Sugar and a High Carbohydrate Diet is a Trigger Factor for Rosacea

If you check the 'official' trigger factor list at the NRS you will not find sugar as a trigger factor for rosacea. Now, why is that? I have some theories on this but I thought you should first know that sugar is a rosacea trigger factor and some proof of this.

I have said that sugar is a trigger factor for rosacea since 1999 when I first published my Rosacea Diet. Carbohydrate is basically different forms of sugar. Carbohydrate is a word derived from Greek meaning, "carbon plus water." All carbohydrate is composed of different units of sugar. The list of these different units of sugar is quite impressive and I may have one of the longest lists of different sugars you can find published in my book. Besides sugar being a rosacea trigger factor, eating a high carbohydrate diet is also a rosacea trigger factor.

What is a trigger factor in rosacea? The NRS is credited with making up the first 'official' rosacea trigger factor list. A trigger factor for rosacea is simply anything that may trigger a rosacea flare-up. The emphasis is on MAY trigger a rosacea flare-up. While a trigger factor may trigger a flare-up for you it may not trigger a rosacea flare-up in another rosacean. This has been dubbed part of the X-Factor in rosacea.

Many rosaceans are concerned about any trigger that may induce flushing and I have written an editorial on flushing trigger factors. A trigger factor does not mean that this causes rosacea, since no one knows what causes rosacea. A trigger factor is simply anything that may trigger a rosacea flare-up and may or may not be related to the cause. Furthermore, a trigger factor for you may not be a trigger factor to another rosacean and vice versa.

In 1999 I was the sole voice who discovered that sugar is a rosacea trigger factor and published my first version of the Rosacea Diet explaining the role sugar has in triggering rosacea flare-ups and began my presence on the internet with my first web site advertising my book. In 2001 Geoffrey Nase, Ph.D., published his book which was the only other voice who said that sugar is a rosacea trigger factor (see page 101 of his book). Later the International Rosacea Foundation also published on their website that sugar and eating a high carbohydrate diet can be a rosacea trigger factor on its Lifestyle Recommendations page. Since then there has been little research on this subject nor recognition of sugar being a rosacea trigger factor. However, recently some have discovered the connection that rosacea has with diet.

For instance the Rosacea Support Resource Pages suggests that "studies suggest that the body produces Phospholipase A2 which stimulates the pro-inflammatory Arachidonic Acid products in response to insulin secretion," and that "This might explain why so many rosaceans seem to find considerable benefit from limiting their intake of carbs and sugars. Furthermore, recent studies in diabetes suggest that inflammation plays a significant role in this disease, and that inhibiting LOX pathways (in this case 5-LOX and 15-LOX) actually decreases resting glucose levels." Whether these suggestions actually fund any research related to rosacea remains to be seen.

In early 2006 a noted respected 'authority' on rosacea made this comment:

"If indeed acne, and perhaps other inflammatory skin conditions like rosacea are mediated by diet, then why are there no studies? A great series of questions asked by this paper. If cited papers is a measure of how well the background research is, this paper shines with 106 references. It will be interesting to see if inflammatory pathways causing rosacea can be tied back to what we eat. " source

An interesting thread on the subject of diet and rosacea can be found by clicking here.

Although dermatologists have denied the skin condition [acne] has a direct link to diet, a recent nutritional study has proved the connection according to the Daily Telegraph (Sydney, Australia). Whether this will be researched for rosacea remains to be seen.

Dr. Loren Cordain has published scientific papers on the subject of diet and acne. One paper says, "Within the dermatology community, a general consensus has emerged that diet is unrelated to the etiology of acne. Except for 2 poorly designed studies, now more than 30 years old, there are few objective data to support this notion. In contrast, a large body of evidence now exists showing how diet may directly or indirectly influence the following 5 proximate causes of acne: (1) increased proliferation of basal keratinocytes within the pilosebaceous duct, (2) incomplete separation of ductal corneocytes from one another via impairment of apoptosis and subsequent obstruction of the pilosebaceous duct, (3) androgen-mediated increases in sebum production, (4) colonization of the comedo by Propionibacterium acnes, and (5) inflammation both within and adjacent to the comedo. This article will provide a review of the currently available literature on the association between diet and acne vulgaris as well as a discussion of the physiologic principles that may underlie this association."

Another of Dr. Cordain's papers says, "In most carbohydrate-containing foods, the blood insulin response is predictable and is closely linked to the food’s glycemic index (GI).  A single study, examining whole milk and fermented milk products made from whole milk, recently reported a large dissociation between the GI and insulinemic index (II) in healthy normals.  Because the fat component of a food may influence the GI and II, it is unclear if a similar dissociation may exist for skim milk in normals.  We determined the GI and II of both skim and whole milk in nine healthy, male (n=6) and female (n=3) subjects (23.6 ± 1.4 years).  No significant (p>0.05) differences existed between GI and II for skim and whole milks.  Significant (p<0.05) differences were observed between the actual and predicted areas under the insulin curves for both skim milk (predicted 1405 ± 289 pmol.min/L; actual 6152 ± 1177 pmol.min/L) and whole milk (predicted 1564 ± 339 pmol.min/L; actual 5939 ± 1095 pmol.min/L).  Consequently, a large and similar dissociation of the GI and II existed for both whole milk (42 ± 5 and 148 ± 14) and skim milk (37 ± 9 and 140 ± 13).  It is concluded that the dissociation of the GI and II in milk is not related to its fat content."

Another paper also says, "There is growing awareness that the profound changes in the environment (e.g., in diet and other lifestyle conditions) that began with the introduction of agriculture and animal husbandry approximately 10,000 years ago occurred too recently on an evolutionary timescale for the human genome to adjust.  In conjunction with this discordance between our ancient, genetically determined biology and the nutritional, cultural and activity patterns of contemporary western populations, many of the so-called diseases of civilization have emerged.  In particular, food staples and food processing procedures introduced during the Neolithic and Industrial Periods have fundamentally altered seven crucial nutritional characteristics of  ancestral hominin diets: 1) glycemic load, 2) fatty acid composition, 3)  macronutrient composition, 4) micronutrient density, 5) acid/base balance, 6) sodium/potassium ratio, and 7) fiber content.  The evolutionary collision of our ancient genome with the nutritional qualities of recently introduced foods may underlie many of the chronic diseases of western civilization."

The above papers along with others can be found at this url. Dr. Cordain says eating a high protein diet helps acne, and no doubt will help rosacea. Dr. Cordain is so sure about this that she has written a book about the dietary cure for acne.

My Rosacea Diet Users Support Group with over 200 members has enough evidence that what I have been saying since 1999 is true. There are many comments from users of the Rosacea Diet that indeed this is true.

I have been saying that sugar and a high carbohydrate diet is a trigger factor for rosacea since 1999. There will no doubt be others who will confirm that sugar and a high carbohydrate diet triggers rosacea and scientific papers will emerge that this is the case. One day even the NRS will list sugar and a high carbohydrate diet triggers rosacea.

Sources

Could rosacea be caused by diet ? source

Cordain, L. Implications for the role of diet in acne. Semin Cutan Med Surg 2005;24:84-91.

Hoyt G, Hickey MS, Cordain L. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. Br J Nutr 2005;93:175-177.

Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J.  Reply to SC Cunnane. Am J Clin Nutr 2005;82:483-84.

O'Keefe JH, Cordain L, Harris, WH, Moe RM, Vogel R. Optimal low-density lipoprotein is 50 to 70 mg/dl. Lower is better and physiologically normal. J Am Coll Cardiol 2004;43: 2142-6.

O'Keefe JH Jr, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds with our Paleolithic genome: how to become a 21st-century hunter-gatherer.  Mayo Clin Proc 2004 Jan;79(1):101-8.

Lindeberg S, Cordain L, and Eaton SB.  Biological and clinical potential of a Paleolithic diet.  J Nutri Environ Med 2003; 13(3):149-160.

Cordain L, Eades MR, Eades MD.  Hyperinsulinemic diseases of civilization: more than just syndrome X. Comp Biochem Physiol Part A 2003;136:95-112. 

Lindeberg S, Ahren B, Nilsson A, Cordain L, Nilsson-Ehle P, Vessby B. Determinants of serum triglycerides and high-density lipoprotein cholesterol in traditional Trobriand Islanders: the Kitava Study. Scand J Clin Lab Invest 2003; 63: 175-180.

Cordain L, Lindeberg S, Hurtado M, Hill K, Eaton SB, Brand-Miller J. Acne vulgaris: A disease of western civilization. Arch Dermatol 2002; 138:1584-90.

Cordain L, Eaton SB, Brand Miller J, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: Meat based, yet non-atherogenic. Eur J Clin Nutr 2002; 56 (suppl 1):S42-S52.

Cordain L, Watkins BA, Florant GL, Kehler M, Rogers L, Li Y. Fatty acid analysis of wild ruminant tissues: Evolutionary implications for reducing diet-related chronic disease. Eur J Clin Nutr, 2002; 56:181-191.

Cordain L, Eaton SB, Brand Miller J, Lindeberg S, Jensen C. An evolutionary analysis of the etiology and pathogenesis of juvenile-onset myopia. Acta Ophthalmologica Scandinavica, 2002; 80:125-135.

Eaton SB, Strassman BI, Nesse RM, Neel JV, Ewald PW, Williams GC, Weder AB, Eaton SB 3rd, Lindeberg S, Konner MJ, Mysterud I, Cordain L. Evolutionary health promotion. Prev Med 2002; 34:109-118.

Eaton SB, Cordain L. Evolutionary Health Promotion. A consideration of common counter-arguments. Prev Med 2002; 34:119-123.

Cordain L. The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. J Am Nutraceut Assoc 2002; 5:15-24.

Cordain L. Syndrome X: Just the tip of the hyperinsulinemia iceberg. Medikament 2001; 6:46-51.

Cordain L, Watkins BA, Mann NJ. Fatty acid composition and energy density of foods available to African hominids: evolutionary implications for human brain development. World Rev Nutr Diet 2001, 90:144-161.

Cordain L, Brand Miller J, Eaton SB, Mann N, Holt SHA, Speth JD. Plant to animal subsistence ratios and macronutrient energy estimations in world wide hunter-gatherer diets. Am J Clin Nutr 2000, 71:682-92.

Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Brit J Nutr 2000, 83:207-217.