Occasional High Fat, High Protein Foods Linked to Decreased Atopic Dermatitis Risk

Occasional intake of high-fat and high-protein foods may be linked to a lower odds of developing atopic dermatitis, according to recent findings.1

These data represent the conclusion of new research conducted in Singapore and Malaysia regarding diet and its impact on atopic dermatitis. The study was authored by a team led by Jun Jie Lim, of the department of biological sciences at the National University of Singapore.

The effect of macronutrients on patients with inflammatory skin diseases has been covered before and modification of diet may lead to positive effects, this study’s investigators discuss. Despite this acknowledgement, the research team highlighted that there had been a lack of clear guidance and a limited set of data on optimal macronutrient intake on atopic dermatitis.

“Using our derived frequency-based dietary indices], we investigated the association between macronutrient intake and current [atopic dermatitis] in a well-defined cohort from Singapore and Malaysia,” Lim and colleagues wrote. “These indices assess overall diet quality based on the intake frequency of high-fat, high-protein and high-glycemic index foods, offering valuable insights into how dietary habits may impact [atopic dermatitis] risk.”1,2

Analysis of Diet's Impact on Atopic Dermatitis

In the period between 2005 and 2023, the research team looked at data from the Singapore/Malaysia Cross-sectional Genetics Epidemiology Study (SMCGES) cohort. A standardized questionnaire was then adapted by the team from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol.

Various pieces of information on participants’ medical history related to socioeconomic and lifestyle factors, atopy, habits related to diet, and anthropometric measurements, were collected by the investigators in this survey. Their study cohort was mostly made up of university students, with subjects reporting an average age of 23.0 years and an average body mass index (BMI) of 20.6 kg/m².

Current existence of atopic dermatitis was diagnosed by the investigative team in 16.0% of the cohort through criteria which had been established by the UK Working Party and Hanifin-Rajka. The team evaluated atopy through positive results on skin prick tests (SPTs) using house dust mite allergens, observed among 62.4% of participants.

The researchers gathered diet-related information through the use of a semi-quantitative food frequency questionnaire (FFQ). This FFQ had been validated for large-scale research and was used to assess intake frequencies across 16 different food groups.

The investigators adjusted their logistic regression analysis for education, sex, age, BMI (Asian classification), alcohol use, parental history of atopic dermatitis, and energy intake. The team noted that they had identified a dose-dependent link between diminished intake of high-protein, high-fat, and high-glycemic index (GI) foods and lowered subjects’ odds of atopic dermatitis.

Controlling for multiple comparisons with the False Discovery Rate method, the team’s findings demonstrated significant associations.

Notable Findings on Dietary Intake

The investigators concluded that lower consumption of high-fat foods showed an association with reduced odds of atopic dermatitis development (AOR: 0.625; 95% CI: 0.544–0.718; P < 0.001). This was also the case with lower high-protein food consumption (AOR: 0.620; 95% CI: 0.548–0.701; P < 0.001) and high-GI food consumption (AOR: 0.656; 95% CI: 0.575–0.749; P < 0.001).

In their sensitivity analysis, the research team found that the link between dietary protein and atopic dermatitis was primarily driven by atopic sensitization as opposed to disease symptoms alone. In a similar finding, the team identified a notable and significant link between high-GI food consumption and atopic dermatitis only in situations where both clinical symptoms and atopic sensitization took place.

The investigative team then placed trial participants into 8 cohorts based on their macronutrient intake scores, conducting a 3-way interaction analysis. They observed the lowest odds of atopic dermatitis among subjects who reported infrequent intake of all 3 of the aforementioned macronutrient categories (AOR: 0.526; 95% CI: 0.445–0.623; P < 0.001).

Despite this conclusion, it was highlighted by the team that strict moderation across all macronutrients had not been necessary. They added that occasional intake of high-fat and high-protein foods alone lowered odds of the skin disease significantly, regardless of GI intake (AOR: 0.688; 95% CI: 0.571–0.828; P < 0.001).

Additionally, the investigators’ synergy factor analysis suggested that the impact of macronutrients had been independent. They added that reductions in any single macronutrient significantly lowered participants’ odds of atopic dermatitis, even without reductions across the other 2.

“Our findings support a balanced approach, challenging extreme dietary paradigms that advocate severe restriction or elimination of specific macronutrients,” they wrote. “Occasional high-fat and high-protein intake may be sufficient to lower the odds of current [atopic dermatitis], providing a practical and sustainable dietary strategy for long-term [atopic dermatitis] management.”2

References

1. Lim, J.J., Reginald, K., Say, Y.-H., Liu, M.H. and Chew, F.T. (2025), Associations Between Self-Reported Dietary Intake and Atopic Dermatitis Risk in Young Adults From Singapore and Malaysia. Clin Exp Allergy. https://doi.org/10.1111/cea.14629.
2. J. J. Lim, Y. Y. E. Lim, J. Y. Ng, et al., “An Update on the Prevalence, Chronicity, and Severity of Atopic Dermatitis and the Associated Epidemiological Risk Factors in the Singapore/Malaysia Chinese Young Adult Population: A Detailed Description of the Singapore/Malaysia Cross-Sectional Genetics Epidemiology Study (SMCGES) Cohort,” World Allergy Organization Journal 15, no. 12 (2022): 100722, https://doi.org/10.1016/j.waojou.2022.100722.