cne has been reported to be the most common chronic inflammatory skin disease worldwide, [1][2][3] occurring mostly in the 15-to 17-year age group. [4][5][6] Epidemiologic data from Western countries suggest that the prevalence of acne in adults older than 25 years is approximately 50%, with female predominance. [7][8][9][10] In this so-called adult acne group, there are 2 distinct populations: patients who developed acne during adolescence and have persistent acne and those who developed de novo acne during adulthood.Adult acne has various consequences; one of these is psychological harm associated with low self-esteem, poor perception of one's body, social isolation, and depressive symptoms. 11,12 Acne is reported to have the same emotional, social, and psychological consequences as chronic diseases, such as asthma, arthrosis, epilepsy, and diabetes. 13 Acne appears to be a multifactorial disease in which both genetic and environmental factors have pivotal roles. Endocrine disorders and genetic predispositions can lead to the development of acne; in addition, cosmetic products, tobacco use, stress, exposure to pollution, and dietary behavior may be associated with the development and severity of acne. [14][15][16][17][18][19] People with acne have been reported to believe that consumption of foods affects their condition. Although chocolate, fatty foods, and milk are frequently thought to be responsible, 20,21 data on the role of nutrition in acne are scarce. It has been hypothesized that a glycemic diet 22,23 or the consumption of dairy products (particularly milk) 24-28 is associated with the pathophysiologic mechanism of acne via androgens and insulinlike growth factor-1 (IGF-1). [29][30][31][32] However, published studies presented several limitations. IMPORTANCE Acne is a chronic, multifactorial inflammatory disease. The association between consumption of dairy products and fatty and sugary foods and occurrence and progression of acne remains unclear.OBJECTIVE To assess the association between dietary behavior and current acne in adults.
DESIGN, SETTING, AND PARTICIPANTSA cross-sectional study was performed as part of the NutriNet-Santé study, which is an ongoing observational, web-based cohort study that was launched in France in May 2009. The present study was conducted from November 14, 2018, to July 8, 2019. A total of 24 452 participants completed an online self-questionnaire to categorize their acne status: never acne, past acne, or current acne. Associations between dietary behavior (food intake, nutrient intake, and the dietary pattern derived from a principal component analysis) and current or past acne were studied in multinomial logistic regression models adjusted for potential confounding variables (age, sex, physical activity, smoking status, educational level, daily energy intake, number of dietary records completed, and depressive symptoms).
RESULTSThe 24 452 participants (mean [SD] age, 57 [14] years; 18 327 women [75%]) completed at least 3 dietary records. Of these, 11 324 individuals (46...