Associations between dietary patterns, gut microbiome diversity, and itch severity in preschool aged children with atopic dermatitis: A cross-sectional study

Abstract

Background The diet-gut microbiota-disease axis has been explored in infancy, but its role in preschool atopic dermatitis (AD) remains unclear. This study investigated associations between dietary patterns, gut microbiota, and AD severity in Korean preschoolers.Methods We evaluated 75 preschool children aged 3-6 years, including 24 with AD and 51 healthy controls. AD severity was assessed by Eczema Area and Severity Index (EASI) and SCORing Atopic Dermatitis (SCORAD), and quality of life by Children's Dermatology Life Quality Index (CDLQI). Gut microbiota composition was characterized using 16S rRNA sequencing, and group differences were analyzed by Linear Discriminant Analysis Effect Size (LEfSe).Results Based on factor analysis, dietary patterns were categorized into a Traditional Korean (TK) diet and a Processed food and Snack (PS) diet. Children with AD who followed the PS diet showed lower vitamin C intake and higher levels of Dorea and Anaerostipes (LDA scores: 3.4 and 3.9). This microbial composition was associated with greater sleep-disturbing itching and poorer CDLQI (p = .032 and .041). Lower vitamin C intake correlated with higher Anaerostipes abundance (r = -.436, p = .042) as well as with higher EASI (r = -.52, p = .03) and SCORAD (r = -.41, p = .045). Dorea abundance was positively correlated with daytime itching (r = .42, p = .049).Conclusions In preschool children with AD, a dietary pattern high in processed foods and snacks was associated with increased Dorea and Anaerostipes and greater AD severity and poorer quality of life. These findings suggest that dietary modification may alleviate clinical symptoms in early childhood AD by modulating the diet-gut-skin axis.