Linking diet to acne metabolomics, inflammation, and comedogenesis: an update

Figures & data

Figure 1 Acne vulgaris: a Western diet-induced sebofollicular inflammasomopathy.

Abbreviations: IGF-1, insulin-like growth factor 1; BCAAs, branched-chain amino acids; miR21, microRNA-21; FoxO1, forkhead box class O1; mTORC1, mechanistic target of rapamycin complex 1; AR, androgen receptor; PPARγ, peroxisome proliferator-activated receptor-γ; LXRα, liver X receptor-α; SREBP1c, sterol response element binding protein 1c; Δ6D, Δ6-desaturase; SCD, stearoyl-CoA desaturase; TG, triglyceride; P. acnes, Propionibacterium acnes; QS, quorum sensing; C16:0, palmitic acid; C18:1, oleic acid; TLR2, toll-like receptor 2; NLRP3, Nod-like receptor family, pyrin domain containing 3 inflammasome; IL-1β, interleukin-1β; Th17, Th17 T-cell; IL-17, interleukin-17, IL-1α, interleukin-1α.

Table 1 Acneigenic food components of Western diet

Nutrients	Metabolic and nutrigenomic effects	Sources
Hyperglycemic carbohydrates	Postprandial hyperinsulinemia	Sugar
	Insulin-mediated hepatic IGF-1 synthesis	Sweets
	Reduction of IGFBP3	Soft drinks
	Increased bioavailability of free circulating IGF-1	Pizza
	Reduction of SHBG	Pasta
	Increased bioavailability of free circulating testosterone	Wheat bread
	Reduced nuclear activity of FoxO1	Wheat rolls
	Increased expression of sebocyte SREBP-1c	Cornflakes
	Activation of mTORC1
	Glucose-mediated microRNA-21 expression
Milk and dairy products	Postprandial hyperinsulinemia	Whole and skim milk
	Increased levels of circulating IGF-1	Pasteurized fresh milk
	Leucine-mediated activation of mTORC1	Yogurt
	Glutamine-mediated activation of mTORC1	Ice cream
	Palmitate-mediated activation of mTORC1	Whey and casein supplements
	Milk-microRNA-21-mediated proliferation and inflammation	Cheese
Saturated fats	Palmitate-mediated activation of mTORC1	Butter
	Palmitate-driven inflammasome activation	Cream
Trans-fats	Possible mTORC1 activation	Fast food
	Proinflammatory signaling	French fries

Abbreviations: IGF-1, insulin-like growth factor 1; IGFBP3, IGF binding protein 3; SHBG, sex hormone binding globulin; FoxO1, forkhead box O1; SREBP-1c, sterol response element binding protein 1c; mTORC1, mechanistic target of rapamycin complex 1.

Table 2 Paleolithic-type diet for the nutrition therapy of acne

Nutrients	Metabolic effects	Sources
Carbohydrates with low glycemic index	Reduced insulin signaling	Salads
	Reduction of free IGF-1	Vegetables
	Increase of IGFBP3 und SHBG
	Increase of nuclear FoxO1
	Reduction of SREBP-1c
	Attenuation of mTORC1
ω-3-fatty acids(docosahexaenoic acid and eicosapentaenoic acid)	Inhibition of mTORC1	Sea fish ω-3-fatty acid-containing oils
	Inhibition of SREBP-1c
	Reduction of proinflammatory
	eicosanoids (LTB4, PGE2)
	Inhibition of NRLP3
	inflammasome activation
Plant products and spices enriched in natural mTORC1 inhibitors and FoxO1 enhancers	Inhibition of mTORC1	Green tea (EGCG)
	Activation of nuclear FoxO1
	Inhibition of P. acnes/biofilm	Berries (resveratrol) Curcumin

Abbreviations: IGF-1, insulin-like growth factor 1; IGFBP3, IGF binding protein 3; SHBG, sex hormone binding globulin; FoxO1, forkhead box O1; SREBP-1c, sterol response element binding protein 1c; mTORC1, mechanistic target of rapamycin complex 1; LTB4, leukotriene B4; PGE2, prostaglandin E2; EGCG, epigallocatechin-3-gallate.