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Got milk? Got acne?

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By Warren R. Heymann, MD
July 30, 2016

I loved to drink milk as a kid — I would guzzle it. I was on the chunky side, so my mother encouraged me to have skim milk to cut down on the calories. I never really cared for it, but she did the shopping. As a teenager I also had some acne, and was told to cut out pizza and chocolate — those were the culprits back then. Who would have ever thought that skim milk could be associated with acne?

Lately, as you are aware, skim milk and a high glycemic diet have been associated with acne. The presumptive reasoning, which is almost Talmudic in approach, suggests that skim milk leads to increased insulin and insulin-like growth factor-1, which increases 5a-reductase, leading to increased androgens (gonadal and adrenal), causing increased sebaceous excretion, resulting in acne (1).

LaRosa et al performed a case-control study of 225 teenagers (14-19 years old) with either no acne or moderately severe acne, assessing them for food and nutrient intake using interviews via the Nutrition Data System for Research. They found that the amount of low fat/skim milk consumed by acne patients was significantly higher in patients with acne than without it. There was no association with the glycemic index in this study. The authors assert that although there is an association of skim milk with acne, this does not imply causation. Appropriately, they are asking for more research, specifically a study eliminating skim milk from the diet to determine if this maneuver would have a beneficial effect on acne (2).

That makes sense. What is interesting is that a greater consumption of total dairy products may actually have great health benefit, including prevention of weight gain in middle age. In a study of 18,438 healthy, non-obese women aged ≥45 year old, over 11.2 years, 8238 women became overweigh or obese. A greater intake of high-fat dairy products, but not intake of low-fat dairy products, was associated with less weight gain (P-trend = 0.004). In multivariable-adjusted analyses, lower risk of becoming overweight or obese was observed in the highest quintile of high-fat dairy product intake (3).

While it’s hard to reach any definitive conclusions on how diet can keep us thin with a clear complexion, it is gratifying that we can at least think about it over a breakfast with whole milk and a cheese omelet!

1. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol 2009; 18: 833-41.
2. LaRosa CL, et al. Consumption of daily in teenagers with and without acne. J Am Acad Dermatol 2016: 75: 318-22.
3. Rautiainen S, et al. Dietary consumption in association with weight change and risk of becoming overweight or obese in middle-age and older women: A prospective cohort study. Am J Clin Nutr 2016; 103: 979-88.

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