Food restriction, nutrition status, and growth in toddlers with atopic dermatitis

Abstract

Background: Multiple factors affect growth in children with atopic dermatitis (AD). We investigated food restriction practice, nutrition, and growth in children with AD. Food restriction is defined as restriction ≥3 types of food due to AD or food allergy. Methods: A cross-sectional study was performed in 150 children aged 12-36 months. Exclusion criteria: recurrent infections, moderate to severe asthma, recent systemic steroid, other diseases affecting growth/nutrition. Growth parameters, SCORing Atopic Dermatitis (SCORAD), hemoglobin, hematocrit, sodium, potassium, albumin, protein, calcium, phosphate, B12, iron, and folate values were determined. Parents completed a 3-day food diary. Results: The prevalence of food restriction was 60.7%. Commonly restricted foods were shellfish 62.7%, nuts 53.3%, egg 50%, dairy 29.3%, and cow's milk 28.7%. Food-restricted children have significantly lower calorie, protein, fat, riboflavin, vitamin B12, calcium, phosphorus and iron intakes and lower serum iron, protein and albumin values. Z scores of weight-for-age (−1.38 ± 1.02 vs −0.59 ± 0.96, P =.00), height-for-age (−1.34 ± 1.36 vs −0.51 ± 1.22, P =.00), head circumference-for-age (−1.37 ± 0.90 vs −0.90 ± 0.81, P =.00), mid-upper arm circumference (MUAC)-for-age (−0.71 ± 0.90 vs −0.22 ± 0.88, P =.00), and BMI-for-age (−0.79 ± 1.15 vs −0.42 ± 0.99, P =.04) were significantly lower in food-restricted compared to non-food-restricted children. More food-restricted children were stunted, underweight with lower head circumference and MUAC. Severe disease was an independent risk factor for food restriction with OR 5.352; 95% CI, 2.26-12.68. Conclusion: Food restriction is common in children with AD. It is associated with lower Z scores for weight, height, head circumference, MUAC, and BMI. Severe disease is an independent risk factor for food restriction.