After years of being told that diet doesn’t affect acne, there is a growing abundance of research showing that it can have a big impact on our skin. Acne is a modern disease that only seems to affect those that adopt the western diet. Populations such as the Canadian Inuit, South African Zulus and the Japanese Okinawans were completely absent of acne and their diets were also very different from ours, leaning towards a more palaeolithic way of eating.
WHAT HAPPENS WHEN WE EAT SUGAR.
When we eat sugar and carbohydrates, they are broken down by enzymes in the small intestine in to glucose and then released into the bloodstream. As blood sugar levels rise, the pancreas releases insulin which is a hormone that helps the glucose to be absorbed by our cells so it can be used for energy or storage.
HOW DOES THIS AFFECT ACNE.
Insulin is a master hormone that triggers the release of other hormones such as insulin-like growth factor-1 (IGF-1) that has growth promoting effects on every cell in the body so skin cell production is increased. IGF-1 activates mammalian target of rapamycin complex 1 (mTORC1) which also stimulates production of sebum and new skin cells.
Androgens (reproductive hormones) production is increased causing enlargement of the sebaceous glands and excessive sebum secretion. The surplus sebum also increases the activity of androgen hormones and IGF-1 resulting in a vicious hormone production cycle.
Cutibacterium acnes (C. acnes) is a bacteria associated with acne that can be found in the sebum on the surface of the skin and deep within the follicles and pores. When there is an over production of skin cells, they become trapped in the follicles. Blocked follicles combined with an elevated amount of sebum are the perfect environment for C. acnes to grow and multiply triggering inflammation and acne.
ARE ALL CARBOHYDRATES BAD?
Not all carbohydrates are created equally. Refined carbohydrates will certainly spike your blood sugar levels a lot more than a whole food carbohydrate. The Glycaemic Index or Glycaemic Load are both useful tools when trying to ascertain what foods are going to have the biggest impact on your insulin. Pairing high glycaemic foods with protein, fat and fibre can also help to slow down the digestion and therefore reduce the blood sugar spike.
Although insulin sounds like the bad guy here, it is actually essential for survival and there are other factors that could be contributing to your acne but controlling those blood sugar spikes is a good place to start.