The first thing to know about acne that it is an inflammatory disease, where the most significant is:
-Increased keratinization of the hair follicles, which causes the follicle to become plugged.
-Increased sebum formation.
-Microbial colonization of the pilosebaceous unit.
-Inflammation.
Other factors, such as heredity and stress, can also aggravate acne.
In scientific terms and in schematic form, it could be said that the initial element is the abnormal keratinization of keratinocytes, which creates the microcomedone. At the same time, the increase in circulating androgens at puberty stimulates sebum production. All these elements combine in the pilosebaceous unit to create a favorable environment for colonization by Propionibacterium acnes, which ultimately initiates and maintains the inflammatory response.
What diet influences
The increase in keratinization, i.e. the plugging of the hair follicle, is influenced by growth factors, which in turn are supported by two hormones: insulin and growth hormone.
Let us focus on insulin. Its increase in blood increases proliferation and decreases cell self-destruction (apoptosis), and vice versa a decrease in insulin decreases keratinization, and therefore, the plugging of the pilosebaceous follicle. The more we eat carbohydrates with a high glycemic load – with the capacity to increase insulin rapidly – the more the keratinization process is stimulated. In other words, carbohydrates with a high glycemic load/high insulin index influence the appearance and maintenance of acne.
Sebum formation (stimulated by the action of androgens), if excessive, also favors the appearance of acne. When blood insulin increases, androgen levels increase. Therefore, diets rich in fiber improve circulating androgens and, consequently, acne.
Foods rich in omega 3 and omega 6
The bacteria involved in the pathogenesis of acne provoke a cascade of inflammatory reactions that we can modulate with food. One of the most relevant factors in the influence of diet on inflammation is the relationship between omega 6 and omega 3 fatty acids.
Since omega-6 fatty acids have pro-inflammatory properties while omega-3 fatty acids have anti-inflammatory activity. Therefore, a favorable diet to treat acne should have a high consumption of Omega 3, such as fish, for its anti-inflammatory action.
Instead, it is significant to see how humans evolved with a diet where the omega 6/omega 3 ratio was approximately 1, and in Western diets it is now 15/1, originated by the predominance of omega 6 in most vegetable oils and processed foods made with these oils.
All in all, we can conclude that diet-induced acne inflammation is due to:
-High consumption of saturated and trans fats.
-Increased consumption of sugars and refined products (rice, pasta, bread)
Decreased consumption of natural antioxidants (fruits and vegetables) -Sedentary life
-Sedentary life
Overconsumption of omega-6 acids (sunflower oil, corn oil, directly or through industrialized products), without adequate compensation of foods rich in omega-3 (fish, flaxseed).