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An esthetician explores skincare issues and concerns

Dairy, Carbs, Sugar and Acne: Is There a Connection? September 12, 2013

Filed under: Acne — askanesthetician @ 7:30 am
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I’ve written a lot in this blog about the connection between food and acne and diet and skincare in general.  (See the links at the end of this post)  This post will highlight new research that has emerged about the connection between diet and acne.

From the Skin Inc. article Long-term Research Links and High Sugar Foods to Acne we learn the following:

Review of 50 years of clinical studies indicates there may be a link between diet and acne after all. It’s been a subject of debate for decades, but it seems diet really does have an impact on a person’s complexion.

A landmark overview of research carried out over the past 50 years has found that eating foods with a high glycaemic index (GI) and drinking milk not only aggravated acne, but in some cases triggered it, too.  …

Since the late 19th century, research has linked diet to acne, with chocolate, sugar and fat singled out as the main culprits. But studies carried out from the 1960s onwards have disassociated diet from the development of the condition.

Jennifer Burris, researcher and doctoral candidate within New York University’sDepartment of Nutrition, Food Studies, and Public Health in Steinhardt School of Culture, Education, and Human Development, says, “This change [in attitude] occurred largely because of the two important studies that are repeatedly cited in the literature and popular culture as evidence to refute the association between diet and acne.

“More recently, dermatologists and registered dietitians have revisited the diet-acne relationship and become increasingly interested in the role of medical nutritional therapy in acne treatment.”

Eating high GI foods – foods that are absorbed into the bloodstream quickly – is thought to have a direct effect on the severity of acne because of the hormonal fluctuations that are triggered. High GI foods cause a spike in hormone levels including insulin which is thought to instigate sebum production. A 2007 Australian study showed that young males who were put on a strict low GI diet noticed a significant improvement in the severity of their acne.

Milk is thought to affect acne because of the hormones it contains. A 2007 study carried out by Harvard School of Public Healthfound that there was a clear link between those who drank milk regularly and suffered with acne. Interestingly, those who drank skimmed milk suffered with the worst breakouts, with a 44% increase in the likelihood of developing blemishes. It is thought that processing the milk increases the levels of hormones in the drink.

Another Skin Inc. article expands on what I referenced above:

“The strongest evidence we have to date of a link between diet and acne comes from the glycemic index studies,” says Whitney P. Bowe, MD, FAAD, who is the lead author of the article “Diet and Acne,” published in the Journal of the American Academy of Dermatology. “These studies show that low-glycemic index diets may improve acne. The consumption of high-glycemic index foods appears to trigger a cascade of responses, which can lead to acne through effects on growth hormones and sex hormones,” Bowe adds.

The glycemic index (GI) is a ranking of carbohydrate-rich foods based on their potential to increase blood sugar levels. For example, high GI foods include white bread, chips and white potatoes; low GI foods include multi-grain bread, peanuts, vegetables and beans.

A study of 23 Australian males ages 15–25 who followed a strict, low-glycemic load (LGL) diet experienced significant improvement in acne severity by adhering to a LGL diet. However, the participants in the LGL group also lost weight, which means the LGL diet may not solely be attributed to the outcome. Specifically, studies have also shown that acne improves when the patients’ blood sugar levels are controlled and a low-carbohydrate diet stabilizes hormones.

In addition, a web-based survey assessing the role of a low-glycemic diet in the treatment of acne found that 86.7% of the 2,528 dieters who completed this online survey reported improvements in their skin while following this diet. Still, based on some of the flaws in the design of the study, the results must be interpreted with “cautious optimism,” says Bowe.

Although there is weak evidence that dairy also impacts acne, Bowe says there’s still a possibility that an association may exist. While there were several flaws in the studies, “Dairy does appear to be weakly associated with acne, with the strongest association being skim milk,” according to Bowe. While the exact mechanism behind this association is unclear, she suspects that hormones and growth factors in milk might play a role.

While more clinical research is needed to determine dairy’s impact on acne severity, Bowe advises patients to speak with their dermatologist to determine if certain dairy products aggravate their acne. She also says patients who choose to limit dairy products should supplement their diets with appropriate levels of calcium and vitamin D.

(From Can Eating Carbs Give You Pimples?)

Still not convinced about the connection between acne and diet?  Check out the following information about societies that ate a plant based diet and acne:

Rural cultures with diets high in fruits, nuts and root vegetables have been observed to have a very minimal incidence of acne. Communities of Kitavan Islanders of Papua New Guinea and Achè hunter-gatherers of Paraguay were observed to not even have a single comedo while eating their native diets rich in fruits, coconut, wild foods and fish, with minimal amounts of Western foods. Similar rural cultures, which have zero incidence of acne, suddenly experience breakouts when introduced to a Western culture and diet.  This suggests that the disorder cannot be solely attributed to genetics, but is likely sourced from differing environmental factors.

These studies point to whole foods, such as fruits and vegetables, as having a positive correlation with clear skin. This makes sense: Plants are, by and large, some of the strongest anti-inflammatory food sources available. By increasing daily intake of fruits, greens and vegetables, clients biologically increase their immunity and could potentially decrease signs of acne.

(From The Diet-Acne Connection – Skin Inc.)

So how can you change your diet in order to prevent breakouts?  Here are some suggestions:

Choosing low GI foods

  • Only carbohydrates have a GI rating.
  • Because low GI foods take longer for the body to break down they help you feel fuller for longer too.
  • High GI foods include sugary fizzy drinks, cakes, pastries, chocolate, white bread and potatoes.
  • Low GI foods include fruit and vegetables, wholegrain options such as brown pasta, basmati rice, couscous and pulses.
  • Not overcooking your pasta and vegetables helps lower the GI.
  • Watch for food triggers that may seem to aggravate acne.
  • Keep a food diary and share it with your dermatologist.
  • Be patient. It may take up to 12 weeks of a diet change to determine if certain foods are contributing to acne.
  • Continue following your regular acne treatment routine. Diet changes are only a small part of an acne treatment plan and are meant to be used in conjunction with proven medical therapies for acne.

Have you seen a connection between your diet and your breakouts?  Please share your experiences below.

My Related Posts:

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Is Your Diet Causing Your Acne? January 25, 2010

Filed under: Acne,beauty,Recommended Reading — askanesthetician @ 7:52 pm
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One of the more controversial issues surrounding the causes of acne is the role diet plays in triggering acne.  Experts’ opinions on the subject vary tremendously and are also very polarizing.  For example in her book Rx for Brown Skin Dr. Susan Taylor writes: “Although many women believe that certain foods contribute to their acne outbreaks, there’s no evidence that food contributes to acne.  So the good news is that fried foods, greasy foods, chocolate, soda, and candy do not cause acne!” (p. 173).  Furthermore, Dr. Taylor writes that if you notice breakouts after you eat certain foods you shouldn’t jump to the conclusion that the foods triggered the acne.  Instead she points out: “the foods you may tend to eat when you’re stressed – sugary or greasy comfort foods – are probably just coincidental.”  (p. 174)  The acne that you see after eating sugary or greasy foods is related to  hormonal changes brought on by stress and not by the foods, Dr. Taylor concludes.

Dr. Doris J. Day takes a similar approach to Dr. Taylor in regards to foods as an acne trigger.  While Dr. Day writes in her book 100 Questions and Answers about Acne that “there is no scientific evidence available to show that high-carbohydrate and/or fat intake has any effect on sebum production or acne” (p.45) she does point out that there might be an explanation to the long held idea that diary can make acne worse.  Dr. Day explains that the hormones that are naturally found in the milk of cows, particularly pregnant cows which produce between 75% to 90% of the milk sold in stores, could play a role in acne formation (p.45).  Further, Dr. Day does suggest that eliminating certain foods from your diet that you deem are acne triggers is ok as long as those foods do not affect your overall health.  Dr. Day will concede that there is one ingredient that, if consumed in large enough quantities, can trigger acne.  That ingredient is iodine.

At the complete opposite spectrum is the advice of dermatologist Dr. Nicholas Perricone.  As outlined in his best-selling book The Clear Skin Prescription and on his website Dr. Perricone promises a flawless complexion, in only four weeks, if one is to follow his anti-inflammation diet, take the supplements he recommends (which he conveniently sells for a very high price on his website), and use the topical treatments he recommends.  Why is Dr. Perricone so convinced that food does make a significant difference in the appearance of one’s skin and in the formation of acne?  Because Dr. Perricone believes that all acne is inflammatory acne and that a diet that combats inflammation will positively affect acne, i.e. stop acne from occurring in the first place. 

How exactly does the inflammation trigger acne?  Acne begins to form when pores become clogged with dead cells that have not been properly removed.  In his book Dr. Perricone writes that an increase in blood sugar causes retention hyperkeratosis or the retention of and sticking together of dead cells in the pores.  This same increase in blood sugar causes inflammation on a cellular level and can even increase sebum production in the sebaceous glands.  The inflammation continues working on a molecular level in the cells, and causes the sebaceous cells to secrete proinflammatory fatty acids.  The crux of Dr. Perricone’s reasoning for following his anti-inflammatory diet is that by reducing the inflammation on a cellular level through the foods we eat will radically affect existing acne and prevent future breakouts.

Dr. Perricone writes that the foods one eats as well as the foods one avoids are equally important.  Dr. Perricone explains that one needs to carefully regulate their blood sugar level in order to have clear, healthy skin.  A rapid rise in blood sugar levels makes the body create insulin which then causes the body to have an inflammatory response.  More insulin equals more inflammation equals more acne, according to Dr. Perricone.  Sweets are certainly rapidly converted to sugars in the body but so are simple starches such as bananas, potatoes, corn, and peas – to name a few.  When you eat these foods your body experiences a rapid rise in blood sugar, which triggers an increase in insulin, and then inflammation on a cellular level (p.57).  In addition to avoiding foods that trigger that above mentioned responses it is important, according to Dr. Perricone, to integrate anti-inflammatory foods into one’s diet.  These foods are usually high in essential fatty acids.  He particularly advocates eating a lot of wild Alaskan salmon, fresh berries and melon, and drinking lots of water ( p.59). 

Dr. Perricone is only one of a few experts who see a direct connection between food and acne.  Certainly his argument does make some sense and the before and after photos in his book are dramatic and intriguing, but if Dr. Perricone is so right about the role diet plays in the formation of acne why do more experts not agree with him?  In my opinion, Dr. Perricone’s advice is certainly another acne solution to consider especially if one is inclined to seek more natural solutions for health issues as opposed to prescription solutions or if one has tried numerous options and has yet to experience relief from acne breakouts.  Yet for Dr. Perricone’s advise to be taken more seriously more studies have to be done that are independent of his own research.  It will be interesting to see what research about the connection between acne and diet reveals in the future.


 UPDATE:  Since I wrote this post I’ve reconsidered the idea of how diet impacts acne.  See my post Book Review:  The Clear Skin Diet for more information.



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