Dietary Habits in Japanese Patients with Alopecia Areata

Figures & data

Table 1 Demographic Characteristics and Intake of Nutrients and Foods in Controls and Patients with Alopecia Areata (AA)

	Control (n = 70)	AA (n = 70)	p values
Sex	Male 19	Male 19	1^c
	Female 51	Female 51
Age (years)^a	49.0 (35.25–61.75)	47.5 (35.5–58.75)	0.144
Body mass index (kg/m^2)^a	20.22 (19.21–22.38)	21.86 (20.0–24.17)	0.00506**
Energy intake (kcal/day)^a	1778 (1461–2010)	1602 (1305–2005)	0.287
Nutrients
Animal protein (% energy)^a	8.746 (6.625–10.009)	8.823 (7.165–10.284)	0.730
Vegetable protein (% energy)^b	6.50 ± 1.03	6.44 ± 1.19	0.687
Animal fat (% energy)^a	12.69 (10.76–15.90)	13.25 (9.16–15.54)	0.314
Vegetable fat (% energy)^a	15.10 ± 3 0.37	15.47 ± 3.89	0.503
Carbohydrate (% energy)^b	50.45 ± 7.40	51.45 ± 8.44	0.467
Na (mg/kcal)^a	2.13 (1.97–2.56)	2.27 (2.05–2.65)	0.377
K (mg/kcal)^a	1.35 (1.10–1.69)	1.29 (1.13–1.62)	0.861
Ca (μg/kcal)^a	283.0 (231.1–346.0)	272.0 (213.5–347.5)	0.748
Mg (μg/kcal)^a	133.5 (114.5–160.8)	127.2 (110.1–158.2)	0.472
Pi (μg/kcal)^a	549.5 (488.6–642.1)	552.2 (462.8–652.5)	0.627
Fe (μg/kcal)^a	4.27 (3.43–5.07)	4.08 (3.41–5.04)	0.704
Zn (μg/kcal)^a	4.41 (3.94–4.85)	4.35 (3.86–4.93)	0.386
Cu (μg/kcal)^a	0.603 (0.521–0.670)	0.582 (0.513–0.676)	0.874
Mn (μg/kcal)^a	1.65 (1.41–1.97)	1.64 (1.34–2.38)	0.311
Retinol (μg/kcal)^a	0.256 (0.139–0.370)	0.174 (0.137–0.293)	0.114
β-carotene (μg/kcal)^a	1.76 (1.03–2.95)	1.92 (1.14–3.06)	0.464
Vitamin D (ng/kcal)^a	5.18 (3.47–7.77)	5.49 (3.55–8.52)	0.953
α-tocopherol (μg/kcal)^b	4.145 ± 1.009	4.350 ± 1.093	0.178
Vitamin K (μg/kcal)^a	0.165 (0.116–0.220)	0.137 (0.105–0.216)	0.364
Vitamin B1(μg/kcal)^a	0.419 (0.369–0.499)	0.420 (0.349–0.514)	0.520
Vitamin B2(μg/kcal)^a	0.730 (0.634–0.863)	0.716 (0.591–0.865)	0.911
Niacin (μg/kcal)^a	9.53 (8.01–10.88)	9.48 (8.03–11.14)	0.497
Vitamin B6(μg/kcal)^a	0.676 (0.587–0.805)	0.690 (0.531–0.827)	0.547
Vitamin B12 (ng/kcal)^a	3.94 (2.98–5.77)	3.96 (3.17–5.84)	0.986
Foric acid (μg/kcal)^a	0.176 (0.142–0.237)	0.172 (0.147–0.232)	0.865
Panthotenic acid (μg/kcal)^a	3.62 (3.05–4.11)	3.52 (3.00–4.03)	0.717
Vitamin C (μg/kcal)^a	55.3 (40.8–77.9)	61.1 (49.2–88.3)	0.0211*
SFA (% energy)^b	8.016 ± 2.134	7.596 ± 2.083	0.216
MUFA (% energy)^b	10.298 ± 2.082	10.126 ± 2.370	0.594
n-3PUFA(% energy)^a	1.21 (1.06–1.45)	1.26 (1.03–1.55)	0.673
n-6PUFA(% energy)^b	5.302 ± 1.046	5.509 ± 1.287	0.274
Cholesterol(μg/kcal)^a	207.7 (164.6–250.9)	211.3 (168.8–247.4)	0.704
Dietary fiber (mg/kcal)^a	6.281 (5.19–8.12)	6.161 (4.80–7.85)	0.874
Alcohol (% energy)^a	1.886 (0.105–7.595)	0.0182 (0–3.009)	0.058
Foods
Cereals (mg/kcal)^b	183.90 ± 67.15	186.44 ± 64.89	0.803
Potatoes (mg/kcal)^a	13.25 (7.72–31.59)	16.34 (9.78–34.53)	0.824
Pulses (mg/kcal)^a	1.80 (1.07–3.17)	2.02 (1.30–4.60)	0.093
Green and yellow vegetables (mg/kcal)^a	59.31 (34.76–83.83)	56.33 (30.60–90.18)	0.949
Other vegetables (mg/kcal)^a	75.54 (54.64–105.52)	87.86 (57.44–22.99)	0.512
Fruit (mg/kcal)^a	50.65 (28.56–86.91)	67.59 (23.39–115.67)	0.0313*
Fish and shellfish (mg/kcal)^a	29.85 (20.49–47.44)	30.06 (22.23–44.76)	0.842
Meat (mg/kcal)^a	46.29 (36.10–57.04)	43.32 (29.80–57.64)	0.109
Eggs (mg/kcal)^a	15.88 (10.91–28.01)	20.83 (12.42–29.54)	0.505
Dairy products (mg/kcal)^a	79.58 (28.40–107.61)	73.32 (24.59–12.70)	0.939
Oils and fats (mg/kcal)^b	6.11 ± 2.67	6.63 ± 2.93	0.204
Confection (mg/kcal)^a	26.18 (13.02–49.69)	25.39 (15.76–41.72)	0.819
Beverages (mg/kcal)^a	427.85 (246.2–542.6)	382.17 (276.3–595.2)	0.574
Seasonings and spices (mg/kcal)^a	101.85 (76.49–142.74)	124.67 (86.55–73.25)	0.139
Sugar/sweeteners (mg/kcal)^a	1.80 (1.07–3.17)	2.01 (1.30–4.60)	0.093

Notes: ^aData provided as the median (interquartile range), analyzed by Wilcoxon signed rank test. ^bData provided as the mean ± standard deviation, analyzed by paired t-test. ^cFisher’s exact test was used to test the significance of difference in frequency distribution. *Significant differences at p < 0.05. **Significant difference at p < 0.01.

Abbreviations: SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid.

Table 2 The Association of Alopecia Areata with Each Variable Analyzed by Multiple Logistic Regression Analysis

	Odds Ratio	95% Confidential Interval	P values
(Intercept)	0.0438	0.00188–1.02	0.0517
Age (years)	0.986	0.963–1.01	0.232
Sex (M=1, F=2)	1.17	0.512–2.66	0.715
Body mass index (kg/m^2)	1.15	1.02–1.29	0.0207*
Vitamin C (μg/kcal)	1.01	0.99–1.02	0.522
Fruit (mg/kcal)	1.00	0.995–1.01	0.420

Note: *Statistically significant at p < 0.05.

Table 3 Correlations of Severity of Alopecia Tool with Intakes of Nutrients/Foods in Patients with Alopecia Areata Using Spearman Correlation Coefficients

	Rho	p		Rho	p
Age (years)	0.0435	0.72	Nutrients II
Body mass index (kg/m^2)	0.218	0.07	SFA (% energy)	−0.0927	0.445
Energy intake (kcal/day)	−0.134	0.27	MUFA (% energy)	−0.0211	0.862
Nutrients I			n-3PUFA (% energy)	−0.161	0.182
Animal protein (% energy)	−0.0408	0.737	n-6PUFA (% energy)	−0.00796	0.948
Vegetable protein (% energy)	−0.199	0.0986	Cholesterol(μg/kcal)	−0.0727	0.55
Animal fat (% energy)	−0.0451	0.711	Dietary fiber(mg/kcal)	−0.0628	0.605
Vegetable fat (% energy)	−0.0441	0.717	Alcohol (% energy)	0.0711	0.558
Carbohydrate (% energy)	−0.168	0.163	Foods
Na (mg/kcal)	0.0624	0.608	Cereals (mg/kcal)	−0.166	0.17
K (mg/kcal)	−0.0416	0.732	Potatoes (mg/kcal)	−0.0711	0.559
Ca (μg/kcal)	−0.0481	0.692	Pulses (mg/kcal)	0.133	0.273
Mg (μg/kcal)	−0.0199	0.87	Green and yellow vegetables (mg/kcal)	0.0104	0.932
Pi (μg/kcal)	−0.0812	0.504	Other vegetables (mg/kcal)	−0.0384	0.752
Fe (μg/kcal)	−0.0842	0.488	Fruit (mg/kcal)	−0.124	0.306
Zn (μg/kcal)	−0.172	0.156	Fish and shellfish (mg/kcal)	0.112	0.355
Cu (μg/kcal)	−0.117	0.334	Meat (mg/kcal)	−0.0605	0.619
Mn (μg/kcal)	−0.104	0.393	Eggs (mg/kcal)	−0.128	0.292
Retinol (μg/kcal)	0.272	0.0228*	Dairy products (mg/kcal)	0.0344	0.778
β-carotene (μg/kcal)	0.031	0.799	Oils and fats (mg/kcal)	0.0895	0.461
Vitamin D (ng/kcal)	0.0364	0.765	Confection (mg/kcal)	0.014	0.909
α-tocopherol (μg/kcal)	−0.0315	0.796	Beverages (mg/kcal)	−0.0221	0.856
Vitamin K (μg/kcal)	−0.0552	0.65	Seasonings and spices (mg/kcal)	−0.0788	0.516
Vitamin B1(μg/kcal)	−0.204	0.0903	Sugar/sweeteners (mg/kcal)	0.133	0.273
Vitamin B2(μg/kcal)	−0.0875	0.471
Niacin (μg/kcal)	0.0365	0.764
Vitamin B6(μg/kcal)	−0.0364	0.765
Vitamin B12 (ng/kcal)	0.0984	0.418
Foric acid (μg/kcal)	−0.00861	0.944
Panthotenic acid (μg/kcal)	−0.0832	0.494
Vitamin C (μg/kcal)	−0.087	0.474

Note: *Statistically significant at < 0.05.

Abbreviations: SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid.

Table 4 The Predictive Factors for Severity of Alopecia Tool Analyzed by Linear Multivariate Regression Analysis

	β Coefficient	Standard Error	t	p
(Intercept)	25.33	25.78	0.983	0.329
Age	−0.0297	0.214	−0.139	0.890
Sex	−3.97	7.994	−0.497	0.621
Body mass index (kg/m^2)	−0.291	0.866	−0.336	0.738
Retinol (μg/kcal)	40.82	18.44	2.214	0.0303*

Note: *Statistically significant at p < 0.05.

Table 5 Demographic Characteristics and Intake of Nutrients and Foods in Mild (Severity of Alopecia Tool [SALT] ≦25) and Moderate to Severe (SALT > 25) Alopecia Areata Groups

	Mild (n = 54)		Moderate to Severe (n = 16)		p values
Sex	Male	14	Male	5	0.752^c
	Female	40	Female	11
Age (years)^a	48.50 ± 16.38		47.94 ± 18.20		0.907
Body mass index (kg/m^2)^b	21.93 (19.54–24.40)		21.86 (21.06–23.75)		0.654
Energy intake (kcal/day)^b	1606 (1361–2028)		1545 (1221–1853)		0.390
Nutrients
Animal protein (% energy)^a	8.578 ± 2.786		8.855 ± 4.296		0.760
Vegetable protein(% energy)^a	6.507 ± 1.272		6.196 ± 0.831		0.362
Animal fat (% energy)^a	12.77 ± 4.00		13.05 ± 5.88		0.830
Vegetable fat (% energy)^a	15.51 ± 4.02		15.34 ± 3.56		0.885
Carbohydrate (% energy)^a	52.17 ± 8.04		49.01 ± 9.56		0.190
Na (mg/kcal)^b	2.230 (1.954–2.440)		2.456 (2.069–2.699)		0.506
K (mg/kcal)^b	1.302 (1.133–1.635)		1.277 (1.109–1.506)		0.796
Ca (μg/kcal)^b	273.5 (217.8–357.2)		257.9 (199.1–304.5)		0.413
Mg (μg/kcal)^b	128.7 (110.4–161.5)		126.2 (110.2–156.8)		0.883
Pi (μg/kcal)^b	555.1 (482.1–661.6)		522.1 (430.9–631.7)		0.506
Fe (μg/kcal)^b	4.05 (3.48–5.03)		4.24 (3.38–5.07)		0.994
Zn (μg/kcal)^a	4.384 ± 0.778		4.173 ± 1.145		0.398
Cu (μg/kcal)^a	0.610 ± 0.135		0.587 ± 0.137		0.559
Mn (μg/kcal)^b	1.60 (1.35–2.09)		1.95 (1.18–2.49)		0.711
Retinol (μg/kcal)	0.163 (0.134–0.214)		0.310 (0.181–0.412)		0.0165*
β-carotene (μg/kcal)^b	1.88 (1.07–2.95)		2.28 (1.35–3.24)		0.525
Vitamin D (ng/kcal)^b	5.68 (3.55–8.31)		4.69 (3.67–9.33)		0.994
α-tocopherol (μg/kcal)^a	4.350 ± 1.050		4.351 ± 1.266		0.999
Vitamin K (μg/kcal)^b	0.138 (0.107–0.216)		0.118 (0.098–0.231)		0.610
Vitamin B1(μg/kcal)^a	0.438 ± 0.109		0.408 ± 0.133		0.363
Vitamin B2(μg/kcal)^b	0.716 (0.613–0.867)		0.702 (0.545–0.801)		0.552
Niacin (μg/kcal)^a	9.571 ± 2.514		10.297 ± 3.136		0.342
Vitamin B6(μg/kcal)^a	0.700 ± 0.204		0.717 ± 0.253		0.782
Vitamin B12 (ng/kcal)^b	4.10 (3.17–5.72)		3.92 (3.13–7.20)		0.872
Foric acid (μg/kcal)^b	0.167 (0.147–0.232)		0.189 (0.148–0.236)		0.742
Panthotenic acid (μg/kcal)^b	3.520 (3.063–3.996)		3.474 (2.608–4.078)		0.543
Vitamin C (μg/kcal)^b	61.12 (51.09–88.30)		62.92 (45.11–87.33)		0.629
SFA (% energy)^a	7.623 ± 1.898		7.504 ± 2.686		0.843
MUFA (% energy)^a	10.109 ± 2.350		10.185 ± 2.512		0.911
n-3PUFA(% energy)^a	1.276 ± 0.348		1.400 ± 0.461		0.250
n-6PUFA(% energy)^a	5.470 ± 1.195		5.643 ± 1.596		0.639
Cholesterol(μg/kcal)^a	214.01 ± 71.37		196.83 ± 80.60		0.414
Dietary fiber (mg/kcal)^b	6.11 (4.80–7.92)		6.57 (5.11–7.31)		0.939
Alcohol (% energy)^b	0.018 (0–1.065)		0.454 (0–7.249)		0.496
Foods
Cereals (mg/kcal)^a	188.30 ± 61.55		180.16 ± 76.99		0.663
Potatoes (mg/kcal)^b	15.36 (9.92–38.02)		24.97 (9.25–30.68)		0.796
Pulses (mg/kcal)^b	1.92 (1.35–4.60)		2.78 (1.28–4.57)		0.711
Green and yellow vegetables (mg/kcal)^b	53.79 (29.82–90.18)		63.23 (41.17–83.14)		0.732
Other vegetables (mg/kcal)^a	90.284 ± 46.788		85.674 ± 43.021		0.724
Fruit (mg/kcal)^b	72.41 (26.40–121.93)		35.40 (14.39–84.32)		0.105
Fish and shellfish (mg/kcal)^b	29.30 (22.31–43.03)		35.21 (20.68–64.87)		0.454
Meat (mg/kcal)^a	43.27 ± 20.43		45.29 ± 22.99		0.737
Eggs (mg/kcal)^b	21.13 (13.99–29.24)		15.16 (7.27–29.80)		0.317
Dairy products (mg/kcal)^b	74.09 (29.87–113.76)		52.80 (21.38–83.39)		0.506
Oils and fats (mg/kcal)^a	6.445 ± 2.814		7.250 ± 3.303		0.338
Confection (mg/kcal)^b	26.31 (17.11–43.87)		20.42 (14.86–35.06)		0.543
Beverages (mg/kcal)^b	382.2 (287.8–591.0)		400.1 (223.6–863.4)		0.928
Seasonings and spices (mg/kcal)^b	122.6 (95.5–167.3)		151.9 (79.1–181.3)		0.774
Sugar/sweeteners (mg/kcal)^b	1.918 (1.353–4.599)		2.781 (1.279–4.572)		0.711

Notes: ^aData provided as the mean ± standard deviation, analyzed by Student’s t-test. ^bData provided as the median (interquartile range), analyzed by Mann–Whitney U-test. ^cFisher’s exact test was used to test the significance of difference in frequency distribution. *Significant difference at p < 0.05.

Abbreviations: SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid.

Table 6 Demographic Characteristics and Intake of Nutrients and Foods in Alopecia Areata (AA) Groups with and without Atopic Dermatitis (AD)

	AA without AD (n = 54)		AA with AD (n = 16)		p values
Sex	Male	13	Male	6	0.343^c
	Female	41	Female	10
Age (years)^a	51.59 ± 16.60		37.50 ± 11.96		0.00239**
SALT^b	6 (2–17.5)		8 (3–41.5)		0.556
Body mass index (kg/m^2)^b	21.69 (19.43–23.93)		22.28 (20.35–24.53)		0.321
Energy intake (kcal/day)^b	1595 (1326–1995)		1789 (1221–2047)		0.321
Nutrients
Animal protein (% energy)^b	8.59 (6.68–10.28)		9.30 (7.19–10.16)		0.506
Vegetable protein (% energy)^a	6.49 ± 1.20		6.25± 1.14		0.485
Animal fat (% energy)^a	12.44 ± 4.39		14.16 ± 4.53		0.177
Vegetable fat (% energy)^b	15.22 (13.14–18.33)		15.22 (13.87–16.04)		0.905
Carbohydrate (% energy)^a	51.39 ± 8.91		51.63 ± 6.85		0.921
Na (mg/kcal)^b	2.27 (2.03–2.65)		2.26 (2.14–2.57)		0.785
K (mg/kcal)^b	1.302 (1.128–1.635)		1.255 (1.135–1.544)		0.534
Ca (μg/kcal)^b	273.5 (226.8–347.5)		268.2 (190.9–347.1)		0.498
Mg (μg/kcal)^b	130.6 (116.3–161.6)		114.7 (108.1–141.1)		0.196
Pi (μg/kcal)^b	552.2 (478.3–652.5)		553.3 (449.7–636.9)		0.764
Fe (μg/kcal)^b	4.08 (3.49–5.13)		4.02 (3.27–4.55)		0.506
Zn (μg/kcal)^a	4.295 ± 0.899		4.4769 ± 0.776		0.468
Cu (μg/kcal)^b	0.582 (0.520–0.698)		0.587 (0.506–0.606)		0.48
Mn (μg/kcal)^b	1.67 (1.35–2.38)		1.57 (1.16–2.21)		0.571
Retinol (μg/kcal)^b	0.173 (0.134–0.285)		0.197 (0.145–0.306)		0.515
β-carotene (μg/kcal)^b	1.923 (1.068–3.184)		2.052 (1.326–2.487)		0.828
Vitamin D (ng/kcal)^b	5.512 (3.798–9.029)		4.957 (2.305–7.019)		0.291
α-tocopherol (μg/kcal)^a	4.408 ± 1.162		4.154 ± 0.818		0.418
Vitamin K (μg/kcal)^b	0.140 (0.107–0.251)		0.115 (0.096–0.158)		0.164
Vitamin B1 (μg/kcal)^a	0.429 ± 0.120		0.438 ± 0.099		0.780
Vitamin B2 (μg/kcal)^b	0.715 (0.591–0.862)		0.722 (0.624–0.864)		0.994
Niacin (μg/kcal)^a	9.865 ± 2.857		9.304 ± 1.871		0.463
Vitamin B6 (μg/kcal)^b	0.715 ± 0.222		0.666 ± 0.184		0.432
Vitamin B12 (ng/kcal)^b	3.91 (3.18–5.89)		4.37 (2.72–5.72)		0.961
Foric acid (μg/kcal)^b	0.180 (0.150–0.238)		0.166 (0.137–0.207)		0.413
Panthotenic acid (μ/kcal)^b	3.493 (3.029–4.032)		3.574 (2.856–3.981)		0.883
Vitamin C (μg/kcal)^b	62.20 (51.09–90.01)		52.74 (39.01–80.83)		0.186
SFA (% energy)^a	7.384 ± 1.986		8.311 ± 2.309		0.119
MUFA (% energy)^a	9.995 ± 2.531		10.570 ± 1.708		0.398
n-3PUFA (% energy)^a	1.333 ± 0.396		1.207 ± 0.296		0.241
n-6PUFA (% energy)^a	5.550 ± 1.404		5.371 ± 0.791		0.627
Cholesterol (μg/kcal)^a	203.87 ± 74.50		231.06 ± 67.23		0.195
Dietary fiber (mg/kcal)^b	6.476 (5.059–7.918)		5.908 (4.417–6.838)		0.304
Alcohol (% energy)^b	0 (0–5.418)		0.537 (0–2.484)		0.703
Foods
Cereals (mg/kcal)^a	181.31 ± 68.59		203.74 ± 48.28		0.227
Potatoes (mg/kcal)^b	15.36 (9.67–28.81)		30.40 (10.45–45.07)		0.184
Pulses (mg/kcal)^b	2.015 (1.277–4.725)		2.127 (1.406–3.024)		0.916
Green and yellow vegetables (mg/kcal)^b	56.33 (29.82–90.96)		58.32 (38.64–78.10)		0.817
Other vegetables (mg/kcal)^a	90.01 ± 44.61		86.60 ± 49.59		0.794
Fruit (mg/kcal)^b	72.13 (23.39–134.11)		46.38 (24.75–75.47)		0.193
Fish and shellfish (mg/kcal)^b	31.64 (22.63–48.94)		26.53 (20.11–40.47)		0.338
Meat (mg/kcal)^b	40.06 (25.38–55.42)		47.94 (41.88–58.79)		0.0974
Eggs (mg/kcal)^b	19.33 (12.04–27.19)		25.80 (16.03–31.36)		0.254
Dairy products (mg/kcal)^b	74.08 (27.17–114.80)		68.38 (21.38–92.55)		0.600
Oils and fats (mg/kcal)^a	6.593 ± 3.168		6.750 ± 1.988		0.852
Confection (mg/kcal)^b	25.62 (17.93–41.11)		23.22 (12.64–42.28)		0.905
Beverages (mg/kcal)^b	382.1 (287.8–621.2)		397.5 (230.4–535.7)		0.382
Seasonings and spices (mg/kcal)^b	121.6 (81.5–153.7)		144.1 (114.1–183.7)		0.160
Sugar/sweeteners (mg/kcal)^b	2.015 (1.277–4.725)		2.127 (1.406–3.024)		0.916

Notes: ^aData provided as the mean ± standard deviation, analyzed by Student’s t-test. ^bData provided as the median (interquartile range), analyzed by Mann–Whitney U-test. ^cFisher’s exact test was used to test the significance of difference in frequency distribution. **Significant difference at p < 0.01.

Abbreviations: SALT, severity of alopecia tool; SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid.

Table 7 The Association of Comorbid Atopic Dermatitis in Alopecia Areata Patients with Each Variable Analyzed by Multiple Logistic Regression Analysis

	Odds Ratio	95% Confidential Interval	p
(Intercept)	1.82	0.0247–134.0	0.785
Age (years)	0.941	0.901–0.984	0.00743**
Sex (M=1, F=2)	0.826	0.219–3.11	0.777
Body mass index (kg/m^2)	1.05	0.904–1.23	0.502

Note: **Statistically significant at p < 0.01.