I am putting this together to inform the people out there that diet plays a significant role in acne. The skin is an organ which is an external manifestion of what's going on in the inside. Acne is and was virtually non-existant in populations who abstain from the typical 'Western Diet.' Epigentics, is how the environment affects gene expression. In other words, what you eat, think, and do plays an enmourous role on gene expression and therefore health, including acne. In order for this to work, it requires some sacrifice and discipline. If you are weak-willed and lack discipline you will uiltimately fail. I began to do research in the nutrition-acne connection once traditional dermatological methods failed. Pay attention to the way diary particularly has negative effects. My own personal results have shown that eliminating dairy intake, lowering "bad carbs," and eating more veggies and fruits as the primary carb source (paleo) has eliminated my acne. I only posted a fraction of the studies in diet-acne connection, there are many more. The following sample of studies demonstrate why this works; it is primarily due to the role these foods have on hormones and other pathways in the body which lead to inflammation:
1.) Evaluation of serum vitamins A and E and zinc levels according to the severity of acne vulgaris.
http://www.ncbi.nlm....ubmed/23826827; "....Thus there was a negative correlation between acne severity and vitamin E and zinc levels. Conclusion: Our study marks the importance of diet in patients with acne. We offer supportive dietary measures with foods rich in vitamin A and E and zinc in the acne prophylaxis and treatment. Supportive treatment with these vitamins and zinc in severe acne may lead to satisfactory results."
2.)Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets
http://www.ncbi.nlm....pubmed/23801097 ;...From the 1960s onwards they have become widely known as one of the most common methods for obesity treatment. Recent work over the last decade or so has provided evidence of the therapeutic potential of ketogenic diets in many pathological conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors. The possibility that modifying food intake can be useful for reducing or eliminating pharmaceutical methods of treatment, which are often lifelong with significant side effects, calls for serious investigation. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases.
From here on, we begin to see that Dairy is a major component of acne:
3.)Turning acne on/off via mTORC1 ;http://www.ncbi.nlm....pubmed/23800069. Over the past 10 years, the increase in comprehension of the mechanisms behind acne has been truly exponential. Starting with the ethnological work of Cordain, accelerated by the epidemiological work of Adebamowo, supported by the clinical trials of Smith and Mann, Kwon, DiLandro and others, the interface of diet and acne is coming into focus. Melnik now presents an exceptional pair of papers that illustrate for dermatologists what translational research is all about. The Western diet, the role of dairy, FoxO1 and mTORC1, the interplay of agonists and antagonists, therapeutics present and future - the jigsaw puzzle is coming together.
4.)Acne and diet; http://www.ncbi.nlm....ubmed/23529682; ..In industrialized countries acne presents as an epidemic disease of civilization affecting sebaceous follicles of adolescents and young adults, associated with increased body mass index and insulin resistance. "Western style" diet, characterized by high glycaemic load and increased consumption of insulinotropic milk proteins, plays an important role in acne pathogenesis. On the cellular level, nutrient-derived metabolic signals are sensed by the metabolic transcription factor FoxO1 and integrated by the regulatory kinase mTORC1. mTORC1, the central hub of protein- and lipid biosynthesis, cell growth and proliferation, is activated by insulin, IGF-1 and branched-chain essential amino acids, especially leucine. The understanding of Western diet-mediated nutrient signalling with over-activated mTORC1 offers a reasonable approach for dietary intervention in acne by lowering glycaemic load and consumption of milk and milk products. A suitable diet attenuating increased mTORC1 activity is a Palaeolithic-like diet with reduced intake of sugar, hyperglycaemic grains, milk and milk products but enriched consumption of vegetables and fish.
5.)High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. http://www.ncbi.nlm....ubmed/22898209; Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris
6.) Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial. http://www.ncbi.nlm....pubmed/22678562
"Subjects within the low glycaemic group demonstrated significant clinical improvement in the number of both non-inflammatory and inflammatory acne lesions. Histopathological examination of skin samples revealed several characteristics, including reduced size of sebaceous glands, decreased inflammation, and reduced expression of sterol regulatory element-binding protein-1, and interleukin-8 in the low glycaemic load group. A reduction in glycaemic load of the diet for 10 weeks resulted in improvements in acne."
7.)Diet in acne: further evidence for the role of nutrient signalling in acne pathogenesis; http://www.ncbi.nlm....pubmed/22419445
"... in this issue of Acta Dermato-Venereologica, have provided evidence for the beneficial therapeutic effects of low glycaemic load diets in acne. Epidemiological evidence confirms that milk consumption has an acne-promoting or acne-aggravating effect. Recent progress in understanding the nutrient-sensitive kinase mammalian target of rapamycin complex 1 (mTORC1) allows a new view of nutrient signalling in acne by both high glycaemic load and increased insulin-, IGF-1-, and leucine signalling due to milk protein consumption
8.) Over-stimulation of insulin/IGF-1 signaling by western diet may promote diseases of civilization: lessons learnt from laron syndrome;http://www.ncbi.nlm....pubmed/21699736 Western diet with high intake of hyperglycemic carbohydrates and insulinotropic dairy over-stimulates IIS. The reduction of IIS in Laron subjects unmasks the potential role of persistent hyperactive IIS mediated by Western diet in the development of diseases of civilization and offers a rational perspective for dietary adjustments with less insulinotropic diets like the Paleolithic diet.
9.)Nutrition and acne; http://www.ncbi.nlm....pubmed/21034984. There are significant data supporting the role of diet in acne. Our Western diet includes many dairy sources containing hormones.. The natural function of milk being to stimulate growth, it contains anabolic steroids as well as true growth hormones and other growth factors. The presence of 5α-pregnanedione, 5α-androstanedione, and other precursors of 5α-dihydrotestosterone add to the potency of milk as a stimulant of acne. In addition, foods with significant sugar content and other carbohydrates yielding high glycemic loads affect serum insulin and insulin-like growth factor-1 levels, both of which promote increased production of available androgens and the subsequent development of acne.
10.)Acne: prevalence and relationship with dietary habits in Eskisehir, Turkey; http://www.ncbi.nlm....pubmed/22070422 Acne prevalence is high among adolescents in Eskisehir but the rate of consulting doctor is low. Increasing public awareness is critical for convincing adolescents to seek medical help earlier. Acne was related with dietary habits. Fat, sugar and fast food consumption is found to be positively correlated with acne prevalence.
11.)Pathways to inflammation: acne pathophysiology; http://www.ncbi.nlm....pubmed/21609898 A recurring question from patients who seek help from various healthcare professionals - their pharmacist, family doctor or dermatologist, is "why?" They also ask questions about a possible familial link, the impact of their diet and the association with their hormones. The following review aims to link these factors with the end result - inflammation.
12.)Evidence for acne-promoting effects of milk and other insulinotropic dairy products;http://www.ncbi.nlm....pubmed/21335995
cne vulgaris, the most common skin disease of western civilization, has evolved to an epidemic affecting more than 85% of adolescents. Acne can be regarded as an indicator disease of exaggerated insulinotropic western nutrition. Especially milk and whey protein-based products contribute to elevations of postprandial insulin and basal insulin-like growth factor-I (IGF-I) plasma levels. It is the evolutional principle of mammalian milk to promote growth and support anabolic conditions for the neonate during the nursing period. Whey proteins are most potent inducers of glucose-dependent insulinotropic polypeptide secreted by enteroendocrine K cells which in concert with hydrolyzed whey protein-derived essential amino acids stimulate insulin secretion of pancreatic β-cells. Increased insulin/IGF-I signaling activates the phosphoinositide-3 kinase/Akt pathway, thereby reducing the nuclear content of the transcription factor FoxO1, the key nutrigenomic regulator of acne target genes. Nuclear FoxO1 deficiency has been linked to all major factors of acne pathogenesis, i.e. androgen receptor transactivation, comedogenesis, increased sebaceous lipogenesis, and follicular inflammation. The elimination of the whey protein-based insulinotropic mechanisms of milk will be the most important future challenge for nutrition research. Both, restriction of milk consumption or generation of less insulinotropic milk will have an enormous impact on the prevention of epidemic western diseases like obesity, diabetes mellitus, cancer, neurodegenerative diseases and acne.
13.)Acne: Diet and acnegenesis;http://www.ncbi.nlm....pubmed/23130204 Acne is a manifestation of hormonal overstimulation of the pilosebaceous units of genetically susceptible individuals. Endogenous reproductive and growth hormones, exogenous reproductive hormones, insulin and endogenous insulin-like growth hormone-1, sourced from and stimulated by dairy and high glycemic load foods, all appear to contribute to this overstimulation. A postulated molecular mechanism linking food and acne is reported and integrated into the clinical picture.
14.)Effect of the glycemic index of carbohydrates on Acne vulgaris; http://www.ncbi.nlm....pubmed/22253996 Acne vulgaris may be improved by dietary factors that increase insulin sensitivity. We hypothesized that a low-glycemic index diet would improve facial acne severity and insulin sensitivity.Longer time frames, greater reductions in glycemic load or/and weight loss may be necessary to detect improvements in acne among adolescent boys.
15.)Innovative uses for zinc in dermatology; http://www.ncbi.nlm....pubmed/20510767....severe zinc deficiency states, such as acrodermatitis enteropathica, are associated with a variety of skin manifestations, such as perioral, acral, and perineal dermatitis. These syndromes can be reversed with systemic zinc repletion. In addition to skin pathologies that are clearly zinc-dependent, many dermatologic conditions (eg, dandruff, acne, and diaper rash) have been associated and treated with zinc.
16.)Does diet really affect acne?;http://www.ncbi.nlm....pubmed/20361171 Acne vulgaris has anecdotally been attributed to diet by individuals affected by this skin condition. In a 2009 systematic literature review of 21 observational studies and 6 clinical trials, the association between acne and diet was evaluated. Observational studies, including 2 large controlled prospective trials, reported that cow's milk intake increased acne prevalence and severity. Furthermore, prospective studies, including randomized controlled trials, demonstrated a positive association between a high-glycemic-load diet, hormonal mediators, and acne risk. Based on these findings, there exists convincing data supporting the role of dairy products and high-glycemic-index foods in influencing hormonal and inflammatory factors, which can increase acne prevalence and severity
Diet Protocol: The proper diet protocol to follow would be Paleo. That means total abstience from dairy, dairy-like products, and milk by-products. Some of you, will immedietely see results just by stoping the intake of milk. However, it is my reccomendation that you also follow proper carb intake. Both of these, together, compliment eachother to supercharge your results. Proper carbohydrate, in the diet, is the single most important factor for health (diet-wise). This usually means that carbs only come from vegetables, fruits, and sometimes oatmeal or the like. No potatoes, french fries, pastries, bread, baked goods, pasta, chips, ect.
A good exaple demonstrating glycemic load is white bread. Look at the back for nutrition information on white bread. It is, essentially, just sugar and a potato. The body just breaks it down into glucose. Vegetables and fruits, on the other hand, are not acidic and contain micro-nutrients that something like pasta and bread doesn't contain.
Insulin is key. I have followed low carb intake to the point where my body entered ketosis: less than 50g of carbs a day. Amazing things happen. It essentially detoxifies the body. Try this out, for atleast a few weeks, and see how you feel. You will be amazed, on the changes, once all this processed crap food is cut from your diet. On this diet I have lost over 30 pounds and sit at 8% bodyfat year round.
I understand that this asking a lot. Do not simply just take my words for it. Do the research yourself and even expirement on your own body to see what works for you. Remember, you are literally "what you eat."
Edited by Absthethics, 19 August 2013 - 06:53 AM.