Anti-acne diet

Today we're going to take a look at how your diet influences your skin quality and acne, and how the medical community has failed miserably on this subject.

History of medical concepts on diet and acne.

Let's go back in time to understand what happened. It's the '60s, you've got theacne and you decide to consult your dermatologist for advice, and during the consultation he tells you that your diet has nothing to do with your acne. In fact, a few years ago, two studies caused a stir in the medical community by finding no link between acne and eating habits. As a result, doctors felt that the link between acne and diet was not scientifically established. However, we now know that both studies were flawed in their design - for example, to carry out the study, patients were asked to eat either chocolate bars or placebo bars, but in fact the placebo bars were just as high in Sugar and fat as the cholocolate bars, no wonder the study's conclusions were flawed. For forty years, no more research was carried out in this field, and the role of diet in the onset of acne was forgotten. It's only recently that the link between acne and diet has been re-examined. In 2002, Lorain Corden published a study in the archive Dermatology journal in which he describes how he studied populations in Paraguay and New Guinea and found that people who lived in a non-industrialized world, with a diet close to that of the Paleolithic era, had virtually no acne. This observation had already been made by an American dentist at the beginning of the twentieth century. But what's even more interesting is that when these populations adopt a Western diet rich in sugar and dairy products, they start to develop acne. It was on the basis of this evidence that the medical community began to change its mind, and nowadays things have changed: every year there are more and more studies on the relationship between our diet and the onset of acne.

Today we're going to take a look at the foods implicated in the onset of acne, what strategy to put in place to adapt your diet to your advantage to improve your skin quality, and of course get to the bottom of chocolate or Whey protein.

Understanding acne

Let's start with a quick reminder: in Western countries, acne affects 80% of teenagers and a third of women between the ages of 20 and 50. There are four key factors favoring acne: increased sebum production, proliferation of Cutibacterium acnes bacteria, skin inflammation and hyperkeratinization. This diagram from a study published in 2021 illustrates the complexity of the link between our diet, hormones and the mechanisms leading to the appearance of acne. A poor diet will increase blood levels of insulin, insulin-mimetic growth hormone and androgen, inducing the sebaceous glands to secrete more sebum. Sebum production is a natural phenomenon, and the presence of a lipidic film is essential to protect the skin. However, if sebum production is too high, it will not be able to evacuate normally, leading to sebum retention in the sebaceous glands and inflammation of the skin. Add to this colonization by cutibacterium acnes bacteria, and the inflammation and acne become uncontrollable. Diet plays an important role, but we mustn't neglect the following factors anti-acne creams.

The role of foods with a high glycemic index:

Let's get to the heart of the matter, and start with foods with a high glycemic index, as this is the criterion on which the scientific community is unanimous. Foods with a high glycemic index are those that trigger insulin spikes.
Insulin is a hormone secreted by the pancreas that regulates blood sugar levels, and certain extremely sweet foods cause blood sugar levels to soar and, by correlation, insulin levels to soar when consumed. Researchers have developed the glycemic index, which indicates how much a food will raise blood sugar and therefore insulin levels when absorbed. For example, the glycemic index of glucose is 100 and the glycemic index of an apple is 35. This diagram shows how insulin levels change according to the glycemic index of foods. If foods have a low glycemic index, the increase in insulin will be slight and you won't experience hypoglycemia after meals. On the other hand, if you eat foods with a high glycemic index, insulin levels will explode, inducing reactive hypoglycemia and a cascade of interactions leading to an increase in insulin-mimetic growth hormone IGF1 and androgens, the end result of which is the appearance of skin blemishes or even acne.

To give you further proof of the direct link between insulin, insulin-like growth hormone and acne, I'll give you an example. Patients with LARON syndrome, a kind of dwarfism due to the absence of a growth hormone receptor, have no acne and, incidentally, hardly any cancer. However, when these patients are supplemented with IGF1, i.e. insulin-mimetic growth hormone, they start to develop acne.
Based on these findings, numerous studies have been carried out by the scientific community, revealing a direct link between a low-glycemic index diet and a reduction in androgen levels, a reduction in insulin-mimetic growth hormone and a reduction in acne lesions. The scientific evidence is therefore strong, and it's now clear that an adapted diet can play a major role in the fight against acne and skin imperfections.
Don't worry, I'm going to give you some practical advice on how to reduce the glycemic load of foods and thus reduce your acne and, in the process, lose weight easily, reduce vascular accidents and prevent diabetes, but that's not our problem!

Avoid foods with a high glycemic index

To lower insulin levels, you need to avoid foods with a high glycemic index, or eat them at the end of a meal, and especially not between meals. This mainly concerns all sources of sugar, whether sugar you add yourself or sugar contained in industrial products such as cookies, cakes and soft drinks.
However, there are some interesting subtleties. For example, the avocado, a fruit rich in sugar and fat, has a low glycemic index of 10, as it has been found that the combination of sugar and fat helps to reduce the absorption of sugar into the blood. This is all the more useful in the case of avocados, as they contain mainly good fat with unsaturated fatty acids.
Another subtlety is that cooking has a major influence on the glycemic index of foods. The more a food is cooked, the higher its GI. The GI of al dente pasta is therefore lower than that of well-cooked pasta. As for potatoes, their GI is 65 when steamed, but rises to 95 when baked. In fact, heavy cooking will begin to predigest complex sugars, which will be released more rapidly when they are absorbed.
Another important criterion is the presence of fiber, which reduces the glycemic index of foods because fiber slows the passage of sugar into the bloodstream. For example, white pasta, bread or rice are rich in complex sugars and have a high glycemic index, but wholemeal rice, wholemeal bread or wholemeal pasta will have a lower glycemic index thanks to the presence of fiber. For example, white rice has a glycemic index of 70, basmati rice 50 and brown rice 45.
Final tips: Like lipids, the presence of protein in meals reduces the speed of carbohydrate absorption and therefore the meal's glycemic index. On the other hand, the presence of vegetables in your meals will also help lower the glycemic index of your food.

Dairy products and acne

Now we turn to dairy products. A study published in 2020 and carried out on 24,000 people revealed a link between acne and dairy consumption. So, as with chocolate, there's a strong presumption but no certainty. Casein accounts for 80% of cow's milk protein, and the remaining 20% is WHEY protein. Casein tends to increase IGF1, while Whey mainly increases insulin. However, the hyperinsulinemia induced by Whey also causes an increase in IGF1, which may explain why athletes, particularly gym-goers, who supplement with Whey may develop or worsen acne. Of course, this will only happen to a minority of people. On the other hand, it's important to distinguish between milk, which has a high glycemic index, and cheeses, which have a low glycemic index, which may explain some of the discrepant results among the various studies. With regard to dairy products, a generally useful attitude is to stop consuming dairy products for a month and then start introducing them again little by little. On the other hand, if you are taking an oral treatment with Doxicycline, its intestinal absorption is diminished by the intake of dairy products, which reduces its efficacy.

Chocolate and acne

Now let's talk about chocolate, which is a controversial subject! In 2014 a double-blind study was carried out on men suffering from acne, who were given either a capsule containing unsweetened cocoa or one containing gelatin. The study revealed a statistically significant increase in acne lesions in subjects given the cocoa-filled capsule. What's more, there was a correlation between the amount of cocoa and the number of new acne lesions. Numerous other studies have been carried out to find out whether chocolate actually induces acne, and the results of these studies are contradictory. Is chocolate incriminated because of CACAO or is it simply the increase in sugar that causes acne? It's hard to say. I think more studies are needed to assess the relationship between cocoa and acne, and at the moment it's just a presumption. If you have an important appointment in the next few days and a sudden craving for chocolate, perhaps it's best to avoid it if you have acne-prone skin.

Fatty acids

Now omega 3 and omega 6 fatty acids, found in fish and olive oil, are known for their ability to reduce the insulin-like growth hormone IGF1 responsible for increased sebum production and pore clogging. One study compared 2 groups of acne sufferers and supplemented one group with omega-3 fatty acids and linoleic acid for 10 weeks. The result was that after 10 weeks, the supplemented group had a statistically significant reduction in acne lesions.

Probiotics

Now let's talk about probiotics, a study carried out in 2016 showed promising results. 20 acne-prone adults were given either a probiotic-containing supplement or a placebo for 3 months, and at the end of the 3 months the probiotic group had a significant reduction in acne lesions. Biopsies were taken and showed a decrease in IGF1 levels. The results of this study are promising, but further research is needed to consider probiotics as a reference treatment.

Zinc

Now let's talk about zinc, considered a potential acne treatment that can be used both orally and topically. Studies show a benefit, but it's small, so yes, it's useful, but in moderation. I also suggest a diet rich in antioxidants, which is always beneficial for the skin, especially acne-prone skin.

What we can say today is that we have strong certainties about the efficacy of a low glycemic index diet in the treatment of acne. Data on dairy products are less powerful, but there is a presumption that milk proteins, and WHEY in particular, play a role in the onset or aggravation of acne. Regular consumption of omega-3 fatty acids is protective against acne. And of course, diet is only the first step, and an effective skincare routine is needed to treat acne quickly.