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Research Article| Volume 50, ISSUE 1, P41-52, April 2008

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The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides

      Summary

      Background

      Dietary factors have long been implicated in acne pathogenesis. It has recently been hypothesized that low glycemic load diets may influence sebum production based on the beneficial endocrine effects of these diets.

      Objective

      To determine the effect of a low glycemic load diet on acne and the fatty acid composition of skin surface triglycerides.

      Methods

      Thirty-one male acne patients (aged 15–25 years) completed sebum sampling tests as part of a larger 12-week, parallel design dietary intervention trial. The experimental treatment was a low glycemic load diet, comprised of 25% energy from protein and 45% from low glycemic index carbohydrates. In contrast, the control situation emphasized carbohydrate-dense foods without reference to the glycemic index. Acne lesion counts were assessed during monthly visits. At baseline and 12-weeks, the follicular sebum outflow and composition of skin surface triglycerides were assessed using lipid absorbent tapes.

      Results

      At 12 weeks, subjects on the experimental diet demonstrated increases in the ratio of saturated to monounsaturated fatty acids of skin surface triglycerides when compared to controls [5.3 ± 2.0% (mean ± S.E.M.) vs. −2.7 ± 1.7%, P = 0.007]. The increase in the saturated/monounsaturated ratio correlated with acne lesion counts(r = −0.39, P = 0.03). Increased follicular sebum outflow was also associated with an increase in the proportion of monounsaturated fatty acids in sebum (r = 0.49, P = 0.006).

      Conclusion

      This suggests a possible role of desaturase enzymes in sebaceous lipogenesis and the clinical manifestation of acne. However, further work is needed to clarify the underlying role of diet in sebum gland physiology.

      Keywords

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      References

        • Rasmussen J.
        Diet and acne.
        Int J Dermatol. 1977; 16: 488-491
        • Michaëlsson G.
        Diet and acne.
        Nutr Rev. 1981; 39: 104-106
        • Harris H.
        • Downing D.
        • Stewart M.
        • Strauss J.
        Sustainable rates of sebum secretion in acne patients and matched normal control subjects.
        J Am Acad Dermatol. 1983; 8: 200-203
        • Downing D.
        • Strauss J.
        • Pochi P.
        Changes in skin surface lipid composition induced by severe caloric restriction in man.
        Am J Clin Nutr. 1972; 25: 365-367
        • Pochi P.
        • Downing D.
        • Strauss J.
        Sebaceous gland response in man to prolonged total caloric deprivation.
        J Invest Dermatol. 1970; 55: 303-309
        • Llewellyn A.
        Variations in the composition of the skin surface lipid associated with dietary carbohydrates.
        Proc Nutr Soc. 1967; 26: 11
        • MacDonald I.
        Changes in the fatty acid composition of sebum associated with high carbohydrate diets.
        Nature. 1964; 203: 1067-1068
        • MacDonald I.
        Dietary carbohydrates and skin lipids.
        Br J Dermatol. 1967; 79: 119-121
        • Downing D.
        • Strauss J.
        • Pochi P.
        Variability in the chemical composition of human skin surface lipids.
        J Invest Dermatol. 1969; 53: 322-327
        • Kellum R.
        Human sebaceous gland lipids.
        Arch Dermatol. 1967; 95: 218-220
        • Greene R.
        • Downing D.
        • Pochi P.
        • Strauss J.
        Anatomical variation in the amount and composition of human skin surface lipid.
        J Invest Dermatol. 1970; 54: 240-247
        • Cassidy D.
        • Lee C.
        • Laker M.
        • Kealey T.
        Lipogenesis in isolated human sebaceous glands.
        FEBS Lett. 1986; 200: 173-176
        • Middleton B.
        • Birdi I.
        • Heffron M.
        • Marsden J.
        The substrate determines the rate and pattern of neutral lipid synthesized by isolated human sebaceous glands.
        FEBS Lett. 1988; 231: 59-61
        • Downing D.
        • Stewart M.
        • Wertz P.
        • Strauss J.
        Essential fatty acids and acne.
        J Am Acad Dermatol. 1986; 14: 221-225
        • Katsuda Y.
        • Iida T.
        • Inomata S.
        • Denda M.
        Unsaturated fatty acids induce calcium influx into keratinocytes and cause abnormal differentiation of epidermis.
        J Invest Dermatol. 2005; 124: 1008-1013
        • Nicolaides N.
        Skin lipids: their biochemical uniqueness.
        Science. 1974; 186: 19-26
        • Shalita A.
        Genesis of free fatty acids.
        J Invest Dermatol. 1974; 62: 332-335
        • Maeda T.
        Electrons microscopic study of experimentally-induced comedo effects of vitamin A acid on comedo formation.
        J Dermatol. 1991; 18: 397-407
        • Stewart M.
        • Grahek M.
        • Cambier L.
        • Wertz P.
        • Downing D.
        Dilutional effect of increased sebaceous gland activity on the proportion of linoleic acid in sebaceous wax esters in epidermal acylceramides.
        J Invest Dermatol. 1986; 87: 733-736
        • Ge L.
        • Gordon J.
        • Hsuan C.
        • Stenn K.
        • Prouty S.
        Identification of the D-6 desaturase of human sebaceous glands: expression and enzyme activity.
        J Invest Dermatol. 2003; 120: 707-714
        • Cordain L.
        • Lindeberg S.
        • Hurtado M.
        • Hill K.
        • Eaton B.
        • Brand-Miller B.
        Acne vulgaris – a disease of Western civilization.
        Arch Dermatol. 2002; 138: 1584-1590
        • Brand-Miller J.
        • Thomas M.
        • Swan V.
        • Ahmad Z.
        • Petocz P.
        • Colagiuri S.
        Physiological validation of the concept of glycemic load in lean young adults.
        J Nutr. 2003; 133: 2728-2732
        • Smith R.
        • Mann N.
        • Braue A.
        • Mäkeläinen H.
        • Varigos G.
        The effect of a high protein, low glycemic load diet versus a conventional, high glycemic load diet on biochemical parameters associated with acne vulgaris. A randomized, investigator-masked, controlled trial.
        J Am Acad Dermatol. 2007; 57: 247-256
        • Smith R.N.
        • Mann N.J.
        • Braue A.
        • Mäkeläinen H.
        • Varigos G.A.
        A low-glycemic-diet improves symptoms in acne vulgaris patients: a randomized controlled trial.
        Am J Clin Nutr. 2007; 86: 107-115
        • Nordstrom K.
        • Schmus H.
        • McGinley K.
        • Leyden J.
        Measurement of sebum output using a lipid absorbent tape.
        J Invest Dermatol. 1986; 87: 260-263
        • Martin A.
        • Lookingbill D.
        • Botek A.
        • Light J.
        • Thiboutot D.
        • Girman C.
        Health-related quality of life among patients with facial acne – assessment of a new acne-specific questionnaire.
        Clin Exp Dermatol. 2001; 26: 380-385
        • Doran T.
        • Baff R.
        • Jacobs P.
        • Pacia E.
        Characterization of human sebaceous cells in vitro.
        J Invest Dermatol. 1991; 96: 341-348
        • Sinclair A.
        • O’Dea K.
        • Dunstan G.
        • Ireland P.
        • Niall M.
        Effects on plasma lipids and fatty acid composition of very low fat diets enriched with fish or kangaroo meat.
        Lipid. 1987; 22: 523-529
        • Strauss J.
        • Pochi P.
        The quantitative gravimetric determination of sebum production.
        J Invest Dermatol. 1961; 36: 293-298
        • Strauss J.
        • Kligman A.
        • Pochi P.
        The effect of androgens and estrogens on human sebaceous glands.
        J Invest Dermatol. 1962; 39: 139-155
        • Farrell L.
        • Strauss J.
        • Stranieri A.
        The treatment of severe cystic acne with 13-cis-retinoic acid. Evaluation of sebum production and the clinical response in a multiple-dose trial.
        J Am Acad Dermatol. 1980; 3: 602-611
        • Stewart M.
        Sebaceous gland lipids.
        Sem. Dermatol. 1992; 11: 100-105
        • Zheng Y.
        • Eilertsen K.
        • Ge L.
        • Zhang L.
        • Sundberg J.
        • Prouty S.
        • et al.
        Scd1 is expressed in sebaceous glands and is disrupted in the asebia mouse.
        Nat Genet. 1999; 23: 268-270
        • Perisho K.
        • Wetz P.W.
        • Madison K.C.
        • Stewart M.E.
        • Downing D.T.
        Fatty acids of acylceramides from comedomes and from the skin surface of acne patients and control subjects.
        J Invest Dermatol. 1988; 90: 350-353
        • Sansome-Bassano G.
        • Cummings B.
        • Seeler A.
        • Reisner R.
        Differences in the lipid constituents of sebum from pre-pubertal and pubertal subjects.
        Br J Dermatol. 1980; 103: 131-137
        • Downie M.
        • Guy R.
        • Kealey T.
        Advances in sebaceous gland research: potential new approaches to acne management.
        Int J Cos Sci. 2004; 26: 291-311
        • Downie M.
        • Kealey T.
        Human sebaceous glands engage in aerobic glycolysis and glutaminolysis.
        Br J Dermatol. 2004; 151: 320-327
        • Downie M.
        • Kealey T.
        Lipogenesis in the human sebaceous gland:glycogen and glycerophosphate are substrates for the synthesis of sebum lipids.
        J Invest Dermatol. 1998; 111: 199-205
        • Im M.
        • Hoopes J.
        Enzymes of carbohydrate metabolism in normal human sebaceous glands.
        J Invest Dermatol. 1974; 62: 153-160
        • Brand-Miller J.
        • Holt S.
        • Pawlak D.
        • McMillan J.
        Glycemic index and obesity.
        Am J Clin Nutr. 2002; 76: 281S-285S
        • Kiens B.
        • Richter E.
        Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans.
        Am J Clin Nutr. 1996; 63: 47-53
        • Tsai M.
        • Chen W.
        • Cheng Y.
        • Wang C.
        • Chen G.
        • Hsu T.
        Higher body mass index is a significant risk factor for acne formation in schoolchildren.
        Eur J Dermatol. 2006; 16: 251-253
        • Spieth L.
        • Harnish J.
        • Lenders C.
        • Raezer L.
        • Pereira M.
        • Hangen J.
        • et al.
        A low glycemic index diet in the treatment of pediatric obesity.
        Arch Pediatr Adolesc Med. 2000; 154: 947-951
        • Ebbeling C.
        • Leidig M.
        • Sinclair K.
        • Hangen J.
        • Ludwig D.
        A reduced-glycemic load diet in the treatment of adolescent obesity.
        Arch Pediatr Adolesc Med. 2003; 157: 773-779
        • Draelos Z.
        The effect of a daily facial cleanser for normal to oily skin on the skin barrier of subjects with acne.
        Cutis. 2006; 78: 34-40
        • Foster-Powell K.
        • Holt S.
        • Brand-Miller J.
        International table of glycemic index and glycemic load values.
        Am J Clin Nutr. 2002; 76: 5-56
      1. The Glycemic Index and GI database is produced by Sydney University and is available at http://www.glycemicindex.com (accessed 2003).