Impact of the Mediterranean Diet and Physical Activity on the Severity of Atopic Dermatitis

Abstract: Background: Atopic dermatitis (AD) is a common chronic inflammatory skin condition influenced by genetic and environmental factors. The role of lifestyle on AD remains unclear. This study explores the association between adherence to the Mediterranean diet (MD), physical activity (PA) levels, and AD severity. Methods: A cross-sectional study was conducted on AD patients. Disease severity was assessed using the Eczema Area and Severity Index (EASI) and the Patient Oriented Eczema Measure (POEM) scores, among others. MD adherence was evaluated using the Prevention with Mediterranean Diet (PREDIMED) questionnaire, and PA levels via the International Physical Activity Questionnaire (IPAQ). Results: 124 AD patients with moderate-to-severe disease (EASI 11.44 ± 11.64, POEM 12.46 ± 23.12) were included. MD adherence was moderate (7.55 ± 1.93), as were PA levels (2,265.34 ± 3,098.45 METs). Higher MD adherence was associated with lower disease severity ( P < 0.0001), particularly with greater consumption of vegetables, fruits, legumes, and fish ( P < 0.05). Lower PA ( P = 0.05) and sedentary behavior ( P = 0.02) were linked to greater severity. Lower MD adherence ( P < 0.0001) and reduced PA ( P = 0.02) were also related to increased pruritus. Conclusion: AD patients showed low adherence to both the MD and PA. The MD could be an appropriate dietary pattern for AD, and combining this with increased PA could offer additional benefits.