Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort

Importance: The association of diet with atopic dermatitis (AD) in children is understudied and may present an opportunity to optimize AD management in a cost-effective and low-risk manner. Objective: The aim of this study was to determine the extent to which dietary sugar is associated with AD peri...

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Main Authors: Judy Shan, Morgan Ye, Sheng-Pei Wang, Hannah Kang, Ahnna Lee, Sinéad M. Langan, Erin L. Van Blarigan, Katrina Abuabara
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:JID Innovations
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667026725000220
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author Judy Shan
Morgan Ye
Sheng-Pei Wang
Hannah Kang
Ahnna Lee
Sinéad M. Langan
Erin L. Van Blarigan
Katrina Abuabara
author_facet Judy Shan
Morgan Ye
Sheng-Pei Wang
Hannah Kang
Ahnna Lee
Sinéad M. Langan
Erin L. Van Blarigan
Katrina Abuabara
author_sort Judy Shan
collection DOAJ
description Importance: The association of diet with atopic dermatitis (AD) in children is understudied and may present an opportunity to optimize AD management in a cost-effective and low-risk manner. Objective: The aim of this study was to determine the extent to which dietary sugar is associated with AD period prevalence and severity in a longitudinal pediatric cohort. Design, setting, and participants: This was a longitudinal cohort study of children from the Avon Longitudinal Study of Parents and Children with food frequency questionnaire data to estimate dietary carbohydrate and sugar at 1, 3, 5, 7, 10, and 13 years. Exposure: The exposure was dietary sugar as a proportion of total caloric intake. Main outcome and measure: The primary outcome was AD based on a maternal- or self-reported questionnaire that asked about disease activity and severity over the past 12 months. Logistic regression models adjusted for sex, race, maternal delivery age, highest parental education level, social class assessed through parental occupation, body mass index, total caloric intake, and maternal history of AD. Results: The study population included 5372 unique participants, 50% of whom were female, and 20–30% of whom reported AD at any time point. No significant associations were found at ages 1, 3, 5, and 7 years. At age 13 years, logistic regression revealed that a 10% increase in dietary sugar as a proportion of total caloric intake was associated with a 22% (95% confidence interval = 7–40%) increase in odds of AD overall. There was a dose–response relationship with disease severity: there was a 19% (95% confidence interval = 0–42%) increase in the odds of mild AD and 32% (95% confidence interval = 5–86%) increase in the odds of moderate–severe AD. When examining subtypes of dietary sugar, the effect was limited to nonmilk extrinsic sugars. Conclusions and relevance: Given the known health benefits, reduction of nonmilk sugars could be studied as a cost-effective and low-risk intervention for AD in late childhood and early adolescence.
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spelling doaj-art-bb02d98cf4c245b59da4149deb0631972025-08-20T03:49:41ZengElsevierJID Innovations2667-02672025-05-015310036610.1016/j.xjidi.2025.100366Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth CohortJudy Shan0Morgan Ye1Sheng-Pei Wang2Hannah Kang3Ahnna Lee4Sinéad M. Langan5Erin L. Van Blarigan6Katrina Abuabara7School of Medicine, University of California, San Francisco, California, USA; Judy Shan, School of Medicine, University of California, 500 Parnassus, San Francisco, California 94122, USA.Department of Dermatology, University of California, San Francisco, California, USADepartment of Dermatology, University of California, San Francisco, California, USASchool of Medicine, University of California, San Francisco, California, USADepartment of Dermatology, University of California, San Francisco, California, USAFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United KingdomSchool of Medicine, University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USASchool of Medicine, University of California, San Francisco, California, USA; Department of Dermatology, University of California, San Francisco, California, USA; School of Public Health, University of California, Berkeley, California, USA; Correspondence: Katrina Abuabara, 2340 Sutter Street, San Francisco, California 94115, USA.Importance: The association of diet with atopic dermatitis (AD) in children is understudied and may present an opportunity to optimize AD management in a cost-effective and low-risk manner. Objective: The aim of this study was to determine the extent to which dietary sugar is associated with AD period prevalence and severity in a longitudinal pediatric cohort. Design, setting, and participants: This was a longitudinal cohort study of children from the Avon Longitudinal Study of Parents and Children with food frequency questionnaire data to estimate dietary carbohydrate and sugar at 1, 3, 5, 7, 10, and 13 years. Exposure: The exposure was dietary sugar as a proportion of total caloric intake. Main outcome and measure: The primary outcome was AD based on a maternal- or self-reported questionnaire that asked about disease activity and severity over the past 12 months. Logistic regression models adjusted for sex, race, maternal delivery age, highest parental education level, social class assessed through parental occupation, body mass index, total caloric intake, and maternal history of AD. Results: The study population included 5372 unique participants, 50% of whom were female, and 20–30% of whom reported AD at any time point. No significant associations were found at ages 1, 3, 5, and 7 years. At age 13 years, logistic regression revealed that a 10% increase in dietary sugar as a proportion of total caloric intake was associated with a 22% (95% confidence interval = 7–40%) increase in odds of AD overall. There was a dose–response relationship with disease severity: there was a 19% (95% confidence interval = 0–42%) increase in the odds of mild AD and 32% (95% confidence interval = 5–86%) increase in the odds of moderate–severe AD. When examining subtypes of dietary sugar, the effect was limited to nonmilk extrinsic sugars. Conclusions and relevance: Given the known health benefits, reduction of nonmilk sugars could be studied as a cost-effective and low-risk intervention for AD in late childhood and early adolescence.http://www.sciencedirect.com/science/article/pii/S2667026725000220ALSPACAtopic dermatitisClinical researchDietary sugarEpidemiology
spellingShingle Judy Shan
Morgan Ye
Sheng-Pei Wang
Hannah Kang
Ahnna Lee
Sinéad M. Langan
Erin L. Van Blarigan
Katrina Abuabara
Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
JID Innovations
ALSPAC
Atopic dermatitis
Clinical research
Dietary sugar
Epidemiology
title Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
title_full Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
title_fullStr Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
title_full_unstemmed Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
title_short Dietary Sugar and Atopic Dermatitis in a Longitudinal Birth Cohort
title_sort dietary sugar and atopic dermatitis in a longitudinal birth cohort
topic ALSPAC
Atopic dermatitis
Clinical research
Dietary sugar
Epidemiology
url http://www.sciencedirect.com/science/article/pii/S2667026725000220
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