Exploratory analyses of frequent high-fat food intake in diets and its association with increased odds of atopic dermatitis in Singapore and Malaysia Young Chinese adults

Abstract

High-fat food intake is associated with atopic dermatitis (AD), but the role of habitual dietary habits related to the frequency of high-fat food intake remains unclear. To address this, we developed a frequency-based dietary index, Diet Quality based on Dietary Fat Score, to assess high-fat food intake and examined its association with AD in 13 561 young Chinese adults (mean age = 22·51 years, (sd 5·90)) from Singapore and Malaysia. Using an investigator-administered questionnaire aligned with the validated International Study of Asthma and Allergies in Childhood protocol, we conducted multivariable logistic regression analysis, adjusting for demographics, body mass index, genetic predisposition and lifestyle factors, with false discovery rate correction for multiple comparisons. Frequent high-fat food intake was associated with higher odds of AD (adjusted OR (AOR): 1·53; 95 % CI: 1·31, 1·77; P< 0·001). The association remained significant regardless of total fat intake (AOR: 1·45; 95 % CI: 1·05, 1·80; P< 0·001) and among individuals with high fruit and vegetable intake (AOR: 1·49; 95 % CI: 1·19, 1·86; P< 0·001) or low energy intake (AOR: 1·40; 95 % CI: 1·05, 1·86; P< 0·05). No synergistic effects were observed between dietary factors. These findings highlight that frequent intake of high-fat foods is independently associated with AD, emphasising the potential of dietary moderation in AD risk management.

Keywords: Atopic dermatitis; Dietary fats; Dietary habits; Epidemiology; Intake frequencies.

Figure 1.

OR plot illustrating the association between the frequency-based dietary index (Diet Quality based on Dietary Fat Score (DQDFS) and various atopic dermatitis (AD) phenotypes, (a) AD presentation, (b) AD persistency, (c) AD chronicity and (d) AD severity. Results are presented in adjusted odds ratios (AOR), 95 % confidence intervals (CI) and P-value. P-value was adjusted by false discovery rate for multiple comparisons and P-value < 0·05 to be statistically significant and written in bold. Multivariable analysis was adjusted for age, sex, body mass index (Asian class), parental eczema, tobacco smoking and use of alcohol. A reference dotted line is drawn at the interception point where AOR equals 1·00, and the 95 % CI is represented by a single line that cuts the AOR.

Figure 2.

OR plot illustrating the association between the frequency-based dietary index (Diet Quality based on Dietary Fat Score (DQDFS) and AD phenotypes, stratified by covariates: negative (fruit and vegetable intake) and positive (energy intake). Results are presented in adjusted odds ratio (AOR), 95 % confidence intervals (CI) and P-value. P-value was adjusted by false discovery rate for multiple comparisons and P-value < 0·05 to be statistically significant and written in bold. Multivariable analysis was adjusted for age, sex, body mass index (Asian class), parental eczema, tobacco smoking and use of alcohol. A reference dotted line is drawn at the interception point where AOR equals 1·00 and the 95 % CI is represented by a single line that cuts the AOR.

Figure 3.

OR plot illustrating the association between combined dietary indices (Diet Quality based on Dietary Fat Score (DQDFS) and Diet Quality based on Total Fat Amount (DQTFA)) and AD presentation. DQDFS assesses intake frequency of high-fat foods, while DQTFA assesses total estimated dietary fat intake. Results are presented in adjusted odds ratios (AOR), 95 % confidence intervals (CI) and P-value. P-value < 0·05 to be statistically significant. Multivariable analysis was adjusted for age, sex, body mass index (Asian class), parental eczema, tobacco smoking and use of alcohol. A reference dotted line is drawn at the interception point where AOR equals 1·00, and the 95 % CI is represented by a single line that cuts the AOR.