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Diet does matter when it comes to acne

LESLIE BECK | Columnist profile | E-mail
From Wednesday's Globe and Mail

It’s estimated as many as 80 per cent of teenagers experience some degree of acne, a condition that makes them feel isolated, diminishes self-esteem and can cause depression.

Acne can begin in adulthood, too, with the majority of cases – 75 per cent – occurring in women.

Many people who’ve battled acne attest that certain foods aggravate their skin. Yet most dermatologists contend there’s no scientific link between diet and acne. The prevailing view is that the food-acne connection is a myth.

Recent studies are, however, challenging this stance. Dairy products and high glycemic foods (e.g. sugary foods and those made from refined flour) have been shown to worsen acne, while omega-3 fats may alleviate it.

Body weight may also play a role. A study published this month in the Archives of Dermatology found that among 3,600 boys and girls, aged 18 and 19, girls who were overweight or obese were twice as likely to have acne as their leaner peers. In boys, there was no link between acne and overweight.

Having a body mass index (BMI) of 25 or greater was associated with acne in girls even after accounting for diet, smoking and mental stress. (BMI is calculated as your weight in kilograms divided by the square of your height in metres. In adolescents aged 18 and older, a BMI of 25 or more signals overweight; 30 more indicates obesity.)

Acne is caused by the combination of too much sebum and a buildup of dead skin cells. (Sebum is an oily fluid secreted by glands in pores to keep skin and hair moisturized.) In teens, rising levels of male hormones, especially testosterone – present in males and females – are thought to trigger acne by creating a surplus of sebum.

Changes in the level of insulin, the hormone that clears sugar from the blood, can also increase the formation of acne.

The link between overweight and acne makes sense to researchers. Insulin and other hormones are often altered in overweight adolescents, increasing the likelihood of acne.

It’s also possible that polycystic ovary syndrome could explain some of the findings. It’s a hormonal problem that causes women to have symptoms such as irregular menstrual periods, obesity, acne and excess hair growth.

Although diet contributes to weight gain, it’s not clear from this particular study if specific foods are to blame.

But other studies have pinpointed certain foods, opposing the notion that diet has nothing to do with acne.

The role of diet in the development of acne wasn’t always refuted. Prior to the 1960s, dietary advice was a standard part of acne therapy. At the time, elevated blood sugar and impaired carbohydrate metabolism was implicated in acne. Patients were told to avoid eating too much carbohydrate and too many sugary foods. Dermatology textbooks discouraged foods such as chocolate, sweets, fatty foods and carbonated beverages.

Later, two studies published in 1969 and 1971 – ones that wouldn’t be published today – caused doctors to abandon thinking that diet and acne were related. Both studies, fraught with major design flaws, failed to find a link between acne and a handful of foods.

Now, four decades later, researchers are re-examining the diet-acne connection and coming up with evidence that, for certain foods, there is a link.

While there’s isn’t absolute proof the following dietary factors cause acne, some modifications may be worth considering. And many are all-round healthy suggestions.

High glycemic foods

The most convincing evidence to date has identified high glycemic index (GI) foods as an offender. High GI foods such as white bread, white rice, refined breakfast cereals, cookies, cakes and sugary drinks cause spikes in insulin. This, in turn, limits the production of proteins that attach to testosterone, leaving the hormone free to roam the body and possibly cause acne.

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