Bond University is seeking volunteers for a new clinical trial after uncovering the strongest evidence to date that certain foods may trigger eczema flare-ups.
The trial, for people with moderate to severe atopic dermatitis, follows a Bond study published in the journal Nutrients which found that compounds such as histamine, other amines, and salicylates - naturally present in many everyday foods - may worsen eczema symptoms.
The evidence offers new clues in the search for non-drug treatment options for the 129 million people worldwide who live with the chronic inflammatory skin condition.
In one noteworthy finding, 41 percent of study participants with eczema who followed a low-histamine diet showed clinically significant improvements in their symptoms such as less itching, redness, or inflammation.
Histamine is found in fermented and aged foods such as cheeses, cured meats, sauerkraut, alcohol, vinegar-based foods and smoked fish.
However, the study’s authors said the findings were insufficient for clinical recommendation because the overall quality of evidence was low and the sample sizes were small.
The Bond researchers sifted through more than 2300 studies but only four met their strict criteria, namely those that used double-blind, placebo-controlled challenges, the gold standard for diagnosing food-related reactions.
PhD student and nutritionist Karen Fischer said she initiated the study after two decades of working with patients whose eczema didn’t respond to conventional treatments.
“I noticed a recurring pattern: many experienced flare-ups after consuming everyday, healthy foods like avocado, tomato, and fermented products,” she said.
“These foods are naturally high in compounds such as histamine, amines, and salicylates.
“Despite decades of anecdotal reports and patient improvement on elimination diets, no high-quality systematic review had been conducted to assess the strength of the evidence.”
Ms Fischer said the study’s findings were ‘encouraging’ but it was too early to translate the findings into everyday treatment plans.
However, for people who suspect their persistent eczema could be linked to food, a short-term elimination diet could be considered under the supervision of a qualified nutritionist or dietitian who is experienced with eczema and food intolerances.
Undertaking an elimination diet without professional guidance could lead to lead to deficiencies or a lack of dietary diversity, particularly for children, fussy eaters or people with eating disorders.
“The aim of any elimination diet should be to temporarily remove potential triggers, then systematically reintroduce foods to pinpoint sensitivities, not to avoid entire food groups indefinitely or unnecessarily,” she said.
Ms Fischer said she would like to see further studies that test how certain food compounds affect eczema symptoms and the body’s biology, like changes in the immune system.
Future research should also look at the gut microbiome to see how the gut and skin might be connected. Potentially explaining why some people react more strongly to certain food chemicals than others.
Assistant Professor Hayley O’Neill and Associate Professor Mark Jones were also involved in the research.
People experiencing moderate to severe atopic dermatitis may be eligible to join the clinical study at Bond University investigating whether specific dietary approaches can help reduce symptoms.
To express an interest in taking part, email [email protected] for details.