Subscribe Paleo and Acne Most people think of acne as a normal part of adolescence, just one of the many hormonal tricks the teenage body likes to play on us. Before the early s, the standard clinical opinion was that acne and diet were completely unrelated: acne was a bacterial infection, or a genetic trait. Some studies even attempted to explain it as an evolutionary adaptation, to ward off prospective mates until the acne sufferer was more physically mature. But since many people suffer acne well into their 20s when their ability to raise a baby is greatest and even beyond, this is a less than satisfying explanation. Cordain studied two hunter-gatherer societies, the Kitavans and the Ache, and found that none of them had acne. The research into diet and acne is still in its infancy, since dermatologists have only been seriously studying it for a few years and many still believe that the two are unrelated.
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Cordain received his Ph. He is the author of more than peer-review Loren Cordain, Ph. Most recently his work has focused upon the harmful health effects of the high dietary glycemic load that is ever-present in the typical western diet and how 5 it adversely affects skin health. In Dr. He is the recipient of the Scholarly Excellence Award at Colorado State University for his contributions into understanding optimal human nutrition. This paper represented the second in a series of his three scientific publications outlining the central role diet plays in causing acne.
I quote a recent scientific review paper by Drs. If you were to press your doctor a bit further and ask them if diet causes your bad complexion, most would likely tell you that diet has virtually nothing to do with acne. Go ahead and ask your dermatologist how they know that diet does not cause acne. I had pretty much assumed the party line that diet and acne were unrelated was correct — that is, until the day when I finally got around 7 to reading an obscure scientific paper written by Dr.
Schaefer was a frontier physician who treated the Inuit Eskimo people in remote villages and outposts from the late s until the early s.
During this 30 year span, Dr. Schaefer observed the Inuit as they literally were transformed from the Stone Age to the space age. When he started his practice, most of the Inuit in remote areas lived and ate in the traditional manner of their ancestors dating back thousands of years.
Their diet consisted almost entirely of wild animals obtained from hunting and fishing and the few wild plants that were gathered during summer. As these people altered their native diet and became more and more westernized, their health began to decline, as Dr. Schaefer extensively documented in the medical literature of the time. The condition used to be unknown among Eskimos, but one can see it readily amongst teenagers on the streets of Inuvik, Frobisher Bay, and Cambridge Bay.
It is far less prevalent in the smaller centers. Old North men, such as missionaries, traders, trappers, men of the Royal Canadian Mounted Police and others who have known and watched the Eskimos closely for many years, frequently remark to their physician friends on the change in the complexions of the young people. Many Eskimos themselves blame their pimples on the pop, chocolate, and candies the youngsters consume as if addicted.
One wonders what these people and the other old Northerners would think if they were to read 8 some recent medical publications in which dermatologists belittle or deny the role of dietary factors in the pathogenesis of acne vulgaris. One of my first stopping points was the position in the current dermatology textbooks.
What was this information based upon? You might think that there was a long and well established trail of scientific literature conclusively demonstrating that diet and acne were unrelated, and that the remarks in the textbooks simply reflected well know facts.
Nothing could be further from the truth! The viewpoint penned in these textbooks relied upon only two scientific studies of diet and acne that are now more than 30 years old. But more importantly, both of these dated studies contained fatal flaws in their experimental design which rendered their conclusions that diet does not cause acne erroneous.
In the often cited study by Dr. Fulton and colleagues , examining the effect of chocolate consumption upon the development of acne, the authors gave the subjects a placebo control candy bar with a sugar content nearly as high as the chocolate bar. If sugar consumption has anything whatsoever to do with causing zits, then the experiment could never isolate this effect, since the treatment and control bars had nearly identical sugar contents. Until late in , the last dietary intervention concerning acne was published 34 years ago by Dr.
If the study by Dr. Fulton and 9 colleagues was fatally flawed, then the study by Dr. Anderson was a complete joke! No control group was employed in the experiment, and the data zit count were not statistically analyzed, nor was the lesion zit count even presented!
Although these early physicians and dermatologists did not have the advantage of knowing the hormonal, biochemical and molecular underpinnings of acne, they were astute clinicians who carefully examined their patients and recorded detailed patient histories.
After decades of practice, and having examined tens of thousands of patients, these physicians were able to formulate admittedly non-scientific informed hypotheses about the causes of acne. As regards the diet, it is usually important to restrict the amount of carbohydrate and fat, and sweets, cakes, pastries, puddings, jam and marmalade, pig-fat, chocolate. Plenty of fresh fruits and green vegetables and lean meat, fish and poultry should be taken.
However, 70 years later it can now be supported from clinical dietary trials that have shown how sugary foods and high glycemic load carbohydrates like those listed above can adversely influence the hormones that are directly involved in causing acne. The recommendation to eat fresh fruits, green vegetables, lean meat, fish and poultry now makes perfect sense with our new understanding of how diet can influence the hormonal, cellular and molecular underpinnings of acne.
As you can see, the case against the causal link between diet and acne is weak, or non-existent. However, of more importance is the flip side of the coin: how do we know that diet is indeed responsible for acne?
In science we use four procedures to establish cause and effect between diet and disease. Figure 1. In the case of simple diseases like dental cavities, cause and effect are relatively easy to establish, because all four lines of evidence epidemiological studies, tissue studies, animal studies and human dietary interventions point in the same direction. With more complex diseases like coronary heart disease CHD causality is more difficult to establish because there are so many environmental and genetic factors that operate together to cause the disease.
When this happens, the results from human dietary interventions represent the trump card, and their results prevail. Human dietary Figure 1. If we put vitamin C back into their diet, scurvy is cured. Only two modern epidemiological studies and exist which have examined the relationship between diet and acne. However, having said this, there are literally thousands of dietary studies which indirectly link diet to acne via nutritional mechanisms.
In the first part of the study my co-author Dr. The sample included subjects who were between 15 and 25 years of age. Lindeberg and his co- workers did not find a single case of acne in the entire population including teenagers and young adults. The picture you see on the next page is that of an adolescent Kitavan girl with a representative acne-free complexion. If you were to round up teenagers in the U. Acne runs rampant in western adolescent populations.
Kim Hill and Dr. Magdalena Hurtado examined Ache hunter gatherers who were living in a remote jungle area in Paraguay. In this study we did things a little differently. We followed these people for more than 2 years and periodically examined them for acne symptoms. Once again, we did not find a single case of acne in the Figure 1. Photo: Staffan Lindeberg, M. The photograph you see directly below on this page is that of an Ache teenaged girl with representative acne-free skin.
When we examined the diets of both the Kitavans and the Ache, they were quite unlike anything the typical U. The dietary staples for the Kitavans were tubers taro, yams and sweet potatoes , fruit banana, papayas, mangoes, guavas and pineapples , fish and coconuts.
Their intake of dairy, alcohol, coffee, and tea was nil, and their consumption of cereals, Figure 1. Photo: Kim Hill, Ph. Virtually all carbohydrate came from low glycemic load tubers, fruits and vegetables. Twenty percent of their daily energy came from hunted, wild game and domestic meats. Energy Provided by Food Groups in the U.
Food Supply. Later on in the book, I will explain to you precisely how all of these foods contribute to the development of acne by directly influencing the hormonal dysfunction that underlies acne and by displacing more healthful fresh fruits, vegetables, lean meats and seafood. Our paper was the first line of evidence to show from an epidemiological perspective that acne almost certainly was caused by an interaction of an environmental factor diet with genetic factors. How did we know this?
When we looked at previous studies of South American Indians with an overall genetic makeup similar to the Ache , those living in more westernized towns and cities had intermediate levels of acne — not as high as westerners, but certainly not absent as we reported in the Ache. Similarly, South Pacific islanders living in more westernized ways had a considerably higher incidence of acne than the Kitavans who were completely free of this skin disorder.
In February of , an epidemiological study by the well known research group from the Harvard School of Public Health demonstrated that milk consumption was associated with the development of acne in a group of 47, women who had participated in the on-going Nurses Health Study.
Neil had read our paper in The Archives of Dermatology and was familiar with my ideas of how the typical western diet could cause acne. He was fortunate to get funding to initiate an experimental study to test my hypotheses and in May of began a 2 and a half year dietary intervention in 43 acne patients.
When I saw Neil in November of at the Nutrition Society meeting, he released the results of his study to the world. Diet, indeed, caused acne, and Neil and his co-workers were able to show how a high protein, low glycemic load diet improved acne symptoms as well as the hormonal problems that underlie acne. We finally had our trump card! It will take a decade or more of research to precisely pinpoint all of the physiological and biochemical mechanism underlying the dietary links to acne.
But you know what? You can begin to clear up your acne today by following the diet I prescribe. This is the diet that I recommend to not only clear up your acne, but also to maximize your health and normalize your body weight. It is actually not a diet at all, but rather a lifetime way of healthy eating!
Acne vulgaris: a disease of Western civilization.
Paleo and Acne