Here’s a bit of weird news. A study finds that using oral antibiotics may increase your risk of getting sore throat.

The researchers followed 576 University of Pennsylvania students for nine months. It’s not clear from the study abstract but I’m assuming that all the participants had acne. They tracked oral anti-acne antibiotic use and visits to the health center for sore throat. More than 11% of those taking oral antibiotics visited the health center for sore throat compared to about 3% or those not taking antibiotics. Oddly the infections were not due to the strains of bacteria that normally cause sore throat.

The study also tracked topical antibiotic use, but there was no association between topical antibiotic use and getting sore throat.

One of the study authors noted in an interview that antibiotics may disturb the balance of bacteria in the throat. And this can allow more harmful bacteria to thrive. The same thing that happens in the gut when you take too many antibiotics.

This is just one more reason to avoid antibiotics for acne. They only help you temporarily and don’t do anything to address the real causes behind acne.

References:

• Association of Pharyngitis With Oral Antibiotic Use for the Treatment of Acne – Archives of Dermatology
• Antibiotics for acne raise sore throat risk – Modern Medicine

Lactoferrin is a protein that’s part of the human immune system. Because of its ability to regulate the immune system it’s studies as a possible treatment for acne and other inflammatory conditions. And indeed early research shows promising results.

Lactoferrin is part of the innate part of the human immune system. Innate immune system is transferred from the mother to the baby and protects the baby before the other parts of the immune system develop. So it’s the first line of defense for infants.

Later in life lactoferrin is found in body secretions, such as tears, mucous, blood and saliva. Researchers believe that lactoferrin plays an important role in protecting the mucous parts of the body.

Lactoferrin is also found in the skin. And that makes it interesting as a potential treatment for acne.

Studies show lactoferrin may help with acne

I found 2 studies on lactoferrin and acne. Not much to go by, but they show some interesting results.

A Korean study published in the journal Nutrition was the better of the two. It was controlled, double-blinded and randomized – meaning we can have more confidence on the results. The Korean researchers gave fermented milk for 36 people. 18 out of the 36 also got 200mg of lactoferrin with their fermented milk. The other 18 didn’t and acted as a control group.

Compared to the controls the people who got lactoferrin had:

• Almost 40% decrease in inflammatory lesions
• More than 20% less pimples overall
• Acne was graded as 20% less severe
• Sebum levels on the skin went down by 31%

The people who drank the lactoferrin beverage also had a better sebum fatty acid profile. What that means is their sebum was more resistant to inflammation, which helps to protect against acne breakouts.

The other study was also positive. In this German study the researchers gave 43 teens and young adults a chewable table with lactoferrin. They were measured the total pimple count and compared it to the pre-study count. They found that 77% of the subjects had fewer pimples than before the study. The average decrease was 22.5% in 8 weeks.

Interesting, but the problem with this study is that it had no controls. So we can’t say if the improvement was due to placebo or specific effect by the lactoferrin tablet.

Lactoferrin inhibits skin inflammation

I found a few other studies on lactoferrin and skin issues. In some of these studies the researchers looked into its ability to suppress inflammation in the skin. They rubbed an irritating substance to the skin and looked the effect of lactoferrin on the resulting inflammation. They found that lactoferrin can suppress the production of inflammatory substances on the skin. They also found that lactoferrin can’t protect against inflammatory molecules from other sources.

What this means is lactoferrin probably can’t protect against food allergy induced acne, but it can help to protect the skin against irritation by harsh skin washes, sun light, pollution and so on.

Lactoferrin

I’m not aware of any serious health risks with lactoferrin. WebMD reports this on safety of lactoferrin

Lactoferrin is safe in amounts consumed in food. Consuming higher amounts of lactoferrin from cow’s milk might also be safe for up to a year. Human lactoferrin that is made from specially processed rice appears to be safe for up to 14 days. Lactoferrin can cause diarrhea. In very high doses, skin rash, loss of appetite, fatigue, chills, and constipation have been reported.
WebMD: Lactoferrin

Conclusion

So what can we make of all this? Can lactoferrin help you to get clear?

It’s too early to say yet. But the results look interesting. In two studies lactoferrin was shown to help with acne. Other studies have shown that it can reduce inflammation in the skin – one of the causes behind acne. We know lactoferrin plays a role in beneficially regulating the immune system. And there doesn’t appear to be any serious safety concerns.

You can find several brands from Amazon for less than $20 (please don’t ask me which one is good – I don’t know). With all this in mind I think lactoferrin is one of the few supplements worth trying.

References:

• Dietary effect of lactoferrin-enriched fermented milk on skin surface lipid and clinical improvement of acne vulgaris.
• Efficacy and tolerability of oral lactoferrin supplementation in mild to moderate acne vulgaris: an exploratory study.
• Lactoferrin and host defence: an overview of its immuno-modulating and anti-inflammatory properties.
• Lactoferrin: influences on Langerhans cells, epidermal cytokines, and cutaneous inflammation.
• Regulation of epidermal Langerhans cell migration by lactoferrin.
• Exogenous topical lactoferrin inhibits allergen-induced Langerhans cell migration and cutaneous inflammation in humans.

Whey protein can help you to build big muscles and lean body. But it can also add unwanted cherries on the cake by giving you acne. Every so often someone asks me whether it’s safe to use whey protein to complement their efforts at the gym.

Anecdotal evidence is all over the map. Some say whey gives them pimples. Others say it doesn’t. But these could be just coincidences. Is there any real evidence for or against whey protein in acne formation? That’s the topic for this post. I’ll very quickly review the hormonal factors behind acne and how dairy products affect them. Then we’ll look at studies on protein supplementation on these hormones. Finally we’ll see if you can avoid potential problems by using soy protein.

From the horse’s mouth

The most damning piece of evidence comes straight from the horse’s mouth, from a presentation and a paper at Nestle Nutritional Workshop titled: “Evidence for acne-promoting effects of milk and other insulinotropic dairy products.” Points of interest:

• Dairy products increase post-meal insulin and insulin like growth factor 1 (IGF-1) levels
• This leads to increases in all major factors of acne pathogenesis (i.e. causes of acne), such as:
  • Increased sebum production through up-regulation of androgen receptors in the skin
  • Increased cell growth and turnover and blocking cell separation at cell death àmore dead skin cells
  • Inflammation in the skin
• Whey proteins may increase insulin and IGF-1 levels more than other forms of dairy products

From the study’s conclusion

The elimination of the whey protein-based insulinotropic mechanisms of milk will be the most important future challenge for nutrition research.

Melnik BC.
Evidence for acne-promoting effects of milk and other insulinotropic dairy products.
Nestle Nutr Workshop Ser Pediatr Program.
2011;67:131-45. Epub 2011 Feb 16. Review. PubMed PMID: 21335995.

Basically the author is saying that if Nestle wants to sell more milk and dairy based products they should create dairy products that don’t increase insulin levels. Because, the authors continue “generation of less insulinotropic milk will have an enormous impact on the prevention of epidemic western diseases like obesity, diabetes mellitus, cancer, neurodegenerative diseases and acne.”

Studies show that protein supplementation and resistance training increases IGF-1 levels

I took this a bit further and looked for studies on protein supplementation and resistance training on IGF-1 levels.

Let’s first look at why IGF-1 is relevant to bodybuilding and muscle mass. IGF-s acts as anabolic growth hormone. It stimulates cell growth, and thus also muscle growth. And that’s why bodybuilders look for ways to ‘max’ it.

So let’s look at protein powders and IGF-1 levels. Unfortunately I could only find a few studies, and not all of them specified the protein in the supplements.

• One study found that 20g of protein + amino acid (14g whey & casein + 6g amino acids) increased IGF-1 more than 20g of dextrose after 10 weeks of resistance training.
• Another study found an increase in IGF-1 with protein supplement (42g of PRO, 24g of CHO and 2g of FAT) of 70 g carbohydrate (CHO) supplement. This study went on for 6 months, and looking at the graph the difference between the groups increased over time. Unfortunately the authors didn’t mention what protein they used.
• On the other hand, this study, found no increase in IGF-1 with CHO, PRO or CHO/PRO supplements. Unfortunately the abstract didn’t mention the type of protein used.

That’s all the studies I could find on resistance training and protein supplementation. Not much to go by. But it looks like protein supplementation possibly leads to increase in IGF-1 levels, which then increases your risk of getting acne.

What about soy protein

Whey protein stimulates insulin and IGF-1. That much we know. But what about soy protein? From the data at hand we can’t say much about soy protein.

There are some studies about soy protein and soy supplement on bone loss. IGF-1 is relevant in bone formation, and that’s why it’s often mentioned in these studies. Unfortunately these are often conducted on postmenopausal women (the group at highest risk for bone loss). Not exactly the most relevant comparison to young guys looking to get buffed. One such stud

Nevertheless, one study looked at the effect of protein supplementation on bone density on older men. What makes this study interesting is that it compared two different types of protein supplement: dairy and soy. The result: Soy protein increased IGF-1 levels more than dairy based protein supplement.

Quite surprising. Given that research generally shows that protein from non-dairy sources doesn’t affect IGF-1 levels. As this is just one study it could be a coincidence.

Conclusion

Studies consistently show a small but positive effect from protein supplementation to muscle mass and strength. So protein powders do work. But they may also give you acne. We can’t say for sure, but it looks like protein supplementation, and especially whey protein, increases the hormones indicated in causing acne.

However this doesn’t mean that protein supplementation (whey or otherwise) would give acne to everyone prone to getting it. This insulin/IGF-1 is pathway is just one way to get acne. There are others also. For many people acne is more tied to inflammation and food allergies. These people may easily tolerate whey protein but break out after eating a slice of bread.

Finally, research always gives data on the level of ‘many’. We can say that in a large group of people what is likely to happen on average. But no research can say what happens with a specific individual, such as you. So the only way to know for sure how whey protein supplementation affects your acne is to test it out.

References

• Evidence for acne-promoting effects of milk and other insulinotropic dairy products.
• Effect of protein supplementation during a 6-mo strength and conditioning program on insulin-like growth factor I and markers of bone turnover in young adults.
• Effects of resistance training and protein plus amino acid supplementation on muscle anabolism, mass, and strength.
• Dietary supplements affect the anabolic hormones after weight-training exercise.
• Soy Protein Supplementation Increases Serum Insulin-Like Growth Factor-I in Young and Old Men but Does Not Affect Markers of Bone Metabolism.
• The association between diet and serum concentrations of IGF-I, IGFBP-1, IGFBP-2, and IGFBP-3 in the European Prospective Investigation into Cancer and Nutrition.

I recently posted a detailed article about the connection between gluten and skin diseases to my other website. It’s a fairly long and maybe a bit technical. Here are summary points from that article:

• With a whopping zero studies on the effect of gluten on acne we have no direct, reliable evidence
• However there are a handful of studies on psoriasis that show interesting results
• One study showed that gluten-free diet significantly reduced psoriasis severity and area for those patients who are gluten sensitive. Whereas the diet made no difference for those who are not gluten sensitive
• A few studies showed that gluten sensitivity is far more common among psoriasis patients than in healthy population
• Dermatitis herpetiformis (DH) is often called as celiac disease of the skin. Telling. It’s an intensely itchy, rash-like condition on the skin. As you can imagine the connection between DH and gluten has been studied quite a bit. DH patients are often gluten sensitive and their skin improves with gluten-free diet.
• Given all the anecdotal reports on people getting clear skin after dropping wheat and the studies on other inflammatory skin conditions, we can label wheat as high risk food for acne.
• That said, gluten probably doesn’t aggravate acne for everybody. For psoriasis patients it only made a difference for those who were diagnosed as gluten sensitive (i.e. had gluten antibodies in blood). Another study showed that only 16% of psoriasis patients is gluten sensitive.
• The situation with acne is probably similar. It affects a small portion of acne sufferers, many of whom gather at various natural, diet and holistic acne treatment corners of the web. This can make the problem appear more widespread than it is because we never hear from the thousands and thousands of acne patients who can eat gluten without any problems.
• If you suspect you have gluten sensitivity you can talk to your doctor about getting tested.
• Can people who are gluten sensitive eat oats? Studies on celiac patients show little or no problems after eating pure (uncontaminated) oats. Ditto with studies on DH patients and oats. But if you want to eat oats look for brands that are gluten-free.
• Probiotics might help. It’s worth to add some fermented foods into your diet.

You can check out the full article along with all the references here: Gluten and acne.

Antioxidants are all rage among health conscious people. As always marketing hype far exceeds their real benefits. But while antioxidants may not make you immortal they may play a crucial role in skin health. Take a few minutes to read more.

A Japanese study compared the skin antioxidant levels from acne patients to those with clear skin. Researchers collected samples from several areas. A spot in face affected with acne and another spot that had no pimples. They also collected a sample from forearm. Then they compared the antioxidant levels between acne patients and those with clear skin. What they found is that the quantity of antioxidants from each area was significantly lower in acne patients than that of people with healthy skin.

Other studies have been done with similar results.

An Egyptian study from 2009 found that acne patients have significantly fewer antioxidants on the skin. This study also looked at free radicals (oxidants) on the skin and found that acne patients have more free radicals (causes inflammation) in the skin than those with healthy skin. Furthermore they found acne severity correlated with free radical levels. In other words, the more free radicals on the skin the worse the acne was.

A study published in Journal of the European Academy of Dermatology and Venereology looked into antioxidant and free radical levels in the blood. This study found that acne patients have significantly more oxidative stress (inflammation) and fewer antioxidants when compared to healthy controls.

There are also other studies with similar findings, but I think we’ve looked at enough studies for one blog post.

What we can conclude from these is that inflammation plays a significant role in acne; both systemic inflammation in the body and local inflammation in the skin.

What causes this inflammation?

Unfortunately we don’t know yet. Perhaps it’s because acne patients produce more sebum and thus need more antioxidants to protect it. There’s also some evidence that the skin immune system in acne patients is trigger happy compared to those with healthy skin. This means that it reacts easier to any outside substances on the skin (such as bacteria and pollution). This would increase demand for antioxidants. Stress can also play a role in this. Acne patients in general are under more stress than the general population. Unfortunately we can’t say for sure yet.

Oxidative stress as cause for acne also helps to explain why antibiotics effectively clear acne – at least temporarily. Antibiotics don’t just kill bacteria. They also have significant antioxidant activity.

All this underscores the importance general skin health plays in acne. Acne is not caused by bacteria, thought they do play a role later in the pimple formation process. And simply killing bacteria isn’t a good way to treat acne. What you need to do is to reduce oxidative stress (inflammation) in the skin. One way is to apply antioxidant treatments on the skin, with vitamin E being one of the most important antioxidants on the skin. You should also protect the skin from further sources of inflammation, such as excess exposure to sunlight. Air pollution also stresses the skin. As do excessive use of chemicals.

That’s that. Go get your vitamins!

References:

• Decrease in glutathione may be involved in pathogenesis of acne vulgaris.
• Glutathione peroxidase and malondialdehyde in skin lesions of acne vulgaris.
• Oxidative stress in acne vulgaris.

Every acne victim knows that acne is more than just a skin disease. In fact pimples are just a minor part of acne. What really causes problems is the emotional suffering that acne causes. I see evidence of this suffering in almost every email and forum post I read.

Most would say that acne causes emotional suffering because it’s such a visible skin condition. And acne victims usually agree with this. They believe they will feel better once they manage to clear their skin. For many this leads to desperate measures; anything from extremely strict diet and detox routines to spending thousands and thousands of dollars on every imaginable treatment. Many even drink and douse their face with their own urine.

Clearly these people are in massive pain.

While it’s true that you do feel better when your skin is clear emotions-acne connection is more complex than that. My theory is that rather than causing emotional pain acne merely triggers some deep-seated insecurities and wounds.

Scientists have studies emotional suffering and quality of life of acne victims. In fact this subject has been studies extensively. Here are some interesting findings.

Research findings

Emotional pain and quality of life is not linked to severity of acne. This finding comes up in most studies. Researchers use validated questionnaires to measure the quality of life (or emotional suffering) of acne victims. They also have a dermatologist who objectively measures the severity of acne. These two measurements almost never correlate. If acne would be the cause of emotional pain then you would expect the more severe acne the more pain the person experiences. However this is not the case.

Another interesting point is that successful treatment of acne often doesn’t lead to improvements in quality of life. Again you would expect that if acne causes emotional pain then improvements in acne would improve the quality of life for the patients. This doesn’t happen always.

One study found that while emotional suffering is not linked to objective severity of acne it is linked to the patient’s subjective assessment of their acne. In other words the worse the patient thought their acne is the worse they felt.

Other studies have shown that patients rate their acne worse than dermatologists do. Similarly patients are less likely to notice improvements on their own skin.

Let me say this again. It’s not how bad your acne is that makes you feel bad, it’s how bad you think it is. And most people think their acne is far worse than it actually is.

Body Dysmorphic Disorder

While reading studies about acne and emotional suffering I came across something called body dysmorphic disorder (BDD). Mayo Clinic defines it well.

Body dysmorphic disorder is a type of chronic mental illness in which you can’t stop thinking about a flaw with your appearance — a flaw that is either minor or imagined. But to you, your appearance seems so shameful that you don’t want to be seen by anyone. Body dysmorphic disorder has sometimes been called “imagined ugliness.”

Body dysmorphic disorder – Definition
Mayo Clinic

Sounds at all familiar?

Here are some interesting things about BDD:

• Prevalence in general population is 1 to 2%.
• It’s much more common among dermatology patients and those seeking plastic surgery.
• Surveys of acne patients estimate that 10 to 20% of acne patients suffer from BDD, a 10-fold increase from general population.

Dermatologists know that patients with BDD are notoriously difficult to treat. They often don’t respond to treatments as well as other patients do. Further, studies show that regardless of the objective outcome patients with BDD are rarely satisfied with the treatment.

Remember that how you feel is linked to what you think of your acne. So if you suffer from BDD then you are likely to see every little flaw as a major disaster (and who doesn’t have even a small flaw). In such case you wouldn’t be very satisfied with the treatment.

Can emotional problems cause acne?

It’s too early to say this yet, but I wouldn’t be surprised if they did. First, why is BDD so much more prevalent among acne victims? Of course this alone doesn’t mean BDD causes acne, but it’s an interesting point anyway.

Second, we know that stress can cause acne. If you suffer from BDD and constantly worry about your appearance, it’s likely that this causes a lot of stress on you. This then would trigger or aggravate acne and give you even more to worry about. Perpetual cycle.

Breaking free

You can’t break this cycle with fork and knife. In other words, if acne causes you a lot of suffering then diet is not the answer. This is a mistake I see over and over. People are desperate to get clear. They are in pain. In order to get clear they keep improving their diet. They cut out bad foods. They take supplements. They fast and detox. Don’t do this!

What you are dealing with is an emotional problem. You have to address it with emotional tools. After  being in touch with thousands of acne victims I can say that diet might help, but there are countless people who see no difference in their skin no matter how good their diet is.

This is clear even from research. Studies show that patients are most reliable helped by psychological treatment. Either drugs or therapy, such as cognitive behavioral therapy.

Some good self-help alternatives are:

• Meditation, as little as 15 minutes a day helps. Just be consistent with it.
• Journal writing. Take a few minutes to write about your problem can help a lot. When you write you are forced to organize the issue in your mind. This then helps you to resolve it. This whole exercise doesn’t have to take more than a few minutes a day. Again, consistency is the key.
• SkinDeep book is also a good resource. See SkinDeep discussion at the forums for more info.

Take home messages

• Emotional suffering acne causes is more complex than most people believe.
• Rather than causing emotional problems acne may simply trigger deep-seated issues.
• If you are overtly critical of your own skin and/or never satisfied with treatments it’s possible your suffering is rooted to self-esteem issues.
• Trying to cure acne is not the answer to these problems. In fact making progress with your skin may not make you much happier.
• These emotional problems may even slow down or prevent your skin from healing

References:

• Body image disturbance in patients with acne vulgaris.
• Psychosocial impact of acne vulgaris: evaluating the evidence.
• Quality of life in mild to moderate acne: relationship to clinical severity and factors influencing change with treatment.
• There is no correlation between acne severity and AQOLS/DLQI scores.
• Disease-specific quality of life is associated with anxiety and depression in patients with acne.
• Evaluation of acne quality of life and clinical severity in acne female adults.
• Clinical and psychological correlation in acne: use of the ECLA and CADI scales.
• Acne prevalence and beyond: acne disability and its predictive factors among Chinese late adolescents in Hong Kong.
• Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients.
• Patient’s perspective: an important issue not to be overlooked in assessing acne severity.
• Acne in Adolescents: Quality of life, self-esteem, mood, and psychological disorders.
• Psychological impact of acne vulgaris.
• Body dysmorphic disorder. A guide for dermatologists and cosmetic surgeons.
• Body dysmorphic disorder and cosmetic dermatology: more than skin deep.
• Body dysmorphic disorder.
• Body dysmorphic disorder symptoms among patients with acne vulgaris.

Should acne victims use moisturizers? Acne victims usually struggle with too much oil on the skin. So adding moisturizer to this mix doesn’t sound like a good idea. But is it really so? Does moisturizers make already bad situation worse or can they help with acne? I looked at studies on the use of moisturizers on treatment of acne and other skin conditions. Here’s what I found.

The skin barrier function

To understand the importance of moisturizers we need to briefly talk about skin barrier function. The skin is much more than a ‘bio-plastic wrap’ around your body. It plays an active role in maintenance of health. For example, it regulates moisture absorption and retention based on environmental humidity. The skin immune system also active protects you from bacteria and other harmful organisms. The skin also prevents a host of harmful substances from entering the body. All these are examples of the skin barrier function.

One common theme among all inflammatory skin conditions is weakening of this barrier function. One study for example found that acne patients have significantly higher water loss through the skin than those with healthy skin.

Excessive moisture loss and dryness often lead to weakening of the skin barrier function. There are water containing cells between the skin cells that in a way bind the skin cells together. When some of this water is lost ‘cracks’ form between the skin cells. This hinders the skin barrier function.

Some consequences of impaired skin barrier function are:

• The skin is more sensitive and prone to irritation
• Dryness of the skin
• The skin is more prone to infections

The role of moisturizers

Quick look at the PubMed database shows that several studies support the use of moisturizers in treatment of skin conditions. Moisturizers:

• Help to repair the skin barrier function.
• Prevent and treat skin dryness associated with many acne treatments. This in turn makes you more likely to stick with the treatment and get the benefits.
• Reduce skin irritation.
• Increase skin tolerance to UV rays and other sources of inflammation.

What all this means is moisturizers help to support the overall health of the skin and makes it less prone to acne.

From the studies I’ve seen I can’t make detailed recommendations on which moisturizer to use. But I can give you a few pointers:

• Use different moisturizer for face and other parts of the body. Facial moisturizers are formulated somewhat differently from other moisturizers.
• Naturally avoid any irritants you are aware of. However you shouldn’t get overtly paranoid with all the chemical names you see in the ingredients list. They are there for a purpose. This page, Moisturizers: What They Are and a Practical Approach to Product Selection lists several substances used in moisturizers and why they are there.
• Look for moisturizers with therapeutic ingredients. For example vitamins E and B3 (niacin/niacinamide) are very helpful for acne patients. The same goes with green tea extracts. Daily moisturizer is a great vehicle for delivering these to the skin.

I’ve heard a lot of good feedback for Proactiv Green Tea Moisturizer. Among Proactiv’s products it’s one that most users like. It’s not exactly cheap, but might be worth checking out. Amazon usually has the best price. Click here to check it out at Amazon.

References:

• Impaired water barrier function in acne vulgaris.
• Combination effects of cosmetic moisturisers in the topical treatment of acne vulgaris.
• Moisturizers for the treatment of inflammatory skin conditions.
• Impaired skin barrier function in dermatologic disease and repair with moisturization.
• Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders.
• Improved clinical outcomes with moisturization in dermatologic disease.

Acne victims are often shy and embarrassed about their skin. They feel that having acne makes them less appealing to other people, and that other people perceive them badly because of acne. Unfortunately recent research shows that there is some truth behind those beliefs.

A recent study published at the BioPsychoSocial Medicine studied how people view teenagers with acne as compared to those with clear skin. The researchers presented people with photos of people with acne and people who have clear skin. The researchers digitally altered the photos to remove acne. In this way they were able to measure the difference in perceptions of the same person with or without acne.

Not surprisingly the pictures with clear skin were perceived as more positive than those with acne. Here are the biggest differences. People with acne were perceived as:

• 41% shyer
• 25% nerdier
• 22% more stressed
• 22% lonelier

The above percentages are averages of teenage and adult responders. Adults perceived acne on others less negatively than teenagers.

These results aren’t that surprising. Everybody knows that how you look affects the way other people perceive you. But the important thing to keep in mind is that having acne is not the end of the world. Each and everyone has their own flaws. The trick is to do your best to accept them. Then you can develop other characteristics to outshine your flaws.

Or you can turn your flaws into your advantage. Self-confidence radiates brighter than acne. So cracking a joke about your skin condition takes the edge of it and focuses people on your strengths.

Sources:

Psychosocial Judgements and Perceptions of Adolescents with Acne Vulgaris: A Blinded, Controlled Comparison of Adult and Peer Evaluations (PubMed abstract), Full text PDF.

Every now and then I get emails from people asking about a specific diet or health program and whether it can cure acne. This time a reader asked me about Dr. Graham’s 80/10/10 Diet. So let’s take a look at it and what, if any, it can do for your skin.

If you’ve been with me for some time you might remember that I used to be into 80/10/10 diet and it influenced the earlier versions of Clear for Life.

Who, What, Where

But first a brief overview of who Dr. Graham is and what his 80/10/10 Diet is all about. Dr. Douglas Graham is a chiropractic doctor and, I think, also natural hygiene doctor. Both of these disciplines are based on ancient ideas of vitalism and have been thoroughly bunked by science.

The 80/10/10 Diet is based on the idea that caloric ratio of 80% carbohydrates, 10% fat and 10% protein is optimal for humans. And everything you eat should be raw. So basically you eat tons and tons of raw fruits and vegetables and little bit of nuts and seeds. That, according to Dr. Graham is the elixir of health and longevity.

In all fairness I should point out that 80/10/10 Diet is much more than just a diet book. Dr. Graham also talks about the importance of exercise, emotional poise, sleep and other lifestyle areas.

In this post I’m going to focus on the diet portion of the book. Because that’s where I see the most glaring errors are. The other parts of the book are actually pretty good, if a tad extreme.

Fat, the evil nutrient that makes you sick?

80/10/10 is the perfect recipe for breeding fat-phobic people. That’s because Dr. Graham comes down hard on fat. According to him consuming more than 10% of your calories from fat leads to rapid decline of health.

I junked my copy of 80/10/10 already so I can’t check all the reasons Dr. Graham says fat is bad. But the main idea is that eating too much fat messes up your blood sugar levels. Dr. Graham claims that fat prevents insulin from taking sugar from bloodstream into cells.

As a result your blood sugar levels remain high and the pancreas has to pump more insulin to bring them down. Over time this leads to negative spiral where your blood sugar and insulin levels get steadily higher. This is a condition known as metabolic syndrome. Excessively high blood sugar and insulin levels can also increase inflammation, and this deadly cocktail is behind many of the major killer diseases of the Western world.

High insulin and blood sugar levels are also linked to acne. High insulin levels cause the skin glands to produce more sebum and block your pores.

So obviously high insulin and blood sugar levels are bad. But can you fix those by dropping fat and eating as much fruit as you want?

Well, like all good quackery there’s a grain of truth behind what Dr. Graham preaches. It’s a well-known medical fact that too much fat does lead to insulin resistance. However the maximum of 10% of calories from fat that Dr. Graham proposes is absurd. I have looked far and wide of the medical literature and I haven’t been able to find a single study to back that up. Not a single study that says that eating more than 10% of fat causes problems.

Dr. Graham justifies this claim by using the vegan/low-fat echo chamber. Basically it goes like this. Dr. YY treats his patients with low fat approach and he has cured many people. And so does this institute. Therefore this claim must be right. Among this echo chamber is Dr. McDougall, Dr. Fuhrman, Hippocrates Health Institute and so on. And even most of these docs don’t agree with the 10% of calories from fat claim.

How much fat?

So how much fat can you eat before developing insulin resistance? As always is the case medicine and health are complex issues, and they just can’t be diluted to simple 10% claims. How much fat you can eat depends on the kind of fat you eat.

The best study so far I’ve found is the Kanwu study, also here. This study showed that people who eat more saturated fat are more insulin resistant than those who eat more unsaturated fats. But this beneficial effect disappeared when fat consumption went above 37% of total calories. Note that the 37% is average of all people and there will be individual variation in this.

There are also countless studies that show that substituting saturated fat for unsaturated fat reverses this fat induced insulin resistance.

So in the end we are left with no credible evidence backing Dr. Graham’s claim that eating more than 10% of calories from fat is harmful. Note that he makes no distinction between different types of fat. From his book I got the impression that fat is fat is fat – and it’s all bad.

Dangers of too much sugar

This is where Dr. Graham rides his dogma fueled pony off the cliff of science and reason.  He makes no mention that eating too many carbohydrates causes the exact problems he blames fat for.

The simple explanation is that eat too many carbohydrates also causes insulin resistance. This process is known as lipogenesis. Again we can’t say exactly how much is too many, but 50% to 60% of total calories is the most I would recommend. Excess carbs are converted by the liver into triglycerides (TG), a form of saturated fat. It’s been shown time and time again that too high triglyceride levels lead to insulin resistance. In a nutshell too many carbs are exactly the same as too much fat.

Out of all the sugars fructose looks to be the worst in this. Many studies have linked excessive fructose consumption with insulin resistance. Gorging on unlimited amount of fruit overloads the body with fructose, and this can lead to serious consequences for some people. Others seem to have no problems with it.

My 80/10/10 story

As I mentioned in the beginning I used to be into raw foods and 80/10/10 lifestyle. I wasn’t perfect with it, but I can honestly say I did it 85% seriously. I wasn’t religious about keeping my fat intake below 10% of calories but I can say it was below 15%.

For the first year I was doing well. My energy levels went up and I felt somewhat happier. My skin got somewhat better, but it never cleared completely. During this time I was also exercising a lot. Mostly running 45 to 90 minutes 4 times a week. I also did some bodyweight exercises.

However 15 months down-the-line things started to get worse. First I noticed persistent lack of energy. It got to a point where I was sleeping 11 to 12 hours a day and still feeling tired. I also developed severe joint pains. It got to a point where I had severe pain in my ankle, knee, shoulder and jaw joints.

First I chucked these as effects of detoxification and old injuries healing. However after 3 months I started suspecting something’s wrong. Dr. Graham helpfully blamed it all on me and said why I don’t do the program 100%. He also said that my joint pains were due to withdrawal effects from meat.

Anyway, I still wasn’t willing to consider that there’s something wrong with this dietary dogma. After all it felt so logical and made sense. I bought a blood sugar monitor to prove that eating a lot of fruit doesn’t’ cause blood sugar problems.

That’s when I got the rude awakening.

I was shocked to discover that my blood sugar readings almost touched diabetic levels.  After that I got off the crazy diet and started eating more balanced meals. Within a month or two my joint pains disappeared and I started feeling alive again.

Conclusion

Dr. Graham’s 80/10/10 Diet is one of the crazier diets out there in the already crazy world of wacky diet books. It’s basically the invention of one well-meaning person, Dr. Graham, with zero credible evidence behind it (at least I haven’t been able to find any).

The way Dr. Graham tells the story of this diet it all makes sense and feels so right. Unfortunately in this case intuition and good feelings can leads to serious trouble later on. The diet itself is based on flawed premise (that fat is the cause of most health problems). And this premise is contradicted by actual research. There’s good evidence to show that excessive consumption of carbohydrates, and especially fructose, leads to insulin resistance. This then can make your acne worse.

Keeping all this in mind I wouldn’t recommend the 80/10/10 Diet for treatment of acne. In my opinion you are much better off with more balanced and sensible approach. Though, the other sections of the book can be helpful for acne patients.

I know fully well that some people do well with the 80/10/10 approach and Dr. Graham’s website is armed with countless testimonials. But just keep in mind that we are individuals. So even if the diet does work for somebody it doesn’t mean it’s going to work for you. Not to mention that many of the prominent success stories are very active athletes. Because they exercise much more than normal people they can get away with eating more carbohydrates.

If you are into Dr. Graham’s particular brand of raw food ideology, I also suggest you check out these two articles:

• Matt Stone’s post at 180 Degree Health blog: The 80-10-10 Diet (811rv)
• Science Based Medicine blog post: Simply Raw: Making overcooked claims about raw food diets

Is there something in your life you know you should do, or should stop doing? Something that would make your life better. But for some reason you just haven’t been able to nail it. I know my history is littered with such good intentions.
Here’s a simple way to solve this problem. The 30 day challenge. Matt Cutts talks about this in a recent Ted Talk. This video is worth spending 3 minutes and 27 seconds on.

The simple idea is to take something you know is good for you and then do it for the next 30 days. Why 30 days? Because 30 days is a much smaller commitment than promising to make something a lifelong habit. 30 days gives you a very concrete goal, and you can tick off the days from your calendar. If you really want it you can always get yourself to do anything for 30 days.

After the 30 days you are free to drop the new habit if you don’t want to keep doing it. Also, 30 days is about the time it takes to establish a new habit.

If you are like me and don’t really trust that you will follow up with your good intentions, then start small. Small changes are easier and they help to grow your confidence in yourself.

30 day challenge ideas for clear skin

So how could this help you to get clear? Well, make the new habit or thing something that helps your skin also. When it comes to getting clear key areas usually are: stress and emotional health, diet, exercise, external skin care and sleep.

And here are some suggestions on some of those areas:

Diet

• No sugar for 30 days
• Eat a salad every day for 30 days
• Green smoothie a day for 30 days

Stress and emotional health

• Don’t criticize yourself for 30 days.
• Meditate once a day for 30 days. This could be as little as 10 to 15 minutes a day. You can use my free mindfulness meditation from CFL Meditations package. Download here (right-click and choose ‘Save As’ (or something like it))
• Journaling for 30 days. Here’s a simple tip. Every day take a few minutes to write down your about something that’s been bothering you. Research has shown that taking just a few minutes to write about a problem helps you to process it. When you write something you force yourself to organize and make sense of it in your head. Sounds like a perfect 30 challenge to start with?

Sleep

Sleep deprivation increases inflammation and can be a key factor in acne.

• Go to bed before 11 for 30 days
• No computer/TV after 10 PM for 30 days

So there you have it. Simple challenge and simple ideas that if you apply them for 30 days will help your skin.

So, what’s your 30 day challenge?