Dietary Supplements for Eczema (Atopic Dermatitis)

Are there dietary supplements that can help with atopic dermatitis?

Atopic dermatitis, more commonly known as eczema, ranks “as the skin disease with the greatest health burden worldwide” because it’s just so common, affecting maybe one in ten kids and about 3 percent of adults, causing patches of red, itchy skin. Topical steroids, like cortisone cream, have been “the mainstay treatment” since their Nobel Prize-winning discovery in 1950.

People are scared of steroids, though, and “it is not uncommon for patients to express irrational fear and anxiety about using topical corticosteroids”—steroid creams and ointments. This phobia may arise from confusing topical steroids with oral or injected steroids, which have different effects. Really potent topical steroids can thin your skin, but skin thickness should return to normal a month after stopping. So, yes, topical steroids can cause side effects, but the concern people have “seems out of proportion” to the small risk they actually pose. Still, if there’s a way you can resolve a problem without drugs, that’s generally preferable. What did they do for eczema before the 1950s?

In the 1930s, some researchers tried using vitamin D dissolved in corn oil, and to their surprise, it worked—but so did the corn oil without the vitamin D they were using as a control. Others reported cases improving after feeding flaxseed oil and even ingesting lard, from a study “aided by a grant from the National Live Stock and Meat Board,” which apparently did not want to be left out of the action. The problem is that none of these studies had a control group. So, yes, after feeding someone corn oil for 12 to 18 months, they got better—but maybe they would have gotten better anyway. You don’t know until you put it to the test. 

Nearly all of those researchers who claimed benefit from the use of the various fats apparently “lack[ed]…any great interest in a controlled series,” but one researcher tested some oils and found no evidence of benefit over routine treatment. Indeed, as you can see at 2:06 in my video Eczema Treatment with Evening Primrose Oil vs. Borage Oil vs. Hempseed Oil, most got better either way, which suggests that the previous “benefits claimed may be due to the usual treatment, with perhaps a dash of enthusiasm.”

By then, hydrocortisone was out, so the medical community gave up on dietary approaches—until a letter was published in 1981 about the treatment of eczema with supplements of evening primrose oil, which contains gamma linolenic acid, an anti-inflammatory omega-6. And, indeed, when it was put to the test, it seemed to help, but then a subsequent larger study found no effect. Whenever there are conflicting findings, it helps to do a meta-analysis, where you put all the studies together. So, there was the study that showed benefit, the one that didn’t, and seven other studies. What did those find? Seven out of the seven showed benefit. “The results show that the effects of Epogam [a brand of primrose oil supplement] are almost always significantly better than those of placebo.” Case closed, right? Well, the analysis was funded by the supplement company itself, which can be a red flag, and where exactly were the other seven studies published? They weren’t. The company just said it did those seven studies but never released them. When asked to hand them over, the company said it would but never did, even threatening a lawsuit against researchers who dared to question the studies’ efficacy.

An independent review failed to find evidence that evening primrose oil or borage oil worked better than placebo. “As we bid goodnight to the evening primrose oil story, perhaps we can awaken to a world where all clinical trial data…reach the light of day…” 

Borage oil actually has twice the gamma linolenic acid as evening primrose yet it still didn’t work, but that didn’t stop researchers from trying hempseed oil, which “has been used as a food and medicine for at least 3000 years in China.” Researchers tried giving about a quarter cup of hempseeds’ worth of oil to people every day for a few months and found significant improvements in skin dryness, itchiness, and the need for medications—but not compared to placebo. In fact, studies of dietary supplements across the board, whether fish oil, zinc, selenium, vitamins D, E, or B6, sea buckthorn oil, hempseed oil, or sunflower oil, overall, showed “no convincing evidence that taking supplements improved the eczema of those involved.” That’s disappointing, but wait a second. That’s just for oral supplements. What about natural remedies applied topically? I discuss that in my video Eczema Treatment with Coconut Oil vs. Mineral Oil, vs. Vaseline.

Meta-analyses can be skewed the other way, too, when negative results are quietly shelved so only positive findings are published. Antidepressant medications are a classic example of this publication bias. Check out my coverage of it in my video Do Antidepressant Drugs Really Work?.

As I queued up at the end, I cover topical natural treatments in my next video, Eczema Treatment with Coconut Oil vs. Mineral Oil vs. Vaseline.

What about skipping the lard and trying to eat more healthfully? See what happened in Treating Asthma and Eczema with Plant-Based Diets.

For more on skin health, check out:

In health, 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How the Meat Industry Reacted to the New Cancer Warnings

What was the meat industry’s response to leading cancer charities’ recommendation to stop eating processed meat, like bacon, ham, hot dogs, sausage, and lunch meat? As I discuss in my video Meat Industry Reaction to New Cancer Guidelines, the industry acknowledges that the most recent international cancer prevention guidelines now urge people to avoid processed meat.

“It is evident that…such a statement represents ‘a clear and present danger’ for the meat industry,” reads one response in the journal Meat Science. However, processed meat, it continues, is “a social necessity.” (How could anyone live without bologna?) The challenge for the meat industry, the response outlines, is to find a way to maintain the consumption of these convenience products while somehow not damaging public health.

We’re still not sure what in processed meat is so carcinogenic, but the most probable educated guess for explaining the damaging effect of processed meats involves heme iron, along with nitrosamine and free radical formation, ultimately resulting in carcinogenic DNA damage. To reduce the nitrosamines, they could remove the nitrites, something the industry has been considering for decades because of the long-known toxic effects they cause. The industry adds them to keep the meat pink. There are, evidently, other coloring additives available. Nevertheless, it’s going to be hard to get industry to change “in view of the positive effects” of these substances as preservatives and in achieving a “desirable flavour and red colour developing ingredients.” No one wants green eggs and ham.

It’s like salt reduction in meat products. The meat industry would like to reduce it, but “[o]ne of the biggest barriers to salt replacement is cost as salt is one of the cheapest food ingredients available.” A number of taste enhancers can be injected into the meat to help compensate for the salt reduction, but some leave a bitter after-taste. To address that, industry can also inject a patented bitter-blocking chemical that can prevent taste nerve stimulation at the same time. This “bitter blocker is only the first of what will become a stream of products that are produced due to the convergence of food technology and biotechnology.”

The meat industry could always try adding non-meat materials to the meat, such as fiber or resistant starch from beans that have protective effects against cancer. After all, in the United States, dietary fiber is under-consumed by most adults, “indicating that fiber fortification in meat products could have health benefits.” But, of course, the meat industry’s own products are one of the reasons the American diet is so deficient in fiber in the first place.

The industry is all in favor of reformulating their products to cause less cancer, but “[o]bviously any optimization has to achieve a healthier product without affecting quality, particularly hedonic aspects.”

“It is important to realise that nutritional and technological quality [in the meat industry] are inversely correlated. Currently, improvement in one will lead to deterioration of the other.” Indeed, the meat industry knows that consumption of lard is not the best thing in the world—what with heart disease being our number-one killer—but those downsides “are in sharp contrast to their technological qualities that make them indispensable in the manufacture of meat products.” Otherwise, you just don’t get the same “lard consistency.” The pig’s fat doesn’t get hard enough, and, as a result, “a fatty smear upon cutting or slicing can be observed on the cutting surface of the knife.” Less heart disease versus absence of that fatty smear? I suppose you have to weigh the pros and cons…

According to the World Health Organization’s IARC, processed meat is now a Group 1 carcinogen—the highest designation. How is it that schools still feed it to our children?

How Much Cancer Does Lunch Meat Cause? Watch the video to find out.

For more on carcinogens, cancer, and meat, see:

Some of the meat industry’s finagling reminds me of tobacco industry tactics. See, for example, Big Food Using the Tobacco Industry Playbook and The Healthy Food Movement: Strength in Unity. You can also check out American Medical Association Complicity with Big Tobacco.

Skeptical about the danger of excessive sodium intake? Check out The Evidence That Salt Raises Blood Pressure. If you’re still not convinced, see Sprinkling Doubt: Taking Sodium Skeptics with a Pinch of Salt and Sodium Skeptics Try to Shake Up the Salt Debate. Why do the meat industries add salt when millions of lives are at stake? Find out in Big Salt: Getting to the Meat of the Matter.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

White Meat May Be as Cholesterol-Raising as Red

White Meat May Be as Cholesterol-Raising as Red2

In light of recommendations for heart healthy eating from national professional organizations encouraging Americans to limit their intake of meat, the beef industry commissioned and co-wrote a review of randomized controlled trials comparing the effects of beef versus chicken and fish on cholesterol levels published over the last 60 years. They found that the impact of beef consumption on the cholesterol profile of humans is similar to that of fish and/or poultry—meaning that switching from red meat to white meat likely wouldn’t make any difference. And that’s really no surprise, given how fat we’ve genetically manipulated chickens to be these days, up to ten times more fat than they had a century ago (see Does Eating Obesity Cause Obesity?).

There are a number of cuts of beef that have less cholesterol-raising saturated fat than chicken (see BOLD Indeed: Beef Lowers Cholesterol?); so, it’s not so surprising that white meat was found to be no better than red, but the beef industry researchers’ conclusion was that “therefore you can eat beef as part of a balanced diet to manage your cholesterol.”

Think of the Coke versus Pepsi analogy. Coke has less sugar than Pepsi: 15 spoonfuls of sugar per bottle instead of 16. If studies on blood sugar found no difference between drinking Coke versus Pepsi, you wouldn’t conclude that “Pepsi may be considered when recommending diets for the management of blood sugars;” you’d say they’re both equally as bad so we should ideally consume neither.

That’s a standard drug industry trick. You don’t compare your fancy new drug to the best out there, but to some miserable drug to make yours look better. Note they didn’t compare beef to plant proteins, like in this study published in the American Journal of Clinical Nutrition. As I started reading it, though, I was surprised that they found no benefit of switching to a plant protein diet either. What were they eating? You can see the comparison in Switching from Beef to Chicken & Fish May Not Lower Cholesterol.  

For breakfast, the plant group got a kidney bean and tomato casserole and a salad, instead of a burger. And for dinner, instead of another burger, the plant protein group just got some boring vegetables. So, why was the cholesterol of the plant group as bad as the animal group? They had the plant protein group eating three tablespoons of beef tallow every day—three tablespoons of straight beef fat!

This was part of a series of studies that tried to figure out what was so cholesterol-raising about meat—was it the animal protein or was it the animal fat? So, researchers created fake meat products made to have the same amount of saturated fat and cholesterol by adding extracted animal fats and cholesterol. Who could they get to make such strange concoctions? The Ralston Purina dog food company.

But what’s crazy is that even when keeping the saturated animal fat and cholesterol the same (by adding meat fats to the veggie burgers and making the plant group swallow cholesterol pills to equal it out), sometimes they still saw a cholesterol lowering advantage in the plant protein group.

If you switch people from meat to tofu, their cholesterol goes down, but what if you switch them from meat to tofu plus lard? Then, their cholesterol may stay the same, though tofu and lard may indeed actually be better than meat, since it may result in less oxidized cholesterol. More on the role of oxidized cholesterol can be found in my videos Does Cholesterol Size Matter? and Arterial Acne.

Just swapping plant protein for animal protein may have advantages, but if you really want to maximize the power of diet to lower cholesterol, you may have to move entirely toward plants. The standard dietary advice to cut down on fatty meat, dairy, and eggs may lower cholesterol 5-10%, but flexitarian or vegetarian diets may drop our levels 10 to 15%, vegan diets 15 to 25%, and healthier vegan diets can cut up to 35%, as seen in this study out of Canada showing a whopping 61 point drop in LDL cholesterol within a matter of weeks.

You thought chicken was a low-fat food? It used to be a century ago, but not anymore. It may even be one of the reasons we’re getting fatter as well: Chicken Big: Poultry and Obesity and Infectobesity: Adenovirus 36 and Childhood Obesity.

Isn’t protein just protein? How does our body know if it’s coming from a plant or an animal? How could it have different effects on cardiovascular risk? See Protein and Heart Disease, another reason why Plant Protein [is] Preferable.

Lowering cholesterol in your blood is as simple as reducing one’s intake of three things: Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero.

What about those news stories on the “vindication” of saturated fat? See the sneaky science in The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: