Does dairy cause acne?

Growth factors can cause acne, either androgens or anything acting on the insulin receptor (including IGF-1) that enhance androgen signaling. Dairy is currently weakly suspected to contribute via the above, but not enough evidence exists to support a strong relationship.


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Dairy and Acne

Mechanisms

Acne, or as it is technically called Acne Vulgaris, has historically been linked to dairy (being the most commonly reported dietary association with acne[1]).

Acne can be furthered and made worse by excessive insulin secretion[2] and appears to also be exacerbated by IGF-1[3] and Glucose-dependent insulinotropic polypeptide (GIP). In the case of IGF-1, there are repeated correlations between those with acne and higher serum IGF-1 concentrations.[4][5]

These systemic factors appear to be induced following dairy consumption with insulin, IGF-1,[6] and GIP (which acts to further induce insulin[7]) being increased to levels greater than that of an equicaloric portion of meat (as a comparative protein source).

When looking at serum anabolic factors, dairy protein appears to induce some of these factors to a greater degree than other protein sources

Insulin and IGF-1 both act upon the insulin receptor, the typical signalling pathway includes signalling via PI3K to mTOR/Akt which then induces nuclear ejection of FOX01.[8]

This nuclear ejection of FOX01 tends to be seen as anabolic, as the presence of FOX01 in the nucleus per se is anti-anabolic and ejection hinders its actions.[9][10][11] By facilitating anabolic signalling FOX01 ejection can augment androgen-dependent or insulin-receptor (mTOR dependent) anabolism, both the androgen pathway[12] and the mTOR/Akt pathway (downstream of the insulin receptor)[13] increase sebaceous lipogenesis (production of lipids in sebocytes, these cells being skin cells that have a high likelihood of acne production) and activation of the mTOR/Akt pathway can augment androgen signalling.[14]

Anything that activates mTOR/Akt can plausibly increase the efficacy of androgen signalling. Activation of the insulin receptor reliably activates mTOR/Akt (and IGF-1 also acts on this receptor) and is thought to be the main player as there are correlations between diet, insulin and IGF-1 (known to reflect the diet), and acne in humans

Interventions

A few studies have claimed that reducing total insulinogenic secretions of the diet (limiting grains and dairy) would be beneficial in acne control[15][16] or at least that the link between dairy and acne requires more investigation.[17][18]

When looking at surveys, there does appear to be an increased risk of acne associated with dairy products although the relative risk ratios (ranging from 1.12[19]-1.44 depending on dairy product or 1.10-1.19[20]) appears to be weak.

There is a plausible link between dairy consumption and acne but correlational research does not fully support this link; studies tend to be conducted in adolescents (rather than adults) and the results are not too in favor of a strong link; perhaps weak at best

There appears to be a more reliable link between IGF-1 per se than dairy products per se, and although the latter may spike the former current (limited) research does not support a strong relation between dairy and acne

Dairy By-products?

As both Whey Protein and Casein Protein are dairy byproducts, and thus can spike insulin and GIP levels, they are theoretically able to also induce acne.

Tags: dairy, milk, acne, eczema, rash, insulin, FOX01, androgen, break outs

  1. ROBINSON HM. The acne problem. South Med J. (1949)
  2. Melnik BC. Evidence for acne-promoting effects of milk and other insulinotropic dairy products. Nestle Nutr Workshop Ser Pediatr Program. (2011)
  3. Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentiation. Endocrinology. (1999)
  4. Aizawa H, Niimura M. Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne. J Dermatol. (1995)
  5. Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. (2005)
  6. Hoppe C, et al. High intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boys. Eur J Clin Nutr. (2004)
  7. Salehi A, et al. The insulinogenic effect of whey protein is partially mediated by a direct effect of amino acids and GIP on β-cells. Nutr Metab (Lond). (2012)
  8. Melnik BC. FoxO1 - the key for the pathogenesis and therapy of acne. J Dtsch Dermatol Ges. (2010)
  9. Kim SJ, et al. Glucose-dependent insulinotropic polypeptide (GIP) stimulation of pancreatic beta-cell survival is dependent upon phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB) signalling, inactivation of the forkhead transcription factor Foxo1, and down-regulation of bax expression. J Biol Chem. (2005)
  10. Melnik BC. Is nuclear deficiency of FoxO1 due to increased growth factor/PI3K/Akt-signalling in acne vulgaris reversed by isotretinoin treatment. Br J Dermatol. (2010)
  11. Melnik BC. The role of transcription factor FoxO1 in the pathogenesis of acne vulgaris and the mode of isotretinoin action. G Ital Dermatol Venereol. (2010)
  12. Makrantonaki E, Zouboulis CC. Testosterone metabolism to 5alpha-dihydrotestosterone and synthesis of sebaceous lipids is regulated by the peroxisome proliferator-activated receptor ligand linoleic acid in human sebocytes. Br J Dermatol. (2007)
  13. Smith TM, et al. IGF-1 induces SREBP-1 expression and lipogenesis in SEB-1 sebocytes via activation of the phosphoinositide 3-kinase/Akt pathway. J Invest Dermatol. (2008)
  14. Fan W, et al. Insulin-like growth factor 1/insulin signaling activates androgen signaling through direct interactions of Foxo1 with androgen receptor. J Biol Chem. (2007)
  15. Melnik B. {Acne vulgaris. Role of diet}. Hautarzt. (2010)
  16. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. (2009)
  17. Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. (2012)
  18. Danby FW. Acne and milk, the diet myth, and beyond. J Am Acad Dermatol. (2005)
  19. Adebamowo CA, et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol. (2005)
  20. Adebamowo CA, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. (2008)

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