Your food may not need to be raw, but some of it definitely needs to be alive. No, I'm not talking about some strange throwback practice. (No live goldfish!)
I'm talking about probiotics. Probiotics are live bacteria. They're also known as "good" bacteria, and you'll find them in foods such as yogurt with live cultures. They're also sold over-the-counter as supplements. There's been a lot of research in the last several years on the gut microbiome. This refers to the type of bacteria that live in your gut. It turns out that there's bad bacteria, and there's good bacteria. And you need the good bacteria in your system to help you stay healthy. Studies of children with eczema have shown that they have higher levels of certain harmful bacteria in their gut. They also have less of a variety of bacteria in their guts (as compared to children without eczema.)
In light of these findings, researchers have wondered whether giving children with eczema a variety of good bacteria would help "repopulate" their guts. And if these good bacteria repopulated the gut, would that help decrease the inflammation in their skin?
While not all studies have shown that this approach works, a number of studies have found promising results. In 2014, researchers performed a meta-analysis, which is an analysis that combines the results of multiple studies.
The analysis concluded that probiotics did show promise in the treatment of children and adults with eczema. In adults and children over the age of 1 year, use of probiotics that contained a mixture of different bacterial species helped to reduce the SCORAD index (a measure of eczema severity) in some patients.
Based on this research, what probiotics would be best? At this time, I can't recommend a particular supplement. That's because the studies have used all sorts of different strains of bacteria, at all sorts of doses. Further studies are trying to figure out the optimal combination and dose of good bacterial strains. I can, however, recommend natural probiotics. These are foods that contain living strains of bacteria. Every culture seems to have a prized probiotic food. Germans have sauerkraut, Japanese have miso, Koreans have kimchi, and Indians (and many others) have yogurt. Other cultures consume kefir, a fermented dairy drink, while many cultures consume vinegar and pickles.
Foods that contain live cultures, such as kefir, miso, kimchi, and yogurt, serve as natural probiotics.
You can buy these at the grocery store – look for yogurt with active cultures or pickles that are unpasteurized – or you can learn to make your own. I've learned how to make some of these, and I'll share some tips in future posts.
Of course, you can't just consume good bacteria and stop there. It's important that you feed those bacteria the right type of food. In medical terms, this means consuming prebiotics. Some researchers refer to prebiotics as "fertilizer" for good bacteria. They're substances that are found naturally in different types of foods, such as certain vegetables. The fiber in certain fruits and vegetables is considered a prebiotic.
The fiber found in certain fruits and vegetables is considered a prebiotic.
It turns out that ingesting good bacteria along with prebiotics, a combination known as synbiotics, may also be a valuable approach. In another analysis of multiple studies, the use of synbiotics showed promise in the treatment of atopic dermatitis in adults and children over the age of 1 year.
While not all studies showed this effect (and certainly not all patients benefited), some did improve with this addition to their treatment.
These results are promising enough that I recommend adding more vegetables and fiber to your diet, since these are good sources of prebiotics. And why I now also recommend that at least some of your food be "alive."
Dr. Rajani Katta is the author of Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet. To receive future updates on preventive dermatology and the role of diet, sign up here.