Food allergies are a related condition to atopic dermatitis (AD), also commonly known as atopic eczema. Food allergies occur when the immune system overreacts to a particular protein found in a food, and symptoms may appear with any contact with that food, even a tiny amount. The foods that are responsible for the majority of food allergies include cow’s milk, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat.1
Children with AD are at a higher risk of developing food allergies.2,3 After reviewing the research, experts have now created guidelines on how probiotics and prebiotics may reduce the risk of food allergy in children with AD.4
How the atopic march creates a ripple effect
The word “atopy” means a genetic predisposition to developing an allergic reaction. Allergic reactions occur when the body responds with elevated levels of immunoglobulin E (IgE) in response to an environmental allergen. IgE sets off a chain of events in the body that results in the signs and symptoms of an allergic reaction on the skin, eyes, nose, or throat and may include inflammation, itchiness, redness, sneezing, runny nose, and/or difficulty breathing.1
Researchers use the term “atopic march” to describe how children with AD can later develop additional allergic conditions, like hay fever, asthma, and food allergies. It is believed that the damaged skin barrier caused by AD allows allergens into the body. When those allergens are later inhaled or ingested, the body is predisposed to react in an allergic manner, which may result in food allergy, asthma, or allergic rhinitis (hay fever).3,5
The microbiome, probiotics and prebiotics
The microbiome is the community of microorganisms that live in our bodies. They are found in the intestines (previously known as gut flora), on the skin, in the mouth, vagina, urinary tract, and lungs. The microbiome is important to our health and proper functioning, including aiding in our digestion, boosting our immunity and keeping harmful microorganisms in check.6
Probiotics are live microorganisms that can provide health benefits. Probiotics come in several different strains, and different strains have unique benefits. Probiotics are available in fermented foods such as yogurt, some cheese, and kimchi, and they are also available as a dietary supplement.6
Prebiotics are compounds that aren’t digested by the human body but act as food for the beneficial bacteria in our gut. By serving them food in the form of prebiotics, we can encourage the good bacteria to grow, which in turn makes our bodies healthier. Prebiotics are naturally found in foods like onions, garlic, and bananas, and they are sometimes added to foods like yogurt, cereals, breads, or drinks.6
Probiotics and prebiotics in food allergy prevention
Many studies have been conducted using probiotics and prebiotics in allergy prevention. In a recent meta-analysis – which reviews all the previous research data – experts found that the use of probiotics and prebiotics during pregnancy, breastfeeding, and in infancy may reduce the risk of the child developing AD and subsequent food allergy. Probiotics and prebiotics may be especially helpful for those who are at higher risk of developing AD, including those with a family history or sibling with AD. Unfortunately, the data does not provide clear evidence as to which strains of probiotics may have the greatest benefit, as different studies used different strains.4
If your family has a high incidence of atopic eczema, or if you are planning on getting pregnant and have an older child with AD, talk to your doctor about adding probiotics and prebiotics to your diet, as they may help reduce the risk of allergic diseases like AD and food allergy.4
American Academy of Allergy, Asthma & Immunology. Accessed online on 9/15/17 at https://www.aaaai.org.
American Academy of Dermatology. Accessed online on 9/15/17 at https://www.aad.org/media/news-releases/dermatologists-caution-that-atopic-dermatitis-is-a-strong-precursor-to-food-allergies.
Dhar S, Srinivas SM. Food Allergy in Atopic Dermatitis. Indian Journal of Dermatology. 2016;61(6):645-648. doi:10.4103/0019-5154.193673
Fiocchi A, Pecora V, Dahdah L. Probiotics, prebiotics & food allergy prevention: clinical data in children. J of Pediatric Gastroenterology & Nutrition. 2016 Jul;63(1S):S14-S17. doi: 10.1097/MPG.0000000000001220
Bantz SK, Zhu Z, Zheng T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014 Apr; 5(2): 202. Published online 2014 Apr 7. doi: 10.4172/2155-9899.1000202
International Scientific Association for Probiotics and Prebiotics. Accessed online on 9/15/17 at https://isappscience.org/.