The old wives’ tales—that pizza (mmm, processed carbs and dairy!) and milk chocolate (yum, sugar! oh and dairy!) can cause acne—may be true according to recent research, despite the fact that many derms traditionally denied such ties. But new links between our age-old skin battles and diet may be equally illuminating.

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In a recent meta-analysis published in Cutis, authors Nanette B. Silverberg M.D. and Whitney B. Veith M.S. reviewed the literature on diet and acne and asserted that the type of dietary factors that promote insulin resistance may also promote acne, even going so far as to suggest that derms should potentially screen for it when treating patients.

Insulin resistance, which occurs when the body isn’t processing insulin effectively, causes blood sugar and fat levels to rise. This condition not only puts you at risk for heart disease and type 2 diabetes, but also, surprise, surprise: it’s highly associated with obesity and eating high-glycemic load foods.Silverberg admits the results of studies linking acne and obesity are mixed, and experts in the field are also conflicted about just what, exactly, is linking this complicated web of acne, obesity and insulin. (And, oh yeah, hormones like testosterone likely play a part, too.)

What is a clearer picture is that addressing the diet may help with all of these issues. A high glycemic diet (which can lead to obesity) seems to trigger both acne and insulin resistence. Too bad for us, the staples of the modern Western diet, like oh say, the aforementioned pizza and our favorite burgers and fries, are high glycemic foods.

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Starting to see all the connections? Obviously, not every obese person is prone to breakouts, but cutting glycemic loads and practicing weight control might just help acne sufferers, in addition to all the other health benefits, of course.Los Angeles dermatologist and author of “Feed Your Face,” Dr. Jessica Wu is highly aware of the links between what we eat and our skin’s appearance. “As far as diet is concerned, there is the greatest amount of evidence linking dairy and high-glycemic foods with acne. This is likely due to the effect of these foods on insulin levels, and we also know that insulin resistance is associated with obesity,” she says. “What remains to be proven is a direct link between obesity and acne.”

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Dr. Alan Dattner, a holistic dermatologist based in New York, concurs. “There is clearly an association with diet and acne,” he agrees. “And if someone is obese and they have increased insulin activity and they are eating sugar and driving sugar levels up, certainly there will likely be acne. But if someone is trying to paint a clear picture of a direct link between obesity and acne, well, it just doesn’t work that way. With acne, you’re looking at multiple factors like hormones, etc. There are too many pathways.” In other words, let’s not jump to conclusions.

Still, no matter what your scale says, Dr. Wu advises her patients to banish processed carbs and dairy (making sure to get calcium and vitamin D from other sources), in addition to avoiding iodized salt. “I also recommend eating foods rich in omega-3 fatty acids. These have been shown to reduce inflammation, which we now think is the primary cause of acne—not bacteria infection—and help reduce breakouts,” says Dr. Wu. And the latter connection, my friends, is a whole other story.

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