Dietary Interventions in Atopic Dermatitis: A Comprehensive Scoping Review and Analysis

Abstract

Background: This scoping review aims to critically assess gaps in the current literature on atopic dermatitis (AD) by evaluating the overall effectiveness of dietary interventions. Through a comprehensive analysis that follows the Preferred Reporting Item for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a thorough search on the Web of Science database in May 2023 using specific search strategies to identify all relevant studies on the research topic.

Summary: A total of 104 full-text articles were included for review. Our synthesis identified seven notable categories of dietary interventions for AD, showcasing the diversity of interventions utilized. This includes vitamin supplementation, probiotic and prebiotic supplementation, dietary fat, biological compounds, foods from natural sources, major nutrients, and diet-related approaches. Further analyses stratified by targeted populations revealed a predominant focus on pediatrics, particularly in probiotic supplementation, and on adults, with an emphasis on vitamin D and E supplementation.

Key messages: Despite most dietary interventions demonstrating overall effectiveness in improving AD severity and its subjective symptoms, several significant gaps were identified. There was a scarcity of studies on adults and whole-diet interventions, a prevalence of short-term interventions, heterogeneity in study outcomes, designs, and population, occasional disparity between statistical significance and clinical relevance, and a lack of a comprehensive multidisciplinary approach. Nonetheless, these findings offer valuable insights for future AD research, guiding additional evidence-driven dietary interventions and informing healthcare professionals, researchers, and individuals, advancing both understanding and management of AD.

Keywords: Atopic dermatitis; Diet; Dietary interventions; Nutrition; Randomized controlled trials.

Fig. 1.

PRISMA flowchart illustrating the search strategy from Tricco et al. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–473. doi:10.7326/M18-085.

Fig. 2.

Summary of dietary interventions categorized into seven main types which include vitamin supplementation, probiotic and prebiotic supplementation, dietary fat manipulation, utilization of biological compounds, consumption of foods from natural sources, major nutrients, and dietary approaches. *The total studies for both probiotics and prebiotics intervention.

Fig. 3.

Summary of the changing trend for dietary intervention studies on atopic dermatitis (AD) published in three periods (1990–2000, 2001–2011, and 2012–2023 May) based on seven main dietary intervention categories. A dotted line was used to demarcate the various categories of dietary intervention.

Fig. 4.

A summary detailing the identified research gap and proposed future research strategies for AD and dietary intervention.