What diet is best for acne?

Diet as a foundation for healthy skin

 

Healthy skin comes from within. Your diet can be your skin’s best friend or worst enemy. The relationship between diet and acne is the subject of heated debate in both research and clinical circles.

 

Changing what you eat may not be the only thing you need to clear your skin it does provide a firm base to modify many of the drivers of acne and hey, you’ve got to eat anyway!

 

• Balance hormones
• Provide antioxidants
• Reduce inflammation
• Optimise liver and kidney function
• Improve bowel motions
• Make sure getting enough of the vital skin nutrients

 

What diet should you choose?

 

In my experience, there is no single “acne busting diet”. I advise and support my clients to construct a healthful, sustainable eating plan to suit their budget and lifestyle. Cause that’s the one you’ll stick to. Consistency is key.

 

Here are some simple principles I use in my Naturopathy clinic. Much of this has been said before. But if you’re feeling overwhelmed by the avalanche of diet information on the internet, it’s good to stop, take a deep breath and get back to basics.

 

Eat your fruit and veggies

 

Aim for 5-7 serves of vegetables and two serves of fruit per day. Choose what’s in season. You’ll increase the diversity and amount of nutrients you consume.

 

Another sound principle here is to “eat the rainbow” – lots of different colours on your plate.

 

If you can only change one thing in your diet do this.

 

Why:

• You’ll increase your vitamin and mineral intake. In season vegetables should be the highest in nutrients as they haven’t been in storage.
• Plants contain phytochemicals such as polyphenols and flavonoids which are powerful antioxidants to reduce inflammation.
• Fruits and vegetables contain loads of fibre. Fibre supports healthy bowel motions and balances hormones. It also feeds your good gut bugs which in turn creates a healthy microbiome on your skin.
• You’ll regulate your blood sugar intake; you’ll feel satiated and won’t want sweet treats.

 

Good fats, bad fats

 

Healthy skin needs healthy fats. Fats are not created equal Choosing ones that are helpful and reducing the fat “frenemies” will help your skin.

• Include a moderate amount of healthy fats such as olive oil, nuts, chia, hemp, flax seeds, nuts, avocado and oily fish.
• Reduce the more inflammatory fats from meats, dairy, corn, sunflower, canola and safflower oil. * Many processed health foods contain sunflower oils so be sure to check the labels. ** Meat and dairy from grass-fed animals have less inflammatory fats than grain fed.
• Avoid transfats. Transfats occur when unsaturated fatty acids are chemically altered to improve shelf life and taste of food. Pies, pastries, bagels and doughnuts have high levels of trans fats.

Why:

 

Getting the correct balance of fats in your diet reduces inflammation, and less inflammation throughout your body will reduce acne.

 

Protein

 

Consume moderate amounts of good quality protein – either plant-based or lean animal protein or a combination of the two. Space out your protein intake throughout the day to support appetite control and balance insulin.

 

If you are a meat eater, choose the free range, grass fed meat and eggs and wild caught fish. Avoid meat and fish raised with growth-promoting hormones and grains. You don’t want to be consuming any external hormones to upset the balance.

 

How much: Between 0.8- 1 gram per kilo of body weight is good for the average person. I.e., a 70kg person would need between 56-70g of protein per day.

 

Why you need protein

 

Protein provides essential building blocks (amino acids) to produce keratin and collagen required for healthy skin. These amino acids are also required for hormones and neurotransmitters.

 

Meat also contains good amounts of zinc, a mineral essential in skin healing and hormone regulation.

 

Stay hydrated for healthy skin

 

While drinking water won’t of itself cure acne, being dehydrated (even slightly) may impact on your skin’s health.

 

• When you are dehydrated skin becomes rough, and there is an increased shedding of dead cells, increasing the risk of blocked pores.
• A lack of water in the underlayer of the skin may trigger the sebaceous glands to increase sebum production.
• Your kidneys, liver and colon all need water to work correctly. Being well hydrated supports healthy detoxification.

How much hydration?

 

Aim for 30mL per kilo of body weight (65kg = 1.95litres) per day. You may need to increase this if you are doing high levels of physical activity, sweating or losing fluid through vomiting/diarrhoea.

 

Where from

 

Most of it should come from H20, but you can also include the amounts in food (depending on the number and type of fruits and veggies you may get up to 500mL of fluid per day there), tea, coffee, juices.

Liquid from alcoholic beverages doesn’t count.

 

Avoid these things which contribute to dehydration:

• Excess salt (processed food is the main culprit here not so much the little bit of seasoning you add in your home cooking.
• Alcohol
• Excess caffeine >2-3 cups per day (if you’re having less than this the diuretic effect is minimal)

 

Grains

 

In clinical practice, I have sometimes found the removal of grains can help improve skin and sometimes it doesn’t have much of an effect at all.

 

If you know, you are intolerant to grains or have a condition such as coeliac disease you should avoid them. However, 1 serving a day of whole grains can form part of a healthy diet, providing vitamins, minerals and fibre.

 

Whole grains to include:

 

• Brown or basmati rice
• Traditional sough dough bread
• Rolled oats
• Buckwheat
• Amaranth
• Whole wheat couscous
• Bulgur

 

Forms of grains to avoid/limit:

 

• Processed white flours (bread, cakes, pastries)
• Processed breakfast cereals
• Pasta
• Sushi rice
• Crackers

 

Dairy

 

Although sometimes controversial, consumption of dairy has been shown to correlate with moderate to severe acne¹.

It contains both high levels of insulin-like growth factor 1 (IGF-1) and stimulates the body’s production of this. IGF-1 is essential for both infant and adolescent growth, but excessive amounts stimulate androgen receptors, which in turn, stimulate sebaceous glands². It also magnifies insulin by 2-3 times creating an increased risk of insulin resistance.

Another way dairy contributes to acne involves the proteins. Branched-chain amino acids (BCAA) in dairy activate a cellular signalling protein (mTOCR1) which stimulates the sebaceous glands to produce more oil. BCAA acids are high in whey protein products and are also sold as a stand-alone product to promote recovery and muscle growth after exercise³.

After infanthood, our production of lactase, the enzyme which digests milk, sharply declines. Undigested lactose in the digestive tract contributes to inflammation.

 

Dietary take home

 

• If you have moderate to severe acne, try eliminating all dairy products for 4-6 weeks to see if your skin improves. Swap to plant-based mylks such as almond, hazelnut, rice or oat.
• Reduce the amount of dairy. I often say to think of it as a condiment. I.e., Have a cube of feta crumbled on your salad, not half a block or a couple of tablespoons of yoghurt with your fruit, not a whole tub.
• Switch to plant-based protein powders such as pea or rice.

 

Refined sugar

 

Another age-old question is; does a high sugar diet contribute to acne? Recent studies certainly suggest if we can’t quite yet arrest and charge sugar, it’s certainly a prime suspect. Glycemic load is higher in those with acne than those without ³.

Sugar and refined carbohydrates spike insulin creating hormonal imbalance and altered retinoid signalling (retinoid signalling is what the acne drug Roaccutane targets)⁴. They also often replace more nutrient-dense foods.

A high sugar diet causes increased urinary secretion of zinc and vitamin C. These two nutrients are essential for healthy skin.

Excess sugar also brings along our old friend inflammation to the party.

There’s no need to list sugary and processed foods, but some things you might not be aware of causing insulin imbalance include:

 

• Dried fruit
• Fruit juices and smoothies
• Alcohol

 

 In a nutshell

 

In summary, here are six takeaways (not the food type!) for how to use diet to support healthy skin.

 

1. Eat 5-7 serves of vegetables every day, two serves of fruit
2. Include good fats, reduce inflammatory fats
3. Have adequate protein
4. Stay hydrated
5. Limit or avoid dairy to see if this is a factor for you
6. Limit refined carbohydrates and sugar

 

A healthy diet will not only help your skin; it will also improve your overall health.

 

This post is part 2 of a 5-part series on acne treatment.

Part 1 Acne: Discover the underlying cause

Part 3 A guide to herbs for acne

Part 4 What vitamins work best for acne?

Part 5 Isotretinoin side effects: read this before you take roaccutane

 

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References

1. Kanters JK, Ellervik C. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients. 2018;10(1049):1-13. doi:10.3390/nu10081049.
2. Melnik BC. Milk disrupts p53 and DNMT1 , the guardians of the genome : implications for acne vulgaris and prostate cancer. Nutr Metab. 2017;14(55):1-12. doi:10.1186/s12986-017-0212-4.
3. Melnik BC. Acne vulgaris : The metabolic syndrome of the pilosebaceous follicle. Clin Dermatol. 2018;36(1):29-40. doi:10.1016/j.clindermatol.2017.09.006.
4. Davidovici BB, Wolf R. The role of diet in acne : facts and controversies. Clin Dermatol. 2010;28:12-16. doi:10.1016/j.clindermatol.2009.03.010.