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Re: Sugar Sugar!
Nov 11, 2004
[QUOTE=surenitynow]i really wish i can remember where i read this, but i know it was on the internet somewhere when i tried to look up info on cameron diaz and her acne(which i do recommend because it made me feel better knowing not all pretty famous people have perfect skin)...but anyway, i came across something that said how people in Africa(or south america?) had a significantly lower number of people with acne, i mean hardly anyone has acne there, especially people in african tribes and indian tribes...they attribued this to all natural foods they ate and the lack of processed foods which Americans have.

This does make since because although i have yet to see some numbers from a "study", i can make a fair guess that america holds the trophy for most people with acne, shairing it with maybe some Europeian countrys which also are known to not eat very many "healthy" foods (alot of breads/pastas/pasteries..ect)

so think about it, im guessing that if i were to go live with some african tribe for a year, my acne (although not severe) would basically dissapear. because i wouldnt be exposed to all this processed crap we eat,even vegetables are sprayed with god knows what, not to mention the polution in the air seaping into our skin everyday. its just a thought, but im begining to believe it more and more.

anyone feel free to embelish(sp?) on that if you want.

another thing is, that i think some people dont like to believe that diet can contribute to the health of their skin because if they DID believe it then that means they will have to watch what they eat,...and lets face it its annoying and hard to do and involves a whole new level of controlling acne, its a slow long process that would mean they would have to be involved their whole life practically..THATS why i think some people are discouraged from admiting that it just might be diet..
i will always believe that diet can better your skin/health in some way, maybe you dont see it right away(yet another reason why people dont believe, they like a quick fix) but a healthy diet will make you healthy from the inside and is good for long term health. Vitamins that are good for cell growth must do something for skin cells eventually, although i could be wrong.

as far as waiting for something to be proven through a "study", i dont know how much i trust certian studys anyway, i guess you need to listen to your own body to understand what works for you(trial and error), but there has been times when there will be a study about something and soon enough theres another study prooving that other one wrong. its just hard to trust what you hear sometimes and you have to consider who its coming from...alot of people are just out for money more times than not.[/QUOTE]

Oh most definately that's true. Health experts take a look at foreigners health before they enter the U.S. and then several decades after and guess what, they end up with the same health problems! Ever heard of Glucose/[B]Carbohydrate Intolerance [/B] or [B]Skin Diabetes[/B]? Well this is basically the way our genes are dictating how much sugar/carbs we can take in before our bodies will rebel against us. Those of us that aren't caucasion have a much greater chance of acquiring carbohydrate intolerance, which is also known as Insulin Resistance, especially when we consume the [B]same [/B] amounts of sugar or more than. Yet, it's no longer all about the Asian American, African American, American Indian, Mexican American anymore (notice the trend) as you noted it is increasing in Europe as well.

I do believe that the hesitancy in "believing" how much of an impact our diets make on our growth & developement does have a bit do with how much easier it is to continue living the way that we do. Yet just because something is "easy" or convenient & cheap in this case, that doesn't make it right or healthy for us. So, regarding your diet question there's two types of acne that's can be a result of our diets:

[B]Inflammatory[/B] (Allergies, Intolerances, Sensitivities, Metabolic Syndrome)

[B]Hormonal[/B] (Hypothyroidism, Adrenal Disorders, Metabolic Syndrome/Insulin Resistance Syndrome related health problems)

However, hormonal can also induce inflammation (cystic) as it's a vicious little cycle that occurs during the presence of insulin and the growth factors and pro-inflammatory cytokines that show up to supress it. It's a long story but basically, this is what I've found regarding those following a "western" diet and have acne or some other (related) health problem:

[b]HIGH LEVELS:[/b]
Insulin - boosts androgens & inflammatory events
LDL Cholesterol - encourages cholesterol buildup
Triglycerides
Free Fatty Acids
Androgens/Free Androgens
DHT - super androgen that initiates sebum production, hirsutism, alopecia

Arachidonic Acid - omega 6, converts into PGE2 inflammatory prostaglandin

IGF-1 = Insulin-like Growth Facter (10x more potent than insulin), stimulates growth of cells esp. in the presence of estrogen or androgens.

C-Peptide - byprodut of insulin formation
COX - cyclooxygenase boosts PGE2 and increases oxidation

[u]Inflammatory Cytokines[/u] (can also be attributed to bacteria and Perricone's Acne Prescription also mentions this)
- Interleukin 6 (Il-6)
- Interleukin 1 (IL-1) - inhibits Alipoprotein A1
- TNF-alpha = Tumor Necrosis Factor, increases IL-1 and inhibits IGF-1



[b]LOW LEVELS:[/b]
SHBG - binds Free Testosterone so it won't convert to DHT & is a marker for Insulin Resistance

IGFBP-3 - binds IGF-1
HDL Cholesterol - encourages cholesterol elimination
Glutathione - reduces IGF-1, liver aid
Adiponectin
Alipoprotein A1 - forms HDL

Notice the inflammatory cycle I was talking about? Inflammation can be an double edged sword; it can be a symptom or it can be a contributor to the problem. Of course, the brilliant thing is that while some people's lab results will clearly show that they have too much or too little of something, you can also have Low-Normal levels of some of these (ex: HDL) and be considered functioning normal, just as you can have High-Normal levels (ex: androgen) and still be considered normal. Therefore, if you are breaking out it's worth a shot at seeing if altering your diet, taking supplements, and/or appropriate medication can annhilate your acne (& other symptoms).

When it comes to picking any of the above, you want them to directly or indirectly affect your hormone and/or inflammation production. [U]Saturated & Trans Fats [/U] will affect your inflammation & hormone production, but I think they are greater in the inflammation area. [U]Refined Sugars, especially High Fructose Corn Syrup & corn syrup[/U] will also affect your inflammation production. Where as other [U]refined sugars, refined carbohydrates, gluten[/U], and maybe [U]dairy[/U] would be in this category too, will affect your hormone production more so than your inflammation. This is possibly why you will see people say that it was the reduction/elimination of certain carbs or the fat that made the biggest difference, yet for some of us, it's a combination of the two!
Re: Sugar Sugar!
Nov 14, 2004
ClearSkin,
Yeah I have Dr. Perricone's book too. Not because I needed it to help my skin, but because I like having various references and wanted to know what foods & supps he was reccommending for acne sufferers. The thing I really liked about his approach was how he said we should treat our acne in this order:

Diet
Supplements (or meds)
Topicals

LOL, yet how many of us did things backwards for sooooo long? OMG, I have post somewhere way back where I made a list of all the things I've tried an people were just shocked. They didn't believe it was worth doing so much, yet it was the natural event of things for me ;-) I started puberty at age 8 (not certain if that puts me at precocous puberty which is associated with future health & hormonal problems), but I didn't start breaking out until I was 10 years old. Then I didn't start to get the cystic stuff & body acne until I was 11 and this was also when I began to see a Dermatologist. I think that some people, granted the severity and deepness of the cystic acne is probably a factor, like myself have a skin texture that is still smooth & free of pits because I started getting help ASAP.

Oh my and RetinA & Azelex (both retinoid antiandrogens) were my FAVORITES! Except, I couldn't afford to use that stuff on my back all the time so my back never looked as "good" as my face did. Regardless though topicals weren't THE answer for me as not only would the acne always come back (even while using them), I was begginning to see physical signs that there was something major going on with me that was probably the reason I had acne to begin with.

Acne is acne, yet there are clinical definitons for severity & types of acne, it can affect all of us on deeply on a mental and emotional level. That's why I really don't understand how some people can disregard the extent that acne has incorported itself into our lives, and as such assume that ours could not possibly be as bad as theirs because of how we were most successful at treating it. Grrr... I've been dealing with this for 14 years now, and it's been only the past 2.5 years that I've been 99% clear as a result of following a Hormone Balancing Diet (he he) and I'm far from grown out of it. If I stop following my diet or I do happen to go for something with added sugar, I'll breakout, I'll get horrible menstrual cramps again, and more body hair will grow back. I haven't grown out of this, though I wish that were true, I have not.

Anyway, the other thing I liked about Perricones book was that while he didn't get into details about the hormones that contribute to acne, he does mention pro-inflammatory cytokines. So I did some research on this and indeed, these do happen to be more prominent in people that have hyperinsulinemia, metabolic syndrome, and Type II Diabetes! It's a lovely little cycle where you get too much insulin in your system so your body sends out insulin inhibiting growth factors (IGF-1) that happen to be more potent than insulin (LOL), and while it inhibits it also begins to stimulate our sebaceous glands, etc. Of course because those growth factors are now present, the body sends out pro-inflammatory cytokines to inhibt the growth factors. Except, they are...inflammatory and as such further contribute to the development of acne (menstrual cramps, & rheumatoid arthritis)!!! Sigh...the body is an amazingly complicated and beautiful machine yet it is quite capable of getting glitches that can make something that should be a normal daily process or protective become the source for a variety of problems...

Thankfully though, we understand how food can affect us and greatly contribute to the above and by "simply" adjusting our diet to reduce certain types of fuel for the above processes, most of us end up with vastly improved, if not 100% clear skin. Unfortunately though, my house like yours isn't the best place to have a perfectly "human diet" as one brilliant member once said. As such, I don't eat my veggies as often either. I tend to eat more salads with spinach, romaine, cabbage than I do other vegetables. When I do eat vegetables, its' usually sqaush, various greens, (potato), broccoli, cauliflower, (corn), (string/green beans), okra, olives, pickles, cucumbers, green onions, cooked celery and occasionally raw carrots. Yet just to get your vegetables you can grab the pre-packaged fresh or frozen veggies and toss them in the oven or steam (or boil) them for a quick fix. At least that's my plan as eating fruits are good, but vegetables have more fiber and more of certain nutrients & antioxidans than fruits. That's pretty much what I'm not doing that those that are 100% clear are, plus people have found that their skin heals faster when they eat more veggies ;-)

Say, do you eat bread, pasta, etc? Do you know if you are really sensitive to table sugar or if it is because those sweets had high fructose corn syrup? If not, then maybe when you do chose to eat chocolate candy you should go for the (organic) dark chocolate that is made with sugar, evaporated cane syrup/juice, or brown rice syrup...unless you want maltitol. Plus they won't have diary or trans fats which can also give some people pustular and cystic acne. I know that [B]Ecco Bella [/B] has some out, along with [B]Orgins[/B] (good, but expensive), [B]Tropical Source [/B] (weird taste), [B]Cloud Nine[/B], Sunspire (not gluten-free), and [B]Endangered Species Chocolates [/B] (good). There's a few other varieties out there and usually when you go gourmet you will also get good quality chocolates that are also free of most (except for "sugar") acne irritants.

Also, do you eat chocolate candy because you are craving sweets or just chocolate? If it's the chocolate you want you can also always make your own and then add stevia or xylitol (good stuff) to it and you wan't have to worry about breakouts! If it's the sweets or just something to snack on, are you getting any other fruits, dried fruits, (nuts), or seeds in your diet?

Oh and in terms of healthier processed food, you can get nitrate & sugar free lunchmeats & saugages (Sheltons, Applegate Farms, Wellshire Farms) and Trans Fat Free Potatos/Fries (Wild Oats, Alexia - walmart has this too).

Say are you also eating blueberries daily? I know there's a post around here raving about it's healing properties.

Bye for now =)
Re: Sugar Sugar!
Nov 15, 2004
Believe it or not, I remember my first pimple. My reaction and my shock at such a young age. On my forehead. I was about 8 years old. Then, when I was about 10 years old, my forehead was covered in red bumps, there wasn't one clear space. The rest of my face was clear. I tried Clearasil and Oxy-- they did nothing. My mom continued to use Retin-A at the time for many years to keep them away, then she was begging me to use it. I refused many times, then I gave in and finally decided to try because it was so ugly. In about 3 months, my forehead cleared up completely. I had no acne or pimple for years. It was as if I had nothing before. I beat myself a little for this because I started to have acne on the side of my face only, then overtime it just blended to my chins. I refused to be on Retin-A again because of high school. I didn't want my acne to get worse in a self-counscious phase in high school, so I postponed getting help until my senior year. I got so fed up. I was using mom's retin-A from time to time, then everyday, which didn't do much for some reason. I couldn't understand. Then I tried antibiotics which only made it come back worse or didn't do much. I used a sulfuric treatment that only made really ugly pimple show up--I stopped it because it wasn't normal. I was using Nature's Cure for awhile in the summer a year back which was doing good, then I stopped everything alltogether when I found cystic acne forming along my jawline--Nature's Cure wasn't working anymore, including cystic back-acne. It was just showing up like crazy daily. I was doing researching and saw that Retin-A Micro might be best for oily skin which I have. I used it, and it helped a lot more than Retin-A cream. I am not completely clear like my forehead, but I know that Retin-A is keeping a lot of it from coming back again. I know that a combination of food and Retin-A Micro helps my skin :) . When I am on my period...I get about 3 bad acne if I don't behave with my food.

[QUOTE]Oh my and RetinA & Azelex (both retinoid antiandrogens) were my FAVORITES! Except, I couldn't afford to use that stuff on my back all the time so my back never looked as "good" as my face did. Regardless though topicals weren't THE answer for me as not only would the acne always come back (even while using them), I was begginning to see physical signs that there was something major going on with me that was probably the reason I had acne to begin with.[/QUOTE]

I tried using Retin-A on my back but it would become so red and really painful from these cystic forming. I get mostly zits which a good diet clears it up.

I was beginning to think if you were in college or had a profession in the science field :) and you are! Right now, I am thinking that maybe I should try something to help control my hormones in order to control acne. I get really bad acne during or before my period if I eat bad. I was thinking of trying natural homeopathic or pills to start with. Someone suggested 1,200 mg of Calcium and in 3 months many of the symptoms are gone. I don't take many of my vitamins religiously as I am unemployed right now, and I feel unstructured with my life at the moment. Fish oil capsules are good, but I find that eating the fish show good effectiveness than the capsules.

I almost feel sad that my mother isn't understanding how much I want to change my diet to a great extent. She needs it too as she gets acne on her back still in her 50's. She didn't get them until her 30's. Her face began at around age 12, I think. I don't know about my dad's, but it's obvious he had it because of scars along his jawline. There are weeks, where I just stop eating veggies entirely, then I start again. Isn't that weird? Why is that?

[QUOTE]Say, do you eat bread, pasta, etc? Do you know if you are really sensitive to table sugar or if it is because those sweets had high fructose corn syrup? If not, then maybe when you do chose to eat chocolate candy you should go for the (organic) dark chocolate that is made with sugar, evaporated cane syrup/juice, or brown rice syrup...unless you want maltitol. Plus they won't have diary or trans fats which can also give some people pustular and cystic acne. I know that [B]Ecco Bella [/B] has some out, along with [B]Orgins[/B] (good, but expensive), [B]Tropical Source [/B] (weird taste), [B]Cloud Nine[/B], Sunspire (not gluten-free), and [B]Endangered Species Chocolates [/B] (good). There's a few other varieties out there and usually when you go gourmet you will also get good quality chocolates that are also free of most (except for "sugar") acne irritants.[/QUOTE]

I am not sure. That's a good question. I have stopped eating cereals, bagels, white breads and white rice. I do have pasta and bagels, but those are almost rare times when I do. I just crave and miss the taste of cream cheese with bagels :). As for chocolates, I usually go for Hershey's bar or chocolates candies. I don't know what I crave, but when I drink coffee, I don't think that caffeine is my addiction, I think it's the sugar and milk I add in it that I crave. Sometimes I crave sweets at night. Recently, I ate Troufles ( I think that's the name). I ate cupcakes that I baked the week before my period, and that just made 3 imflammatory acne pop. They are just so bad in large quantities. Once I have one, I can't stop having a few others. I crave sweets during my period. I wish I could control this with natural medicines. Coffee is bad because as Perricone stated on Oprah a few days ago, it rises your blood sugar. I can't seem to stop. I can skip a day, but I think it's the sweet I add that I crave.

[QUOTE]Also, do you eat chocolate candy because you are craving sweets or just chocolate? If it's the chocolate you want you can also always make your own and then add stevia or xylitol (good stuff) to it and you wan't have to worry about breakouts! If it's the sweets or just something to snack on, are you getting any other fruits, dried fruits, (nuts), or seeds in your diet[/QUOTE]?

What's stevia or xylitol? I have never heard of those. I am not sure how to make my own chocolates lol. Sometimes I make myself chocolate milk. Maybe I crave both things--sugar and chocolates. My mom steals my almonds, but heck it's good for her. I have stopped with the almonds, I think I just don't like the brand. I need to switch it to one I liked. I try to get my fruits! :) , but I can go weeks without it for some reason.

[QUOTE]Say are you also eating blueberries daily? I know there's a post around here raving about it's healing properties.[/QUOTE]

Hmm...that's the problem. I think I hate blueberries although I know it's so good for your skin. Maybe I should try tasting it again--who knows when my taste buds will change. I have tried Strawberries which has gotten along better with me.
Re: Sugar Sugar!
Nov 15, 2004
[QUOTE=grape_of]SweetJade, do you think we need to use an anti-androgen drug, or dietary changes are enough? Some people, like prometheus are against any use of drugs. Don't know if they're right..[/QUOTE]

Hey =)

Honestly it's not up for me to say, as your body will decide what approach is THE best one for you. My personal motto is "happy, healthy, & clear" and so I aim to do what I can as naturally as I possibly can (which still isn't "perfect"), but not everyone practices the same belief. Some people believe that they shouldn't have to "sacrifice" their diet for clear skin and well,[B] if [/B] B5 Therapy or Spironolactone will clear them, then I guess they were right ;-)

On the other hand, if taking anti-androgens such as Accutane, Birth Control or Spironolactone isn't enough, like it wasn't for myself, then one would hope you would press on until you found a much more effective solution. Therefore when it comes to finding that solution, I really encourage people to see a specialist (Endocrinologist, Allergist, Naturopath). In fact, all acne sufferers, especially chroniic (5, 10, 20 years plus) sufferers, should definately see an [B]Endocrinologist[/B]. This is a medical doctor that specializes in metabolic & hormonal disorders and he/she will be able to test you and help determine the underlying or the root source of your acne.

Now, considering that acne can stem from allergies, intolerances, or toxins/chemical sensitivites, that's where an allergist would come in handy. A naturopthic doctor if he's licensed, will be able to run blood work and determine your nutrient & hormone levels, just like a regular doctor (or nutritionist) can. Yet with an Endocrinologist, they specialize in helping you determine if your acne stems from a nutrient defficiency, a (benign) tumor, a metabolic disorder such as Insulin Resistance, or some other type of enzyme defect. Therefore, while DHT is primarily produced in the skin's androgen receptors for those that are just "sensitized", supposedly 10% of acne sufferers have a hormonal imbalance where they actually produce too much androgens overall as a result of a [B]defect[/B] in one or more of the following: ovaries, testes, adrenal gland, thyroid gland, pituitary gland, (liver or pancreas). Although, considering that other health problems are on the rise, I'm guessing that the number of acne sufferers with actual hormonal imbalances is slowly increasing as well...

I see that you are a newbie, yet you mentioned Prometheus so I guess you've been reading around =) She is definately brilliant on her quest for a "human diet" and even I didn't think that I could be as sensitive to certain ingredients until I decided to check my diet against her list. I knew that gluten was a problem, my biggest problem, but there were other aggrevators that were less obvious and were the reason I was getting sporadic cystic acne still. On her list was avoidance of refined sugars, something I hadn't given up entirely. I was still consuming high fructose corn syrup & corn syrup in usually less obvious foods (roasted chicken & sausages, cracker jacks, ketchup, sauces, etc) and my poor brain didn't fully connect the dots until I thought about my reaction to soda. See, I had been avoiding soda for over 10 years and my skin never improved so once it did, I thought I could start consuming soda again. Well, nope, soda gave me cystic acne so I immediately stopped, but I never bothered to check what was used to sweeten it, LOL. Usually, unless you go to an organic store, most sodas & non-100% fruit juices will be sweetened with HFCS..Acck.

Anyway, something you may have noticed is that our diets vary. Since, to some extent, we vary genetically it makes sense that not all of us will or must follow the same exact diet to acheive results. As such, there are foods even on prometheus's good list that cause me problems and foods (eggs) on her avoid list that I've yet to determine to be a factor either way as I rarely consume them.

Regardless, the avoidance of certain foods work for us because we are either avoiding the allergen or we are reducing the amount of fuel needed to help our body produce hormones & inflammatory products. A Low - Moderate Carbohydrate diet [U]will [/U] produce less androgens than a High Carb or Carb Loading Diet, yet for some of us it's not about the glycemic index/load but about reduction or avoidance of grains, refined sugars, trans fats, (and sometimes certain fruits, nuts, & dairy). However, this is usually enough to help most people eliminate most symptoms, but if you have more "sensitive" symptoms such as hirsutism, then you will also need to add an Androgen Blocker or DHT Inhibitor (supplement or a drug) as the same rules don't apply (unless you cease ALL production of DHT).

So once again, you can decide whether to take a natural (supplements or diet) approach or a medicinal approach, but in the end, your body will tell you which is the most effective for you. Sometimes it may be all natural focusing on diet only or diet and supps. Sometimes it will be diet & medication or medication & supps, etc There are many combinations here, but if you happen to have a [U]health problem [/U] that is giving you acne, then from what I've noticed from other's regimens, those that don't go on a "hormonal balancing diet" to the extent that some of us do or not at all, tend to be on several medications AND several supplements and sometimes even at high doses. =(

That's not meant to scare you into any direction but when you are fighting a [I]preventable[/I] disease with medication, but you are still feeding your body foods that encourage the disease....it's an uphill battle. That's also the reason Spiro nor Avandia (insulin sensitizer) didn't work effectively enough for me. However, I fully believe that these drugs and other supplements can and will continue to do good for others.

So, with that, do you have an idea as to what is it that you would prefer to do? Have you been to doctor to see if you have a hormonal imbalance? Does anyone in your family have obesity, diabetes, heart disease, thyroid problems, digestive problems, allergies or any other health problems? Do you show signs that you may have something more than just acne going on? Of course, are you a male or a female as, it's usually a lot easier for a female to get tested, diagnosed, & treated than it is a male. Yet if you are, you shouldn't give up, you should check out posts by Joeh & Karl or stuff on B5 Therapy as there is still hope.

Take care
Re: Sugar Sugar!
Nov 16, 2004
Hey all, say does anyone understand the events below?

(Insulin) --- Cholesterol (LH or ISCH) --- Pregnenolone --- Progesterone --- DHEA --- Androstenedione --- [estrogen or] < = > Testosterone --- Estrogen


AND


(Insulin) --- Cholesterol --- (LH or ISCH) -- Pregnenolone --- Progesterone -- DHEA --- Androstenedione and/or Androstenediol < = > Testosterone ---.DHT < = > 3-alpha Androstenediol Glucuronide (or other androgen metabolites)


<=> means has the ability to switch back and forth from it's potent/active form to it's less potent/weak form


Well this is a more simplified, yet still complicated VISUAL explanation of what happens when you (over)consume the foods you eat. Sugar isn't really the main enemy here, but this is [U]one[/U] example of how it can influence acne production via hormone synthesis by encouraging our pancreas to shunt out [U]more[/U] Insulin. Basically the process of things is that you [B]need[/B] Cholesterol in order to produce Steriod Hormones (progesterone, androgen, estrogen). [B]There is NO way that you can ever produce, Estrogens without [U]first[/U] producing Androgens.[/B]

Of course, because of this little problem we are always hyperandrogenic [B]initially[/B] until certain enzymes, growth factor binding proteins, sex-hormone binding proteins, etc come into play and encourage some or most (depends on gender) androgens to become estrogen.

Yet, there are so many ways that our body can prevent that from occuring either due to a an nutrient deficiency, overconsumption of the wrong "sugars" (refined & added), wrong carbohydrates (refined, high glycemic, gluten, grains) and/or the wrong fats (trans fats, saturated animal fat) that [B]encourage/activate[/B] certain liver enzyme defects & associated hormonal imbalances that will FAVOR androgen production and it's active and most potent form....DHT.

Remember, DHT or Dihydrotestosterone or super testosterone, is what bind's to the skins androgen receptors and initiates the process of acne production via growth factors & inflammatory products. If you dont believe that androgens play a huge role in acne production, then why is "everyone" praising Accutane, [B]an Antiandrogen & DHT Inhibitor [/B] as being the greatest invention of our acneic time???

Anyway I've gotta run, but please know that it isn't your fault if you're [I]unknowingly[/I] consuming certain foods that either contribute to acne and are currently or silently fueling future health problems. Yet once you do know, [B]you[/B] have the POWER to change things. =)

Remember, we are [B]ALWAYS [/B] what we eat, but it doesn't mean that it will always manifest itself as acne.

Peace
Re: Sugar Sugar!
Nov 21, 2004
S Jade please indicate which study showed acne prone people benefited from a diet that elimated high fructose corn syrup and wheat gluten. Keep in mind the study or trial must have had a minumun of 1100 participants to be statistically valid. The number of participants is a key factor. You mentioned a New Guinea study of 1300 people. These people did not have the genetics for acne to begin with. Other studies you mentioned had 239 or 400 people. That is not enough to be statistically valid.





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