Advertisement

A Low Glycemic Index and Glycemic Load Diet Decreases Insulin-like Growth Factor-1 among Adults with Moderate and Severe Acne: A Short-Duration, 2-Week Randomized Controlled Trial

Published:April 22, 2018DOI:https://doi.org/10.1016/j.jand.2018.02.009

      Abstract

      Background

      A high glycemic index (GI) and glycemic load (GL) diet may stimulate acne proliferative pathways by influencing biochemical factors associated with acne. However, few randomized controlled trials have examined this relationship, and this process is not completely understood.

      Objective

      This study examined changes in biochemical factors associated with acne among adults with moderate to severe acne after following a low GI and GL diet or usual eating plan for 2 weeks.

      Design

      This study utilized a parallel randomized controlled design to compare the effect of a low GI and GL diet to usual diet on biochemical factors associated with acne (glucose, insulin, insulin-like growth factor [IGF]-1, and insulin-like growth factor binding protein [IGFBP]-3) and insulin resistance after 2 weeks.

      Participants

      Sixty-six participants were randomly allocated to the low GI and GL diet (n=34) or usual eating plan (n=32) and included in the analyses.

      Main outcome measures

      The primary outcomes were biochemical factors of acne and insulin resistance with dietary intake as a secondary outcome.

      Statistical analyses

      Independent sample t tests assessed changes in biochemical factors associated with acne, dietary intake, and body composition pre- and postintervention, comparing the two dietary interventions.

      Results

      IGF-1 concentrations decreased significantly among participants randomized to a low GI and GL diet between pre- and postintervention time points (preintervention=267.3±85.6 mg/mL, postintervention=244.5±78.7 ng/mL) (P=0.049). There were no differences in changes in glucose, insulin, or IGFBP-3 concentrations or insulin resistance between treatment groups after 2 weeks. Carbohydrate (P=0.019), available carbohydrate (P<0.001), percent energy from carbohydrate (P<0.001), GI (P<0.001), and GL (P<0.001) decreased significantly among participants following a low GI/GL diet between the pre- and postintervention time points. There were no differences in changes in body composition comparing groups.

      Conclusions

      In this study, a low GI and GL diet decreased IGF-1 concentrations, a well-established factor in acne pathogenesis. Further research of a longer duration should examine whether a low GI and GL diet would result in a clinically meaningful difference in IGF-1 concentrations leading to a reduction in acne. This trial was registered at clinicaltrials.gov as NCT02913001.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bhate K.
        • Williams H.C.
        Epidemiology of acne vulgaris.
        Br J Dermatol. 2013; 168: 474-485
        • Timms R.M.
        Moderate acne as a potential barrier to social relationships: myth or reality?.
        Psychol Health Med. 2013; 18: 310-320
        • Bowe W.P.
        • Leyden J.J.
        • Crerand C.E.
        • Sarwer D.B.
        • Margolis D.J.
        Body dysmorphic disorder symptoms among patients with acne vulgaris.
        J Am Acad Dermatol. 2007; 57: 222-230
        • Ahmed A.
        • Leon A.
        • Butler D.C.
        • Reichenberg J.
        Quality-of-life effects of common dermatological diseases.
        Semin Cutan Med Surg. 2013; 32: 101-109
        • Halvorsen J.A.
        • Stern R.S.
        • Dalgard F.
        • Thoresen M.
        • Bjertness E.
        • Lien L.
        Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: A population-based study.
        J Invest Dermatol. 2011; 131: 363-370
        • Yentzer B.A.
        • Hick J.
        • Reese E.L.
        • Uhas A.
        • Feldman S.R.
        • Balkrishnan R.
        Acne vulgaris in the United States: A descriptive epidemiology.
        Cutis. 2010; 86: 94-99
        • McConnell R.C.
        • Fleischer Jr., A.B.
        • Willford P.M.
        • Feldman S.R.
        Most topical tretinoin treatment is for acne vulgaris through the age of 44 years: An analysis of the national ambulatory medical care survey, 1990-1994.
        J Am Acad Dermatol. 1998; 38: 221-226
        • Williams H.C.
        • Dellavalle R.P.
        • Garner S.
        Acne vulgaris.
        Lancet. 2010; 379: 361-372
        • Tan J.K.
        Psychosocial impact of acne vulgaris: Evaluating the evidence.
        Skin Therapy Lett. 2004; 9: 1-3
        • Zaenglein A.L.
        • Pathy A.L.
        • Schlosser B.J.
        • et al.
        Guidelines of care for the management of acne vulgaris.
        J Am Acad Dermatol. 2016; 74: 945-973
        • On S.C.
        • Zeicher J.
        Isotretinoin updates.
        Dermatol Ther. 2013; 26: 377-389
        • Tripathi S.V.
        • Gustafson C.J.
        • Huang K.E.
        • Feldman S.R.
        Side effects of common acne treatments.
        Expert Opin Drug Saf. 2013; 12: 39-51
        • Snyder S.
        • Crandell I.
        • Davis S.A.
        • Feldman S.R.
        Medical adherence to acne therapy: A systematic review.
        Am J Clin Dermatol. 2014; 15: 87-94
        • Tan X.
        • Al-Dabagh A.
        • Davis S.A.
        • et al.
        Medication adherence, healthcare costs and utilization associated with acne drugs in Medicaid enrollees with acne vulgaris.
        Am J Clin Dermatol. 2013; 14: 243-251
        • Miyachi Y.
        • Hayashi N.
        • Furukawa F.
        • et al.
        Acne management in Japan: Study of patient adherence.
        Dermatology. 2011; 223: 174-181
        • Rosenberg M.E.
        • Rosenberg S.P.
        Changes in retail prices of prescription dermatologic drugs from 2009-2015.
        JAMA Dermatol. 2016; 152: 158-163
        • Bickers D.R.
        • Lim H.W.
        • Margolis D.
        • et al.
        The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology.
        J Am Acad Dermatol. 2006; 55: 490-500
        • Taylor M.
        • Gonzalez M.
        • Porter R.
        Pathways to inflammation: Acne pathophysiology.
        Eur J Dermatol. 2011; 21: 323-333
        • Melnik B.C.
        • Schmitz G.
        Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris.
        Exp Dermatol. 2009; 18: 833-841
        • Burris J.
        • Rietkerk W.
        • Woolf K.
        Acne: A potential role for medical nutrition therapy.
        J Acad Nutr Diet. 2013; 113: 416-430
        • Smith R.
        • Mann N.
        • Mäkeläinen H.
        • Roper J.
        • Braue A.
        • Varigos G.
        A pilot study to determine the short-term effects of a low glycemic load diet on hormonal markers of acne: A nonrandomized, parallel, controlled feeding trial.
        Mol Nutr Food Res. 2008; 52: 718-726
        • Smith R.N.
        • Mann N.J.
        • Braue A.
        • Mäkeläinen H.
        • Varigos G.A.
        A low-glycemic-load diet improves symptoms in acne vulgaris patients: A randomized controlled trial.
        Am J Clin Nutr. 2007; 86: 107-115
        • Smith R.N.
        • Mann N.J.
        • Braue A.
        • Makelainen H.
        • Varigos G.A.
        The effect of a high-protein, low-glycemic-load diet versus a conventional, high-glycemic-load diet on biochemical parameters associated with acne vulgaris: A randomized, investigator-masked, controlled trial.
        J Am Acad Dermatol. 2007; 57: 247-256
        • Smith R.N.
        • Braue A.
        • Varigos G.
        • Mann N.J.
        The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides.
        J Dermatol Sci. 2008; 50: 41-52
        • Kwon H.H.
        • Yoon J.Y.
        • Hong J.S.
        • Jung J.Y.
        • Park M.S.
        • Suh D.H.
        Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: A randomized, controlled trial.
        Acta Derm Venereol. 2012; 92: 241-246
        • Reynolds R.C.
        • Lee S.
        • Choi J.Y.
        • Atkinson F.S.
        • Stockmann K.S.
        • Petocz P.
        • Brand-Miller J.C.
        Effect of the glycemic index of carbohydrates on acne vulgaris.
        Nutrients. 2010; 2: 1060-1072
        • Jenkins D.J.
        • Wolever T.M.
        • Taylor R.H.
        • et al.
        Glycemic index of foods: A physiological basis for carbohydrate exchange.
        Am J Clin Nutr. 1981; 34: 362-366
        • Wolever T.M.
        The glycemic index.
        World Rev Nutr Diet. 1990; 62: 120-185
        • Salmerón J.
        • Manson J.E.
        • Stampfer M.J.
        • Colditz G.A.
        • Wing A.L.
        • Willett W.C.
        Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women.
        JAMA. 1997; 277: 472-477
        • Cordain L.
        Implications for the role of diet in acne.
        Semin Cutan Med Surg. 2005; 24: 84-91
        • Bronsnick T.
        • Murzaku E.C.
        • Rao B.K.
        Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer.
        J Am Acad Dermatol. 2014; 71: 1039.e1-1039.e12
        • Matthews D.R.
        • Hosker J.P.
        • Rudenski A.S.
        • Naylor B.A.
        • Treacher D.F.
        • Turner R.C.
        Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.
        Diabetologia. 1985; 28: 412-419
        • Kaliyadan F.
        • Manoj J.
        • Venkitakrishnan S.
        • Dharmaratnam A.D.
        Basic digital photography in dermatology.
        Indian J Dermatol Venereol Leprol. 2008; 74: 532-536
      1. US Department of Health and Human Service. Food and Drug Administration. Center for Drug Evaluation and Research 2005. Acne vulgaris: developing drugs for treatment.
        (Accessed July 5, 2017)
        • Lucky A.W.
        • Barber B.L.
        • Girman C.J.
        • Williams J.
        • Ratterman J.
        • Waldstreicher J.
        A multirater validation study to assess the reliability of acne lesion counting.
        J Am Acad Dermatol. 1996; 35: 559-565
        • Karahalios A.
        • Baglietto L.
        • Carlin J.B.
        • English D.R.
        • Simpson J.A.
        A review of the reporting and handling of missing data in cohort studies with repeated assessment of exposure measures.
        BMC Med Res Methodol. 2012; 12: 96
        • Livesey G.
        • Taylor R.
        • Hulshof T.
        • Howlett J.
        Glycemic response and health—A systematic review and meta-analysis: relations between dietary glycemic properties and health outcomes.
        Am J Clin Nutr. 2008; 87: 258S-268S
        • Brand-Miller J.C.
        • Liu V.
        • Petocz P.
        • Baxter R.C.
        The glycemic index of foods influences the postprandial insulin-like growth factor-binding protein responses in lean young subjects.
        Am J Clin Nutr. 2005; 82: 350-354
        • Runchey S.S.
        • Pollak M.N.
        • Valsta L.M.
        • et al.
        Glycemic load effect on fasting and post-prandial serum glucose, insulin, IGF-1 and IGFBP-3 in a randomized, controlled feeding study.
        Eur J Clin Nutr. 2012; 66: 1146-1152
        • Crave J.C.
        • Lejeune H.
        • Brébant C.
        • Baret C.
        • Pugeat M.
        Differential effects of insulin and insulin-like growth factor I on the production of plasma steroid-binding globulins by human hepatoblastomoa-derived (Hep G2) cells.
        J Clin Endocrinol Metab. 1995; 80: 1283-1289
        • Singh A.
        • Hamilton-Fairley D.
        • Koistinen R.
        • et al.
        Effect of insulin-like growth factor-type I (IGF-I) and insulin on the secretion of sex hormone binding globulin and IGF-I binding protein (IIBP-I) by human hepatoma cells.
        J Endocrinol. 1990; 124: R1-R3
        • Kumari R.
        • Thappa D.M.
        Role of insulin resistance and diet in acne.
        Indian J Dermatol Venereol Leprol. 2013; 79: 291-299
        • Zouboulis C.C.
        • Eady A.
        • Philpott M.
        • et al.
        What is the pathogenesis of acne?.
        Exp Dermatol. 2005; 14: 143-152
        • Ben-Amitai D.
        • Laron Z.
        Effect of insulin-like growth factor-1 deficiency or administration on the occurrence of acne.
        J Eur Acad Dermatol Venereol. 2011; 25: 950-954
        • Rosenbloom A.L.
        The role of recombinant insulin-like growth factor 1 in the treatment of the short child.
        Curr Opin Pediatr. 2007; 19: 458-464
        • Klinger B.
        • Anin S.
        • Silbergeld A.
        • Eshet R.
        • Laron Z.
        Development of hyperandrogenism during treatment with insulin-like growth factor-I (IGF-I) in female patients with Laron syndrome.
        Clin Endcrinol. 1998; 48: 81-87
        • Tasli L.
        • Turgut S.
        • Kacar N.
        • et al.
        Insulin-like growth factor-1 gene polymorphism in acne vulgaris.
        J Eur Acad Dermatol Venereol. 2013; 27: 254-257
        • Mirdamadi Y.
        • Thielitz A.
        • Wiede A.
        • et al.
        Insulin and insulin-like growth factor-1 can modulate the phosphoinositide-3-kinase/Akt/FoxO1 pathway in SZ95 sebocytes in vitro.
        Mol Cell Endocrinol. 2015; 415: 32-44
        • Melnik B.
        Dietary intervention in acne: attenuation of increased mTORC1 signaling promoted by Western diet.
        Dermatoendocrinol. 2012; 4: 20-32
        • Zhao Y.
        • Tindall D.J.
        • Huang H.
        Modulation of androgen receptor by FOXA1 and FOXO1 factors in prostate cancer.
        Int J Biol Sci. 2014; 10: 614-619
        • Melnik B.C.
        • Zouboulis C.C.
        Potential role of FoxO1 and mTORC1 in the pathogenesis of Western diet-induced acne.
        Exp Dermatol. 2013; 22: 311-315
        • Napolitano M.
        • Megna M.
        • Monfrecola G.
        Insulin resistance and skin disease.
        ScientificWorldJournal. 2015; : 47934
        • Basiotis P.P.
        • Welsh S.O.
        • Cronin F.J.
        • Kelsay J.L.
        • Mertz W.
        Number of days of food intake records required to estimate individual and group nutrient intakes with defined confidence.
        J Nutr. 1987; 117: 1638-1641
        • Gersovitz M.
        • Madden J.P.
        • Smiciklas-Wright H.
        Validity of the 24-hr. dietary recall and seven-day record for group comparisons.
        J Am Diet Assoc. 1978; 73: 48-55
        • Biró G.
        • Hulshof K.F.
        • Ovesen L.
        • Amorim Cruz J.A.
        • for the EFCOSUM Group
        Selection of methodology to assess food intake.
        Eur J Clin Nutr. 2002; 56: S25-32
        • Bingham S.A.
        Limitations of the various methods for collecting dietary intake data.
        Ann Nutr Metab. 1991; 35: 117-127
        • Schaller M.
        • Sebastian M.
        • Ress C.
        • Seidel D.
        • Hennig M.
        A multicenter, randomized, single-blind, parallel-group study comparing the efficacy and tolerability of benzoyl peroxide 3%/clindamycin 1% with azelaic acid 20% in the topical treatment of mild-to-moderate acne vulgaris.
        J Eur Acad Dermatol Venereol. 2016; 30: 966-973
        • Berger R.
        • Barba A.
        • Fleischer A.
        • et al.
        A double-blinded, randomized, vehicle-controlled, multicenter, parallel-group study to assess the safety and efficacy of tretinoin gel microsphere 0.04% in the treatment of acne vulgaris in adults.
        Cutis. 2007; 80: 152-157
      2. Test 36365: Insulin-like growth factor 1 (IGF1), LC-MS and insulin-like growth factor-binding protein 3 (IGFBP3) growth panel. Mayo Clinic May Medical Laboratories website.
        (Accessed March 29, 2018)
        • Abe T.
        • Yasuda T.
        • Midorikawa T.
        • et al.
        Skeletal muscle size and circulating IGF-1 are increased after two weeks of twice daily “KAATSU” resistance training.
        Int J Kaatsu Training Res. 2005; 1: 6-12
        • Melnik B.C.
        Evidence for acne-promoting effects of milk and other insulinotropic dairy products.
        Nestle Nutr Workshop Ser Pediatr Program. 2011; 67: 131-145
        • Danby F.W.
        Nutrition and acne.
        Clin Derm. 2010; 28: 598-604
        • Aizawa H.
        • Niimura M.
        Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne.
        J Dermatol. 1995; 22: 249-252
        • Burris J.
        • Rietkerk W.
        • Shikany J.M.
        • Woolf K.
        Differences in dietary glycemic load and hormones in New York City adults with no and moderate/severe acne.
        J Acad Nutr Diet. 2017; 117: 1375-1383

      Biography

      J. Burris is a certified diabetes educator and a certified nutrition support clinician, and a part-time faculty member, Department of Kinesiology and Nutritional Science, California State University, Los Angeles, and Department of Nutrition and Food Studies, New York University, New York; at the time of the study, she was a PhD candidate in nutrition, Department of Nutrition and Food Studies, New York University, New York.

      Biography

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

      Biography

      W. Rietkerk is a dermatologist, Conejo Dermatology, Thousand Oaks, CA; at the time of the study, he was a dermatologist, Manhattan Dermatology and Cosmetic Surgery, New York, NY.

      Biography

      K. Woolf is an associate professor in nutrition, Department of Nutrition and Food Studies, New York University, New York.