Research
Original Research
Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne

https://doi.org/10.1016/j.jand.2017.03.024Get rights and content

Abstract

Background

Glycemic index (GI) and glycemic load (GL) may be implicated in acne pathogenesis.

Objective

This cross-sectional study examined differences between GI/GL and biological factors associated with acne among adults with and without moderate/severe acne. Secondary objectives included examining differences between food-aggravated acne beliefs and acne-specific quality of life among adults with and without moderate/severe acne.

Design

As part of a cross-sectional study, participants completed a 5-day food record; blood draw to measure biological factors associated with acne (ie, glucose, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3, and sex hormone-binding globulin concentrations); body composition assessment; and questionnaire to evaluate food-aggravated acne beliefs and acne-specific quality of life. Food records were analyzed using Nutrition Data Services for Research.

Participants

Sixty-four participants (no acne, n=32; moderate/severe acne, n=32) from New York City, NY, were included in this study.

Statistical analysis

Independent sample t tests and Mann-Whitney tests examined differences in anthropometric measurements, dietary intakes, biological factors associated with acne, insulin resistance, and acne-specific quality of life between acne groups. A χ2 test for independence assessed differences in food-aggravated acne beliefs between acne groups.

Results

Participants with moderate/severe acne consumed greater total carbohydrate (P=0.003), available carbohydrate (P<0.001), percent energy from carbohydrate (P<0.001), and GL (P<0.001) compared to participants without acne. Participants with moderate/severe acne had greater insulin (P=0.002) and insulin-like growth factor-1 (P=0.009) concentrations, greater insulin resistance (P=0.001), and lower sex hormone–binding globulin (P=0.015) concentrations compared to participants without acne. Although there were no differences between groups, 61% of participants reported food-influenced acne. Participants with moderate/severe acne reported a lower quality of life compared to participants without acne (P<0.001).

Conclusions

The results from this cross-sectional study suggest a relationship between dietary carbohydrate, including GL, and acne. Future research is necessary to determine the effect of medical nutrition therapy on biological factors associated with acne and acne severity.

Section snippets

Study Design and Sample

Participants were recruited for this cross-sectional study between September 2013 and September 2014 in New York City, NY, through flyers posted at local universities, community boards, and dermatology offices, and information distributed on university listservs and Craigslist. Participants were eligible for inclusion in the study if they had a history of no acne or moderate or severe acne for ≥6 months, were between 18 and 40 years old, had a body mass index (BMI; calculated as kg/m2) between

Results

A total of 231 individuals were recruited and screened for eligibility. Ninety-three met the study eligibility criteria, provided informed consent, and were enrolled in the study. Of these 93 participants, 16 participants were excluded from the final analysis because of a diagnosis of mild acne by the dermatologist and 13 participants were lost to follow-up or withdrew from the study after the initial study visit because of the time commitment required. Sixty-four participants (no acne, n=32;

Discussion

In this study, participants with moderate/severe acne reported consuming significantly greater total carbohydrate, percent energy from carbohydrate, available carbohydrate, and GL compared to those without acne. Participants with moderate/severe acne had higher insulin and IGF-1 concentrations, greater insulin resistance, and lower SHBG concentrations compared to participants without acne. There were no differences in food-aggravated acne beliefs between acne groups. Finally, participants with

Conclusions

In summary, participants with moderate/severe acne reported greater carbohydrate intake, including GL, had greater insulin and IGF-1 concentrations, had greater insulin resistance, and had lower SHBG concentrations compared to participants without acne. In addition, acne-specific quality of life was lower among participants with moderate/severe compared to those without acne. Overall, most participants believed food influences acne development and severity. Although the results from our study

J. Burris is a certified diabetes educator, a certified nutrition support clinician, and a research assistant, Department of Nutrition and Food Studies, Steinhardt School of Culture, Education and Human Development, New York University, New York.

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    J. Burris is a certified diabetes educator, a certified nutrition support clinician, and a research assistant, Department of Nutrition and Food Studies, Steinhardt School of Culture, Education and Human Development, New York University, New York.

    W. Rietkerk is a dermatologist, Conejo Dermatology, Thousand Oaks, CA.

    J. M. Shikany is a professor, Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham.

    K. Woolf is an assistant professor, Department of Nutrition and Food Studies, Steinhardt School of Culture, Education and Human Development, New York University, New York.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT The authors received partial funding from the Steinhardt Doctoral Dissertation Grant, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.

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    © 2017 by the Academy of Nutrition and Dietetics.