Diet and Acne (continued)

I’ve blogged several times about environmental causes of acne, especially diet. Cynthia Graber, a science journalist, wrote a whole article about diet and acne, a link that dermatologists deny much more strongly than the evidence warranted. Why do they act so sure? I asked Graber. Because, low on the medical totem pole, they want to appear more scientific, she said. Genetics and drugs — that’s science. Diet — that isn’t science.

Here is more data on the subject, from two widely-different sources. The first is a comment on Dennis Mangan’s blog:

I had some acne when I was a teen. I was considered a very “pretty” teenager, but was painfully shy whenever my face “broke out”. I remember going to a dermatologist who put me on a sulfur cream and antibiotics for it. He emphasized over and over that diet “had absolutely nothing” to do with it, and that I should eat whatever I wanted and that “only by eating huge amounts of fish” could I actually aggravate it.

I still had some breakouts even until my twenties every so often. Because I was basically bodybuilding as a “hobby”, I switched to diet colas and started eating a great deal of tuna and canned chicken around this time. Guess what? The acne completely went away at about 21 and didn’t come back until about 26. At 26 I had some hard bumps under my chin like boils. The dermatologist said they were folliculitis and told me to make sure my razors were dry and my sink was super clean. But I noted that I had drifted back to a fast food diet and was drinking regular colas again–and kind of power-lifting a couple of days a week but not hitting it hard.

I got back into it at the gym, and wanted a six-pack again. I went back to diet cola and started dieting again. The result? The acne completely went away. This time I made a connection.

I have sworn up and down to some of my friends that I think our diets might lead to acne when we’re teens. One of my pals, Myron, took his kids (both teens) off cokes and instant soups and started cooking for them and making them drink orange juice and apple juice and tea. Their faces completely cleared up (they were 14 and 16) in about two months. No trips to the doctor, no anti-bacterial soaps, nothing. Just diet. They have had lovely clear skin ever since.

I have another friend at work whose teenage daughter “got off” colas and he started cooking for her (single parent). Her face cleared up. He mentioned it. She was a pretty girl but used to break out fairly badly. According to him, she’s on top of the world now that her skin is cleared up and is confident (and she should be because she really is a cutie).

I read a little bit about the study doctors cite about acne and diet. They fed a big chocolate bar to one group and fed another a CANDY bar that didn’t contain chocolate to another group. Since both groups had acne at the same levels, they declared that diet had nothing to do with acne. WHAT HOGWASH!!!!! If they were both drinking sodas, both eating tons of refined white flour, white pasta, and both eating a big candy bar (so what if one was toffee and one was chocolate) every day, they still were eating a “western diet”.

Anyway, I’ve read about the severe uptick in acne in newly “Westernized” populations. I’ve read about the rate of prostate difficulties of Asian-Americans versus rural Asians. Diets do INDEED affect much more about ourselves than we’d like to admit. I can guarantee you, because I’ve seen it on my own face and have friends who I trust who have seen it on the faces of their children, that diet does indeed influence acne and that high glycemic index foods and colas and sugars certainly worsen it at the least.

The thing that REALLY got me thinking this was a few years ago, I saw a couple of very Indian-looking Mexican teenagers. They didn’t look like they had a drop of European blood in them. They had BAD acne on their cheeks. Hell, I thought those people never broke out, yet there they were at a convenience store buying two colas and potato chips–looking like Oxy poster-children.

The second source is Arbor Clinical Nutrition Updates, an excellent Australian publication aimed at nutrition professionals. The latest update, which I cannot link to, is about acne and diet. From its conclusions:

For many years the conventional wisdom dispensed by physicians on the relationship between diet and acne vulgaris has been that there is none. In a recent study, the fact that nearly a half of a group of final year medical students believed that diet was an important factor in acne was held to be an unfortunate misconception “likely to perpetuate misinformation in the community.”

The “expert view” from doctors is in stark contrast to what their patients think. Many studies have shown that the average person is under the distinct impression that diet can indeed affect acne, particularly fatty foods and chocolate.

A careful look into this question reveals something rather fascinating — that although medical textbooks used to strongly support the idea of “acne diets”, in the last 50 years this has completely reversed. Yet experts’ current confidence that there is nothing to the diet-acne story is itself based on almost no evidence.

The update describes two studies. One found that a low-glycemic-index diet reduced acne. The other found that, in teenage boys, greater milk consumption was associated with slightly more acne.

More Maybe Graber was too kind. Confidence that diet had nothing to do with acne allowed dermatologists to prescribe dangerous and expensive drugs. I wish I could be sure no payola was involved, but — given a horrifying story in today’s NY Times about several psychiatrists’ total and dishonest disregard of conflict-of-interest rules — I can’t. From the article:

From 2000 through 2006, Dr. [Charles] Nemeroff [of Emory University] earned more than $960,000 from GlaxoSmithKline but listed earnings of less than $35,000 for the period on his university disclosure forms, according to Congressional documents. Sarah Alspach, a GlaxoSmithKline spokeswoman, stated in an e-mail message that “Dr. Nemeroff is a recognized world leader in the field of psychiatry.”

What does that say about psychiatry?

Shannon Brownlee on the subject. A blog on the subject. A letter from Senator Charles Grassley to James Wagner, the president of Emory, describing Nemeroff’s behavior and asking for more information.