Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1995 Sep;73(3):202–207. doi: 10.1136/adc.73.3.202

Controlled trial of a few foods diet in severe atopic dermatitis.

D C Mabin 1, A E Sykes 1, T J David 1
PMCID: PMC1511267  PMID: 7492155

Abstract

Eighty five children (median age 2.3 years, range 0.3 to 13.3 years) with refractory atopic dermatitis affecting more than 12% of the body surface area, were randomly allocated to receive a few foods diet (eliminating all but five to eight foods) supplemented with either a whey hydrolysate (n = 27) or a casein hydrolysate formula (n = 32), or to remain on their usual diet and act as controls (n = 26), for a six week period. Thirty five patients who received the diet and four controls had to be withdrawn because of non-compliance with the diet or intercurrent illness. The change in dermatitis severity was evaluated by a blinded observer who estimated the extent and severity of the dermatitis, using a skin severity score. After six weeks, there was a significant reduction in all three groups in the percentage of surface area involved (controls, median reduction (MR) = 4.9% (95% confidence interval 1.5%, 11.9%); whey hydrolysate group, MR = 17.8% (8.3%, 23.0%); casein hydrolysate group, MR = 5% (1.6%, 21.2%), and skin severity score (controls, MR = 15.9 (5.0, 22.5); whey hydrolysate group, MR = 21.8 (12.8, 30.2); casein hydrolysate group, MR = 13.5 (3.4, 38.0). Sixteen (73%) of the 22 controls and 15 (58%) of the 24 who received the diet showed a greater than 20% improvement in the skin severity score. This study failed to show benefit from a few foods diet.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atherton D. J., Sewell M., Soothill J. F., Wells R. S., Chilvers C. E. A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema. Lancet. 1978 Feb 25;1(8061):401–403. doi: 10.1016/s0140-6736(78)91199-6. [DOI] [PubMed] [Google Scholar]
  2. Bock S. A. Probable allergic reaction to casein hydrolysate formula. J Allergy Clin Immunol. 1989 Aug;84(2):272–272. doi: 10.1016/0091-6749(89)90335-7. [DOI] [PubMed] [Google Scholar]
  3. Businco L., Cantani A., Longhi M. A., Giampietro P. G. Anaphylactic reactions to a cow's milk whey protein hydrolysate (Alfa-Ré, Nestlé) in infants with cow's milk allergy. Ann Allergy. 1989 Apr;62(4):333–335. [PubMed] [Google Scholar]
  4. David T. J. Dietary treatment of atopic eczema. Arch Dis Child. 1989 Oct;64(10):1506–1509. doi: 10.1136/adc.64.10.1506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. David T. J., Longson M. Herpes simplex infections in atopic eczema. Arch Dis Child. 1985 Apr;60(4):338–343. doi: 10.1136/adc.60.4.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. David T. J., Waddington E., Stanton R. H. Nutritional hazards of elimination diets in children with atopic eczema. Arch Dis Child. 1984 Apr;59(4):323–325. doi: 10.1136/adc.59.4.323. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Devlin J., David T. J., Stanton R. H. Six food diet for childhood atopic dermatitis. Acta Derm Venereol. 1991;71(1):20–24. [PubMed] [Google Scholar]
  8. Devlin J., Stanton R. H., David T. J. Calcium intake and cows' milk free diets. Arch Dis Child. 1989 Aug;64(8):1183–1184. doi: 10.1136/adc.64.8.1183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ellis M. H., Short J. A., Heiner D. C. Anaphylaxis after ingestion of a recently introduced hydrolyzed whey protein formula. J Pediatr. 1991 Jan;118(1):74–77. doi: 10.1016/s0022-3476(05)81849-9. [DOI] [PubMed] [Google Scholar]
  10. Hathaway M. J., Warner J. O. Compliance problems in the dietary management of eczema. Arch Dis Child. 1983 Jun;58(6):463–464. doi: 10.1136/adc.58.6.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Neild V. S., Marsden R. A., Bailes J. A., Bland J. M. Egg and milk exclusion diets in atopic eczema. Br J Dermatol. 1986 Jan;114(1):117–123. doi: 10.1111/j.1365-2133.1986.tb02786.x. [DOI] [PubMed] [Google Scholar]
  12. Pike M. G., Carter C. M., Boulton P., Turner M. W., Soothill J. F., Atherton D. J. Few food diets in the treatment of atopic eczema. Arch Dis Child. 1989 Dec;64(12):1691–1698. doi: 10.1136/adc.64.12.1691. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Salfield S. A., Wardley B. L., Houlsby W. T., Turner S. L., Spalton A. P., Beckles-Wilson N. R., Herber S. M. Controlled study of exclusion of dietary vasoactive amines in migraine. Arch Dis Child. 1987 May;62(5):458–460. doi: 10.1136/adc.62.5.458. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Saylor J. D., Bahna S. L. Anaphylaxis to casein hydrolysate formula. J Pediatr. 1991 Jan;118(1):71–74. doi: 10.1016/s0022-3476(05)81848-7. [DOI] [PubMed] [Google Scholar]
  15. Stuart C. A., Twiselton R., Nicholas M. K., Hide D. W. Passage of cows' milk protein in breast milk. Clin Allergy. 1984 Nov;14(6):533–535. doi: 10.1111/j.1365-2222.1984.tb02240.x. [DOI] [PubMed] [Google Scholar]
  16. Turner M. A., Devlin J., David T. J. Holidays and atopic eczema. Arch Dis Child. 1991 Feb;66(2):212–215. doi: 10.1136/adc.66.2.212. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Van Asperen P. P., Lewis M., Rogers M., Kemp A. S., Thompson S. Experience with an elimination diet in children with atopic dermatitis. Clin Allergy. 1983 Sep;13(5):479–485. doi: 10.1111/j.1365-2222.1983.tb02625.x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES