FiberNEW2026-09

The Gut-Skin Axis in Pediatric Atopic Dermatitis: Nutritional Modulation, Microbiome Interactions, and Emerging Precision Approaches.

Miulescu Raluca-Gabriela, Costescu Mihnea, Marin Ruxandra-Cristina, Mușetescu Alina et al. — Nutrients

Summary

このレビューは、小児アトピー性皮膚炎における腸と皮膚のつながりを通じて、栄養がどのように影響するかを探りました。母乳育児や多様な食事など、確立された食事のアドバイスを特定し、高繊維食には期待が持てるものの、その効果を裏付けるさらなる研究が必要であること、そして個別化された栄養アプローチの開発が今後の課題であることを示しています。

AI-generated summary — read the original

Key points

Breastfeeding and diverse complementary feeding are generally recommended for children with atopic dermatitis.
High-fiber diets show potential benefits, primarily from observational studies, by supporting gut health.
Probiotics offer only a small, inconsistent effect and are not a primary treatment for atopic dermatitis.
Personalized nutrition based on gut microbiome analysis is a promising research area, not yet routine clinical care.

What the study looked at

This narrative review aimed to understand which nutritional strategies are supported by clinical evidence for children with atopic dermatitis, which are still under investigation, and how close the field is to implementing personalized nutrition. Researchers conducted a comprehensive search of medical databases, prioritizing existing guidelines, systematic reviews, randomized trials, and birth cohort studies relevant to pediatric atopic dermatitis. They then synthesized this information to provide an overview of the current evidence. The review found that established advice like breastfeeding, diverse complementary feeding, avoiding unnecessary elimination diets, correcting nutrient deficiencies, and managing confirmed food allergies are supported. While probiotics showed a small, inconsistent effect, and high-fiber diets looked promising in observational studies, personalized nutrition based on individual gut profiles is still a research frontier, not yet ready for routine clinical use. Nutrition acts as a supportive measure, not a replacement for standard medical treatments.

Dietary takeaway

This review suggests that a diet rich in fiber, like those found in fruits, vegetables, and whole grains, could play a supportive role in managing atopic dermatitis by promoting a healthy gut. While encouraging diverse, fiber-rich eating is generally beneficial for overall health, remember that this is a review of existing studies, and more definitive research is needed to establish specific dietary recommendations for this condition. Always consult with a healthcare professional for personalized advice.

Abstract

BACKGROUND/OBJECTIVES: Pediatric atopic dermatitis (AD) is a barrier-driven inflammatory skin disease with systemic immune and microbial correlates. The gut-skin axis offers a biologically plausible framework through which early-life nutrition, gut microbial metabolism, intestinal barrier function, and immune maturation may influence disease risk and expression, but much of the supporting evidence remains associative. This narrative review asks which nutritional strategies are supported by clinical evidence in children with AD, which remain investigational, and how far the field is from precision nutrition. METHODS: PubMed/MEDLINE, Scopus, and Web of Science were searched up to 31 July 2026; guidelines, systematic reviews, randomized trials, birth cohorts, and mechanistic studies with pediatric relevance were prioritized and appraised narratively. RESULTS: Breastfeeding when possible, dietary diversity during complementary feeding, avoidance of unnecessary elimination diets, correction of documented nutritional deficiencies, and management of confirmed food allergy are supported by current guidance. Probiotics and synbiotics lower SCORAD in meta-analyses, but the pooled effect is small, heterogeneous, and below the minimal clinically important difference, so they are best described as an optional adjunct rather than a recommended treatment; Mediterranean-style or high-fiber dietary patterns are backed mainly by observational data. Microbiome profiling, metabolomics, multi-omics endotyping, and artificial intelligence remain research tools without validated predictive value for dietary responses. CONCLUSIONS: Nutrition is an adjunct to, not a substitute for, established topical and systemic therapy in pediatric AD. Precision nutrition is a promising research direction rather than an established component of routine care, and its clinical value will depend on standardized biomarkers and well-designed longitudinal and interventional studies.

View on PubMed →DOI: 10.3390/nu18193138