Clinical Nutritionist: Jennifer Caryn Brand, an expert on skin health for kids, talks to us about why elimination diets don’t often work for eczema.
If you know someone with eczema, the chances are they have been put through the diet ring-around a few times.
Jennifer argues that gut health can be a much more significant factor. Tune in to understand what gut health means and when you should and when you shouldn’t eliminate foods.
Grab your Gut Health Tool Kit here.
Jennifer’s Website is www.jennifercarynbrand.com and you can find her on Instagram at www.instagram.com/jennifercarynbrand
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Disclaimer: The information in this Podcast is for educational purposes only. Vaishnavi Sarathy, Ph.D. is an educator, not a doctor, specifically not your child’s doctor. Please consult your physician before implementing any supplement or diet recommendations.
Audio Transcription:
Vaish:
Why elimination diets don’t work for eczema and what does work. Hi, I’m Vaish. And you’re joining me at functional nutrition and learning for kids, a podcast where my intent is to search far and wide for leading researchers and clinicians that work to make equal education, sound nutrition, and a rested mind accessible to every child.
I’m a proud mother to a non-speaking teen with down syndrome and autism was only a few years ago that I was frustrated running from pillar to post to find the next therapy, the next diet that would help my son, I felt as though I was hitting a wall with communication and died and my son at the time was dysregulated. And from the outside, unresponsive to my attempts at teaching and communication.
Through many lessons, many many lessons learned about the gut, the brain, and the value of assuming intelligence, said travels his neurodiverse path as a happy regulated, almost published for it with fiery ambition. And in order to convey these bite-sized learnings one by one to you, This podcast was born. Now today’s learning is about eczema, skin issues, and gut health. And as you get started, I have a free resource for you and this is my own special gut health toolkit.
This is available free at functionalnutritionforkids.com/guthealth. Again, that’s functional nutrition for kids.com forward-slash gut health. I’m really excited to have Jennifer brand here today, Jennifer is an integrative and clinical nutritionist and she’s the CEO of Jennifer Karen brand nutrition LLC. She specializes in childhood skin rashes, food allergies, sensitivities, and cut problems.
Now conventional means fell flat and didn’t adequately address Jennifer’s own struggle with gut problems, allergies, and disordered eating, which has actually increased by elimination diets. And her father, mother, and brother also had battles with different skin conditions, including sorry acids, and vitiligo, and feeling frustration. These experiences inspire Jennifer to search for a different approach.
I love her different approach because she uses an approach that doesn’t remove more foods from the diet, and an approach that doesn’t include stronger prescription steroid creams and so on. And she’s a relentless detective, putting her strong knowledge of nutritional biochemistry to work for her clients to identify what’s driving the symptoms, and what’s driving the health problems to address the root cause.
She’s a faculty member of learn skin. And her work has been featured in peer-reviewed scientific journals, as well as podcast summits and presentations. Hi, Jennifer, welcome to functional nutrition and learning for kids. I have been super eager to speak with a skin expert for such a long time. And so glad to have you here.
Jennifer Caryn Brand:
Thank you so much. I’m thrilled to be here.
Vaish:
Awesome. Can you tell us a little bit? Can we jump right in into what? What causes skin issues in kids? And I know there may be many causes. But what are the common root cause issues that you see?
Jennifer Caryn Brand:
Oh, that’s a good question. And so when we are starting out exploring what’s happening on the skin, of course, we want to check out what goes in what goes on. And you know what’s around. So from that perspective, I think most people start out with diet, you know, and they take foods out of the diet, if they’re having rashes, I’m assuming that that’s going to be the root cause of the problem. So diet is important. So number one, when it comes to diet, we want to have a diet of whole real foods.
The body runs off of nutrients from foods we eat, and when those nutrients are missing, we develop imbalances and symptoms and health problems can follow including problems on the skin. So this is an example of why elimination diets which are commonly used to help address skin rashes are actually contrary to what we are led to believe can make things worse. And so you know, if you are already on a diet of whole real foods, your child’s eating a diet of whole real foods and there’s still problems on the skin.
This stop relying on diet, especially if there aren’t any identified food allergies. If we’re talking about food sensitivities, for example, that’s a sign not diet, we need to take a look at the gut and I know we’ll get into that. You know, we also want to look at what is around there can be lots of environmental factors that could be triggering on a lot of kiddos have environmental allergies, there could be mold exposure.
We do need to take a look at what’s in the environment and also what goes on. So our skin barrier plays a large role in our skin health and whether or not we develop rashes like eczema, for example. So we want to do things to protect the skin barrier that may involve using something topical.
A common treatment for skin rashes from a conventional medical perspective are steroids. Which don’t really resolve the root cause of the problem, they may help with symptoms temporarily. So we’ve got, again, look at what goes in what’s around and what goes on, you know, but really, when it comes down to it, by the time that people have found me, they’ve explored all of these things, and they’re not solving the problem. So what I find is the primary root cause of skin rashes and skin conditions in the little ones are problems in the gut microbiome through that skin, gut access.
Vaish:
That’s, that’s great. And my next question was going to be about is it always the gut? And I think you already answered that that’s probably predominantly The reason. And it’s interesting that from a conventional perspective, at least, that’s not often where people go first. I don’t know that people ever go there.
Jennifer Caryn Brand:
I, but I get you to know, by the time people find me, a lot of people, this is new to them, and they’re not aware of the connection. The other thing too, a lot of parents and I think you probably get this too in your practice, but by the time people find us, I think especially in the functional medicine world, they’ve exhausted a lot of those conventional means they people have done a lot of their own research, they have a sense of Okay, I think probiotics might be helpful, or I need to heal the gut, but I don’t really know what that means right now. So I think that you know, from what I see, there always is a gut component at the root of the issue, and there might be some other factors playing a role, too.
You know, genetics also can play a role. I don’t believe that anybody is genetical, like, predisposed to struggle for the rest of their life with something like a mom, right? But, but it might, you know, if somebody has a family history of something like that, or allergies for that matter, it’s more likely that the child can struggle with something similar, but it’s not a given. And, you know, when it comes down to it, by taking a look at what’s happening in the gut microbiome, we can really modulate what’s happening on the skin.
Vaish:
And that’s always a positive thing, because there’s so much that can be done. And, you know, genetics is not even close to being a death sentence. We’ll, you talked about elimination diets. And I’m curious, so we, we talked about the, you know, where conventional medicine can fall short micron.
If you think about where functional medicine can fall short, you’re absolutely right, because, and I’m pretty sure I’ve done this myself, but when we tend to go die, die die, right? Because for us a lot of times that help equals die. And, and that may be true when we’re talking about cleaning up from a very inflammatory diet in the very beginning. But then, where have you seen this go overboard? Can you give us an example of where this is like too much stop right now?
Jennifer Caryn Brand:
Sure, sure. So a lot of the clients I work with are on very restrictive diets, you know, beyond gaps beyond the, you know, taking histamines and salicylates, and all of these things out of the diet. But I want to back up for just like a little bit like a real elimination diet, like a true elimination diet is not something that’s done long term.
The idea is that you take potentially triggering foods out of the diet for like a month at most, and you want to identify which foods are potentially triggering symptoms. So after that amount of time, you want to reintroduce foods one at a time in a very controlled manner to see if they trigger symptoms. But what’s missed in this process is that food isn’t the root cause of the problem. So when there are food sensitivities, so this is different than your food allergies, which the food allergies are the IGA ease, they can result in anaphylaxis. When serious.
The IGA G’s are food sensitivities, they’re not life-threatening, they can result in symptoms and some of those similar to allergies, but they can cause skin rash flares, for example. but when we are talking about these food sensitivities, the root of the issue here is actually increased gut permeability, which is leaky gut.
When we have problems in the gut microbiome dysbiotic finding so abnormal bacteria have all the bugs that live in there, there’s bacteria, fungus, parasites, you know, all of these different things live in there, and they’re supposed to be there, but when they get out of balance, we can get some inflammation, which causes the gut lining to get permeable or leaky. food particles get out into the bloodstream, trigger the immune system to react. So this is why we’re reacting to foods when they’re the IGA G’s.
The other thing that’s happening is that it’s not just food getting out into the bloodstream, it’s toxins from these gut bugs. And so those could be potentially triggering as well. So what I tend to see are people that are on an elimination diet and typically, you know, if you take foods out of the diet, somebody might feel better for a little while.
Then the symptoms come back. And then they take more foods out of the diet thinking okay, well it worked before now I just have to take this out also. So the diet continues to get smaller and smaller, these elimination diets go on long term, way longer than a month. And then we start to risk nutrient deficiency and certainly nutrient insufficiency.
Yeah, and I work with a lot of my clients are babies and moms that are breastfeeding. And so we have breastfeeding moms that are now on an elimination diet, and a baby that is now on an elimination diet. And we end up with other health problems, because we are not addressing the root cause of the problem, which is that gut hyperpermeability, and we’re taking nutrients out of the diet, which certainly is contraindicated for somebody who is nursing, and a baby that is growing. So I do see symptoms get worse, including a worsening of skin rashes, as the diet gets smaller and smaller.
Vaish:
So well said, Thank you. And I think I and I’m just going to restate because you said so many wonderful things, I’m going to restate a few things that stood out for me, one of them is that food is not the root cause of the issue. It’s the inflammation may be caused by food temporarily, but maybe not caused by food, that that and it’s the immune response to the food, the gut permeability, caused by many factors. In some cases, that could be food. But that is the thing.
In increasing food elimination, increasing dietary elimination, or maybe let me put that another way, reducing the number of foods that you eat, has a pretty large cascading effect on multiple things, including nutrient deficiency, it could cause more leaky gut, because you’re not getting the nutrients to maintain your, you know, maintain your body or, you know, maintain your by yourself. So there’s so much that could happen. And I remember, you know, a lot of times parents will start with the functional medicine, and then they’re on their own journey.
I remember going to many of these, many of the autism medical forums and talking to parents that have been on gaps and SCD for four or five years and I wouldn’t even while it’s a pretty restrictive diet, there can be more restrictive diets, and even gaps in my opinion, in my mind is not a diet to be on for four years. I mean, you do need to because it is pretty restricted when the carbs that you can eat, and therefore it’s going to be reducing microbiome diversity at some point. yes, yes. So
Jennifer Caryn Brand:
Yeah, that’s a reality we should talk about that for a minute. Because a lot of the clients that I see also, you know, they start some of the foods that tend to be triggering for a lot of like high histamine foods that will fill ate foods. And if you’re sensitive to natural food, chemicals like that, that does go back to gut issues also. But these foods are these natural chemicals are in otherwise healthy foods. So we end up on these diets that start to get limited in whole grains or complex carbs and prebiotic foods.
So fibrous foods, like all those fruits and vegetables. And just like you mentioned, all of those foods are the ones that really help promote gut microbiome diversity and a diverse gut microbiome is what we want, because that confers health benefits, including lower risk for allergic conditions like eczema, like food allergies, like environmental allergies, so it’s often all of the foods that we need most for the health of our not just our body, but our gut microbiome that tend to be taken out on these diets. Right.
Vaish:
So what about the million-dollar question in my mind that he’s What about gluten, dairy and sugar?
Jennifer Caryn Brand:
So okay, so added sugars, I absolutely recommend keeping out of the diet. Sugar is not good for the skin, it spikes insulin, which ends up inflammatory. Sugar can disrupt the skin barrier, the skin microbiome. excess sugar also disrupts what’s happening in the gut microbiome. So too much added sugar promotes the growth and things we don’t want in there. So sugar, I recommend added sugars keeping out of the diet, gluten and dairy. Okay, so these are the tricky ones. I’ve always been up until more recently, no gluten, no dairy. But so let’s start with dairy. And I don’t believe that anybody needs to be drinking glasses of milk every day.
You know, baby cows drink milk. That’s about it. So aside from that, um, there also has been more research in recent years that keeping allergenic foods out of the diet actually contributes to the development of food allergies down the line. So when it comes to dairy, that should be introduced along with other foods when baby starts eating solids around six months of age I’m I recommended in the form of like some yogurt or some cheese just to get the dairy in to prevent the development of an allergy to it.
Same goes for gluten you know gluten there’s research at least you know in the United States it I think it could be different elsewhere I don’t know that we necessarily know this right but I have clients that can’t eat gluten-containing foods here in the US they’re overseas and they’re fine but that said you know if somebody doesn’t have celiac or doesn’t notice a reaction to gluten for example, again he introducing that into the diet can be helpful for the mention of food allergies.
Gluten is however again at least in the United States inflammatory to the gut. So there are some other issues around it from that perspective and you know, I think from the perspective of you know, neurological behavioral concerns that it’s something that you want to keep out Same thing with dairy so I think it depends on the person like it for my clients if it’s I don’t want to say just eczema just allergies but you know, if it’s something like there aren’t neurological concerns, there really aren’t any health concerns it’s you know, they’re flaring with skin rashes.
They don’t notice a difference with dairy or without dairy with gluten or gluten. They’ve had allergy testing they’re not sensitive you know are allergic to it, then keeping it in the diet a little bit here and there as okay, but I really think it’s a case by case basis because
Vaish:
I like that different. Yeah, and I like that so you’re just saying don’t just blindly be gluten-free if I mean if you’ve tried if you’ve given it a fair try and reintroducing it hasn’t done anything. I’m actually with you on that though. For my kids with neuroinflammation on zero gluten and dairy. But yeah, that is not the case if the kid is is is not having neuroinflammatory symptoms. I’m okay with fermented gluten and dairy.
I find that sourdough. Like for me, being on sourdoughs actually better than not being than being complete. I actually feel better. That’s interesting. Yeah. Yes, I find like my gut is happier being on a little bit of sourdough naturally fermented not the eastern one, but like the ones that have been Yeah, I think for a few days with a starter, but yeah, yeah. So having said that, that’s not the position I hold for the kids with pan’s pandas or neuroinflammatory conditions. But and coming to neuroinflammatory conditions and autoimmune, is there a difference in the way that you treat skin conditions that have an autoimmune component?
Jennifer Caryn Brand:
Question? Um, yes, and no, from the perspective if it’s an autoimmune component, I do look more closely at is gluten appropriate is dairy appropriate. So when is at when we have something autoimmune, there are a few more diet strategies or interventions that I think might be helpful. From the perspective of addressing root cause issues?
I still would start with exploring what’s happening in the gut. And the gut microbiome. Yeah. So when we have an autoimmune condition, you know, what we’re looking at in our genes. And, you know, talking about genetics, again, we all have wonky genes, I mean, we just do and they either get turned on or they don’t, so they’re triggered they and that can be anything I mean, it can be stress, it can be something environmental, it can be, you know, something dietary, so something turns that gene on. And then to perpetuate the autoimmunity, we have got hyperpermeability or leaky gut. So we really can’t change our genes.
They are what they are, but we can identify potential triggering factors and help mitigate those, and we can also explore what’s happening in the gut, resolve imbalances in there and seal up the leaky gut.
Vaish:
Makes sense, coming from a parent perspective, if if you have a parent of a child that’s really struggling, the child is really struggling with, you know, rashes that are keeping them awake at night, and I just have a lot I’ve seen a lot of kids that are both on the autism spectrum and really struggling with eczema, what are three things that parents can do to start off their child’s healing journey.
Jennifer Caryn Brand:
So in particular, so if a child is struggling to sleep at night because they’re itchy, and this doesn’t just happen because someone is laying there and doesn’t have anything else to think about, they’re actually biochemical changes that happen in the body at night, the skin barrier becomes more dysfunctional and loses more moisture. So something that we can do is moisturize before bed. You know, parents can do that with some of my favorite Ways to moisturizer omega-six fatty acids, the Omega sixes,
Vaish:
the topicals. Are you saying topical? Yeah, topical.
Jennifer Caryn Brand:
So omega six is like a hobo oil, sunflower seed oil, Rosehip, and hemp seed oil are good omega sixes that you can use topically and you know, give her a little one a massage before bed. It’s calming, it’s relaxing with the moisture. So that’s a strategy and there’s more histamine release at night blood vessels are dilating and constricting so we get more histamine, which can make us itchy. There are natural antihistamines that somebody could use that require certain supplements quercetin is a national antihistamine it’s found naturally in foods like kale and broccoli and grapes.
It’s hard to eat enough of those foods to get a therapeutic dose of it. But so there are natural supplements that somebody can use and also to if, if a child is not sleeping like sleep is a significant lack of sleep but I should say is a significant source of stress on the body and stress can contribute to autoimmunity to skin rashes to rash flares, right that inflammatory cycle that causes all those health problems. So if your child is itchy at night, don’t be afraid you know take a bet to give them a Benadryl you know to use something over the counter.
I had a client who told me once he said to me I had to break the glass it was an emergency I was like what are you talking about? He had to use steroid creams because he was so uncomfortable and I just loved that saying it was like break the in case of an emergency break the glass I like it yeah that and so so I tell my friends like if you can’t sleep at night you know if your child is itchy it’s okay to use an over the counter antihistamine and so something else there was a study that I read that showed that watching a funny movie before bed actually helped promote sleep in children that had rashes like yeah so so things that kind of can elevate the mood can be helpful as well.
Vaish:
That’s nice. So to summarize, you know, some topical lotions, not lotions, but oils that are omega three, omega-six oils to omega, and then you said something that’s an antihistamine, which could either be a natural or an over-the-counter and histamine and something to elevate the mood to Yeah, yeah, yeah. And I go ahead.
Jennifer Caryn Brand:
Oh, I was gonna say it’s tricky like that itch can be really persistent. And unfortunately, it’s hard to manage zinc oxide like cream with like zinc oxide. Some parents have found diaper creams helpful to use topically on the rashes and can be a little bit drying. But it can help with itch also. So yeah, so it’s, it’s more of symptom management. I find over time that, you know, once we start addressing the root cause of the problem looking at what’s happening in the gut, addressing those imbalances, you know, the rashes start to subside, the itching starts to subside to you over time.
Vaish:
That’s good to know, how long does it take? I know it’s a loaded question. But to go from this too, to just being at peace and calm and a rest, you know, just a calm skin calm mind.
Jennifer Caryn Brand:
Good question. Um, I like to say, on average, six months, however, I have had clients that have gotten great results in a few months. Sometimes I have clients that start seeing results in a few weeks, some people I’ve been working with over a year. So everybody’s different, it really varies. But I would say on average, within six months, people are, you know, at least starting to feel better. They’re on the right track. And then what I typically see and it’s not like the rash is just in the itching stops overnight, you know, it’s sort of the flares become fewer and farther between when they do happen.
They’re not as severe. And when they do happen, they go away faster. So they kind of Peter themselves out. And then it really depends, too, I found that with some types of gut microbiome imbalances, like, for example, when I see h pylori on a stool test, that’s a bug in particular that can make people each year some gut bugs produce histamine, you know, which is that itchy, immune, modulating chemical that the immune system releases in allergic responses.
Some gut bugs produce histamine, which I find to be a major source of histamine overload so you know, if you’re someone that’s finding that your kid is sensitive to histamine foods, I find that you know, rather Yes, you can take some of those higher histamine foods out of the diet, but Oh, like avocado bone broth. So some of those foods that we are, you know, taught that will help us heal the gut are actually not necessarily appropriate. fermented foods are high histamine, you know, so we have all of this stuff going on. Yeah, yeah. But you know, addressing what’s happening in the gut can really make a difference, the holistically and what we’re seeing on the skin.
Vaish:
So at that point, even if they’re looking for probiotics, then you want to look at low histamine probiotics.
Jennifer Caryn Brand:
Yes, yeah. So we want to look at that, too.
Vaish:
Thank you. That was so much good information. Jennifer. Thank you. Where can parents reach you if they want to work with you?
Jennifer Caryn Brand:
So my website is Jennifer, Karen, brand calm. Karen is spelled a little funny. It’s C A R Y N. But if you type it in a regular way, k r e m, that’ll take you to my website, too. That’s good. Yeah. So Jennifer, Karen brand. Also, I’m on Instagram, Jennifer Karen brand with the C A R Y N. I do a lot of posting their educational resources. And I have a ton of resources on my website, too, for folks that might be helpful.
Vaish:
And I link to your podcast and Instagram on the show notes. Great. Thank you so much. Thanks for being here. Jennifer. It was it was awesome.
Jennifer Caryn Brand:
Thank you for having me. It was great.
Vaish:
So friend, I hope you learned a lot today. Don’t forget to download my personalized gut health toolkit at functionalnutritionforkids.com gotta talk to you next week. Until then, bye.
