Lower food diversity in infancy may increase risk of eczema, South Korean study finds

A large South Korean cohort suggests that limited food variety in a child’s first year could be linked with a modestly higher risk of developing eczema later, highlighting potential benefits of diverse early diets.

Lower food diversity in a child’s first year of life may be linked with a modestly higher risk of atopic dermatitis later on, according to a large South Korean cohort study published in Pediatric Allergy and Immunology. Researchers examined health records for 267,935 infants born in South Korea between 2009 and 2010 and found that children in the lowest and middle ranges of dietary diversity at 12 months had a slightly greater chance of developing the skin condition than those with the most varied diets.

Atopic dermatitis, also known as eczema, is a chronic inflammatory skin disorder that commonly begins in early childhood and can cause itching, irritation and sleep disruption. In the new analysis, children with low food diversity had an adjusted hazard ratio of 1.08 for later atopic dermatitis, while those in the moderate-diversity group had a hazard ratio of 1.11, compared with the high-diversity group. The researchers excluded infants who already had the condition in an effort to reduce the chance that early symptoms affected feeding patterns.

The findings add to earlier research suggesting that a broader range of complementary foods in infancy may be associated with fewer allergic outcomes. A 2014 study in the Journal of Allergy and Clinical Immunology reported that greater food diversity in the first year was linked with lower rates of asthma and food sensitisation, while a later study published in Pediatrics in 2022 found that higher food diversity in the second year of life was associated with a lower risk of asthma and, in some groups, atopic dermatitis and food allergy.

Still, the authors of the new study stressed that the results show an association rather than proof that diet diversity prevents eczema. They called for randomised controlled trials to determine whether introducing a wider variety of foods during infancy can truly reduce risk and to help shape future feeding guidance. The study did not find clear differences by infant sex or by maternal history of asthma or atopic dermatitis.