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Relationship between rosacea and dietary factors: A multicenter retrospective case-control survey.

J Dermatol. 2019 Jan 18;:

Authors: Yuan X, Huang X, Wang B, Huang YX, Zhang YY, Tang Y, Yang JY, Chen Q, Jian D, Xie HF, Shi W, Li J

Although patients with rosacea often consult dermatologists for dietary factors that might be related to their skin disorders, few studies have been conducted to research the relationship between rosacea and dietary factors. The purpose of this study was to evaluate the potential relationship between rosacea and diet among the large Chinese population with rosacea, which would provide dietary guidelines for patients with rosacea. A multicenter case-control study was conducted. The feeding frequency 2 years before the occurrence of rosacea was collected by standardized questionnaires. Multiple logistic regression analysis was used to calculate risks related to the diet. One thousand three hundred and forty-seven patients with rosacea and 1290 controls were enrolled in our study. We found that high-frequency intake of fatty food and tea presented a positive correlation with rosacea, while high-frequency dairy product intake showed significant negative correlation with rosacea. Sweet food, coffee and spicy food appeared to be independent of any subset of rosacea in our study. However, high-frequency dairy product intake showed a borderline beneficial effect on rosacea severity. We further analyzed the correlation between diet and the subtype of rosacea. We found that high-frequency fatty intake was associated with erythematotelangiectatic rosacea (ETR) and phymatous rosacea, while high-frequency tea intake was only associated with ETR. In addition, high-frequency dairy product intake showed negative correlations with ETR and papulopustular rosacea. Rosacea is associated with some dietary factors, and our study is valuable in establishing dietary guidelines to prevent and improve rosacea.

PMID: 30656725 [PubMed - as supplied by publisher]

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This paper is not a double blind, placebo controlled study on rosacea and diet. As it explains, it was "collected by standardized questionnaires." So the results are based upon anecdotal reports, and none of these 'patients with rosacea' were in a clinical laboratory with controls on what they ate and drank. They simply answered questions on a form. How can anyone be sure that the patients answered correctly or omitted pertinent data?  While the data collected may be helpful, since there are rarely any papers on diet and rosacea, at least they have made an attempt at the task which is monumental, and the paper is interesting, to say the least.  

So when the report says "high-frequency dairy product intake showed negative correlations with ETR and papulopustular rosacea" does it differentiate between ice cream with heavy amounts of sugar or just plain heavy cream without sugar?  There is a big difference. If you took one hundred rosaceans and had them just eat heavy cream for a week and see the results with another group that just ate ice cream for a week you might notice differences. Or compare one hundred rosaceans eating just cheese for a week with a group of a hundred rosaceans who just eat milk shakes.  As for the fatty food and tea, again, there really aren't any controls, and the data could be biased since it is anecdotal. Possibly the one good item about this report is that it may stimulate more papers on diet and rosacea. Most rosaceans have a gut feeling about their rosacea, while other rosaceans report that diet has no effect on their rosacea. 

A real clinical study on rosacea and diet hasn't been done yet. Wouldn't it be something if a non profit organization for rosacea patient advocacy could get 10,000 rosacea sufferers together into one group and conduct their own research (say each one donated $1) on diet and rosacea. 

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