Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student research

Food intolerance in children with eczema

Narelle Greenlees
Master of Science (Nutrition and Dietetics), University of Wollongong
Supervisors: Linda Tapsell, Anne Swain, Velencia Soutter, Robert Loblay
January 1998

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There is little known about the relationship between eczema and food intolerance. Food intolerance is defined as a pharmacological adverse reaction to food. It is diagnosed by a positive reaction to a food challenge after the systematic elimination of all natural and added chemicals, also called the Elimination Diet. The primary aim of this project was to investigate in children with eczema; food intolerance, associated symptoms, most common chemicals not tolerated, clinical reactions to chemicals and coexisting food intolerance and food allergy. The secondary aim was to investigate outcomes of the elimination diet and current dietary restrictions.

Data was collected from medical and dietetic notes of 418 children with eczema ages up to twelve years seen at the RPAH Allergy Unit between 1995 and 1997. Parents and carers were sent a questionnaire to obtain information about the child's symptoms, reactions to food challenges and dietary restrictions. All information was entered into a confidential database for analysis. Children were grouped based on this information as food intolerant; food sensitised/allergic; and food intolerant & sensitised.

Approximately half of those children with food intolerance also had a food allergy. Salicylates, amines and milk were the most common substances responsible for food intolerance reactions and eczema symptoms. Children with food intolerance alone experienced more behaviour-related symptoms than children with both intolerance and allergy. Children who did not attempt the diet commonly avoided additives and dairy. Post elimination diet restrictions included salicylates, amines, milk and additives.

Results indicate that food intolerance in children with eczema is common. Formal dietary investigation should be advised if there is any indication that the child's eczema might be food related. Food intolerance in children, and the coexistence of food intolerance and food allergy need to be further researched.