 Eczema, or dermatitis, is a non-contagious, inflammatory (meaning that the body’s immune system is activated) skin condition that usually involves a combination of itching, redness, oozing, raised bumps or blisters. Whilst not all types of eczema are the same, or have the same causes, this article covers their differences and some common food triggers.
Eczema flares can be ‘acute’, meaning that there is a sudden appearance of symptoms usually involving blisters and oozing, or chronic when the symptoms remain long-term but are drier in appearance with scaling and cracking. Most clients I work with report a mixture of both, chronic dryness with periodic acute flares. The above is, however, a generalisation, even dermatologists admit that in many cases, the exact eczema type cannot be diagnosed and that no two people will experience the same environmental or food triggers or the same eczema symptoms[1] Hearing that you have eczema is one thing but there are different types of eczema and these can be triggered by different things, so it is worth knowing the difference. Eczema being eczema, of course, many people have a combination of several types versus just one. Here is a brief description of the main different eczema’s: Contact Dermatitis Contact Dermatitis is an eczema that is triggered by direct contact with an allergen/sensitivity eg. nickel or fragrance. The eczema only appears around the site of the contact such as earrings, a watch, belt buckle, perfume or deodorant. Contact dermatitis usually resolves itself, within 5-7 days, once the irritant has been removed. Atopic Eczema Atopic Eczema is an allergic eczema that is often linked to asthma and hay fever and is particularly linked to itchiness. A blood test for raised IgE levels can be used to see whether a true allergy is present. Interestingly, however, not all patients with diagnosed atopic eczema show raised IgE, some may experience a food/environmental sensitivity or intolerance reaction.
About 20-30% of UK infants are affected by atopic eczema. Issues with a a skin barrier protein, filaggrin, was found, in 2006, to be strongly linked to atopic eczema.[2] Pompholyx (Dyshidrotic) Eczema Pompholyx/Dyshidrotic Eczema is linked to atopic eczema and appears as extremely itchy, pin-prick blisters on fingers and/or toes. Over time the blisters turn into scaling and crevasses often form. This form of eczema creates intense itchiness but scratching only worsens the symptoms. This form of eczema often appears in young adults and can be triggered by warmer weather. Seborrheic dermatitis Seborrheic dermatitis generally appears on the scalp and above the eyes. It is usually less itchy than atopic eczema and has been linked to yeast infections. Discoid (Nummular) Eczema Discoid eczema usually occurs in middle-aged/older men. If this form of eczema appears in younger patients then it is actually a form of atopic or contact dermatitis. This eczema forms in round-shaped patches and may leave a long-term, lighter skin tone patch after the eczema has cleared. Stasis (Venous) Eczema Stasis eczema is often found on the lower legs and is linked to problems with circulation and veins. Medical treatment is linked to resolving the vein condition and applying creams to the eczema. Neurodermatitis (Lichen Simplex Chronicus) Neurodermatitis is when skin becomes thick and leathery due to repeated scratching or rubbing, either as a habit or due to stress and it is usually found in a single patch either on the leg or back of the neck. Topical creams are usually the first line of treatment. A focus on Atopic Eczema and Common Food Triggers Atopic Eczema is an allergic eczema that is often linked to asthma and hay fever and is particularly linked to itchiness. A blood test for raised IgE levels can be used to see whether a true allergy is present. Interestingly, however, not all patients with diagnosed atopic eczema show raised IgE, some may experience a food/environmental sensitivity or intolerance reaction.
About 20-30% of UK infants are affected by atopic eczema. Issues with a skin barrier protein, filaggrin, was found, in 2006, to be strongly linked to atopic eczema.[3] For those types of eczema that have an inflammatory, immune system response (atopic, pompholyx, discoid and seborrheic) it is useful to find out what your personal triggers are. It is important to note that eczema triggers are individual, during my many years in practice specialising in this area, I have found some common ground and some surprising triggers. My main advice would be to start keeping a food and symptom diary. This means noting what you have eaten during the 3 days preceding a flare. Here is a link to a free 'Food and Symptom Diary' tool I've prepared. The top 6 categories of foods that my clinical experience has identified as the most common are:
Caution, however, about starting to remove whole food groups from your diet, especially if you considering taking anything out of a child’s diet, as doing so can exacerbate the problem rather than alleviate it. My advice would be to work with a nutrition professional. I’ve also found that certain triggers follow what I could only describe as “trends”. For example, in my list above I have gluten, but truth be told, I am finding that it is featuring less and less as a potential trigger. I am, however, finding that triggers to almonds and soy are becoming much more common. Could this be a case of what we eat the most often has the potential to trigger atopic eczema sufferers more? Only time and research will tell. Read more:
My name is Jessica Fonteneau and as a Registered Nutritional Therapist MSc, I have significant clinical experience in supporting clients with digestive, skin and autoimmune disorders. In addition, I have undertaken further study and training in two specific areas:
www.jessicafonteneaunutrition.com [1] Lord RS, Bralley JA (2008) Laboratory Evaluations for Integrative and Functional Medicine, 2nd Edition, Canada. Metametrix Institute [2] Irvine AD, McClean WH (2006). Breaking the (un) sound barrier. The Journal of Investigative Dermatology. 1261200-1202
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 Do you ever start a diet/exercise routine/healthy habit with the best intentions but after a few days or weeks you start to slip back into your old ways. Do you wish that you could just stay on track? Apart from implementing a change, what are you doing to address your mind-set? Have you ever thought that you could be self-sabotaging thanks to unconscious barriers? How do you think you could find out what is holding you back, even if you aren’t aware of it? We all think that we can just willpower our way through it, but if we have subconscious barriers or values that are at odds with our objectives, all the willpower in the world won’t help us succeed. Let’s say you want to lose weight, but you are a sociable person. You can easily see how your objective and your value (sociability) are at odds with each other. I’ve had clients who are willing to suffer a severe eczema flare, rather than tell their friends that they can’t eat a certain food. Exploring our beliefs and barriers via health coaching, opens the doors for change. The concept of thinking about yourself can be very uncomfortable for most people. I mean why, if you could avoid it, would you want to examine your own navel? The thing is, that unless we do go on a voyage of self-discovery, it is impossible to move forward. Whilst we think that our logical mind is doing all the thinking, it is the subconscious mind that has the control. Our subconscious mind makes decisions based on past experiences, good or bad. It takes in cultural and societal norms. Its whole aim is to keep the status quo, to stick with whatever is comfortable and not rock the boat. Even if the change will bring a more positive outcome. Unravelling the decisions your unconscious mind is making without you even realising, is the way to open the door to change. Also, does this sound familiar? You’ve consulted a nutrition/health practitioner and you have all the information you need to reach your health goals. You leave the appointment all fired up, you do a meal plan, buy the ingredients, follow the plan for the first few days and then…. Life happens. You are invited out to a birthday party, or you have leftovers in the fridge that need finishing. You are travelling for work and there is nothing to buy at the train station apart from fast food options and the examples could go on and on and on. When I speak to my clients about previous attempts at changing their nutrition and lifestyle, a common theme is that when they are faced with these kinds of challenges, everything tends to go out of the window, and they give up. They know the what, but they can’t manage the how. When clients come to me and say that they are finding certain situations tricky when following their personalised health and lifestyle plan, my advice to them is to make an intention. Say you are going to a dinner party. If ahead of time you already make the intention of, let’s say having only one glass of wine, but accepting the nibbles or saying no to the bread but having a small portion of pudding, it’s easier to stick with than trying to make all those decisions on the hoof. After having practised as a Registered Nutritional Therapist for a couple of years, I realised that it wasn’t enough to provide the personalised nutrition and lifestyle plan. My clients needed to understand themselves so that they could be open to long-term change. At this point I trained in health coaching and my practice was transformed. I now offer health coaching as standard as part of my packages. The thing about health coaching is that it does require a person to spend time focusing on themselves. Some clients don’t see the utility or think that it is a form of self-indulgence. Do you think that it is an indulgence? In other words, do you think that spending time discovering more about yourself and why you are attached to certain habits is a waste of time? Do you think that if you just dug deeper and mustered a bit more willpower all would be well? The thing about health coaching is that it opens an understanding about yourself that you can apply to anything. You think that a certain tool might help you snack less and then you realise that you can use the same tool to help you procrastinate at work less. The tools and understanding you gain are with you forever and can be applied again and again as you enter different chapters in your life. It’s a life skill. Think of it like a guided prompt, conversations with yourself and tools that allow you to discover some things for yourself, specifically in relation to habits you have. Let me tell you about Sophie (name changed for privacy). She had just had her second child and wanted to lose the baby weight before going back to work. She was exhausted and didn’t have enough minutes in the day but was motivated to achieve her goal. To start off with I empathised with her lack of time and energy. However, when I realised that she was also struggling to follow the programme and was falling behind on her objectives, it was time to highlight how important the coaching side of the programme was. One of my favourite expressions is ‘you can’t pour from an empty cup’. You can’t help others if you aren’t looking after yourself. By her own admission Sophie was giving her all to her family, but was also short-tempered and impatient, because she had nothing left to give. She was also annoyed and felt guilty that she had invested in the programme but wasn’t getting the hoped-for results. We had a long chat about how devoting time to her own health and wellbeing would bring benefits not only to herself but also to all the family. She started to commit to the coaching exercises and was surprised how much easier and less time-consuming it made the whole process. Long story short, whilst she didn’t quite reach her goal by her self-imposed deadline, she was only just off it and had the benefits of more energy, patience, and serenity. She is also grateful for the tools that she now has for life to keep herself on track. Clients tend to think that health coaching is all about weight loss, but my biggest success was with a client who has been battling atopic eczema since she was 6 months old. Julie (name changed for privacy) came to me because she was desperate. Having atopic eczema flares on her hands and face was stopping her from living her life. She was so embarrassed to go out with puffy eyes and bleeding fingers and she was starting to isolate herself and refuse invitations. The thing is Julie knew that she reacted to certain foods. She had done tests with her dermatologist and had the lab results to prove it. Even with these official diagnoses the fact that eating those foods would ‘only’ trigger her eczema rather than an anaphylactic shock, meant that whilst she avoided those foods at home, she didn’t dare refuse foods when she went to others’ houses. So, she kept triggering the flare and it couldn’t never settle properly, causing pain and unhappiness. Working with Julie in a health coaching capacity made her realise that keeping her own inflammation at bay was critical and that with a little preparation and forewarning, her hosts wouldn’t be offended if she said no to something. She found that her friends were only too happy to find alternatives so that she could fully participate. The coaching also helped her make other changes to her diet that supported her skin health and now flares are rare. So don’t think that health coaching is only good for one thing. It is the key to habit change, whatever the reason you need to change your way of eating. Changing the way, we eat takes time. Firstly, because we have to find our own path of what suits us best, without compromising our health. Secondly because changing our habits in a life context that usually stays the same, takes time and guidance. That is why I’ve created a new online, self-guided course, called ‘Unleash the change. Discover the habits and barriers hampering your efforts’ and it’s for people that want change their habits sustainably and for the long term. The course will be available on 23rd February 2023, and I’ll be offering an amazing early bird price for those who get in early. The ability to pre-purchase will be available from 14th February 2023 and I’m so excited for you to see it because it’s going to help you succeed achieve your health and wellbeing objectives. If you aren’t already signed up for my emails which will be featuring an extra discount on top of the early bird offer, click here
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Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com  If you suffer from bloating, painful, hard to pass stools or infrequent stools (e.g., not every day) you or they may be suffering from constipation.
The most important thing you can do if you think you are suffering from constipation is to consult your doctor. Once you’ve been given the all-clear, it’s time to consider some ways to get things moving naturally. This article will cover:
What is a ‘normal’ bowel transit? All foods break down at different rates, moving through the stomach to the small intestine and onto the colon at their own individual speed. Each ingredient from a meal e.g., protein, vegetables and carbohydrates will each arrive in the colon at different times. None of us is average, but research has found that – on average – digestion happens at the following rates:
One to three bowel movements per day is considered normal. If you aren’t passing a stool daily, then it may be time to introduce things that may set that right. The importance of hydration Drink more water - our stools need to be bulked out with water to pass through the gut smoothly. Drink regularly throughout the day rather than a lot in one go so that you are regularly hydrating yourself and your stools. Fibre, the magic ingredient. Whilst many nutrition facts have changed over the years the one thing that hasn't is the importance of fibre. Did you know that you should be aiming for 30g of fibre per day? The average European can barely make 15g. Soluble and insoluble fibre – what’s the difference? Insoluble fibre is considered gut-healthy fibre because it normalises peristalsis (the muscle movement that carries your food through your digestive tract and out) and adds bulk to your stool, helping prevent constipation. Insoluble fibre does not dissolve in water, which means it passes through the gastrointestinal tract relatively intact and speeds up the passage of food and waste through your gut. Insoluble fibres are mainly found in whole grains and vegetables. Soluble fibre binds with water and forms a gel, which slows down digestion and eases the passing of a stool. Soluble fibre delays the emptying of your stomach and makes you feel full, which helps control weight. Slower stomach emptying may also affect blood sugar levels and have a beneficial effect on insulin sensitivity, which may help control diabetes. Soluble fibres can also help lower LDL (“bad”) blood cholesterol by interfering with the absorption of dietary cholesterol. Soluble fibres can be found in food sources such as oats, peas, beans, apples, citrus fruits, carrots, barley, chia seeds and psyllium. How to get enough fibre An average sized orange contains 3.1g of fibre, a 100g portion of cauliflower is between 1.6g, kale has 3.1g per 100g and raspberries knock them all out of range with 6.5g, so it can be difficult to judge your intake. To make it easy you should aim to eat 7 portions of fruit and vegetables per day. I usually recommend 5 portions of vegetables and 2 portions of fruit. You should also include of nuts, seeds, whole grain breads, cereals, beans, and lentils which all contain decent amounts of fibre to boost your intake. It is important to note that fibrous foods are fantastic, but they do need water to help move them along, so go back to my first recommendation. Don’t forget to hydrate! It’s all in the movement Regular exercise and frequent movement are both vitally important to maintain a healthy lifestyle and a state of equilibrium. Without exercise our bodies become sluggish, and this reflects in the state of our gut and the length of our digestion process. Exercise can also help the mechanical part of digestion, peristalsis. The muscle waves that propel the food from your digestive system to the exit. In summary, here are my top tips for relieving symptoms of constipation: Please do not introduce all these options at once, but gradually add one change at a time and note how you feel.
Speak to your medical practitioner/nutritional therapist or pharmacist adviser for further guidance. If on medication, please speak to your GP/consultant before making any changes to your diet. Read more:
My next newsletter will feature an early bird offer for my brand new online, self-guided course ‘Unleash the Change. Discover the habits and barriers hampering your efforts’. Sign-up now to benefit. Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com If one-size-fits-all diets worked, don’t you think we would know the magic formula by now?1/24/2023 My 5 top tips to finding out what eating style works for you Hands up if you’ve seen or heard something about a magic formula that results in weight loss, more energy, miracle reduction in x, y, or z symptoms and all in record time. Maybe you saw something on the television, read it in a magazine or even witnessed a friend being transformed in front of your own eyes.
Now hands up if you tried it yourself. You bought the book/programme and lined yourself up to follow the same plan. If I might hazard a guess, it didn’t have quite the same miraculous effect. What do you think happened? Please don’t tell me that you blamed yourself. If you did, remember this: If one-size-fits-all diets worked, don’t you think we would know the magic formula by now? Finding out what works for you and your lifestyle is the key to it all and in this article, I will give you five ways to explore what that is.
Please note that these tips do not provide any nutritional advice. If you are looking for personalised recommendations to support a specific health issue, you should contact a nutrition or health professional. I offer free (no-obligation) introductory calls if you wish to explore this avenue further. You can book for an adult here or a child here. You know yourself much more than you think you do, so here are my 5 top tips to help you discover what works for you. 1. In your experience, in the past, what has worked, not worked, or worked but not been sustainable? Get a piece of paper and divide it into three columns. Think back to what has worked for you in the past. Was there a time in your life where you were eating a certain way or following certain habits and you felt amazing? Or how about things that you tried but realised didn’t suit you? Please don’t include those times where you crashed dieted to fit into a certain outfit for a certain event. Use the three columns to divide your recollections into things that worked, things that didn’t and finally things that you thought worked but were not sustainable long term. Remember that the things that worked or didn’t, could be a patchwork of things from different periods in your life. At university it may have been the sport, during your first job it could have been enjoying a loaded coffee and muffin every day on your way in and more recently it could be that you tried apple cider vinegar in water before a meal, but you hate the taste, and it gave you heartburn. Don’t just do this exercise in one go, keep coming back to it and adding to the recollections. Review what you have written. Which things in the ‘didn’t work’ column do you find yourself still doing now and that you probably could set to one side? Which in the ‘did work’ had you forgotten about and think that you could reincorporate into your daily life. Finally, are there any in the ‘worked but not sustainable’ column that you could adapt so that they do work for you long term? 2. Keep a record. I work with a lot of clients (adults and children) who suspect that there are foods that don’t suit them. One of the first things I do is ask them to keep a food and symptom diary so that we can, perhaps, identify patterns or triggers. I have a free tool for recording this available here. If you are trying to find out which ways of eating suit you, then you would also benefit from recording what you eat, but instead of writing down what symptoms occur, although you can include those too, you would write down how you felt after a meal. After a baked potato, did you feel great and were able to power through to the next meal without snacking or did you have an energy slump after about 30 minutes and want a nap? If you have breakfast, does that sustain you or does it open the door to feeling hungry for the rest of the morning? Can you identify any foods that bizarrely make you feel hungrier rather than satisfy you? What else have you spotted that give you clues? To find out how we should eat, we need to be an observer of how we feel. Consider it doing your own scientific study. Recording isn’t for everyone, however. If you find yourself spending a bit too much time recording things, then this tip isn’t for you, and you would do better letting it go. We can be too caught up in the detail, the idea is to see the bigger picture and relax about the whole. 3. Use your imagination, but be realistic Now that you’ve sifted through your recollections it’s time to use your imagination. If you could design a way of eating based on what you know about yourself, which fits with your values and is sustainable forever, what would it look like? This tip is about not only choosing foods that suit you in terms of nutrition, but also suit your lifestyle and budget. Whichever way of eating suits you best, be it omnivore, low carb, plant-based or other, must be practical. Otherwise, with all the will in the world, you won’t keep it up. Consistency is the key. Consistency in your eating habits, body movement and lifestyle choices. So, if you could design your perfect nutrition and lifestyle habits, what do you think they would be? Once you have that vision in your mind start implementing them. Don’t go too fast though! It’s easy to do all and then nothing. Introduce one thing at a time, when you feel as if it is integrated into your life, then move on to the next. 4. Don’t get hung up on the hype. This past month has seen the publication of multiple articles predicting this year’s superfoods. Don’t get me wrong, there are some foods that are absolute powerhouses of nutrition, but it doesn’t mean that that you will be under-nourished if you don’t have them. You could go out and spend a fortune on the new wonder food, but there is probably a more local, cost-effective food that will do just as well and that you could eat more regularly. A diet that suits you is one that suits every aspect of your life. 5. What to do if you DO want to follow a certain diet but your body rebels? Ethical, cultural, or religious reasons can make you want to eat a certain way, even if you can sense that it isn’t the best way to eat for you. My advice in these cases is to take it slow and steady. Research has shown that our gut microbiome adapts itself to our diets. Whatever you are eating on a regular basis is reflected in the bacterium types in your gut. Changing your diet suddenly can cause digestive issues simply because there aren’t the right gut bacteria to digest and process the new foods. I always tell my clients to slowly introduce the new way of eating at a pace that allows the new microbiota population to grow at a similar pace. At the right time you may reach a tipping point where you can eat the new diet with no problems. If you are having continued issues with adapting your diet, then it may be best to get the support of a nutrition or health practitioner. So, to summarise my tips:
Read more, here are some of my previous blogs that you may find helpful:
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter. My current newsletter features an early bird offer for my brand new online, self-guided course ‘Unleash the Change. Discover the habits and barriers hampering your efforts’. Sign-up to my newsletter now to benefit. Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com  You know that your symptoms are triggered by something, but you are unsure what. What can you do to decipher those triggers, without removing everything out of your diet and risking your health?
Here’s a quick overview of the information you will find:
Allergies, intolerances, and sensitivities – what’s the difference? There are three categories of food reaction – allergies, intolerances, and sensitivities. Each category has its own severity level. This is a big topic on its own and will covered by itself in next week’s blog. Here’s a quick overview:
If you suspect a reaction to food, then the first thing to do is to flag it to your medical practitioner. Depending on your symptoms your doctor may refer you for allergy testing. Ruling out a potentially serious allergy is vital. Having a diagnosed IgE allergy makes things clearer. There is a medical reason for eliminating that food from your or your child’s diet. If all your allergy tests come back negative, however, but you know that certain foods trigger a reaction, then that is where the complications can set in and it’s time to start deciphering which foods might be the culprit. My first piece of advice remains to consult with a nutrition professional before eliminating one or more food groups. What are elimination diets and why they may not be the answer There is a whole raft of symptoms that can be linked to food triggers. The most common are linked to digestion or skin conditions,, but others can include anything from joint pain to brain fog. One of my clients complained of falling asleep within 10 minutes of eating one square of chocolate! Most of my consultations relate to bloating, acid reflux, stomach pain and skin flares including acne, psoriasis, and atopic dermatitis/eczema. Elimination diets can be as simple as removing one suspected food, to removing many foods for a short period of time, under practitioner supervision. Well-known elimination diets include gluten or dairy free and the FODMAP diet. A more in-depth article on the FODMAP diet is planned for later this year. It is important for me to get this point across. It can be dangerous to follow an elimination diet long-term, especially if it excludes several food groups. My clinical experience has taught me that there is often just one or two true intolerances and sensitivities, which can often start a cascade of inflammatory responses that result in other, innocuous foods, causing reactions. In other words, continuously eliminating more and more foods is not the answer. It often seems that the more a person removes, the more they react to. A vicious cycle without end. Why elimination diets can be dangerous for infants and children and what to do instead Unless there is a diagnosed allergy, eliminating a whole host of foods is dangerous for infants and children. Any removal of individual foods or food groups should only be undertaken with the support of nutrition practitioner, so that this can be achieved safely and with no long-term consequences. Drastic eliminations can not only result in malnutrition, but for the younger population it can turn an unpleasant but innocuous intolerance into a full-blown diagnosed allergy. Infants and children have ‘naïve’ guts. Their gut microbiome (the useful bacteria we all have) is unformed and their immune response underdeveloped. Once foods have been eliminated for some time from this environment, it can be very difficult for those foods to be reintroduced. Subsequent symptoms can be stronger and last longer, even without the development of an allergy. Working with infants and children my aim is always to cautiously remove a highly suspected food and only for a very limited amount of time. My ultimate objective is always to expand the child’s diet as much as possible to support the development and health of their gut microbiome. In my clinical experience, food triggers in children often resolve as their gut and immune systems grow more robust. You think you might have an intolerance or sensitivity, what now? I find that clients who consult with me usually fall within one of three main groups.
They all have the same thing in common, a need to move past the symptoms and start eating in a way that suits them. A Food and Symptom Diary, a great self-help tool It can often be difficult to unravel which foods cause which symptoms. Reactions from one food can transpose or hide reactions from another and not all foods trigger the same symptoms. Digestive symptoms often appear quickly after the problem food, however skin conditions, specifically atopic dermatitis/eczema can take up to 72 hours to manifest. Keeping a record of what you eat and drink and any symptoms that appear can help you uncover patterns that would otherwise have been missed, especially with delayed onset reactions. For example, you’ve had a bad eczema flare and when you look back at your food and symptom diary you can see that prior to each of the last few flares you’ve eaten such and such a food. It may not be the full story, but it’s a definite place to start. The thought of completing a daily food and symptom diary can be daunting for some. So, for those clients who don’t want to do it daily, I suggest that they log the previous 24-72 hours’ worth of food after the development of a symptom. There is a proviso, however, this recall can sometimes be problematic. Humans are notoriously selective in their memory’s. Details can be forgotten, especially after 72 hours. I have a free Food and Symptom Diary tool on my website that anyone can download for free. https://tinyurl.com/4rpwnwrd . How can you be sure if a symptom is linked to a food or not? When a person is being hypervigilant about monitoring their food and symptoms, they can sometimes naturally interpret some symptoms as related to certain foods when they, in fact aren’t. This can be because of a variety of reasons including delayed-onset symptoms, or because some foods are harder to digest regardless of whether you have a digestive condition or not. Research increasingly points to intestinal hyper-permeability (leaky gut) as a root cause of multiple food reactions or it could just be because the gut is so inflamed from a genuine, unidentified trigger, that it starts reacting to random other things. As a Registered Nutritional Therapist, I work with my clients to decipher the level of symptom it might be. Using a traffic light analogy, is it a red symptom that we should absolutely pay attention to or is it a more ambiguous amber? Removing lots of foods might seem to make sense, but it may not be right My suspicions are aroused when a client says that they can eat fewer and fewer foods. This usually indicates that a red symptom trigger is setting off a cascade of inflammation which then causes a raft of ambiguous amber symptoms. Then there is also the consideration, is it a false amber? Could it be manifesting because of the underlying red trigger? Or is it in fact a true amber? This would mean that it does cause symptoms but not to the same extent as a red trigger and it could, potentially, be eaten not too often and not too much. To sum up, my top tips
Read more: What is the atopic march? Why is eczema/atopic dermatitis itchier at night? You’ve been diagnosed with an atopic condition, but what does that mean? Atopic dermatitis/eczema – a chronic condition that effects all ages The skin microbiome, the key to good skin health Autumnal Allergies – Yes it is a thing To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com  It’s autumn, you begin to heave a sigh of relief thinking that the hay fever and seasonal allergies season is finally over. Then you realise that you are still getting symptoms – itchy eyes, runny nose, a dermatitis flare, and that you are suffering from autumnal allergies.
TV adverts and magazine articles would have you think that hay fever and seasonal allergies only happen in the spring and summer, but that isn’t the case. Autumn brings its own set of allergens ready to trigger a runny nose, atopic dermatitis, and itchy eyes. If it isn’t plant pollen, what are the autumnal triggers that can cause so many issues? Weed pollen, mould spores and house mites are the most common triggers for Autumnal allergies, read on to find out more details and to get my 5 tips to lessen the autumnal allergy symptoms. Weed Pollen Not all pollen producing plants flower in spring. A whole category of weeds flower in the autumn and produce the highly allergenic weed pollen. These plants usually flower from late August until the first frost (usually around the end of November but growing later with climate change). This category of plants includes common weeds found in the UK such as nettles and sorrel but also varieties that are much newer to the UK and Europe such as the American Ragweed. Not only is ragweed a recent invader, but it also produces one of the highest amounts of pollen, causing uncomfortable hay fever and dermatitis symptoms in many sufferers. Mould Spores Mould is around us all the time, but at this time of year levels peak with the falling leaves gently composting on the ground releasing large amounts of allergenic spores. These are the main types of mould which have been highlighted as being triggers for allergy symptoms:
Dust Mites Many sufferers of asthma, eczema or hay fever also have a dust mite allergy and whilst dust mites exist all year, reactions tend to peak in autumn as the weather becomes damp but remains relatively warm and we retreat inside and close our doors and windows, but we haven’t yet put our heating on. 5 Tips to Lesson the Autumnal Allergy Symptoms
If you were interested in this article, you may be interested in these other blogs I’ve previously published: What is the atopic march? Why is eczema/atopic dermatitis itchier at night? You’ve been diagnosed with an atopic condition, but what does that mean? Atopic dermatitis/eczema – a chronic condition that effects all ages The skin microbiome, the key to good skin health To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com  We’ve all heard about the gut microbiome (population of bacteria) but did you know that your skin had its own microbiome? We now know that that skin microbiome is implicated in several skin health conditions including Atopic Dermatitis (AD) but also acne, rosacea, and psoriasis. Research has shown that the skin and intestinal microbiomes are similar in a number of ways:
Treatment usually focuses on antimicrobial and antibiotic creams and current research is looking into crems that target the over abundant staphylococcus strains specifically. How to support your skin microbiome Your skin and gut microbiomes are closely linked, so here are my top tips for maintaining a healthy skin microbiome:
References 1. Szari S, Quinn JA. Supporting a Healthy Microbiome for the Primary Prevention of Eczema. Clin Rev Allergy Immunol. 2019;57(2):286–93. 2. Martinez KB, Leone V, Chang EB. Western diets, gut dysbiosis, and metabolic diseases: Are they linked? Gut Microbes [Internet]. 2017;8(2):130–42. Available from: http://dx.doi.org/10.1080/19490976.2016.1270811 3. Nakatsuji T, Gallo RL. The role of the skin microbiome in atopic dermatitis. Ann Allergy, Asthma Immunol [Internet]. 2019;122(3):263–9. Available from: https://doi.org/10.1016/j.anai.2018.12.003  The Atopic March is the term given to the progression of allergic or atopic conditions from infancy into childhood. The ‘march’ usually starts with atopic dermatitis/eczema (AD in babies and sometimes progresses to food allergy, asthma, and allergic rhinitis (hay fever), Don’t panic! Just because there is an atopic march, it doesn’t mean that every infant or child who has AD will go on to develop any of the atopic conditions listed ! Only 60% of children with severe AD go on to experience other conditions within the Atopic March and for those with mild AD, the figure is only 20%.  Figure taken from Tsuge et al., (2021) (1) highlighting the atopic march and some of the different factors thought to be involved. The reasons behind the Atopic March as like those thought to be behind AD generally. A fragile skin barrier that lets possible food or environmental allergens in, triggering the activation of an immune response. Once the initial reaction has been experienced, the body identifies the food or environmental particle as an ‘enemy’ and reactions will manifest either as continuing AD or via other reactions such as hay fever, food allergy or even asthma. (2)
Nutritional strategies for infants and children who may have a familial susceptibility to atopy:
References 1. Tsuge M, Ikeda M, Matsumoto N, Yorifuji T, Tsukahara H. Current insights into atopic march. Children. 2021;8(11):1–17. 2. Yang L, Fu J, Zhou Y. Research Progress in Atopic March. Front Immunol. 2020;11(August):1–11. 3. Davidson WF, Leung DYM, Beck LA, Cecilia M, Boguniewicz M, Busse WW, et al. J Allergy Clin Immunol. 2020;143(3):894–913.  No, it isn’t your imagination that your, or your child’s, eczema is itchier at night. Keep reading to find out more and to get some tips on how to alleviate this occurrence:
Cortisol, the body's natural anti-inflammatory. Levels of our hormones go up and down throughout the day for a variety of reasons, depending on their purpose. One of our main hormones, cortisol is high in the early morning to help wake us up and then lowers as the day progresses until it reaches its lowest level at bedtime, allowing us to become sleepy and have a good night’s rest. Cortisol also has anti-inflammatory effects, which helps naturally dampen eczema’s itchiness and flare. When cortisol levels are naturally low, inflammation will rise, and eczema’s affects will be more readily felt. Hence the night-time itch. The aim for all eczema support is lowering inflammation, often with medication such as hydrocortisone. However, identifying triggers for eczema flares whether environmental, stress or nutrition is ideal for keeping eczema flares and inflammation down. However, they can be tricky to pinpoint, and you should get support from a health or nutrition professional. Some foods are known for their anti-inflammatory properties such as oily fish (sardines, mackerel, salmon), nuts and seeds and green leafy vegetables. Other foods such as ultra-processed foods and drinks can have a more inflammatory effect on the body and so it may be wise to limit those, especially in the evening. Keep cool. For many, temperature differences can be a flare trigger. Too cold and the skin dries and becomes chapped and too hot and the blood vessels nearest the skin barrier, expand, triggering inflammatory cells, raising inflammation, and causing an itch. Consider introducing lighter bed clothes or a weighted blanket with a lower tog if you prefer the feeling of being tucked in. Putting towels in the freezer and then applying them to the itchier parts of the body can be soothing. Natural versus man-made material sheets. Man-made sheets including polyester or nylon are less breathable and can result in more sweating which releases natural body salts which can irritate the skin. Consider investing in cotton or linen sheets which are more soothing to the skin. The only exception to that rule is a wool blanket, the natural lanolin it contains can be extremely triggering for eczema and should, therefore, be replaced with a thin fleece blanket or tucked-in, in a way that so that none of the wool touches the skin. Keep dust at bay. Most eczema sufferers have issues with dust mites and simply dusting the bedroom daily and regularly hoovering under the bed may already lessen a nocturnal flare. Rehydrate. We tend to lose a lot of moisture during the night and so we need to think of hydration both from the inside, by ensuring that we drink plenty of water during the day, but also the outside by moisturising before bedtime to help maintain the skin barrier. If you want to know more about what I do and how I can help, please visit my website: www.jessicafonteneaunutrition.com  If you or a loved one has been diagnosed with ‘atopic’ eczema or dermatitis you might be wondering what the ‘atopic’ bit means.
Basically, atopy is the term used to describe those people who develop allergic conditions including allergic rhinitis (including hay fever), asthma and atopic dermatitis/eczema (AD). It usually means that the diagnosed individual has greater immune response, or ‘atopic reaction’ to common allergens including environmental triggers such as pollen and grasses etc.) and food. Atopy versus Allergy Atopy is a Type I hypersensitivity reaction, which means that there is an immediate hypersensitivity to an antigen which results in an over-exaggerated IgE mediated immune response. Allergies are an exaggerated immune response regarding of the mechanism. This means that whilst all atopic reactions are considered allergies, not allergies are considered atopic. Could Irritable Bowel Syndrome (IBS) be atopic? In 2008 scientists published a paper naming a new subtype of IBS, atopic IBS (1). More recent studies appear to confirm the connection between atopy and IBS, with those diagnosed with atopy being at much higher risk for IBS and even Intestinal Bowel Disease. (2,3) Which symptoms are linked to atopy?
Nutrition and atopy Nutrition to support an atopic medical diagnosis will need to be individualised to the food or environmental triggers involved and the specific atopy – skin, gut, lung etc. If you would like to hear more about how nutrition could support your atopy diagnosis, please book in to tell me your story. https://p.bttr.to/2Lh2ifV References 1. Tobin MC, Moparty B, Farhadi A, DeMeo MT, Bansal PJ, Keshavarzian A. Atopic irritable bowel syndrome: a novel subgroup of irritable bowel syndrome with allergic manifestations. Ann allergy, asthma Immunol Off Publ Am Coll Allergy, Asthma, Immunol. 2008 Jan;100(1):49–53. 2. Walker MM, Talley NJ, Keely S. Follow up on atopy and the gastrointestinal tract – a review of a common association 2018. Expert Rev Gastroenterol Hepatol [Internet]. 2019 May 4;13(5):437–45. Available from: https://doi.org/10.1080/17474124.2019.1596025 3. Koloski N, Jones M, Walker MM, Veysey M, Zala A, Keely S, et al. Population based study: atopy and autoimmune diseases are associated with functional dyspepsia and irritable bowel syndrome, independent of psychological distress. Aliment Pharmacol Ther. 2019 Mar;49(5):546–55. |
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