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Oh what the heck:
[QUOTE]Am J Clin Nutr. [SIZE=4][B]1996[/B][/SIZE] Jan;63(1):22-31. Related Articles, Links

[B]Association of dietary factors and selected plasma variables with sex hormone-binding globulin in rural Chinese women.[/B]

Gates JR, Parpia B, Campbell TC, Junshi C.

Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-4401, USA.

Sex hormone-binding globulin (SHBG) is an important regulator of plasma sex steroids as well as a sensitive indicator of insulin resistance. SHBG may be an important diagnostic measure of risk for pathologies associated with insulin resistance syndrome (IRS) such as non-insulin-dependent diabetes mellitus (NIDDM), obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. In women, SHBG is also implicated in diverse pathologies such as cancers of steroid-sensitive tissues and hirsutism. Data from an ongoing ecological study linking diet and health in rural China were analyzed to determine the relation of selected plasma variables and diet to plasma concentrations of SHBG. All data represent county mean values, pooled by age and sex, to assess the relation between biochemical and lifestyle characteristics and disease-specific mortality rates at the county level. The study sample consisted of 3250 Chinese women between the ages of 35 and 64 y living in 65 widely dispersed rural counties. Consumption patterns for 21 different food groups were derived from a food-frequency questionnaire and a 3-d dietary survey and subsequently compared. [B]Correlation analyses of county mean values demonstrated a significant association between SHBG and insulin, testosterone, triacylglycerols, body mass index, age at menarche, and several foods[/B]. In regression analyses, after adjustments, [B]the strongest predictors of SHBG concentrations were the dietary intake of rice (beta = 0.42, P < 0.01), fish (beta = 0.34, P < 0.05), millet (beta = -0.27, P < 0.01), and wheat (beta = -0.34, P < 0.01[/B]). When insulin, testosterone, and triacylglycerols were added to the model only triacylglycerols (beta = -0.26, P < 0.05) remained a significant independent predictor of SHBG. Additional analyses suggested that the consumption of green vegetables was modestly positively correlated with SHBG and negatively with insulin values. Consumption of rice and fish in particular appeared to favorably influence the principle plasma variables associated with a reduction in the risk for IRS pathologies.

So this is why "bread" can cause/initiate acne production. "Bread" as in Wheat, as this is primarily what is used when we speak of Flour, Bread, Pasta, etc. Now I follow a gluten free (gf) diet and therefore I avoid most grains, yet millet is one of those that is allowed in a GF diet. I however have yet to eat millet and now that I see that it is just a bit less worse than wheat in terms of SHBG levels, I don't think this will be a grain that I will consume. The more stubborn/sensitive yoru body is, the more likely one will have to give up ALL grains. I eat primarily corn, rice and occassionally buckwheat grain products. Buckwheat isn't even a grain though and it actually works to improve SHBG levels as well, but you must eat Buckwheat Farinetta to truly reap therapeutic benefits.

[quote] J Clin Endocrinol Metab. [size=4][b]1995[/b][/size] Jul;80(7):2057-62. Related Articles, Links

[b]Effects of diet and metformin administration on sex hormone-binding globulin, androgens, and insulin in hirsute and obese women.[/b]

Crave JC, Fimbel S, Lejeune H, Cugnardey N, Dechaud H, Pugeat M.

Hospices Civils de Lyon, Laboratoire de la Clinique Endocrinologique, Hopital de l'Antiquaille, France.

Evidence suggests that [b]hyperinsulinemic insulin resistance may increase serum levels of ovarian androgens and reduce sex hormone-binding globulin (SHBG) levels in humans. [/b]The present study was conducted to assess the effect of administration of the biguanide metformin, a drug commonly used in the treatment of diabetes mellitus, on androgen and insulin levels in 24 hirsute patients. The patients selected for the study were obese, with a body mass index higher than 25 kg/m2 and high fasting insulin (> 90 pmol/L) and low SHBG levels (< 30 nmol/L). All patients were given a low calorie diet (1500 Cal/day) and randomized for either metformin administration at a dose of 850 mg or a placebo, twice daily for 4 months, in a double blind study. In the placebo group, diet resulted in a [b]significant decrease in [/b]body mass index (30.8 +/- 1.0 vs. 32.7 +/- 1.5 kg/m2; P < 0.0001), [b]fasting insulin [/b](127 +/- 11 vs. 156 +/- 14 pmol/L; P < 0.01), [b]non-SHBG-bound testosterone [Free Testosterone][/b](0.19 +/- 0.02 vs. 0.28 +/- 0.03 nmol/L; P < 0.02), [b]androstenedione[/b] (5.8 +/- 0.5 vs. 9.0 +/- 1.1 nmol/L; P < 0.03), and [b]3 alpha-diolglucuronide [3-alpha diol G][/b](8.6 +/- 1.1 vs. 11.7 +/- 1.9; P < 0.005) plasma concentrations and a [b]significant increase in [/b]the glucose/insulin ratio (0.047 +/- 0.005 vs. 0.035 +/- 0.003; P < 0.001) and [b]plasma concentrations of SHBG[/b] (26.0 +/- 3.3 vs. 19.1 +/- 1.9 nmol/L; P < 0.001) and [b]dehydroepiandrosterone sulfate [DHEA-S][/b](8.7 +/- 1.5 vs. 8.4 +/- 1.3; P < 0.05). Beneficial effects of diet were not significantly different in the patients who were given metformin instead of placebo. These results confirm that weight loss induced by a low calorie diet is effective in improving hyperinsulinemia and hyperandrogenism in obese and hirsute women. With our study design, metformin administration had no additional benefit over the effect of diet. [url=][/url] [/quote]

In case you are wondering, this is what I was diagnosed as 3.5 years ago. I'm actually atypical for both Polycystic Ovarian Syndrome (PCOS) & Insulin Resistance Syndrome (IR) as I don't carry any of the "classic signs" (ex: you do NOT have to be obese or overweight), yet I do still carry traits for both of these and as such there's actually a PCOS variant known as [B]HAIR-AN Syndrome[/B] (Hyperandrogenism, Insulin Resistance, Acanthosis Negricans) that both men & woman can have and that would explain my symptoms the best.

Now those words in bold are basically what you want to look for in an [b]ANY[/b] acne treatment if your goal is to reduce/inhibit androgens. Like the first study said, [B]SHBG [/B] is now the new indicator (over IGF-1) for insulin resistance & hyperandrogenism. If your SHBG is low, you probably have Hyperinsulinemia (or Hypothyroidism) induced Hyperandrogenism as [U]SHBG is lowered by increased Insulin [/U] and it's job is to bind Free Testosterone/Androgen. [B]DHEA-S[/B] is a bound form of adrenal androgen DHEA (making it less potent), [B]3-alpha diol G[/B] is the product of DHT (Accutane inhibits this also), [B]Androstendione[/B], and [B]Free Testosterone [/B] (convertes to DHT) are all androgens. The super androgen DHT can be the end result of all of these and is implicated in sebum production, acne, hirsutism, androgenic alopecia and interstingly enough certain retinoids that some of you may have used, like RetinA & Accutane, inhibit it's formation.

That study above describes exactly what happened to me when I stopped my medication and some others have also discovered they could do the same. For 1 year I had been taking Avandia (metaformin made me sick) and 150mg of Spironolcatone, but was only a max of 85% clear (for 3 months of the year). Yet when I initially changed my diet, I went up to a CONSTANT 95% clear! Over time, I permanently dropped avandia (after 3 months into my diet) and even dropped the spiro for 6 months (started back on at 100mg for hirsutism treatment) to make sure that it wasn't my medication (like it actually took 6 years of Spiro before it FINALLY fully kicked in,,,LOL). Now, 2.5 years later, I'm 99%+ clear and this includes my face, back, chest, neck, ears (I can breakout in lots of...places), I've got the smallest pores since I hit puberty, have a lot less oil & dandruff, a bit less body hair (a lot less with Spiro) and I no longer suffer from horrible menstrual cramps! Trust me, I have not grown out of it, I can still breakout if I eat the "wrong" foods for me, but I usually don't intentionally do this as most of the time I'll end up with very stubborn cystic acne as a result =/ So I do my very best NOT to =)

Of course there are other hormonal disorders that can lead to hyperandrogensim (in the skin or throught the body), but this is an example as to how food plays a LARGE role in steriod hormone production. Please note how long those studies have been out, for almost 10 years now, yet there are plenty of other, recent & past, studies that exist. In fact, Insulin (and thus food) as been associated with steriod hormone production since the 1960s or 1970s. These doctors should really take the time to be up on the [I]latest [/I] research...

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