Diet and Acne

Between 80 and 90% of all adolescents get acne. So do many adults. Does diet have anything to do with it?

Immigration studies show that acne increases when a population shifts to a more Westernized diet. What’s the cause? A 2009 review of scientific literature showed that dairy products and high-glycemic-index foods (like simple carbohydrates) may be to blame. There’s also evidence that omega-6 fatty acids play a role in acne.

When I was a teenager, we thought that eating chocolate caused acne. But there’s no scientific evidence to back that up. Salt doesn’t seem to play a role either.

Dairy Foods

Researchers think that hormones in cow’s milk play a role in acne. Skim milk showed the strongest association with the frequency and severity of acne in teenage girls, leading scientists to believe that hormones and not milk fat are to blame.

High-Glycemic-Index Foods

The glycemic index measures how fast and how far blood glucose rises after eating foods containing carbohydrates. Foods that are absorbed more slowly after ingestion (like whole-grain, complex carbohydrates) cause a slower rise in blood glucose levels and have a low glycemic index. Other foods – like those containing lots of sugar and simple starch (like white bread, cookies and cake), are digested quicker, causing blood sugar to rise faster. As blood sugar levels rise, the body secretes insulin to help metabolize it. In a number of studies, people given a low-glycemic-index diet showed an improvement in their acne. Scientists believe that insulin and hormones are involved.

Omega-6 Fatty Acids

Acne, depending on the type, may or may not involve inflammation. Although no large studies have been done, it’s believed that high levels of dietary omega-6 fatty acids, which produce inflammation, may be associated with acne. On the other hand, omega-3 fatty acids, which are anti-inflammatory, may decrease the incidence and severity of acne.

What Can You Do?

Severe acne should be treated by a dermatologist. If you’d like to try dietary measures to reduce the frequency or severity of acne, here’s what you can do:

1. Go “dairy-free” for at least several weeks to see if there’s an improvement. Be sure you get enough calcium from alternative sources, like fortified soy milk, almond milk or orange juice, canned salmon and sardines, leafy greens, tofu, or a vitamin supplement.

2. Choose foods with a low-glycemic index, like whole grains, legumes, nuts and vegetables.

3. Stick with fats that are high in healthy omega-3 fatty acids, like olive and canola oil. Eat plenty of fish, especially fatty fish like salmon and sardines. Ground flax seeds and walnuts are also high in omega-3 fatty acids. Reduce your intake of corn, soybean, safflower and sunflower oil, which are all high in omega-6 fatty acids.

4. Limit your intake of processed foods, which tend to be high in simple carbohydrates as well as unhealthy fats.

If acne is a problem, these relatively easy-to-do dietary measures just may make a difference. It’s worth a try!

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Pesach Shopping

Pesach food is a little slow getting onto the grocery store shelves here. But every day there’s something new.

Today I found cooking oils. Fortunately, there was a lot of olive oil – the healthiest choice. They also had canola oil, which some people consider kitniyot. Kosher l’Pesach avocado oil (delicious, healthy and expensive) is also available this year.

Then I saw something else – palm oil.

Years ago, highly saturated palm oil, palm kernel oil and coconut oil were used extensively in commercial baking. When health professionals and the public finally influenced a change, industry switched to hydrogenated oils, which turned out to be full of unhealthy trans fat.

Now that trans fat is out, manufacturers are back to using palm and coconut oil. It’s true – they have 0% trans fat. But they are highly saturated and can raise blood cholesterol levels.

The National Heart, Lung, and Blood Institute warns that the “high content of saturated fat… in… palm kernel oil, palm oil, coconut oil, and cocoa butter” puts people at risk for heart attack or stroke. The World Health Organization states that there is “convincing evidence” that palmitic acid (found in palm oil) increases the risk of heart disease.

That’s reason enough to skip palm oil this Pesach and choose heart-healthy olive, walnut or canola oil instead.

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Trans Fat – The Sequel

The phrases “zero trans fat” and “trans fat free” are now common on packages of cookies, cake, crackers and other convenience foods. Since trans fat must now be listed on nutrition labels, lots of companies have reformulated their products to eliminate them. Instead of partially hydrogenated oils (which result in trans fat), they’re using alternative fats.

That sounds good, right?

If the substitute is liquid oil like canola or soy, it’s probably fine. But if it’s an interesterified fat, it may or may not be any better for you than trans fat.

Interesterified fat is made by combining a solid fat with a liquid fat. The result is a fat that behaves like saturated fat – it keeps the cookies crisp and increases the shelf life of the product.

We don’t know if these fats are safe. Preliminary research suggests that they may raise bad cholesterol and lower good cholesterol, just like trans fat. It’s just too early to tell.

Another problem is that it’s hard to know when they’re being used in a product. Unlike trans fat, interesterified fats are not required to be listed on the label. You have to read the small print. If palm oil or palm kernel oil or fully hydrogenated vegetable oil appear as ingredients, it’s likely to be interesterified fat. Another clue is if the product boasts of being “trans fat free”.

Here’s the ingredient list of a popular cookie.


Can you find the interesterified fat? (Hint: It’s in bold print)

I’d avoid it. I’d also avoid the sugar, white flour and additional sugar (in the form of high fructose corn syrup) in these cookies.

If you eat a diet high in unprocessed foods like vegetables, fruit, whole-grains, low-fat protein and healthy fat like olive oil, you probably won’t come across much interesterified fat. It’s mainly used in highly processed store-bought food. It will be interesting to see if these fats will be around for awhile or if they go out the window along with their trans fat cousins.

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Balancing Act

Broccoli was going to be on the menu tonight. The farm had it as a special. They assured me that it was clean (I’ve thrown out plenty of bug-infested organic broccoli, so I always ask.), and it did indeed look beautiful.

No ideas came to mind, so I flipped through a few cookbooks.  Cream of Broccoli Soup sounded easy and good, especially since I already had vegetable stock in the freezer. The recipe was from an old vegetarian cookbook. High-fat and high-calorie.  

What do I do when a recipe calls for 6 tablespoons of butter, 3 cups of whole milk and a cup of sour cream?

The answer is:  “It depends.”

I thought about the menu. Broccoli soup and home-baked bread made with whole-wheat flour and seven-grain cereal.

With such healthy bread and the good nutrition of broccoli, I thought I could splurge with a few extra fat calories.

Instead of all that butter, I used 2 tablespoons and some canola oil. Rather than whole milk, I used 1/2  cup of (leftover) 10% cream (half & half in the US) plus 1% milk – the standby in our house. I used 9% sour cream, which I happened to have in the refrigerator. 

I think of it as a balancing act.

Lean, crunchy whole-grain bread. Nutrient-dense broccoli. Paired with a higher-than-normal amount of fat, it really wasn’t so bad after all. And the extra fat meant that a little went a long way. In other words, everyone felt quite satisfied with a fairly small serving of soup.

You’re asking how it turned out.

My audience gave dinner “two thumbs up”.


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Chana Rubin, RD

Food for the Soul

Traditional Jewish Wisdom for Healthy Eating
By Chana Rubin, RD

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