Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

All rights reserved with siahmsr digital healthcare[siahmsr wellness]

Reviewed by SIAHMSR medical team.

Do high glycaemic [sugary] foods exacerbate acne?

     Acne is a common problem in adolescence due to the physiological changes in hormones. However sometimes acne is related to some hormonal disorders & dietary errors worsening it. Exacerbation of acne is mostly associated with hormonal triggers, particularly in women.

Polycystic ovarian syndrome [PCOS] affecting adolescent girls and women is one of the best examples to prove the role of hormonal imbalance and associated insulin resistance worsening acne or pimples.

Insulin resistance and  high carbohydrates in our diet have recently been implicated as the major culprits causing acne. 

High insulin level in blood associated with the condition of insulin resistance may exacerbate acne by increasing the proliferation of basal keratinocytes of skin.

What is insulin resistance? 

Insulin is a hormone produced by the pancreas that helps glucose in your blood enter the body cells and use it for various functions of your body as energy. The glucose is obtained from the food you consume and body can also produce glucose in liver. After eating the food, blood glucose level may rise and insulin is secreted by the pancreas to bring back to normalcy.

Insulin resistance is a condition in which the cells in your muscles, fat, and liver don’t respond well to insulin hormone and cells can’t easily take up glucose from your blood.

To overcome this problem, pancreas makes more insulin and tries helping glucose enter your cells [Hyperinsulinemia]. Later it reaches a stage at which pancreatic insulin cannot remove blood glucose and glucose stays elevated in the blood. Eventually diabetes develops.

Polycystic ovarian syndrome and acne also results from this insulin resistance state.

Factors predisposing to insulin resistance

Genes, obesity, certain diseases like polycystic ovarian syndrome, Cushing’s syndrome, certain medications like glucocorticoids, antipsychotics, erratic sleep patterns and physical inactivity predispose to insulin resistance.

 Obesity, specifically central obesity or excessive fat in the abdomen and around the organs [visceral fat], is a main cause of insulin resistance.

A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance.

 Research studies point out that belly fat can make hormones and other substances capable of causing chronic inflammation in the body.  Chronic inflammation has a crucial role in insulin resistance, type 2 diabetes, cardiovascular disease and fatty liver disease. 

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How does insulin resistance worsen acne?

High insulin levels in people with insulin resistance also stimulates production of androgens leading to high sebum production and acne [5].This is the prominent cause of worsening acne ,comedones in adolescent girls & women with polycystic ovarian syndrome [PCOS].

Insulin resistance also increase inflammatory responses within and adjacent to the acne.

The mechanism by which insulin resistance causes acne include:

·       Increased  proliferation of basal keratinocytes within the pilosebaceous duct of sebaceous glands

·        Incomplete  separation of ductal corneocytes from one another via impairment of apoptosis and subsequent obstruction of the pilosebaceous duct

·       Insulin resistance increases androgen hormone production and androgen- mediated increases in sebum production.

·        colonization of the comedo [a form of acne] by Propionibacterium acnes

·       Insulin resistance also increases inflammation both within and adjacent to the comedo. 

How  do high glycaemic index foods [ high sugar content in foods] worsen acne?

      The glycaemic index [GI] of carbohydrate food is very crucial in the management of acne, comedo as the glycemic index (GI) of meals has been directly correlated to insulin response [3].

Research studies show that diet may directly or indirectly influence the causes leading to development of acne.

FOODS TO REDUCE ACNE

Can low glycaemic index foods[ low carbohydrates] reduce acne?

Insulin resistance is the major cause behind the formation of acne, particularly in PCOS which is a syndrome of high insulin resistance. Low glycaemic index diets have been shown to decrease insulin resistance [4].

     Low GI foods are those foods which do not cause an immediate blood sugar spike. Acne may be improved by dietary factors that increase insulin sensitivity. Therefore low glycaemic foods help in reducing acne.

  Studies have demonstrated that reductions in carbohydrate intake with particular emphasis on low glycemic index (GI) carbohydrate foods, improved cutaneous and hormonal markers of acne severity in young adults.

 Weight loss, higher protein and fiber intake have also been linked to improved insulin sensitivity and reduction in acne.

High protein or fiber intake may lead to improvements in glucose and insulin metabolism. It ultimately improves insulin sensitivity in the body.

Low glycaemic index foods which help to reduce acne include:

Low glycemic variety of fruits & vegetables means eating them would not cause an immediate blood sugar spike. They include:

Non starchy vegetables: includes broccoli, carrots, greens, peppers, and tomatoes.

Fruits —include oranges, melon, berries, apples, bananas, and grapes

Grains — it is better to eat whole grains such as wheat, brown rice, oats, cornmeal, barley, and quinoa

Protein:

Lean meat, chicken or turkey without the skin, fish, eggs, nuts and peanuts 

Dried beans ,chickpeas and split peas, tofu 

Dairy—nonfat or low fat 

Milk, yogurt, cheese 

What foods are to be avoided to reduce acne?

The high-carb foods and drinks you should limit include:

Sugary foods, such as candy, cookies, cake, ice cream, sweetened cereals, and canned fruits with added sugar

·       Drinks with added sugars, such as juice, regular soda, and regular sports or energy drinks

·       White rice, tortillas, breads and pasta made of white flour

·       Starchy vegetables, such as white potatoes, corn, and peas

SUMMARY

1. Include low glycaemic index foods [ low carb foods].

2. good amount of protein  and fiber intake helps

3. Promote weight loss, particularly belly fat.

4. Avoid sugary, starchy high carb foods

written by dr sanjana vb[ copyright] 

image courtesy free pik

References

1.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257617/

2.    https://pubmed.ncbi.nlm.nih.gov/16092796/

3.    https://pubmed.ncbi.nlm.nih.gov/3276136/

4.    https://pubmed.ncbi.nlm.nih.gov/10889806/

5.    Cunliffe W., Simpson N.B. Disorders of the Sebaceous Glands. Blackwell Scientific Publications; Oxford, England, UK: 1998. [Google Scholar]

6.    https://pubmed.ncbi.nlm.nih.gov/16823477/

7.    https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance