Effects of Medical Nutrition Therapy on Dietary Quality, Plasma Fatty Acid Composition and Immune Parameters in Atopic Dermatitis Patients / 대한지역사회영양학회지

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.

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

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 B1, vitamin B2 (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 B1, vitamin B2 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.