 평가

  • Chung Yun-Mi (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyunghee University) ;
  • Kim Bang-Shil (Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyunghee University) ;
  • Kim Nack-In (Departments of Dermatology, College of Medicine, Kyunghee University) ;
  • Lee Eun-Young (Research Institute of Clinical Nutrition, Kyunghee University) ;
  • Choue Ryo-Won (Department of Medical Nutrition, Graduate School of East-West Medical Science, Research Institute of Clinical Nutrition, Kyunghee University)
  • 정윤미 (경희대학교 동서의학대학원 의학영양학과) ;
  • 김방실 (경희대학교 동서의학대학원 의학영양학과) ;
  • 김낙인 (경희대학교 의과대학 피부과학교실) ;
  • 이은영 (경희대학교 임상영양연구소) ;
  • 조여원 (경희대학교 동서의학대학원 의학영양학과, 임상영양연구소)
  • Published : 2005.07.01

Abstract

The prevalence of atopic dermatitis (AD) continues to increase in the industrialized countries related to Western lifestyle and dietary patterns. The purpose of this study was to evaluate the nutritional status, dietary patterns and dietary quality of AD patients. AD patients (n=50) and gender age matched healthy control (HC) were studied in case-control clinical trail. Preference and frequencies of consumption for 98 foods were estimated by questionnaires. Dietary pattern, current nutrients intake, and dietary quality were evaluated by the 3-day food records. As a result, anthropometric measurements from HC and AD patients were not significantly different. AD patients had significantly lower preference for buckwheat, some fishes (shellfish, flatfish, salmon), egg yolk, some vegetables (onion, garlic, Chinese-cabbage, radish, pepper, mushroom), coffee, and snack than those of HC had (p<0.05). AD patients had significantly lower frequency for pea, some fishes (shellfish, herring, flatfish, salmon, codfish), egg, some vegetables (spinach, pumpkin, mushroom), margarine/butter, nuts, coffee and apple juice, fried chicken, coke than those of HC had (p<0.05). The intake of vitamin $B_1$, vitamin $B_2$ (p<0.05) and vitamin E (p<0.001) of AD patients were significantly lower than those of HC. The intake for Ca and Zn of AD patients were remarkably lower than RDA for each nutrient. Moreover, AD patients' index of nutritional quality (INQ) and nutrient adequacy ratio (NAR) of vitamin E, vitamin $B_1$, vitamin $B_2$ were lower than those of HC. AD patients' dietary quality including dietary diversity score (DDS), dietary variety score (DVS), DMGFV (dairy, meat, grain, fruit, vegetable), dietary quality index (DQI) was poor. This results indicate that atopic dermatitis patients had significantly different food preference and food frequency when these were compared with those of healthy people. The dietary diversity, dietary variety and dietary quality of atopic dermatitis patients were very limited.

Keywords

References

  1. Leung DYM, Harbeck R, Bina P, Reiser RF, Yang E, Norris DA. Presence of IgE antibodies to staphylococcal exotoxins on the skin of patients with atopic dermatitis. J Clin Invest 92: 374-1380, 1993
  2. Laughter D, Istvan JA, Tofte SJ, Hanifm JM. The prevalence of atopic dermatitis in Oregon schoolchildren. J Am Acad Dennatol 43: 649-655, 2000 https://doi.org/10.1067/mjd.2000.107773
  3. Lehtonen EP, Holrnberg-Marttila D, Kaila M. Cumulative prevalence of atopic eczema and related skin symptoms in a well-baby clinic: a retrospective cohort study. Pediatr Allergy Immunol 14: 405-408, 2003 https://doi.org/10.1034/j.1399-3038.2003.00071.x
  4. Oh JW, Lim KW, Pyun BY. Nationwide study for epidemiological change of atopic dermatitis in school and kindergarten aged children in Korea between 1995 and 2000. Pediatr Allergy Respir Dis (Korea) 3 (2): 121S, 2003
  5. Bannister MJ, Freeman S. Adult-onset atopic dermatitis. Australas J Dermatol 41 (4): 225-228, 2000 https://doi.org/10.1046/j.1440-0960.2000.00442.x
  6. Mark R. Kilkenny M, Plunkett A, Merlin K. The prevalence of common skin conditions in Australian scool student. Br J Dermatol 140: 468-473, 1999 https://doi.org/10.1046/j.1365-2133.1999.02711.x
  7. Yoon SP. The Environment and Lifestyles of Atopic ermatitis Patients. Korean J Dennatol 37 (8): 983-991, 1999
  8. McNally NJ, Williams HC, Phillilps DR. Atopic eczema and domestic water hardness. Lancet 352: 527-531, 1998 https://doi.org/10.1016/S0140-6736(98)01402-0
  9. Moore MM, Rifas-Shirnan SL, Rich-Edwards JW. Perinatal predictors of AD occurring in the fIrst six months of life. Pediatrics 113: 468-474, 2004 https://doi.org/10.1542/peds.113.3.468
  10. Choi YJ, Kim SY, lung KA, Chang YK. An assessment of diet quality in the postmenopausal women. Korean J Nutr 33 (3): 304-313, 2000
  11. Jon M. HanifIn, Georg Rajka. Diagnostic features of Atopic Dermatitis. Acta Dennatovener(suppl) 92: 44-47, 1980
  12. Kunz B. Clinical Validation and Guidelines for the SCORAD Index: Consensus Report of the lEuropean Task Force on Atopic Dermatitis. Dermatology 195: 10-19, 1997
  13. Rath E. Pattersonl. Diet Quality Index: Capturing a multimensional behavior. J Am Diet Assoc 94: 57-64, 1994 https://doi.org/10.1016/0002-8223(94)92042-7
  14. Recommended dietary allowances for Koreans, 7th revision, The Korean Nutritions Society, Seoul, 2000
  15. Korean Society for Lipid and Atheroscleorosis. Guidelines for Treatment of Hyperlipidemia, 1st verson, 1996
  16. Chang YK, Chung YJ, Moon HK, Yoon JS, Park HR. Nutritional Assessment, Shin Gwang publishing Co., Seoul 2nd Ed., pp.132-138, 2001
  17. Guthrie HA, Scheer JC. Validity of a dietary score for assessing nutrient adequacy. J Am Diet Assoc 78 (3): 240-245, 1981
  18. Randall E, Nicharnan MZ, Contant CF. Deit diversity and nutrient intake. J Am Diet Assoc 85 (7) : 830-836, 1985
  19. Gibson RS. Evaluation of nutrient intake data. In: Principles of nutritional assessment. Oxford University Press, pp.137-154, 1990
  20. Kant AK, Block G, Ziegler RG, Nestle M. Dietary diversity in the US population, NHANES II, 1976-1980. J Am Diet Assoc 91 (12): 1521-1531, 1991
  21. Krebs-Smith SM, Smiciklas-Wright HS. The effect of variety in food choices on dietary quality. J Am Diet Assoc 87 (7) : 897-903, 1987
  22. Oh KW, Nam CM. A case-control study on dietary quality and fisk for coronary heart disease in korean men. Korean Nutrition Society 36(6): 613-621, 2003
  23. Kay J, Gawkrodger DJ, Mortimer MJ, Jaron AG. The prevalence of childhood atopic eczema in a general population. J Am Acad Dermatol 30: 35-39, 1994 https://doi.org/10.1016/S0190-9622(94)70004-4
  24. Hussain I, Smith J. Evidence for the Transmissibility of Atopy. CHEST 124: 1968- 1974,2003 https://doi.org/10.1378/chest.124.5.1968
  25. McNally NJ. The problem of atopic eczema: aetiological clues from the environment and lifestyles. Soc Sci Med 46: 729-741, 1998 https://doi.org/10.1016/S0277-9536(97)00174-3
  26. Moore MM, Rifas-Shiman SL, Rich-Edwards JW. Perinatal predictors of AD occurring in the fIrst six months of life. Pediatrics 113:468-474, 2004 https://doi.org/10.1542/peds.113.3.468
  27. Tanaka T, Kouda K, Kotani M, Takeuchi A, Tabei T. Vegetarian diet ameliorates symptoms of atopic dermatitis through reduction of the number of peripheral eosinophils and of PGE2 synthesis by monocytes. J Physiol Anthropol Appl Human Sci 20 (6) : 353-361, 2001 https://doi.org/10.2114/jpa.20.353
  28. Barth GA, Weigl L, Boeing H, Disch R, Borelli S. Food intake of patients with atopic dermatitis. Eur J Dennatol 11 (3): 199-202, 2001
  29. Kim KE, Jung BJ, Lee KY. The incidence and principal foods of food allergy in children with asthma. Pediatr Allergy Respir Dis (Korea) 2: 96-106, 1995
  30. Sampson HA. Food allergy. Part 1: immunopathogenesis and clinical disorders. J Allergy Clin Immunol 103: 717-728, 1999 https://doi.org/10.1016/S0091-6749(99)70411-2
  31. Han YS, Chung SJ, Cho YY. Analysis of the rateof sensitization to food allergen in children with atopic dermatitis. Korean J Community Nutrition 9 (1) : 90-97, 2004
  32. Host A. Cow's milk protein allergy and intolerance in infancy. Pediatr Allergy Immunol 5: 5-36, 1994
  33. Horrobin DF. Low prevalence of coronary heart disease, psoriasis, asthma and rheumatoid arthritis in Eskimos. Are they caused by high dietary intake of eicosapentaenoic acid (EPA). genetic variation of essential fatty acid metabolism or a combination of both? Med Hypotheses 22: 421-428, 1987 https://doi.org/10.1016/0306-9877(87)90037-5
  34. Krornann N, Green A. Epidemiological studies in the Upernavik District, Greenland. Acta Med Scand 208: 401-406, 1980 https://doi.org/10.1111/j.0954-6820.1980.tb01221.x
  35. Hodge L, Salome CE, Peat JK. Consumption of oily fish and childhood asthma risk. Med J Aust 164: 137-140, 1996
  36. Biennann CW, Shapiro GG, Christie DL, Arsdel PP, Furukawa CT, Ward BH. Allergy grand rounds-eczema, rickets, and food allergy. J Allergy Clin Immunol 2: 119-227, 1978
  37. Drouet M, Sellin J, Sabbah A. Does the pork/cat syndrome constitute a predisposition to heparin allergy? Allerg Immunol 29: 43-45,1997
  38. Weigl L, Disch R. Protein contact urticaria in a food handler from different meat. Allergologie 20: 192-194,1997
  39. Fogarty A, Lewis S, Weiss S, Britton J. Dietary vitamin E, IgE concentrations, and atopy. The Lancet 356: 1573-1574,2000 https://doi.org/10.1016/S0140-6736(00)03132-9
  40. David TJ, Weddington E, 'Stanton RHH. Nutritional hazards of elimination diets in children with atopic dermatitis. Arch Dis Child 59: 323-325, 1984 https://doi.org/10.1136/adc.59.4.323
  41. Devlin J, Stanton RH, David TJ. Calcium intake and cows' milk free diets. Arch Dis Child 64: 1183-1184, 1989 https://doi.org/10.1136/adc.64.8.1183
  42. Biermann CW, Shapiro GG, Christie DL, Arsdel PP, Furukawa CT, Ward BH. Allergy grand rounds-eczema, rickets, and food allergy. J Allergy Clin Immunol 2: 119-227, 1978
  43. Chen R, Hu Z, Seaton A. Eating more vegetables might explain reduced asthma symptoms. BMJ 328: 1380,2004
  44. Ellwood P, Asher MI, Bjorksten B, Burr M, Pearce N, Robertson CF. Diet and asthma, allergic rhinoconjunctivitis and atopic eczema symptom prevalence: an ecological analysis of the International Study of Asthma and Allergies in Childhood (ISAAC) data. Eur Respir J 17 (3): 436-443, 2001 https://doi.org/10.1183/09031936.01.17304360
  45. Bodner C, Godden D, Brown K, Little J, Ross S, Seaton A. Antioxidant intake and adult-onset wheeze: a case-control study. Eur Respir J 13: 22-30, 1999 https://doi.org/10.1183/09031936.99.13102299
  46. Hijazi N, Abalkhail B, Seaton A. Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia. Thorax 55: 775-779, 2000 https://doi.org/10.1136/thorax.55.9.775
  47. Inchley J, Todd J, Bryce C, Currie C. Dietary trends among Scottish schoolchildren in the 1990s. J Hum Nutr Diet 14: 207-216, 2001 https://doi.org/10.1046/j.1365-277X.2001.00285.x
  48. Anderson HR, Ruggles R, Strachan DP, Austin JB, Burr M, Jeffs D. Trends in prevalence of symptoms of asthma, hay fever, and eczema in 12-14 year olds in the British Isles, 1995-2002: questionnaire survey. BMJ 328: 1052-1053, 2004 https://doi.org/10.1136/bmj.38057.583727.47
  49. Farchi S, Forastiere F, Agabiti N, Corbo G, Pistelli R, Fortes C, Dell'Orco V, Perucci CA. Dietary factors associated with wheezing and allergic rhinitis in children. Eur Respir J 22 (5) : 772-780, 2003 https://doi.org/10.1183/09031936.03.00006703
  50. Hartert TV, Peebles RS. Dietary antioxidants and adult asthma. Curr OpinAliergy Clin Immunol 1 (5): 421-429, 2001
  51. Shaheen SO. Dietary abtioxidants and asthma in adult: populationbasedcase- eontrol study. Am J Respir Crit Care Med 164 (10 Pt 1): 1823-1828,2001
  52. Solvoll K, Soyland E, Sandstad B, Drevon CA. Dietary habits among patients with atopic dermatitis. Eur J Clin Nutr 54 (2) : 93-97,2000 https://doi.org/10.1038/sj.ejcn.1600901
  53. Farchi S. Dietary factors associated with wheezing and allergic rhinitis in children. Eur Respir J 22 (5) : 772-780, 2003 https://doi.org/10.1183/09031936.03.00006703
  54. Jacob RA, Burri BJ. Oxidative damage and defense. Am J Clin Nutr 63: 985-990,1996
  55. Trak-Fellermeier MA, Brasche S, Winkler G, Koletzko B, Heinrich J. Food and fatty acid intake and atopic disease in adults. Eur Respir J 23 (4) : 575-582,2004 https://doi.org/10.1183/09031936.04.00074404
  56. Dunder T. Diet, serum fatty acids, and atopic diseases in childhood. Allergy 56: 425-428, 2001 https://doi.org/10.1034/j.1398-9995.2001.056005425.x
  57. Lee SI, Hee MS, Lee HB. Prevalence of symptoms of asthma and other allergic disease in Korea children: A nationwide questionnaire survey. J Korean Med Sci 16: 155-164,2001
  58. Troisi RJ, Willett WC, Weiss ST, Trichopoulos D, Rosner B, Speizer FE. A prospective study of diet and adult-onset asthma. Am J Respir Crit Care Med 151: 1401-1408,1995
  59. Tsoureli-Nikita E, Hercogova J, Lotti T, Menchini G. 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 Dermatology 41: 146-150,2002 https://doi.org/10.1046/j.1365-4362.2002.01423.x
  60. Song YJ, Paik HY, Lee YS. Qualitative assessment of dietary intake of college students in Seoul area. Korean Home Economics Association 36(12): 201-216, 1998