Dietary Interventions in Atopic Dermatitis: A Comprehensive Scoping Review and Analysis

Int Arch Allergy Immunol. 2024;185(6):545-589. doi: 10.1159/000535903. Epub 2024 Mar 5.

Abstract

Background: This scoping review aims to critically assess gaps in the current literature on atopic dermatitis (AD) by evaluating the overall effectiveness of dietary interventions. Through a comprehensive analysis that follows the Preferred Reporting Item for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a thorough search on the Web of Science database in May 2023 using specific search strategies to identify all relevant studies on the research topic.

Summary: A total of 104 full-text articles were included for review. Our synthesis identified seven notable categories of dietary interventions for AD, showcasing the diversity of interventions utilized. This includes vitamin supplementation, probiotic and prebiotic supplementation, dietary fat, biological compounds, foods from natural sources, major nutrients, and diet-related approaches. Further analyses stratified by targeted populations revealed a predominant focus on pediatrics, particularly in probiotic supplementation, and on adults, with an emphasis on vitamin D and E supplementation.

Key messages: Despite most dietary interventions demonstrating overall effectiveness in improving AD severity and its subjective symptoms, several significant gaps were identified. There was a scarcity of studies on adults and whole-diet interventions, a prevalence of short-term interventions, heterogeneity in study outcomes, designs, and population, occasional disparity between statistical significance and clinical relevance, and a lack of a comprehensive multidisciplinary approach. Nonetheless, these findings offer valuable insights for future AD research, guiding additional evidence-driven dietary interventions and informing healthcare professionals, researchers, and individuals, advancing both understanding and management of AD.

Keywords: Atopic dermatitis; Diet; Dietary interventions; Nutrition; Randomized controlled trials.

Publication types

  • Scoping Review

MeSH terms

  • Dermatitis, Atopic* / diet therapy
  • Diet
  • Dietary Supplements*
  • Humans
  • Prebiotics / administration & dosage
  • Probiotics* / administration & dosage

Substances

  • Prebiotics

Grants and funding

F.T.C. has received research support from the National University of Singapore, Singapore Ministry of Education Academic Research Fund, Singapore Immunology Network (SIgN), National Medical Research Council (NMRC) (Singapore), Biomedical Research Council (BMRC) (Singapore), National Research Foundation (NRF) (Singapore), Singapore Food Agency (SFA), and the Agency for Science Technology and Research (A*STAR) (Singapore); Grant No. N-154-000-038-001, R-154-000-191-112, R-154-000-404-112, R-154-000-553-112, R-154-000-565-112, R-154-000-630-112, R-154-000-A08-592, R-154-000-A27-597, R-154-000-A91-592, R-154-000-A95-592, R-154-000-B99-114, SIgN-06-006, SIgN-08-020, NMRC/1150/2008, OFIRG20nov-0033, BMRC/01/1/21/18/077, BMRC/04/1/21/19/315, BMRC/APG2013/108, NRF-MP-2020-0004, SFS_RND_SUFP_001_04, W22W3D0006, H17/01/a0/008, and APG2013/108. F.T.C. has received consulting fees from Sime Darby Technology Centre, First Resources Ltd, Genting Plantation, Olam International and Syngenta Crop Protection, outside the submitted work. All funding agencies had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.