Acne-Blog  ·  06. January 2019

The Importance of Vegetables in Acne Treatment

Vegetable consumption has repeatedly been associated with decreased prevalence and severity of acne.[1,2,3,4] That means that people who eat more vegetables suffer less often and less severe from acne. The question then is: Do they suffer less from acne BECAUSE of the increased vegetable consumption or is this a coincidental correlation or is the increased vegetable consumption perhaps a marker for something else which might be the actual cause for the phenomenon seen.

 

Let me give you an example for this: Going to bed with shoes on likely correlates with having headaches in the morning. Does that mean that the shoes cause the headaches? Of course not. It is just that people who go to bed with their shoes on are often times drunk. The alcohol not the shoes cause the headaches. Therefore wearing shoes in bed is a marker for being drunk which then leads to headaches. Shoes and headaches are correlated but there is no direct causal relationship between the two.

 

It is always important to remember, correlation does not imply causation.

 

So, is there a causal relationship between eating more veggies and having less acne or is it like with the shoes?
With very high certainty vegetables can in fact reduce acne. There are several mechanisms by which this might happen:
Vegetable consumption…

 

  1. …in general reduces systemic inflammation and improves immune function due to phytochemicals such as antioxidants and fiber.[7]
  2. …improves insulin sensitivity which can improve acne.[9,10]
  3. …attenuates the signaling of certain growth factors (such as IGF-1) and enzymes (such as mTORC1) which among other things reduces sebum production and proliferation of keratinocytes (top skin cells) which then reduces the clogging of pores and formation of pimples.[8,9]
  4. …improves the quality of our intestinal microbiome through phytonutrients and prebiotics which serve as food for the health promoting intestinal microbes.[10]
  5. …improves sex hormone balance. Especially an excess of male sex hormones (androgens) and progestins have been associated with acne.[10]

 

Now you might be wondering, how many vegetables should one eat to see benefits for the skin. An exact amount cannot yet been given. The available data is not sufficient for that. We should strive to reach AT LEAST the general recommendations of nutritional science organizations such as the American Academy of Nutrition or the German Nutrition Society. These organization recommend around 500 g of vegetables a day. It is often noted that it is crucial to also eat a variety of vegetables instead of just a single or few kinds.

 

Practical tips to increase vegetable consumption:

 

•        Use frozen vegetable mixes. You open the bag, put it into a pan and you‘re done. No cutting, no cleaning.

 

•        Cooke your veggies instead of eating them raw to reduce volume and soften them up. You don‘t need to worry about nutrients being lost.

 

•        Use smoothies and vegetable juices (choose low salt versions)

 

•        Have veggies as snacks. Put them on your desk, your lunch box, next to the couch etc.

 



In the interest of full disclosure, I think it is important to note that in two studies the correlation of increased vegetable consumption and decreased acne prevalence/severity did not reach statistical significance.[5,6] However, that does not seem to undermine the general understanding that increased vegetable consumption can reduce acne.

 

 

 

Sources:

 

  1. Jung JY, Yoon MY, Min SU, Hong JS, Choi YS, Suh DH. The influence of dietary patterns on acne vulgaris in Koreans. Eur J Dermatol. 2010;20(6):768-72. https://www.ncbi.nlm.nih.gov/pubmed/20822969
  2. Di landro A, Cazzaniga S, Cusano F, et al. Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy. J Am Acad Dermatol. 2016;75(6):1134-1141.e1. https://www.ncbi.nlm.nih.gov/pubmed/27542588
  3. Halvorsen JA, Dalgard F, Thoresen M, Bjertness E, Lien L. Is the association between acne and mental distress influenced by diet? Results from a cross-sectional population study among 3775 late adolescents in Oslo, Norway. BMC Public Health. 2009;9:340. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2751780/
  4. Grossi E, Cazzaniga S, Crotti S, et al. The constellation of dietary factors in adolescent acne: a semantic connectivity map approach. J Eur Acad Dermatol Venereol. 2016;30(1):96-100. https://www.ncbi.nlm.nih.gov/pubmed/25438834/
  5. Burris J, Rietkerk W, Woolf K. Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults. J Acad Nutr Diet. 2014;114(3):384-92. https://www.ncbi.nlm.nih.gov/pubmed/24412232
  6. Aksu AE, Metintas S, Saracoglu ZN, et al. Acne: prevalence and relationship with dietary habits in Eskisehir, Turkey. J Eur Acad Dermatol Venereol. 2012;26(12):1503-9. https://www.ncbi.nlm.nih.gov/pubmed/22070422
  7. Hosseini B, Berthon BS, Saedisomeolia A, et al. Effects of fruit and vegetable consumption on inflammatory biomarkers and immune cell populations: a systematic literature review and meta-analysis. Am J Clin Nutr. 2018;108(1):136-155. https://www.ncbi.nlm.nih.gov/pubmed/29931038
  8. Melnik B. Dietary intervention in acne: Attenuation of increased mTORC1 signaling promoted by Western diet. Dermatoendocrinol. 2012;4(1):20-32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408989/
  9. Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol. 2015;8:371-88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507494/
  10. Clark AK, Haas KN, Sivamani RK. Edible Plants and Their Influence on the Gut Microbiome and Acne. Int J Mol Sci. 2017;18(5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454980/