Finally the verdict is out. The positive relationship between diet and acne is not a myth anymore. It is a fact, and there are a number of studies to prove that, according to Bowe WP, Joshi SS and Shalita AR from the State University of New York Downstate Medical Centre and Northwestern University Feinberg School of Medicine, Chicago.
The authors, in a paper titled “Diet and Acne,” published in the July 2010 issue of the Journal of American Academy of Dermatology provides a comprehensive review of clinical studies conducted so far to elucidate the relationship between food and acne eruptions.
Does Food Affect Acne?
Whether diet affects acne or not has been a controversial issue for a long time. The majority of dermatology textbooks before the 1960s supported the view that certain types of food, like milk and chocolates, worsened acne eruptions in the teens. But a couple of studies conducted in 1969 and 1971 failed to show any positive relationship between diet and acne.
Fulton et al, in 1969 studied the effects of chocolate on acne in 65 teenagers. They found that the severity of acne did not alter while the subjects were on chocolate bars for four weeks and on control bars without chocolate for another four weeks with an interval of three weeks in between.
The above study was later criticised by many researchers as being flawed due to a number of reasons including insufficient period of study, low number of subjects and incorrect choice of control bars which contained partially hydrogenated vegetable oil rather than cocoa butter or paste. Researchers also pointed out that most patients with flare ups of acne caused by food complained of inflamed bumps, not comedones. Fulton et al had only counted the total number of acne lesions; hence a shift from comedonal to inflammatory acne could have gone unnoticed.
The study in 1971 by Anderson named “Foods as the cause of acne” published in the journal American Family Physician studied the effects of chocolate, milk, roasted peanuts and cola in 27 students for a period of one week. They also failed to note any significant acne flare-ups during or immediately after the study period. This study also suffered from the shortcomings of the previous study by Fulton et al. In addition, both studies failed to take into account the baseline dietary habits of the subjects involved in the study.
Diet Does Affect Acne
In 2005, Adebamowo et al, in a retrospective study in 47,355 adult women, titled “High school dietary diary intake and teenage acne,” published in the Journal of American Academy of Dermatology, re-examined the relationship between diary products and acne. Their inference was that acne was indeed positively associated with milk, especially skim milk, ingestion.
In 2002, in a significant study published in the Archives of Dermatology, Cordain et al branded acne vulgaris as a disease of Western civilization. They conducted a cross-sectional study in 1300 natives in Papua New Guinea and Paraguay. The staple diet of these two societies consisted of low glycemic (sugar) load which were devoid of the Western refined foods like the cereals, chips, cookies, and bread. Acne was almost non-existent among these tribes.
Food and Acne Relationship: Not a Myth Anymore
The comprehensive review on the “Diet and acne” in the July 2010 issue of Journal of American Academy of Dermatology by Bowe et al examined all studies conducted to date about the acne-diet relationship with particular attention to the influence of diary products and carbohydrate intake in relation to acne severity. Following are their conclusions:
- Dermatologists can no longer dismiss the association of acne and diet as a myth; it is a reality.
- There is reasonably compelling evidence now that food containing high amounts of refined sugars and carbohydrates may aggravate acne. Like the diabetics, it will be beneficial for acne sufferers to avoid high glycemic foods and concentrate more on low glycemic snacks.
- There seems to be weak evidence regarding the dairy products and acne severity, but the association is very much present. (Analysing similar studies, in a review titled “Does Diet Really affect Acne?” published in the March 2010 issue of Skin Therapy, Ferdowsian HR and Levin S from the department of medicine, the George Washington University Medical Center, Washington DC, had a different view from Bowe et al. They affirm that researchers have indeed proven a significant association between all varieties of cow’s milk and severity of acne eruptions).
- The role of omega-3 fatty acids, antioxidants, zinc, vitamin A and dietary fiber in the treatment of acne is still not clear and cannot be recommended yet.
While considering the effects of food on acne, the influence of other factors like hormones, iodine content etc. in poultry, meat, milk and other diary products should also be taken into account. Most of the studies on the acne-food relationship have so far concentrated on diary products and carbohydrates only. The effect of other food items on the cause and maintenance of acne also need to be explored.
It is clear that dermatologists, dietitians and acne sufferers alike will now have to change their dogma regarding the diet-acne relationship in the light of latest studies on the subject.
Food and Acne: Related Articles
References:
- Bowe PW, Joshi SS, Shalita AR. Diet and acne. J Am Acad Dermatol 2010;63:124-41
- Ferdowsian HR & Levin S. Does Diet Really Affect Acne? Skin Therapy Letter 2010;15:3:1-2
- Davidovici BB, Wolf R. The role of diet in acne: facts and controversies. Clinics in Dermatology. 2010;28:12-16
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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