18 Oct 2022 Article

Acne and diet, is there a connection? People who suffer from acne have heard a lot of well-meant advice: don’t eat chocolate, follow a paleo diet, try fasting… This advice is not always based on science. In this article you will find an overview of what is known and proven regarding eating habits and acne.

What is acne?

Acne vulgaris (AV) is one of the most common dermatological diseases and affects the majority of the world’s population. Acne actually affects almost all people at some point in life. It usually starts during puberty. After that it most often disappears on its own. However, it can occur in adults too. The disease is characterized by excessive sebum secretion by the sebaceous glands and formation of comedones and pustules in areas rich in sebaceous glands, mainly the face. Some people only have a few blackheads, while others get a lot of pustules, deep lesions, abscesses and scars.

Much is now known about the development of acne vulgaris. But no “magic pill” has yet been invented that works for everyone who has acne. Both external and internal factors influence the course of AV. The main external factors that aggravate AV are an improper diet, improper skin care, and environmental factors such as air pollution. The main internal factors are hormonal changes and genetic predisposition.

As I am a dietitian, we are going to look at the aspects of diet that influence the development of acne.

Carbohydrates with a high glycaemic index

Carbohydrates play an important role in the development of AV and can exacerbate its course. A diet rich in carbohydrates with a high glycaemic index (GI) is associated with increased production of  insulin-like growth factor (IGF-1). A clear link has been found between IGF-1 and sebum production. The higher IGF-1, the more sebum production is stimulated. This in turn leads to the development and worsening of acne symptoms.

What exactly is glycaemic index? GI is a measure of how quickly carbohydrates are digested in the gut and absorbed into the blood as glucose. Carbohydrates are broken down into glucose in the digestive tract and then absorbed into the blood. Foods that release glucose quickly into the bloodstream have a high glycaemic index, while foods that are digested slowly and release the glucose gradually into the blood have a low glycaemic index.

The GI of pure glucose is 100. Foods can be divided into three groups: those with a low (≤55), moderate (55-69) and high (≥70) GI. People with AV should choose products with a low GI. Tables with GI can be found on the Internet. It is important to realize that the GI of a food is not an absolute number. It is always relative. Because there are quite a few factors that influence GI. These include the ripeness of food (if we are talking about fruit), time and method of preparation of the food, but also the speed at which a person’s stomach empties. That is why a different measure is often used in addition to (or instead of) GI, GL. GL is the abbreviation of ‘glycaemic load’. The glycaemic load takes into account both the amount of carbohydrates in a product and how much a person eats (an average portion). But it’s still not an absolute number. You can use GL as an indication of whether a food is high, moderate or low on the glycaemic scale.

Milk

Milk is known to significantly worsen acne. Like foods with a high glycaemic index, the consumption of dairy products causes an increase in insulin-like growth factor 1 (IGF-1).

Trans fats: NO

Trans fats are known to aggravate acne.

What are trans fats? These are unsaturated fats with a modified chemical structure. In the food industry, unsaturated fats (oil) are converted into saturated fats (hard fats). This is done through a specific chemical process called hydrogenation (also known as hardening). In the recent past, margarines and hard fats for baking and frying contained trans fats. Thanks to the modernization of the production process of cakes and pastries, the amount of trans fat is now significantly reduced.

Milk and meat naturally contain trans fats.

Health authorities recommend consuming as little trans fats as possible.

Omega-3 fatty acids: YES

Unsaturated omega-3 fatty acids have a proven positive effect on acne vulgaris. Omega-3 fatty acids reduce sebum production, liquefy sebum and increase the skin’s tolerance to bacteria.

Omega-3 fatty acids consist of alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is the main fatty acid of the Omega-3 family. The other two Omega-3 fatty acids, EPA and DHA, can be made from ALA.

For optimal health, women should consume two grams of ALA per day. For men, that’s three grams. Flaxseed oil is nature’s richest source of ALA. One tablespoon of flaxseed oil, a.k.a. linseed oil  (14 grams) contains no less than seven grams of ALA. Therefore, consuming just two or three tablespoons of linseed oil will cover your weekly need for ALA. Naturally, linseed (also known as flax seed) itself is also very rich in ALA. One tablespoon of flaxseed contains 2.5 grams of ALA. Other good sources of ALA are walnuts and chia seeds.

EPA and DHA are found almost exclusively in fish. This is because fish stores fatty acids in its adipose tissue. The recommended daily amount for EPA and DHA together is at least 450 mg. Oily fish such as mackerel, salmon, herring, sardines are high in EPA and DHA, they contain up to 5,000 mg per 100 g. For vegetarians and vegans, EPA and DHA from algae are now available.

Summary

Do you suffer from acne? The following dietary adaptations may help:

  • Choose foods with a low glycaemic index.
  • Avoid dairy products.
  • Avoid trans fats.
  • Make sure you get enough Omega-3.

In the next article, we’ll talk about micronutrients (vitamins and minerals) that are associated with acne.