Burgers, fast foods, and increased associated risk for atopic dermatitis: A cross-sectional study of dietary habits among young Chinese adults in Singapore/Malaysia

Background: We see increasing evidence that dietary and nutrients factors play a pivotal role in allergic diseases and recent global findings suggest that dietary habits influence the pathogenesis of atopic dermatitis (AD). Frequent consumption of fast food diets are associated with AD development. Despite the rising prevalence of AD in Asia, efforts in investigating the role of dietary habits and AD in adults are still lacking.Methods: We evaluated the association of foods and dietary habits with AD presentation using our population established for the Singapore/Malaysia Cross-sectional Genetics Epidemiology Study (SMCGES). Dietary habits profiles of 11494 young Chinese adults (1550 AD cases/ 2978 non-atopic controls/6386 atopic controls) were assessed by an investigator-administered questionnaire. AD cases were further evaluated for their chronicity (550 chronic) and severity (628 moderate-to-severe). Additionally, we derived a novel food index, Quality of Diet based on Glycaemic Index Score (QDGIS), to examine the association of dietary habits of GI and foods with AD and various AD phenotypes.Results: The majority of AD subjects are distributed in the good (37.1%) and moderate (36.2%) QDGIS classes. From the multivariate analyses for age and gender, a moderate QDGIS class was significantly associated with a lower odds of AD (Adjusted Odds Ratio (AOR): 0.844; 95% Confidence Interval (CI): 0.719-0.991; p <0.05) and moderate/severe AD (AOR: 0.839; 95% CI: 0.714-0.985; p <0.05). A good QDGIS class was only significantly associated with a lower odds of chronic AD (AOR: 0.769; 95% CI: 0.606-09761; p <0.05). Among high GI foods, frequent consumption of burgers/fast food was strongly associated with an increased risk of chronic and severe AD. Among low GI foods, increased intake frequencies of fruits, vegetables, and pulses decreased the odds of AD. Finally, we identified significant associations between frequent seafood, margarine, butter, and pasta consumption with an increased odds of AD despite them having little GI values.Conclusion: While genetic components are well-established in their risks associated with increased AD prevalence, there is still a lack of a focus epidemiology study associating dietary influence with AD. Based on the first allergic epidemiology study conducted here in Singapore and Malaysia, it laid the groundwork to guide potential dietary interventions from changing personal eating habits.