This is a 4-topic series focused on nutrition for babies and toddlers with eczema. I’m passionate about nutrition and believe that it’s of utmost importance to our health – after all, it’s one of the daily survival activities of breathe, drink, eat and sleep! I’m honored to have Judy Converse, founder of Nutrition Care for Children LLC, to help out in this series. Judy is a licensed nutritionist, a registered dietitian for more than 20 years and authored the first web-interface accredited learning module for health care providers on nutrition and autism.
More on Judy Converse, MPH RD LD – Judy has a master’s degree in public health nutrition and a bachelor’s degree in food science and human nutrition. She authored 3 books including Special Needs Kids Go Pharm-Free and Special Needs Kids Eat Right: Strategies to Help Kids on the Autism Spectrum Focus, Learn and Thrive. She has also testified for safer vaccines and consulted with industry partners on specialized formulas for infants and children with inflammatory conditions. Judy is available for nutrition consultation at http://www.NutritionCare.net
Starting with the Fundamentals – What’s Reliable Nutrition Information?
MarcieMom: Judy, thank you so much for helping with this series, it’s very relevant for children with eczema and parents would be eager to learn more on nutrition (don’t we all think of what to feed our kids!). We will work through 4 different topics for this series, but before that let’s tackle something more fundamental.
Nutrition advice is seldom given by dermatologists or pediatricians and understandably so since doctors are (i) not trained in nutrition and (ii) always careful not to advice beyond what’s been clinical proven. Are there then insufficient studies on nutrition’s impact on health and eczema? If so, can you explain the difficulties with conducting a large scale nutritional impact study? (I’ve googled eczema and nutrition study and could only find studies relating to pregnancy diet, fish oil and probiotics, and even that seem inconclusive.)
Judy: Nutrition is hardly a new science – It has been around as a science for over a century. But it has not been part of most physicians’ training for decades (see my blog post on this from December 2010). So we have a huge gap in the knowledge base of physicians. Some data show pediatricians know little more than parents do about nutrition. To get reliable information, at least here in the US, parents may have to turn to a naturopathic doctor, a dietitian specializing in pediatrics, or find a physician who happens to have decided to become knowledgeable about nutrition. You would look for a masters degree in a nutrition science from an accredited university, in addition to the MD degree, in that case.
As for data on nutrition and health – absolutely, the impact is profound. This is why there are nutrition program initiatives in UNICEF, the World Health Organization (WHO), and US government. You truly are what you eat. You grew in the womb from what your mom ate and rearranged into you! And in infancy and childhood, nothing is more predictive of healthy outcomes than strong nutrition status.
Regarding eczema, I have seen published data on this. Elimination diets, probiotics, fish oils, and other supplements are promising and frequently helpful. This may be a little harder to find since much of what gets published in medical journals is about pharmaceuticals, not natural substances.
Pharmaceuticals get researched much more, because they are patentable and thus very profitiable. Nutrients and foods are neither, so there is less interest in studying these in any medical context.
Studies are hard to do on this topic because it’s hard to control the test variable – mainly, foods eaten. There are a few methods of assessing food intakes in a research context, all of which are time consuming and interviewer dependent. And, people lie or forget when it comes to reporting what they eat. They just do. You then also need well controlled subjects, e.g., 3000 kids age 4-5 years old who all have the same growth status at the start of the study, no bowel or feeding issues, and so on. Lastly there simply is no controlling the biggest wild card: What is in each child’s gut for biome (microbe population), which has much to do with how they digest/absorb food, and how inflammatory a food may become. Lots of moving parts, for something that cannot create a profitable product. This is why these studies don’t get done.
MarcieMom: Thanks Judy for taking time to explain all these to me! I’m appreciating the complexities of a research study and would bear that in mind when I next ask myself why I can’t find a study on nutrition and eczema.