This month we managed to pester Professor Loren Cordain with a few questions regarding his new E-book The Dietary Cure for Acne.

Professor Cordain, please tell our readers about your new E-book, “The Dietary Cure for Acne”. How is this information different than the information one might get from the dermatologist?

Although the medical and dermatology communities generally have gone on record stating that diet and acne are unrelated, there is now extensive evidence to show otherwise—including a recently completed clinical trial from my colleague Neil Mann’s laboratory at RMIT in Melbourne (1, 2). In this book I review the four immediate causes of acne and then show how various elements of diet ultimately influence these four immediate causes. In addition to the high dietary glycemic load that is ubiquitous in the typical Western diet, I explain how other common foodstuffs, including dairy products (3), may provoke acne symptoms.

Isn’t acne just a transitory skin problem? Why be concerned with pimples beyond just the aesthetic issues?

Women with persistent adult acne are at a greater risk for breast cancer. I believe that part of this increased risk for breast cancer stems from similar hormonal changes that are present in both acne and breast cancer patients. These hormonal changes (elevations of IGF-1 and reduction of IGFBP-3) not only increase the risk for breast cancer in women but also increase the risk for prostate cancer in men and colon cancer in both men and women. Hence, even though acne is primarily a problem during adolescent, it may represent an external marker for health problems in later life.

Your research has focused on hunter-gatherer life ways. Why study acne?

I had been quite interested in the classical diseases of insulin resistance (type 2 diabetes, coronary heart disease, obesity, high blood pressure and dyslipidemia [elevated blood triglycerides, reduced HDL cholesterol, and increased small dense LDL cholesterol]. About seven years ago, I began to suspect that acne may also be linked to insulin resistance. In hunter-gatherers, diseases of insulin resistance are rare or lacking. Consequently, we decided to examine non-westernized people to determine if they had acne. In our study of the Ache hunter-gatherers from Paraguay and in our study of Kitavan Islanders, living off the coast of Papua-New Guinea, we did not find a single case of acne. These findings led us to believe that acne was a diet-related disease. We now know this to be true from a recently completed dietary intervention among 43 acne patients from Melbourne (1,2).

I understand you have some projects relating to intermittent fasting and autoimmunity. Can you share any tidbits about those or any other projects in the works our readers should know about?

Meal timing and frequency are poorly studied topics. Despite the almost complete lack of scientific evidence, many nutritionists and physicians as well believe that many small meals are more healthful and may help to promote weight loss than fewer larger meals. Once again I look to the evolutionary template to help unravel difficult diet/health questions. We have preliminarily compiled data from hunter-gatherers, and their meal patterns typically involve a single large meal at the end of the day and sometimes a light morning meal. They almost never eat three large meals a day with snacking in between—a pattern that seems to have become the norm in the U.S.

Experimentally, we have on our plates a project that will examine whether or not dietary lectins (in particular, wheat germ agglutinin [WGA]) can cross the intestinal barrier and enter the bloodstream. We suspect that dietary lectins may play a key role in certain autoimmune diseases like rheumatoid arthritis, irritable bowel syndrome, multiple sclerosis and others.

One final question! What would your dietary recommendation be for a strength athlete like an Olympic weightlifter who needs to gain 10kg to move up to the next weight class? Say they have 6-9 months to make the gains, how would you set caloric content, macronutrient ratios, etc.?

I’m a little bit out of my element here, as most people I deal with are at the other end of the spectrum and want to lose weight. Presumably an Olympic weightlifter would like to gain as much muscle as possible while gaining the weight. An effective strategy for this would be to increase his/her intake of branch chain amino acids [BCAA] (leucine, isoleucine and valine). The highest source of BCAA is dried egg white which contains 43 g of BCAA per 1000 kcal serving. Lean meats (34 g BCAA per 1000 kcal) and seafood (28 g BCAA) are also good sources of BCAA, whereas whole grains (6 g BCAA per 1000 kcal) are not. My second recommendation to increase muscle mass would be to eat a diet that is net base yielding, as this strategy will help to preserve glutamine, a muscle amino acid that is broken down following heavy exercise.


References:
1. Smith R, Mann N, Makelainen H, Braue A, Varigos G. The effect of short-term altered macronutrient status on acne vulgaris and biochemical markers of insulin sensitivity. Asia Pac J Clin Nutr. 2004;13(Suppl):S67.
2. Smith R, Mann N, Braue A, Varigos G. Low glycemic load, high protein diet lessens facial acne severity. Asia Pac J Clin Nutr 2005;14 (Suppl): S97.
3. Adebamowo CA, Spiegelman D, Danby FW, Frazier AL, Willett WC, Holmes MD. High school dietary dairy intake and teenage acne. J Am Acad Dermatol. 2005 Feb;52(2):207-14.