What’s Diet Got to Do With It? Basic and Clinical Science Behind Diet and Acne

Abstract

Acne has been considered a disease of Western society, which consumes a diet that includes high glycemic index dairy and fatty foods. Although large, blinded, randomized controlled trials surrounding the impact of diet on acne are challenging to conduct, there is early evidence from small clinical trials and larger observational studies as well as other basic scientific research on the contributions of diet in the pathogenesis of acne. This article will focus on the existing evidence behind one of the proposed pathways of acne pathogenesismammalian target of rapamycin complex 1 (mTORC1), which is a major promoter of cellular growth and proliferation and is primarily regulated through nutrient availability, insulin, and insulinlike growth factor 1 (IGF-1).

Impact of Diet and Nutrition in Patients with Acne Vulgaris

“…FOXO1 increases the expression of sestrin 3, resulting in the inhibition of mTORC1, while the translocation of FOXO1 into the cytoplasm results in the activation of the mammalian target of rapamycin complex 1 (mTORC1). Sestrin 3 assists in regulating blood glucose levels and supports insulin sensitivity, ehile mTORC-1 is a serine/threonine kinase which functions as a controller of height, proliferation, lipid synthase, and transcription of proteins [32,33]. The function of mTORC1 on the development of acne lesions is to mediate increased sebaceous gland proliferation, lipid synthesis, and keratinocyte proliferation, both alone and through androgen-mediated processes [34,35].…”

“…This leads to the development of biofilm production [37]. This efficient inhibition of FOXO1 additionally enhances the action of androgens, both by enabling the uncontrolled activation of the mTORC1 route and by enhancing the displacement of the androgen receptor to the nucleus, in which it has its effect [32]. It is noteworthy that an increase in S6 kinase-1 secretion is observed in response to the reduced mTORC-1 activity and reduced FOXO1 levels.…”