Systematic reviewindependent cross-checkabstract checked I-EGG-133 standard review
Egg-free diets help only children with proven egg allergy
Dietary exclusions for established atopic eczema.
Overview
Bath-Hextall F et al.. Cochrane Database Syst Rev 2008 · PMID 18254073 · DOI 10.1002/14651858.CD005203.pub2
Avoiding eggs did not help eczema in general, but may help infants with eczema who are sensitised to egg.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Assess exclusion diets for eczema.
- How was the study done?
Cochrane review.
- How many people, animals or samples were studied?
9 trials, 421 people.
- What was actually found?
No general benefit; possible benefit in egg-allergic infants.
- How large was the observed effect?
RR 1.51 (1.07-2.11) in one trial.
- What do the results mean in everyday life?
Egg avoidance makes sense for diagnosed egg allergy, not for everyone.
- What are the study's limitations?
Small, low-quality trials.
- What does it say about Elawady's specific claim?
Supports avoidance only in allergy.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
It cannot support a general egg ban.
Scientific in-depth review
1. Full reference
- Authors
- Bath-Hextall F et al.
- Journal
- Cochrane Database Syst Rev
- Year
- 2008
- Identifier
- PMID 18254073 DOI 10.1002/14651858.CD005203.pub2
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
none; Crossref shows this version updates CD005203 (new version)
- Extent checked
- abstract only
- Conflicts of interest and funding
None known.
2. Research question
Do dietary exclusions improve established atopic eczema?
3. Study design and population
- Study design
- Systematic review – Cochrane systematic review of RCTs
- Population
People with doctor-diagnosed atopic eczema; 9 RCTs, 421 participants
- Country
Multinational
- Period
Search to March 2006
- Sample size
421 (6 egg-and-milk exclusion trials, 288)
- Inclusion and exclusion criteria
not detailed in abstract
4. Methods and endpoints
- Exposure / intervention
Egg and/or milk exclusion, few-foods or elemental diets
- Comparator
Normal diet
- Endpoints
Eczema extent and severity
- Statistical methods
RR and mean differences per trial
5. Actual results
- Results
No benefit of egg- and milk-free diets in unselected participants with eczema. In infants with suspected egg allergy and positive egg-specific IgE, one trial found improvement in affected body surface area with an egg-free diet (RR 1.51, 1.07-2.11; MD 5.50, 0.19-10.81 at 6 weeks). Trials had poor allocation concealment, no blinding and high dropout.
- Absolute risks
not reported
- Authors' conclusion
There may be some benefit of an egg-free diet in infants with suspected egg allergy and positive egg IgE; little evidence supports exclusion diets in unselected people.
6. Strengths
- Cochrane methods
7. Weaknesses
- Small, poor-quality trials
- Old search (2006)
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Cochrane review of low-quality trials.
9. Assessment of the statistical interpretation
Benefit only in a narrowly defined allergic subgroup, from one small trial.
10. Relevance to the specific claim
Supports the correct kernel: egg avoidance can help a specific group (infants with egg allergy and eczema). It does not support avoidance for everyone and does not concern lupus.
11. Independent contrary findings
No benefit in unselected people with eczema.
12. Transferability to Germany and Europe
Universal.
13. Overall methodological judgement
Defines the conditional truth: egg avoidance for proven egg allergy, not for all.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | high |
| Precision of results | low |
| Directness | indirect |
| Reproducibility | not replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Modern trials with confirmed food allergy.
15. Linked fact checks
- Eggs should be completely avoided (all kinds, all cooking methods). – Studies supporting the claim
- Eggs cause red cheeks that are misdiagnosed as lupus; a patient with lupus (including protein in the urine) would heal completely if she stopped eating eggs, instead of taking biological treatment. – Studies with mixed or unclear results