User:Hypochonda/Draft

=Diet= Several dietary factors have been investigated for a potential link to acne.

Some foodstuffs have been indicated by research to play a role in acne, but no causation has so far been proven via high-quality evidence, such as double-blind randomised control studies.

Glycemic Load
As of 2018, several reviews of medical literature examined the glycemic load-acne connection. Of those, two explicitly recommend the adoption of a low-glycemic diet, (Melnik2013, Mahmood, Melnik2015) and two consider the evidence to support the benefit of such a diet. (Kucharska, Bronsnick).

The impact of the glycemic index of patients’ diets on acne is suspected because of population (epidemiological?) studies, intervention studies and the examination of the biomedical pathways acting.

Population Studies In several (seven?) documented cases, native populations who previously displayed almost no acne started to experience it after switching to Western diets, which are marked by a higher glycemic index. The Western diet however is different in several other factors such as levels of dairy and type of fatty acids, therefore not excluding other differences to be the cause of the emergence of acne. (Cordain02)

Intervention and Observational Studies As of 2018, two randomised, investigator-masked intervention studies have tested the impact of a low-glycemic diet on acne. Both found significant decreases in acne lesions after the diet regimen (10 and 12 weeks). Multiple observational studies with tenthousands of participants found a positive correlation between the glycemic load of diets and acne severity.

Pathway Studies The glycemic load of a diet influences the quantity of certain hormones and the expression of certain genes in the skin cells. These changes can affect proximate causes of acne. A high glycemic load diet causes Hyperinsulinaemia, which leads to an increase of IGF1, lower IGFBP3, and increased androgen synthesis. Increased levels of IGF1 affect the transcription factors mTORC1 and Fox01, which regulate among other things, lipogenesis and anabolism. Additionally IGF1 affects keratinocyte proliferation, apoptosis, growth hormones and glucocorticoids. Excess lipogenesis and hyperkeratinization are considered proximate causes of acne. (Melnik 2015)