The problem with these studies is that they use isolated fructose in VERY high doses. One can't conclude that this also applies to fructose as it's found naturally and eaten with fruits . In fruits, a vast amount of other nutritients are found too, forming a big complex (syngergistic). So, avoid HCFS, yes, but fruits, not necesserarily, especially if there's more glucose than fructose. Glucose helps fructose absorption.

And why is my skin so much worse in the evening

It's really hard to attach any objective measurement to intra-day skin changes. Most people can make their skin appear to be very different by standing in different light, doing something (eating/exercising/etc.) to flush the capillaries with blood, etc.

In the morning it's very good, anything I had in the evening has shrinked to almost nothing.

For most people with anything close to a regular and reasonable length bedtime, I would expect the symptoms of acne to be circadian, roughly better (though whether that's subjectively obvious is questionable, IMO) in the morning than evening. Why? Because if you're getting any nocturnal melatonin surge at all, it should elevate (at least somewhat, if not enough to eliminate acne) cell production of superoxide dismutase, and thereby help shutdown the immune response that causes acne (by proceeding to kill human cells with superoxide anions, triggering further immune system overreaction).

One can't conclude that this also applies to fructose as it's found naturally and eaten with fruits . In fruits, a vast amount of other nutritients are found too, forming a big complex (syngergistic).

AFAICT, there's no reason to think any "other nutrients" in fruits help fructose get digested. Certainly the doctors who try to treat "fructose malabsorption" immediately remove high-fructose fruits like apples, pears, etc. from the patient's diet. This is consistent with the idea that the GLUT5 transporter can get saturated at reasonably low levels, so fruits with excess fructose should be expected to contribute to any problem associated with failing to digest all the fructose you eat.

Note that this is directly contrary to people who believe insulin response is what's related to acne (and why fructose is a good choice over glucose if you have diabetes, but not if you have acne). In this model, it matters not a whit what insulin is doing. Rather, it's the problem of overgrowing bacteria in the gut by feeding it (instead of you!) fructose, allowing it to then eat up (or at least keep you from digesting) nutrients you need to prevent acne (zinc, tryptophan, Vitamin B).

This model also makes it a lot easier to explain variability -- even within a single patient. If acne is tied to insulin response, how come I can get acne when I'm eating low GI (just by screwing up my sleep cycle to destroy the normal melatonin surge) and yet avoid acne when I'm drinking massive fructose (by living in bright sunlight to increase my ability to digest fructose)?

I still believe I could induce clinical levels (as opposed to the low levels already present in a large percentage of the population) of acne in most adults just by screwing up their sleep cycle and feeding them large amounts of fructose for a couple of weeks. I certainly see evidence of that in the adults I know well enough to know something of their diet/sleep. E.g., I've watched a clear-faced college student slam down the soft drinks to help them stay awake for marathon all-night weekend study, only to emerge with multiple acne lesions by the next Tuesday.

it's the problem of overgrowing bacteria in the gut by feeding it (instead of you!) fructose, allowing it to then eat up (or at least keep you from digesting) nutrients you need to prevent acne (zinc, tryptophan, Vitamin B).

Bacteria overgrowth could mean, that a recommended approach to fixing acne as fast as possible, is to try antibiotics first. If they fail, it's obvious that your particular kind of acne is not a problem of digestion. If it works (antibiotics cleared me up, as long as I took em), it would be wise to take them until you are cleared, and meanwhile stop all fructose so that no new bacteria can grow once you stop treatment with the medicine.

It would be interesting to know in this regard, how long these bacteria can survive without enough fructose to sustain them, and what sideeffects a mass death might of those will have. I read multiple times that bacteria dying, produce byproducts that can worsen your condition for a short time, despite the actual treatment working overall. ("herx effect")

For me personally, I didn't see any sideeffects of giving up fructose. This stuff is so complex 🙂

I read once, that a theory says that bacteria can actually change their DNA to become another type of bacteria. So death might not even occur when fructose is short. They just switch to something else.

Although I can still eat tons of melons and not get an outbreak. Probably because melons have trypophan (or something like that) which supposedly lowers the overall production of sebum. Might counteract the bacteria.

I still believe I could induce clinical levels (as opposed to the low levels already present in a large percentage of the population) of acne in most adults just by screwing up their sleep cycle and feeding them large amounts of fructose for a couple of weeks.

The funny thing? Acne sufferers will tell you "duh, that's obvious" but won't draw the right consequences for themselves 😉

Bacteria overgrowth could mean, that a recommended approach to fixing acne as fast as possible, is to try antibiotics first. If they fail, it's obvious that your particular kind of acne is not a problem of digestion.

That's not what this hypothesis says. Screw up your melatonin cycle any number of other ways, and still get acne, regardless of your digestive system.

If it works (antibiotics cleared me up, as long as I took em), it would be wise to take them until you are cleared, and meanwhile stop all fructose so that no new bacteria can grow once you stop treatment with the medicine.

If you really killed off all the bacteria in the gut with antibiotics, I think you would feel pretty sick. The bacteria is supposed to be there, and is needed for digestion (and who knows what else). Equally plausibly, the antibiotics decreased P. acnes without doing much to your gut flora at all (depending on type, dosage, duration).

For me personally, I didn't see any sideeffects of giving up fructose.

I don't either -- if I'm not doing what else is required to have a normal melatonin cycle. Decreasing fructose just seems to make me require less daylight exposure to avoid acne. Probably more relevant to me as the winter months loom.

Databased,

I know you have done some experimenting with tryptophan supplements. What is your opinion on them? Do you think it will help achieve deep restful sleep and the nightly melatonin surge?

Data are you still clear on this and have others had good results with this?? And was this with full day outside or also with different lights etc...

I do seem to have less energy without fructose though. It's most likely just because I had such incredible amounts of (short lived? I guess) fructose energy in the past, that I miss it now. I sometimes bought fruit juice and drank a few litres a day.

Hm hm, would be good to have the best of both worlds: energy + no acne

You know what's funny? I always thought that everything in the world has some kind of positive side to it. I googled sugar and didn't find anything. In fact it seems highly toxic from some descriptions.

http://searchwarp.com/swa148760.htm

So not only doesn't sugar provide any nutrients, it actually uses up essential nutrients, just so that the body can deal with it.

Yes, I would call that toxic. Depleting my essential minerals and gnawing at my bones? NO THX.

Denken: depends on the sugar... People like Ray Peat for example, who has written a lot of well researched articles about nutrition, recommends eating a lot of fruits. Sugar is not necessarly bad. If you have a bad digestion (due to bad sleep cycle or other causes) I agree that very high doses of refined sugar definetly would cause problems. However fruits are meant to be eaten on an evolutionary standpoint (so the plant can disperse its seed....) but only if they are seasonal. So fruits in the summer are not a problem, because one typically gets signifantly more daylight. But databased mentioned that before... Whereas typical winter fruits as berries are typically very low in carbs anyway, so they might not cause a problem in this season.

Databased:

One can't conclude that this also applies to fructose as it's found naturally and eaten with fruits . In fruits, a vast amount of other nutritients are found too, forming a big complex (syngergistic).

AFAICT, there's no reason to think any "other nutrients" in fruits help fructose get digested. Certainly the doctors who try to treat "fructose malabsorption" immediately remove high-fructose fruits like apples, pears, etc. from the patient's diet. This is consistent with the idea that the GLUT5 transporter can get saturated at reasonably low levels, so fruits with excess fructose should be expected to contribute to any problem associated with failing to digest all the fructose you eat.

According to many studies (e.g. http://www.ajcn.org/cgi/content/abstract/58/5/748S or http://www.ajcn.org/cgi/content/abstract/48/6/1424) glucose does help fructose absorbtion. As a result, when fructose is better absorbed, there's less feeding ground for "bad" bacterias. Now, I agree, the better your melatonin cycle, the better the absorbtion, regardless of glucose... But choosing foods with at least an equilibrated fructose-glucose ratio (better in favor of glucose) certainly would aslo help.... Or am I missing something here?

That would also explain why berries, melons, bananas etc. cause way less problems than pears or apples. Also, on this german board people have tried almost every thinkable diet... Best results (dietwise!) were always achieved either with low carb OR with high fruit (for example 20 bananas a day). It seems that starch may be problematic in this case, only if one has problems digesting carbs of course, which would be caused by disturbed sleep etc. (your theory). Of course, these are just anecdotical results, but one guy cured his Morbus Crohn by avoiding starch.

I also agree that insulin has nothing to do with acne! And I mostly agree that a lack of absorbed minerals is responsible for many problems, including acne. In the case unfermented wheat, it has very high amounts of phytic acid which blocks mineral absorbtion, potentially leading to many diseases (who knows?)

I really recommend this blog, it's just a pure nutrition gem imo (and luckily it's well backed up scientifically and not commercial): http://wholehealthsource.blogspot.com

Stephan's blog (PhD in neurobiology, Univ or Washington) mainly centers around traditional healthy cultures like the kitava, trobiand islanders, masai etc. and Weston price's observations. It also discusses flawed studies.

Also very interesting: http://rawfoodsos.com/ This blod was originally about raw food, but it has largely moved on from that simplistic dogma imo (the author really likes to "play" with statistics and data sets)

If you really killed off all the bacteria in the gut with antibiotics, I think you would feel pretty sick. The bacteria is supposed to be there, and is needed for digestion (and who knows what else). Equally plausibly, the antibiotics decreased P. acnes without doing much to your gut flora at all (depending on type, dosage, duration).

Agree! My next experiment is to try to 'restore' my gut flora by making my own high-probiotic yoghurt which in theory should implant 'good' bacterias to replace the 'bad' one. But I suspect that it's already enough to have a good sleep cycle and thus, a GOOD DIGESTION.

Ok ive got a few questions:

Whats the effect of glass. (full height glass window/wall). Would this just be as good/almost as sitting in front of it outside?

And what if i sit behind the glass wall looking at my pc screen and not into the garden/outside. What will the difference in this.

ps. theres not a lot of direct sun shining inside does this matter, at least not at eye height.??

BTW: Last holiday I got more sun and my skin improved but only slightly. I was getting sun exposure for 10hours. But I didnt sleep a lot, drank a lot, slept in a tent while lights were on outside, went to bed at 4am and ate a lot. Still that all there bad factors didnt do a lot kinda proves this theory.

I didnt wear any glasses hats , I never do that.

2 years back my acne improved even more. I had less snacking but more bread (with jams and other sugary covers) etc that holiday. So i guess its just as bad. I had the same amount of alcohol (with a lot of sugar). But I slept darker i think.

In 4weeks ill go on holiday. But this time ill live healthy, sleep dark and make sure ill get as much sun as possible. Ill post the results

I know you have done some experimenting with tryptophan supplements. What is your opinion on them?

I tried multiple forms and did not see any significant effect on quality of sleep or acne. YMMV. Worth a try, etc.

Whats the effect of glass.

Glass is good at blocking UVA. My suspicion (and experience) is that UVA in the eye makes sunlight more effective at preventing acne (e.g., more benefit for fewer hours). My best results with least effort have consistently been from outdoor light with my eyes naked to the sky (which regrettably means not being able to see well for me, since I need prescription glasses).

ps. theres not a lot of direct sun shining inside does this matter, at least not at eye height.??

I try to avoid direct sun in my eyes. I've never had much luck trying to get my light from windows. Whether that's due to the much narrower light source, the blocking of UVA, or something else, I don't know.

But choosing foods with at least an equilibrated fructose-glucose ratio (better in favor of glucose) certainly would aslo help...

That is what doctors treating carb malabsorption argue. However, that is not what I see when I read about the biochemistry. It appears to me that the details of who fructose gets absorbed are still being fleshed out. However, this rat study suggests the GLUT5 transporter is key and I know of no reason to believe it can be aided by glucose. I haven't found any replication of the "unexpected" results of the two (almost 20 years old) studies you cite, and can't find any doctors encouraging patients to take glucose pills to avoid fructose malabsorption. More recent inquiries point to the intestine quickly adapting to changes in sugar intake, making everything else a big YMMV. Probably I'll understand much more than I do now about this in a year. 😀

Data are you still clear on this and have others had good results with this?

I'm acne-free so long as I pay the price. As always, looking for a lower price to pay. 😀

You may find Cooling Inflammation blog (by Art Ayers) interesting too: It's a blog about inflammation, gut bacteria, diet etc. There's also a post about acne.

In the comment section he answers to me as I asked him (Art Ayers) what he thinks about this melatonin thing:

The thread that you site is very interesting and makes a lot of sense. I think that acne is not a single disease, but rather a diverse group with different causes and similar symptoms. As a result, cures for individuals may not apply generally, but in one group at least, fastidious day/night cycles may have profound effects.

 

Involvement of superoxide dismutase makes sense, because of the high carb dietary triggers for some with acne. High glucose levels can trigger superoxide production that could contribute to inflammation, but superoxide dismutase would minimize this effect.

 

I would think that levels of diet-based chronic inflammation would dominate other groups of people with acne and could be cured with an anti-inflammatory diet. Vitamin D deficiency may be important in others and direct sun exposure would help only if chronic inflammation is fixed first.

 

I don't understand the whole carb malabsorption and tryptophan angle and question that. I think those effects are attributable to gut flora, otherwise that would be a great way to reduce calorie consumption.

 

Thanks for the input.

Ray Peat is quite an strange guy. His radical recommendations (much less PUFA, less vegetables, more fruit and sugar, more SAFA, more gelatin) and thoughts are quite interesting but he seems not to have reference of every one of his claims and that makes it a bit difficult to know whether he is right or not.

Argh. My skin isn't that good and I would like to test your hypothesis but it's not very easy right now. Can't find good lamps, gotta work inside with no adequate light 9am-3pm, and it's a bit cold outside (here in Finland).

Ju

Just

More recent inquiries point to the intestine quickly adapting to changes in sugar intake, making everything else a big YMMV. Probably I'll understand much more than I do now about this in a year. 😀

Looking forward to it!

@Valtsu:

Thanks for the blog, it's also interesting. I saw the author post on wholehealthsource many times, didn't know he had a site too...

Ray Peat is quite an strange guy. His radical recommendations (much less PUFA, less vegetables, more fruit and sugar, more SAFA, more gelatin) and thoughts are quite interesting but he seems not to have reference of every one of his claims and that makes it a bit difficult to know whether he is right or not.

I agree with that... He's really a unique fellow. The only point I'm having trouble agreeing with him, is his preference for fruits as the main carb providers. He doesn't seem to like starches, except in small quanitities. Art Ayers doesn't recommend starches in his anti-inflammatory diet either. I don't suspect starches in general, but rather grains as potential problem makers... For example, the sweet potato was a basic food for natural 'primitive' tribes like the Kitavas or the ones in Africa etc. without causing problems apparently.

I think I can pretty reliably stop acne with this regimen. It's a pain in the ass, and my lights are still not optimal for the winter. I have a feeling that I need to go outside every few days to get some "real" light. But as long as I don't digest any sugar I'm fine. I can still eat a little bread with homemade jam and not break out.

It's not as effective as Accutane (obviously?) but it works well enough so that I can live my life.

Future problems: Winter and employment in an office without my special lights.

A new observational study of methionine-bound zinc (trade name OptiZinc, I think) has emerged:

http://www.ncbi.nlm.nih.gov/pubmed/20666829

It's interesting for a couple of reasons. First, it claims the benefits are late-onset, requiring typically 8 weeks of dosing (possibly longer than some people test a zinc supplement before giving up). Second, it uses a 3 dose per day schedule, but the commercial product (at least the version I'm looking at) is 1/day containing 30grams of zinc. Will have to grab the full paper next time I'm at University to see whether they were really dosing 90grams of zinc per day, or if they used a smaller formulation.

It's a typical observational acne study (small numbers, no great attempt at objective measurements), but they claim 38/48 patients had 80-100% improvement.

Got the study and read it. Looks like it was 15mg of zinc three times per day, along with a few other vitamins. The point seemed to be to resolve the fact that the effects of zinc on acne in studies have been relatively variable. The authors argue that the variability comes from how well zinc is absorbed, so by using a hopefully more bioavailable form of zinc and dosing 3 times per day, they should have gotten positive results, which they did.

As usual with zinc, there was quite clear statistical improvement (quite good for many of the patients), but nothing like a cure. In fact, they noted no statistical improvement in nodular acne.

This jibes with my own theory that a) zinc is important but not sufficient and b) the bioavailability of zinc is variable (and one strong source of variability depends on how much sunlight you get in your eyes during the day).

This is amazing. THIS TRULY IS.

So here we actually have the truth, we have the secret behind acne. The mystery is solved.

I dont think it will take long time before this is in the media etc etc,

My story.

I have always been thinking that acne is caused by lifestyle, because of prehistorian people that lived a traditional way didnt have acne. And also similar people today. So therefore ive always belived acne has been one of the western diseases, and it is, if we can call it a disease, i guess we can. However, I have always been convinced it was about diet, as I didnt have the creativity to think of something else, like this, that its about the lights!!! ITS AMAZING, and GREAT scienze work behind, and it is a so wonderful logic in everything. DAMN

Thanks for great work, you should really bring this theory up some levels and tell somebody about, I dont know who, but remember to keep the honour yourself. But you can be very proud of yourself. You have actually found out the biggest factor people get acne. And this is something people have tried for years, many people! Damn.. I Have no words.

The only bad thing about this is that its a lot of work to do for each person.. But more scienze on this and maybe we can adapt so it wont be so hard to live like this, and maybe we will recover that illnesses as well is a part of this..........

That was my words. Thanks. Great work. Great science. You are truly a hero - and you will get all the credits you deserve for this. I know you will

http://www.litebook.com/index.asp

Ive got this thing at home, could/should I use it? What do you think. It has around 10000lux on the right distance. And I think it also has more green and blue frequencys.

Ive got this thing at home, could/should I use it?

Sure, why not? The problem is, it's hard to spend hours each day keeping your eyes at a specific distance from a small light source like that. Something is better than nothing, but with indoor lights I find I really have to plant myself in front of them most of the day to get benefit equivalent to just a few mid-day hours in summer-time (UVA-laden) sunlight.

---------

FWIW, attached is a couple of before/after pictures from the OptiZinc study (15mg zinc, 3 times per day, for >8 weeks). Must be taken with a grain of salt since of course they'll show the best results and, with young patients, maybe they just happened to "grow out of it" during the course of the study. Still, it suggests what is possible for some patients just taking zinc.

My practice:

I am outside as often I can, roughly 2-3 hours divided over the whole day its light outside, and spending 20-30min of that time just looking in the sky.

I dont eat after 1900

I have quit consumin fruits, caffein and alkohol

I am sleeping everyday at 23 in the night and wake up at 8 in the morning, I also have no need for a alarmclock. Its completely dark in my room, completely.

I am taking 100-200 g Zink everyday, 10 paranuts for selenium and copper, 2x b-vitamin complex

This made me clear within 2-3-4 days

The eight day i broke out a very little - however I did the same as mentioned above, but I increased my carbohydrate level a great deal from 30 % percent of daily calories to 70%, I also ate a very lot of cacao powder which I later found out had caffein in it, so I guess it was the coffein.

I have some questions :

What about the Sami people who live in northern scandinavia, for most of them the sun disappear completely in half of november, the whole december and half of january. I havent noticed when visiting them they had more acne in those months,

Is it important that you dont use lights also the hours before you sleep? Like reading on the computer right before you sleep.. Will that make your melatonin cycle go crazy? Or is it OK as long as you have no difficulties sleeping within 30min..?

Shouldnt caffeine in the mornings be just good, or will it interfer in a negative way with your melatonin cycle?

As I can not be so much outside, I guess my melatonin level doesnt go completely away during the day. Can it therefore be beneficial taking melatoning pill right when I sleep? just to give it a boost, even though I sleep easily without? But could it be beneficial still?

If I take 100-200mg zink a day, should I take everything on empty stomach right before bed or spread it throughout the day?

In my zink pills there is corn starch, which is fructose isnt it?

Any other tips for me?? =)

What about the Sami people who live in northern scandinavia, for most of them the sun disappear completely in half of november, the whole december and half of january. I havent noticed when visiting them they had more acne in those months,

a) It's hard to tell by casual observation what the acne rate is in any given population. For example, only when detailed studies were done did it become clear that almost half the adults under 40 in civilized society have some acne on any given day, or that zero people among the Trobriand Islanders had any acne.

b) Light, of course, is only one of the factors that influence the (in)digestive issues that keep you from getting nutrients needed to prevent acne. I don't know anything about the Sami in particular, but I do know there is research indicating that Scandinavians in general get dramatically less fructose in their diets than , say, Americans.

Is it important that you dont use lights also the hours before you sleep?

YMMV. I definitely can feel my normal sleepiness delayed if I stay under very bright lights right up until bedtime. However, if all the lights are off and I'm just reading a computer screen before bedtime, that definitely does not produce the same effect (in fact, I sometimes play a video game in a completely dark room on a small laptop screen for 15 minutes if I'm not feeling sleepy yet).

Or is it OK as long as you have no difficulties sleeping within 30min..?

If you're getting sleepy at bedtime, that's the best signal of success you can get until technology lets us monitor the melatonin cycle in real time (someday).

Shouldnt caffeine in the mornings be just good, or will it interfer in a negative way with your melatonin cycle?

Caffeine actually slows the breakdown of melatonin into its metabolized components. For that reason, it's plausible that morning caffeine is actually beneficial for acne. These days, I drink a cup of green tea sweetened with xylitol every morning. It's neither a miracle cure, nor does it keep me from sleeping well or from avoiding acne.

I use xylitol because it may upregulate superoxide dismutase, though I found this only in a patent application and nowhere in published research so far. Again, no great cure there, but of all the things I can do to avoid acne, reaching for a different bag of sugar is pretty trivial, so if it might help a bit, why not?

As I can not be so much outside, I guess my melatonin level doesnt go completely away during the day. Can it therefore be beneficial taking melatoning pill right when I sleep? just to give it a boost, even though I sleep easily without? But could it be beneficial still?

The big issue with daytime bright light exposure is influencing your digestion so that you can get the nutrients you need to make melatonin and other anti-oxidants. In a word, day-long bright light exposure lets you eat more fructose (and other carbs) without getting acne. Can a night-time melatonin pill help? Sure, give it a try. IME, it produces nothing so dramatic as light exposure does. In winter time, I have to work harder to restrict fructose/carbs.

If I take 100-200mg zinc a day, should I take everything on empty stomach right before bed or spread it throughout the day?

There just isn't evidence to say. The recent OptiZinc study used 15mg 3 times per day, so why not go with that. 200mg of zinc/day is too much to take long term.

In my zinc pills there is corn starch, which is fructose isnt it?

As the name implies, it should be just starch, not sugar, but either way it's going to be a trivial amount compared to what you get in your diet.

Any other tips for me?? =)

• Take a Vitamin B complex pill with the evening meal.
• When you can't get daytime light, cut back harder on fructose/carbs.
• Get daily aerobic exercise (not right before bedtime). Exercise can amplify the melatonin surge.

Ive got this thing at home, could/should I use it?

Sure, why not? The problem is, it's hard to spend hours each day keeping your eyes at a specific distance from a small light source like that. Something is better than nothing, but with indoor lights I find I really have to plant myself in front of them most of the day to get benefit equivalent to just a few mid-day hours in summer-time (UVA-laden) sunlight.

 

I guess its pretty easy to get a few hours with it behind the pc, although I really dont like it. I quickly get irritation in my eyes. So I decided to move it more back.

Thanks for great answers.

Do you have any opinion on tobacco, smoking, mariujana or nicotine, if that can have any effect on acne?

Also, if I want to go out on lets say a saturday.. Lets say I am not drinking... Lets say I sleep at 0200 instead of 2300, should I still wake up at 0800 or sleep more? Do you have any other tips to reduce the side effects as much as possible?

Do you have any opinion on tobacco, smoking, mariujana or nicotine, if that can have any effect on acne?

Not much. Clearly, these things can affect both zinc levels and sleep, but exactly what the effects will be on an individual are hard to say. For example, zinc levels in semen will definitely go down in most male smokers (but does that mean an overall loss of zinc, or more zinc available for other compartments of the body?). But one study found a positive correlation of zinc serum levels and smoking for women.

Also, if I want to go out on lets say a saturday.. Lets say I am not drinking... Lets say I sleep at 0200 instead of 2300, should I still wake up at 0800 or sleep more? Do you have any other tips to reduce the side effects as much as possible?

I don't know if there's data relevant to that question or not. My answer is "always sleep until you wake up naturally (unless that's too early, in which case sleep more or just lie there in the dark and be calm)".

What really reduces the side effects of one late night IME is day-long bright sunlight exposure. Research indicates what my personal experience shows, which is that when you have a strong melatonin cycle established, it buys you at least a day's grace period for screwing up.