The Diet Acne Connection

You are what you eat holds particularly true in the case of your skin.

For years, it was believed by some that certain foods may cause acne. For instance, chocolate and high fat foods once believed to be the culprits were found to be innocent. While most early studies of specific foods believed to trigger acne found no direct relationship between acne and diet, new evidence of the diet-acne link are causing scientists to take another look to see if there is a connection between diet and acne breakouts.

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A Healthy Antioxidant and Omega 3-rich Diet

According to the American Academy of Dermatology, “A healthy diet is important for improving raw materials for healthy skin”. Certain diet considerations can help the body’s immune system and directly affect acne treatment. A healthy diet is rich in vegetables, fruits and whole grains. Eating different kinds of fruit, vegetables and whole grains daily provides the body with antioxidants that reduce the inflammation of acne.

The Top 20 Foods Highest In Antioxidants

  1. small red beans
  2. wild blueberries
  3. red kidney beans
  4. pinto beans
  5. cultivated blueberries
  6. cranberries
  7. artichokes
  8. blackberries
  9. prunes
  10. raspberries
  11. strawberries
  12. red delicious apples
  13. Granny Smith apples
  14. pecans
  15. sweet cherries
  16. black plums
  17. russet potatoes
  18. black beans
  19. plums
  20. gala apples

In addition to antioxidant foods, research indicates that eating omega-3 fatty acids may reduce the severity of acne because omega-3 fatty acids have an anti-inflammatory affect.

The typical American diet has 10 times more omega-6 fatty acids than omega-3 fatty acids. Omega-3 fatty acids help reduce inflammation, and some omega-6 fatty acids tend to promote inflammation. A healthy diet contains a balance of omega-3 and omega-6 fatty acids. It’s far healthier to get a 3:1 to 1:1 ratio of omega-6 to omega-3 fats in your diet so that the omega-3’s can provide their anti-inflammatory affect.

The University of Maryland Medical Center lists heart disease, cancer, depression, asthma, and arthritis as the results of too much omega-6 intake and too low omega-3 intake. If the improper balance can cause those conditions it is possible it could aggravate acne. So, it’s best to have a higher intake of omega-3, a lower intake of Omega-6, and most importantly, a good balance between the two.

Foods that have high proportions of omega-6 ratios

  • These oils: corn oil, evening primrose oil, pumpkin oil, safflower oil, sesame oil, soybean oil, sunflower oil, walnut oil, wheatgerm oil
  • All regular meat – beef, chicken (non grass fed)
  • All nuts (with very few exceptions)
  • Peanut butter and other nut butters
  • All cookies, cakes, commercial desserts
  • All commercial snacks, chips, popcorn, any packaged snack

Omega-3 fatty acid rich foods

  • Fatty fish like salmon
  • Flax seed
  • Avocados
  • Canola oil
  • Tofu/soybeans
  • Soybean oil
  • Flaxseed/linseed oil
  • Olive oil
  • Walnuts

It’s sometimes difficult to eat these as often as necessary to get the correct intake so taking a supplement can also help. The World Health Organization and governmental health agencies of several countries recommend consuming 0.3-0.5 grams of daily EPA + DHA and 0.8-1.1 grams of daily α-linolenic acid. A doctor and pharmacist should be consulted for dosing for other conditions.

Low Glycemic Index Diet

A research team, led by Associate Professor Neil Mann from RMIT University, has discovered another possible association between food and acne breakouts.

Professor Mann and his team spent more than two years studying metabolic changes resulting from altered glucose and insulin levels due to diet and its affect on acne. The study recruited 50 boys and divided them into two diet groups.

One group consumed a typical Western teen diet consisting of sugary snacks, processed foods such as sugary cereals, potatoes, rice, chips, white bread, cakes, biscuits, soft drinks and sugary snacks. These are foods known as high-glycemic index foods (GI). High GI foods elevate blood glucose levels and insulin levels dramatically.

The other group followed a healthier, more natural diet higher in protein and with low GI foods such as fruit, vegetables, seafood, wholegrain bread, pasta and legumes replacing the high GI foods. (25% protein and 45% low-glycemic index (GI) carbohydrates).

The Glycemic Index

Researchers have developed a method for measuring how quickly carbohydrates are converted into glucose. Some carbohydrates digest more slowly than others, causing a gradual rise in blood sugar after eating. The more rapidly a food is converted to glucose causing a sharp spike in blood sugar. When blood sugar rises quickly, the body produces a surge of insulin to lower the amount of glucose in the blood. Insulin is a hormone that helps the body take sugar (glucose) out of the bloodstream and put it into cells, where it can be used for energy or stored in fat.

The scale is called the glycemic index. It ranks carbohydrates and other foods according to the effect they have on blood sugar. The glycemic index is a scale of 0-100.

Foods that have a high glycemic index rating include: white bread, white rice, white potatoes depending on how they are cooked, beer, corn products and some products containing refined sugars, watermelon, most white rices, rice krispies and corn flakes.

Foods with moderate glycemic index ratings include: whole grain breads and pastas, brown rice, sweet potatoes, green peas, many fruits (especially when eaten alone) and yogurt. Many of these foods are on the list of foods to avoid in the acne diet.

Low glycemic index or no GI foods include: rye grain, nuts, meat, legumes such as black beans and lentils, eggs, green vegetables, apricots, and cherries. These foods may be enjoyed an may not worsen acne.

Foods that are high in fiber tend to have lower glycemic index numbers, because fiber takes longer to digest. Studies have shown that the presence of other foods such as fats like olive oil, can also slow digestion and keep blood sugar from rising too quickly. The glycemic index can be used along with the acne diet, to help choose which carbohydrates can be eaten with the least effect on blood sugar.

After 3 months the acne of the boys on the higher protein low GI diet improved by more than 50%. The authors conclude that high GI foods increase the levels of insulin in the blood and this effects the production of hormones such as testosterone. Higher levels of hormones may cause acne to worsen.

Compelling evidence by other studies also exist that high glycemic diets may worsen acne leading to the recommendation that eating lower glycemic index foods may help reduce the number and severity of acne breakouts. For instance, another study showed that more than 80% of adherents to the South Beach Diet noticed improvement in their complexion within three months of starting the dietary regimen. (The South Beach diet consists of nutrient-dense, fiber-rich foods, lean protein, such as fish and other seafood; skinless white-meat poultry, and lean cuts of beef, tofu, beans, high-fiber veggies; reduced-fat cheeses; eggs; low-fat dairy; and healthy, unsaturated fats, such as those found in avocados, nuts and seeds, and extra-virgin olive and canola oils).

Studies of the diets of ethnic groups that have a low incidence of acne form the basis of other acne-diet relationship studies. One study was published in the December issue of Archives of Dermatology and it centered around village people’s dietary habits on Kitava Island, Papua New Guinea. When the diets of these people are compared to the typical Western diet, there are nutritional differences. The ethnic groups with very low incidence of acne ate mostly plant-based diets that were low in fat and nearly sugar-free. This diet keeps their insulin level low. The typical Western diet is heavy in meats, saturated fat, refined sugar, and highly processed foods. By studying these differences, doctors and researchers have developed suggestions for dietary changes to improve or eliminate acne.

Dairy Products and Acne

Research has found a possible association between milk intake and the incidence of acne. One study, published in the May 2008 Journal of the American Academy of Dermatology, looked at the diets of teenaged boys. Those who drank the most milk also tended to have the worst acne.

A large study of over 45,000 nurses found a link between the amount of dairy products these women consumed and the severity of acne they experienced. Women who reported consuming higher amounts of dairy products reported more severe acne.

Of all dairy products, milk seemed to be the worst offender. Interestingly, skim milk was more associated with breakouts more often than whole milk, so it seems fat content in milk isn’t the cause. Cottage cheese, and sherbet also had a negative effect on the skin. But other dairy products didn’t seem to cause breakouts. And those who took vitamin D supplements didn’t have more breakouts, so vitamin D isn’t thought to be the cause either.

The culprits that some researchers think are associated with breakouts are the hormones found in milk. Milk contains androgen hormones. Testosterone is an androgen hormone, and it is strongly linked to acne development.

Testosterone creates di-hydrotestosterone (DHT). DHT stimulates the sebaceous glands, creating oily skin that is more prone to pore blockages and pimples. Milk naturally is filled with hormones, including DHT. It’s possible that milk contains enough hormones to have an effect on the body, including the skin.

Many dairy farmers also give their cows additional hormones to stimulate milk production and so the cow to produces more milk. As a result, most milk is very high in IGF-1, a growth factor that peaks in the human body during adolescence, when acne is usually at its worst. It is believed that IGF-1, along with testosterone and DHT, trigger acne breakouts.

The processing of skim milk may explain why it is linked to acne severity more often than whole milk. Whey proteins are added to give skim milk a creamier consistency. Some speculate that these proteins impact acne development. Maybe because whey protein has an insulin stimulating affect.

Of course, not everyone who drinks a lot of milk breaks out in pimples, and many disagree with these findings. The Dairy Council argues that the results are biased.

And many medical professionals are wary of the conclusions being drawn, because the studies don’t take into account other factors that may influence acne severity. They’re also quick to point out that the studies don’t link milk to acne development — they only establish a correlation between milk consumption and acne severity. This no-dairy philosophy however has its believers. Some dermatologists say they have had some success in having their patients decrease or eliminate milk and dairy from their diets.

As interesting as the study results are, they are preliminary and more research needs to be done. Much more research is needed before this theory can be proven.

A healthy diet will certainly improve your overall health. And the results of these studies suggest that a low-carbohydrate or a reduced dairy product may help improve skin condition in people with acne. Certainly for those who have severe acne that is difficult to treat, dietary manipulations would be worth trying.

Keep in mind if you do decide to decrease your dairy intake, limiting intake of calcium can cause deficiency and significant health problems. For that reason, a calcium supplement may be needed to insure daily dietary calcium requirements are met.

Instead of highly processed foods try incorporating more whole grains (such as whole wheat bread, wheat pastas, brown rice, oatmeal, etc.) into your diet, as well as plenty of fresh vegetables, beans, fruit, and lean protein. And drink plenty of water, include antioxidant rich foods and Omega-3 rich foods. Decrease your intake of high Omega-6 foods. Limit the amount of sugary sodas and snacks, and other junk foods.

Not only might these changes help your skin look better but eating this way may help prevent other medical conditions such as diabetes, heart disease, and obesity….and possibly clear up skin too.

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