[PHNUTR-L] Acne, milk and the iodine connection

[Forbes-Ewan, Chris]

It may be only a preliminary finding, but two interesting poster papers (see references and abstracts below my signature block) about a possible link between diet and acne were presented at the Annual Scientific Meeting of the Nutrition Society of Australia last week.

A group from the RMIT University (Melbourne) presented results suggesting that a high-protein, low-GI-carbohydrate diet led to a significant reduction in the severity of acne vulgaris compared to control (no dietary intervention) and favourably altered hormonal markers of acne.

The abstracts do not detail the source of the protein, but one of the authors had previously mentioned that the study involved a 'Paleolithic diet', so milk is unlikely to have been a major component. 

If so, these results are consistent with the concept that milk may be linked to acne.

Chris Forbes-Ewan

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References and Abstracts

Smith R, Mann N, Braue A, Varigos G. (2005). Low glycemic load, high protein diet lessens facial acne severity. Asia Pac. J. Clin. Nutr. 14 Suppl:S97. 

ABSTRACT
Background - Acne vulgaris is a multi-factorial skin disorder which affects the 85-100% of the adolescent population in Western civilizations. Despite its high prevalence in the West, acne prevalence is extremely low or rare in non-westernized societies. It has been proposed that refined, high glycemic foods common in Western societies may accentuate underlying causal factors responsible for its proliferation. Objective - To determine whether a low glycemic load diet, comprised of high levels of protein and low GI foods, can alleviate the severity of acne symptoms in young males Design - Male acne sufferers [n=43, age=18.3 +/- 0.4 (mean +/- SEM)] were randomly assigned to either the dietary intervention (n=23) or control groups (n=20). The intervention diet consisted of 25% energy from protein and 45% energy from low glycemic index carbohydrates. The control group received no information about diet nor were they given dietary instruction. The efficacy of dietary treatment ve!
rsus control was clinically assessed by a dermatologist using a modified Cunliffe-Leeds acne scale. The dermatologist assessed facial acne by means of lesion counts and was blinded to the subject's group. Outcomes - Dietary intervention resulted in a reduction in total lesion counts (-23.1 +/- 4.0 lesions, P <0.001) and inflammatory counts (-16.2 +/- 3.0 lesions, P <0.001). The control group also showed a reduction in total lesion counts (-12.0 +/- 3.5 lesions, P <0.01) and inflammatory counts (-7.4 +/- 2.5 lesions, P <0.05). However, between group analyses showed that the reduction was significantly greater in the intervention group for total counts (P <0.05) and inflammatory counts (P <0.05). Conclusion - These data indicate that a low glycemic load diet, comprised of high levels of protein and low GI foods, significantly decreased the mean number of facial acne lesions, therefore alleviating the severity of acne symptoms. However, the multi-factorial nature of this condit!
ion is reflected in the fact that the control group also showed a decrease over time, thereby suggesting that other factors are at play.



Smith R, Mann N, Braue A, Varigos G. (2005). The effect of a low glycemic load, high protein diet on hormonal markers of acne. Asia Pac. J. Clin. Nutr. 14 Suppl:S43.  

ABSTRACT
Background - Acne vulgaris is a common endocrine condition affecting adolescents in Western civilizations. Acne typically manifests during puberty when there is a transient decrease in insulin sensitivity. It has been suggested that high glycemic nutrition during puberty induces hyperinsulinemia which increases the bioavailability of androgens and certain growth factors. These changes may induce follicular epithelial growth and increased sebum production - two factors responsible for acne proliferation. Objective - To determine the effect of a low glycemic load diet, comprised of high levels of protein and low glycemic index (GI) foods, on hormonal makers of acne vulgaris. Design - Male acne sufferers [n=43, age=18.3+/-0.4 (mean +/- SEM)] were randomly assigned to either the dietary intervention (n=23) or control groups (n=20). The intervention diet consisted of 25% energy from protein and 45% energy from low glycemic index carbohydrates. The control group received no inform!
ation about diet nor were they given dietary instruction. Venous blood was collected at baseline and 12-weeks for an assessment of testosterone, sex hormone binding globulin (SHBG), free androgen index (FAI), dehydroepiandrosterone - sulfate (DHEA-S), insulin-like growth factor (IGF)-I and IGF-binding proteins -I and -3. Outcomes - Dietary intervention resulted in a significant reduction in FAI (-9.1 +/- 4.5, P<0.05) and DHEA-S (-0.72 +/- 0.33 umol/L, P<0.05) and an increase in IGFBP-1 (5.3 +/- 1.6 ng/mL, P<0.01). No significant changes were observed in levels of IGF-I, IGFBP-3, testosterone or SHBG following dietary intervention. The control group showed no change in any of the blood parameters measured. Conclusion - These data suggest that a low glycemic load diet may reduce androgenic activity (as indicated by a reduction in FAI and DHEA-S) and may oppose the growth promoting effects of IGF-I by increasing levels of its binding protein, IGFBP-I. This implies that a low gl!
ycemic load diet may reduce hormonal influences involved in acne pathogenesis.



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Subject: [PHNUTR-L] Acne, milk and the iodine connection

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Acne, milk and the iodine connection

Dermatologists seem to agree that something in milk and dairy products may be linked to teen-age acne.

But is it hormones and "bioactive molecules," as a study in the Journal of the American Academy of Dermatology suggested, or is there something else?

University at Buffalo dermatologist Harvey Arbesman, M.D., says there could be something else: Iodine.

Arbesman, a UB clinical assistant professor of dermatology and social and preventive medicine, details his reasoning in a letter published in the "Notes and Comments" section of the current (December) issue of the journal.

"It has been well-established since the 1960s that iodine intake can exacerbate acne," said Arbesman. "Nevertheless, various studies have shown there is still a significant level of iodine in milk in several countries, including the U.S., Britain, Denmark, Norway and Italy.

"Farmers give their cows iodine-fortified feed to prevent infection," he noted, "and they use sanitizing iodine solutions on their cows' udders and milking equipment. Consequently, there is lot of iodine in dairy products. For that reason, I've advised my acne patients for years to decrease their dairy intake."

Arbesman suggests the connection between acne and dairy products observed in the study could be secondary to the iodine content of the dairy products. "More importantly," he said, "the connection could be a combination of hormones and iodine."

It's important to bring the iodine connection to the fore to encourage the dairy industry to address the issue, Arbesman said. He suggested that future studies on the relationship of milk products and acne should consider the role iodine content may play.
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