Korean Journal of Community Nutrition

Randomized Controlled Trial

[English]
Effects of Nutrition Education Promoting Vegetable, Fruit, and Fish Intake on the Severity of Atopic Dermatitis in Children: Results from a One-year Follow Up Study: Heejin Lee, Kangmo Ahn, Youngshin Han, Sang Jin Chung; Korean J Community Nutr 2013;18(5):515-524. Published online October 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.5.515

Atopic dermatitis (AD) is believed to be associated with the intake of antioxidant nutrients and fatty acids due to its immunological dysfunction. The purpose of this study was to examine the effects of nutrition education promoting vegetable, fruit, and fish intake on the severity of AD in children. Children with AD aged 6 months to 5 years were randomly assigned into education and control groups, and followed for 1 year. Seventy-six children completed the study (38 for control, 38 for education). The education group received education promoting the intakes of antioxidant-rich foods (vegetables, fruits) and n-3 fatty acid foods (fish). A 24-hour food recall was collected for the diet information. After education, all vegetables (p < 0.001), fruits (p < 0.01), and fish (p < 0.05) intakes per 1000 kcal increased significantly in the education group, whereas only vegetable intake increased in the control group (p < 0.001). The SCORAD index, the severity of atopic dermatitis, decreased significantly in the education group (p < 0.05). Increased consumption of dietary vitamin E was significantly associated with reduction in the SCORAD index, after adjusting for age and gender (p < 0.05). A nutritional education program to increase vegetable, fruit, and fish intake may be effective in reducing the severity of AD, and vitamin E intake may be associated with the decreased severity of AD. More controlled studies on the relationship between these intakes and severity of AD, with intensive diet and/or supplement intervention programs, are needed to obtain conclusive results.

Citations

Citations to this article as recorded by

Nutritional Intervention for a Korean Adolescent with Atopic Dermatitis: a Case Report
Sunghee Kim, Sung-Im Lee, Shin-Sook Kang
Clinical Nutrition Research.2021; 10(4): 364. CrossRef
Evaluation of nutritional status and adequacy of energy and nutrient intakes among atopic dermatitis children under 12 years of age: based on Korea National Health and Nutrition Examination Survey data (2013–2015)
Hye Won Kim, Ji-Myung Kim
Journal of Nutrition and Health.2020; 53(2): 141. CrossRef

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Original Articles

[English]
The Comparison of Growth and Nutrient Intakes in Children with and without Atopic Dermatitis: Seung Joo Park, Jae Sun Lee, Kangmo Ahn, Sang Jin Chung; Korean J Community Nutr 2012;17(3):271-279. Published online June 30, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.3.271

Abstract PDF PubReader

The prevalence of atopic dermatitis (AD) has increased recently all over the world. Several studies worldwide reported growth retardation associated with AD, but few studies were reported in Korea. Therefore, the objective of this study was to identity the differences in growth and nutrient intakes between Korean children with and without AD. The participants were 71 AD children and age, gender-matched 81 control children aged 10 to 36 months. Demographic information was gathered by questionnaires. Height and weight were measured at clinic and health centers. Height and weight for age, and weight for height were converted as deviation in Z scores using World Health Organization Standard. A 24 hour dietary recall method was performed to estimate nutrient intakes. A higher percentage of AD children had insufficient energy and intakes of calcium, phosphorus, iron, zinc and vitamin B2 , defined as intakes lower than 75% of the Dietary Reference Intakes for Korean, compared to the control group (P < 0.001, P < 0.001 0.001, P = 0.003, P = 0.001, P = 0.014, P = 0.001, respectively). The percentages of children with height and weight for age Z score below than-1 (stunted) were significantly higher in the AD group (P < 0.001 0.001 and P < 0.001 0.001, respectively). Multiple food restriction, defined as > or = 3 food elimination, was associated with insufficient energy and intakes of calcium, phosphorus, iron, zinc, vitamins A and B2 . In conclusion, children with AD need regular nutrient assessment and education about alternative food choices to avoid r food elimination in order to prevent growth retardation or inadequate nutrient intakes. Further longitudinal studies for growth and nutrient intakes should be performed to understand the patterns of growth in children with AD.

Citations

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Relationship between intake of soft drinks and current prevalence of adult atopic dermatitis: based on the Korea National Health and Nutrition Examination Survey data (2015-2016)
Hye Won Kim, Ji-Myung Kim
Journal of Nutrition and Health.2021; 54(5): 501. CrossRef
The status of food allergy and parental burden of preschoolers in Jeju area
Jeong Eun Oh, Eunyoung Kim, Yunkyoung Lee
Journal of Nutrition and Health.2021; 54(6): 664. CrossRef
Evaluation of nutritional status and adequacy of energy and nutrient intakes among atopic dermatitis children under 12 years of age: based on Korea National Health and Nutrition Examination Survey data (2013–2015)
Hye Won Kim, Ji-Myung Kim
Journal of Nutrition and Health.2020; 53(2): 141. CrossRef
Food Allergy-related Awareness and Performance of Dietitians at Children's Hospitals in Korea: Comparison of Certificate Possession among Clinical Dietitians
Hye-Ran Shin, Sook-Bae Kim
Korean Journal of Community Nutrition.2019; 24(6): 512. CrossRef
Relation of Nutritional Intake and Allergic Rhinitis in Infants: Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2013~2016
Eun-Sil Her, Bo-Young Seo
Korean Journal of Community Nutrition.2019; 24(4): 321. CrossRef
Food allergic reactions in the community: a questionnaire survey of caregivers
An Deok Seo, Jun Yeol Lee, Song I Yang, Hye Ran Lee, So-Yeon Lee
Allergy, Asthma & Respiratory Disease.2017; 5(1): 27. CrossRef
The change in food allergy prevalence of elementary school children in Seoul since the last 20 years and the risk factor analysis
Yeong-Ho Kim, So-Yeon Lee, Eun Lee, Hyun-Ju Cho, Hyo-Bin Kim, Ji-Won Kwon, Song-I Yang, Eun-Jin Kim, Jeom-Kyu Lee, Soo-Jong Hong
Allergy, Asthma & Respiratory Disease.2016; 4(4): 276. CrossRef
Nutrient intakes of infants with atopic dermatitis and relationship with feeding type
Youngshin Han, Youngmi Lee, Haeryun Park, Sunyoung Park, Kyunghee Song
Nutrition Research and Practice.2015; 9(1): 57. CrossRef
Perception on food allergy labelling and management of nutritional education among higher grade elementary school students in Jeju area
Yunkyoung Lee, Hyun-Hee Kim, Yang-Sook Ko
Journal of Nutrition and Health.2015; 48(6): 530. CrossRef
Survey of food allergy in elementary school children in Bucheon-city and relationship between food allergy and other allergic diseases
Jae Young Park, Ga Young Park, Young Shin Han, Mee Yong Shin
Allergy Asthma & Respiratory Disease.2013; 1(3): 266. CrossRef
Nutrient Intake and Food Restriction in Children with Atopic Dermatitis
Hyunjin Lim, Kyunghee Song, Ran Kim, Jiyeon Sim, Eunah Park, Kangmo Ahn, Jihyun Kim, Youngshin Han
Clinical Nutrition Research.2013; 2(1): 52. CrossRef

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[English]
Excessive Food Restriction in Children with Atopic Dermititis: Seokhwa Lee, Heejin Lee, Youngshin Han, Kangmo Ahn, Sangil Lee, Sang Jin Chung; Korean J Community Nutr 2011;16(6):627-635. Published online December 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.6.627

Abstract PDF PubReader

The prevalence of Atopic Dermatitis (AD), a non-infective chronic inflammatory skin disease, is increasing worldwide. Avoiding the allergen is the basic principle in the treatment of AD. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. The objective of the study was to examine the status of the dietary restriction and compare the caregiver's restriction practice with doctor's recommendation in Korean children with AD. A total of 158 children diagnosed with Atopic Dermatitis were recruited for this study. Information about foods that aggravate AD symptoms and food restriction were collected from the mothers of 158 children aged 6 month-5 year with AD using questionnaires. Food restriction recommendation by doctor was collected through medical chart. McNemar and Margianl homogeneity tests were used to detect a relationship between food restriction recommended by doctor and current practice by mother. There were significant proportion differences of food restriction for each food between by doctor and mother. We found 75.9% of children were avoiding eggs although only 61.4% were recommended for egg restriction by a doctor. Children with restriction of more than 4 kinds of food were 53.2% compared to 13.3% by doctor. Excessive restrictors tended to be younger and diagnosed at younger age. The caregivers of excessive restrictors had trends of "being older" and "having higher income". Avoidance of common foods in children without food allergy could result in malnutrition or impaired growth. Nutrition education is needed for sound practice and nutrition care in children with Atopic Dermatitis as well as interactive communication between caregivers and experts.

Citations

Citations to this article as recorded by

Relationship between intake of soft drinks and current prevalence of adult atopic dermatitis: based on the Korea National Health and Nutrition Examination Survey data (2015-2016)
Hye Won Kim, Ji-Myung Kim
Journal of Nutrition and Health.2021; 54(5): 501. CrossRef
Evaluation of nutritional status and adequacy of energy and nutrient intakes among atopic dermatitis children under 12 years of age: based on Korea National Health and Nutrition Examination Survey data (2013–2015)
Hye Won Kim, Ji-Myung Kim
Journal of Nutrition and Health.2020; 53(2): 141. CrossRef
Risk factors for food allergy among children in Seoul: focusing on dietary habits and environmental factors
Mijung Jang, KyooSang Kim
Journal of Nutrition and Health.2019; 52(6): 559. CrossRef
Study on Food-Intake and Atopic Dermatitis among Adolescents : Findings from the Korea Youth Risk Behavior Web-based Survey
Jee Hye Lee
Journal of the Korean Dietetic Association.2016; 22(2): 79. CrossRef
Comparison of elementary school students in atopy-friendly and general schools for their knowledge about environmentally-friendly produces and practice levels for dietary guidelines
Sang-Mi Lee, Hoikyung Kim
Korean Journal of Human Ecology.2014; 23(4): 733. CrossRef
The Comparison of Growth and Nutrient Intakes in Children with and without Atopic Dermatitis
Seung-joo Park, Jae Sun Lee, Kangmo Ahn, Sang-Jin Chung
Korean Journal of Community Nutrition.2012; 17(3): 271. CrossRef

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6 Crossref

[English]
Associated Factors with Severity of Atopic Dermatitis in Children: Jae Sun Lee, Sunmi Jo, Heechul Lee, Kangmo Ahn, Sang Jin Chung; Korean J Community Nutr 2010;15(6):776-782. Published online December 31, 2010

Abstract PDF: The prevalence of atopic dermatitis (AD) has increased over the past decades. A variety of factors are related to the development of atopic dermatitis, including genetics and environmental factors. The purpose of the study was to examine factors associated with severity of atopic dermatitis in 104 children aged 6-60 months. To investigate the association between severity and other factors children were divided into two groups, mild (n = 62) and severe (n = 42) groups, based on SCORAD index which measures the severity of atopic dermatitis. Results showed that family history, family's smoking, period of having AD and the levels of the serum total IgE were significantly higher in severe group. More than 6 months of breastfeeding and weaning after 6 month were not associated with severity of AD, but the number of food eliminated was associated with severity. Only vitamin C intake was significantly different by severity after adjusting for energy intake, family history, family's smoking and period of having AD (p = 0.033). There was no association between the severity of atopic dermatitis and growth of children. This study concluded that the severity of atopic dermatitis was associated with family history, family's smoking, period of having AD, children's serum total IgE, and vitamin C intakes. The result of this study should provide the significant information for better management of AD.

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[English]
Effects of Medical Nutrition Therapy on Dietary Quality, Plasma Fatty Acid Composition and Immune Parameters in Atopic Dermatitis Patients: Bang Shil Kim, Yun Young Kim, Jin Hee Park, Nack In Kim, Ryo Won Choue; Korean J Community Nutr 2008;13(1):80-90. Published online February 29, 2008

Abstract PDF: Atopic dermatitis (AD) is one of the major public health problem. It has been reported that the prevalence of AD in children and adults are 10-20% and 1-3%, respectively. Westernization of food habits, urbanization, and environmental pollution are contributing factors toward the recent rise in prevalence. Excessive dietary restriction leads to chronic malnutrition in atopic dermatitis patients. The purpose of this study was to investigate the effects of medical nutrition therapy (MNT) on quality of diet and blood immune parameters in atopic dermatitis patients. The 19 atopic dermatitis patients (7 men and 12 women) admitted to K University Medical Center were studied. During the 12 weeks of intervention, the subjects were given MNT by a dietitian for 30-45 minutes every other week. MNT was comprised with general dietary therapy, intake of balanced meals, emphasis on n-3 fatty acid contents in foods, and food allergies. Anthropometric and dietary assessment and blood analysis were taken at baseline and after 12 weeks of MNT. After 12 weeks of MNT, the subjects' dietary qualities, including dietary diversity score (DDS), meal balance score (MBS) and dietary variety score (DVS) were significantly increased (p < 0.05). According to significantly increased intake of EPA and DHA, dietary n-6/n-3 fatty acid ratio decreased to the recommended level for the atopic dermatitis patients (p < 0.05). These changes of dietary fatty acid consumption were reflected rythrocyte fatty acid composition. After 12 weeks of MNT, serum levels of IgE and IL-4 levels were significantly decreased, however, the levers of INF-gamma, WBC, lymphocyte and TLC were not changed. As a conclusion, the individualized MNT improved the quality of diet in atopic dermatitis patients thereby influenced RBC fatty acid composition and IgE and IL-4 levels.

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[English]
Sensitization of Food Allergen in Breastfed Infant with Atopic Dermatitis: Young Shin Han, Sang Jin Chung, Kang Mo Ahn, Kwang Shin Lee, Hay Mie Choi, Sang Il Lee; Korean J Community Nutr 2005;10(3):264-270. Published online June 30, 2005

Abstract PDF: Breastfeeding has been known as the best feeding practice to prevent allergies including atopic dermatitis (AD). However, the benefit on the prevention of allergic disease is still controversial. The objectives of this study were to examine the rate of sensitization to the protein of eggs, cow's milk and soy in exclusively breastfed infants and to evaluate antigen-antibody reaction between breast milk and serum of AD infant. Data on feeding and food hypersensitivity were obtained for 62 AD infants (32 male, 30 female) aged < 6 month who had visited Samsung Medical Center from September 2001 to May 2003. Food hypersensitivity was determined by measuring specific IgE to egg, cow's milk and soy. Specific IgE levels > 0.7 kU/L by CAP assay (Pharmacia, Uppsala, Sweden) were considered positive. The rates of sensitization in breastfed infants were 41.9% (26/62) to egg, 30.6% (19/62) to milk and 18.0% (11/62) to soy. Immunoblotting analyses were performed using breast milk with the matched serum of seven AD infants (4 male/3 female). Binding patterns of AD infant's IgE to breast milk extract showed visible specific band for immunoglobulin, especially in case of a lactating mother who did not completely restricted ingestion of egg, milk and soy. These results indicate that sensitization to food allergen develops via breast milk feeding. Breast milk feeding should be recommended in infants at risk of developing allergic disease, but maternal intake of highly allergenic food might be restricted for prevention and treatment of food allergy among the babies with AD.

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[English]
Analysis of the Rate of Sensitization to Food Allergen in Children with Atopic Dermatitis: Young Shin Han, Sang Jin Chung, Young Yun Cho, Hay Mie Choi, Kang Mo Ahn, Sang Il Lee; Korean J Community Nutr 2004;9(1):90-97. Published online February 29, 2004

Abstract PDF: The purpose of this study was to determined the rate of sensitization to food allergen in children with Atopic Dermatitis (AD) in Korea. A total of 3,783 patients (male = 1983, female = 1800) with AD (age under 18 years) who had visited Samsung Medical Center from 1998 to 2003 were enrolled in the study. Food hypersensitivity was measured by specific IgE to egg, cow's milk, soy, peanut, wheat, buckwheat, beef, pork, chicken, shrimp, crab, salmon, mackerel, etc. Specific IgE levels >0.7 kU/L by Captured Allergen Product (CAP) assay were considered positive. Chi-square test at p value < 0.05 was used to examine the difference of the prevalence by sex and age. The rate of sensitization to multiple food allergens was 31.2% and decreased with age. Hypersensitivity to egg showed highest prevalence, which was 24.3%, compared to the prevalence of other foods. High prevalence of hypersensitivity to milk, wheat, soy, peanut, crab or shrimp was observed (11.6 - 17.7%). Low prevalence of hypersensitivity to beef, pork, tuna or chicken was observed (1.9 - 3.5%). Children aged under 3 years had significantly higher prevalence of hypersensitivity to egg, milk, soy and beef than children aged at least 3 years. Our results stress the need for examination of food hypersensitivity aimed at identified and limited each food allergen among children with AD caused by food to help patients outgrow their food allergy.

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