Linking diet to acne metabolomics, inflammation, and comedogenesis: an update
Bodo C Melnik
Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, GermanyAbstract:
Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans
-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Diet-induced insulin/insulin-like growth factor (IGF-1)-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs), glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1). Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1), the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ), liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c), crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea) and composition (dysseborrhea) promote Propionibacterium acnes
overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a “danger signal,” stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte proliferation. Oleate stimulates P. acnes
adhesion, keratinocyte proliferation, and comedogenesis via interleukin-1α release. Thus, diet-induced metabolomic alterations promote the visible sebofollicular inflammasomopathy acne vulgaris. Nutrition therapy of acne has to increase FoxO1 and to attenuate mTORC1/SREBP-1c signaling. Patients should balance total calorie uptake and restrict refined carbohydrates, milk, dairy protein supplements, saturated fats, and trans
-fats. A paleolithic-like diet enriched in vegetables and fish is recommended. Plant-derived mTORC1 inhibitors and ω-3-PUFAs are promising dietary supplements supporting nutrition therapy of acne vulgaris.Keywords:
acne, comedogenesis, diet, inflammasome, metabolomics, quorum sensing
Status: Clear after 30 years. Wow, I guess it's been 6 years, now.
[ Story: Severe Acne since I was 10. 10+ years of Dermatologists, Antibiotics, topicals and ACCUTANE did nothing. Discovered oranges triggered the worst of my cystic acne = about 70% improvement. Tried some nutrient supplements like B-complex with zinc and C, saw palmetto and a BHA like the aspirin mask = more improvement, a lot less oily. Then, Diet changes = Clear.
Regimen: Anti-inflammatory, nutrient dense, blood sugar stabilizing diet and supplements (for hormones, inflammation, aging, health). No soap or other cleanser except for hand washing! Water only or Oil cleanse. Aloe Vera mixed with niacinimide and a high linoleic acid oil for moisturizer and reduce pigmentation.
Diet effects acne in so many ways: hormone balance, inflammation, Insulin levels, digestion, allergies and intolerances, liver function, adrenal function, SHBG levels, sebum quality, cell function and turnover, nutrient deficiencies, body fat, etc. Basic advice: Eat, sleep, supplement and exercise like you are a diabetic. And eat real food!
For more information, see my Good Things for Acne thread *Moderator edit - Please refer to the board rules (see “Advertising/soliciting”, “Linking” and “Signatures”)*
When you eat stuff, Stuff Happens!