Dietary factors have been shown to contribute to acne outbreaks. Acne is caused by overproduction of sebum due to hormone mediators such as SHBG and IGF-1 which increase sebum production, leading to more sebum being released onto the surface of skin and increasing sebum formation.
An on-line diet questionnaire was utilized to measure frequency of specific food consumption and habits within a week. Results were translated into clinical scores to assist clinicians in providing customized dietary recommendations to their patients.
Dietary Patterns
Studies using the Food Frequency Questionnaire MEDAS have conducted numerous investigations of diet and acne. Acne has been linked with an increased consumption of high-fat and high-sugar foods like dairy products, fast foods and confectionary. However, their diets may differ substantially from that of healthy individuals.
Due to questionnaires, it is impossible to ascertain whether any particular dietary pattern caused or worsened acne. Furthermore, diet choices may depend on subjective considerations (e.g. selecting principal components/factors; identifying food groups with large factor loadings and selecting their nomenclature);
Although evidence suggests a low glycemic load diet, dairy food, and fatty acid consumption reduce acne vulgaris, further research must be conducted in order to establish causation.
Saturated Fat
Studies have shown that diets rich in dairy and sugar may contribute to acne. Such diets lead to an increase in insulin and IGF-1 levels, activating mammalian target of rapamycin complex 1 (mTORC1) which encourages sebaceous cell proliferation and lipid production.
Saturated fats derived from animal and hydrogenated plant sources contribute to acne pathogenesis by increasing proinflammatory cytokine production and stimulating signaling pathways associated with acne lesions. According to studies, adding omega-3 fatty acids and probiotics into one’s diet has proven successful at mitigating acne symptoms.
However, results of dietary surveys must be interpreted with caution as self-reporting may alter results. A study comparing individuals with and without acne revealed that those reporting acne tend to consume more milk, high glycemic foods and sugars and less fish.
Trans Fat
An ever-increasing body of evidence indicates that diet plays an integral part in the formation of acne vulgaris. Food choices affect certain biochemical markers and gene transcription related to sebaceous gland function, bacterial proliferation and inflammation which contribute to acne development. Dairy products, chocolate and saturated fats have all been implicated as contributors.
A case-control study by Aalemi et al involving 279 acne patients and 279 controls by Aalemi revealed that whole milk intake was positively linked with acne while skimmed milk intake was negatively related. This suggests low-fat milk may worsen acne; further research must confirm this assumption. Furthermore, food sources rich in stearic acid (such as margarine, pizza or chips) has also been associated with its presence.
Glycemic Index
Glycemic index measures how quickly a food increases blood glucose levels. Foods with a low glycemic index typically contain fewer refined carbohydrates and more nutrients; those with a high glycemic load diets, like high-fat dairy food diets, have been reported to worsen acne symptoms.
Diets with lower glycemic loads could potentially help to decrease acne lesions by decreasing insulin and IGF-1 activity; however, future research on this hypothesis should be performed before making this statement definitive.
Studies on the effect of specific diets on acne are limited and vary in methodology, yet several have demonstrated an association between Mediterranean diet (MD) and southern European countries and an improvement of acne symptoms. This dietary pattern includes olive oil, fruits and vegetables along with reduced dairy and sugar consumption as part of its core ingredients.
Dairy
Dairy foods that have been touted as acne cures include milk, yogurt, cheese and butter. Unfortunately, however, such claims do not stand up against scientific scrutiny; while several observational studies may support their claims; no randomized clinical trials exist yet to substantiate them.
Milk and dairy products contain proteins such as whey, casein and other variants that could contribute to acne formation. Furthermore, dairy contains natural sugars which may trigger an insulin surge and increase IGF-1 production – two proteins which promote sebaceous gland activity and oil production.
One study revealed that women who consumed two glasses of milk daily were 44% more likely to develop acne than those who did not consume dairy, though its effect may also be related to factors like their glycemic index or excessive sugar intake.
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