Association Between Sodium Intake and Risk of Atopic Dermatitis – Basoz Aso Salim

A high sodium diet may increase the risk of atopic dermatitis (AD), according to findings published in JAMA Dermatology. The study authors observed that changes in daily sodium intake might contribute to eczema flares, and reducing sodium consumption could be a cost-effective, low-risk intervention for patients with AD.

Atopic dermatitis, also known as eczema, affects over 31 million people in the United States and is one of the most prevalent skin conditions. AD is a chronic condition that can affect people of any age but is typically seen in children. It is characterized by dry, itchy, and inflamed skin. While the disease is manageable, more severe cases can lead to skin infections if left untreated. Additionally, children and adults with moderate to severe AD may suffer from intense pain and discomfort due to persistent itching, which can also negatively impact their mental health.

Study Findings

The study authors assessed the association between sodium intake and AD using multivariable logistic regression models adjusted for age, sex, race and ethnicity, Townsend deprivation index, and education. The model revealed that a 1-gram increase in estimated 24-hour urine sodium excretion was associated with:

• An 11% higher likelihood of an AD diagnosis (adjusted odds ratio [AOR], 1.11; 95% CI, 1.07-1.14)
• A 16% higher likelihood of having an active case of AD (AOR, 1.16; 95% CI, 1.05-1.28)
• An 11% higher likelihood of increased severity of AD (AOR, 1.11; 95% CI, 1.07-1.15)

The findings showed that each additional gram of sodium excreted in urine over 24 hours was linked to an 11% increase in the odds of an eczema diagnosis, a 16% increase in the odds of having an active case, and an 11% increase in the odds of increased severity. Furthermore, an analysis of 13,000 adults in the United States using data from the National Health and Nutrition Examination Survey found that consuming just 1 extra gram of sodium per day was associated with a 22% higher likelihood of having an active case of AD.

Implications for Treatment

Standard care for AD typically involves regular moisturizing and other habits that reduce irritation and prevent future flare-ups. In more severe cases, treatment may include topical corticosteroids (CS), medicinal ointments, and creams. However, stopping the use of topical CS can lead to a severe condition known as topical steroid withdrawal (TSW), which can take years to resolve.

A recent study suggests that reducing sodium intake could offer patients an affordable, low-risk strategy to manage their symptoms and improve their quality of life. Given that medicinal lotions and ointments can be costly, a dietary approach may be complementary.

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