The majority of the strategies on this website relate to the dreaded “Western lifestyle”. It could be a sun-deprived office worker who gets barely any sleep, or it could be a stressed-out student studying for exams sustained by copious amounts of caffeine. Likewise, countless acne studies available today relate to people eating Western dishes: burgers, octuple-decker ham sandwiches, king-sized pizzas, fruit juice and so on.
Well, now we have a fresh study from sunny, often impoverished Afghanistan, with its own cultural dishes and a male obesity rate of just 3.2%. Furthermore, this study is about milk, one of the most controversial acne foods ever.
Is dairy just as dodgy for acne patients in poorer parts of the world? Here’s the truth, or at least a glimmer of the truth.
Milk drinking Afghans are prone to acne
The study was unleashed in June 2019 and gathered 558 Afghans, 279 who suffered from acne, and 279 smirking clear-skinned people. This study is particularly useful if you’re a teenager fighting acne: the participants were aged between 10 and 24.
The scientists used a trusted cornerstone acne scale in studies, the Acne Severity Index, followed by a questionnaire on the participants’ diet, physical exercise, smoking habits, and more. People with diabetes, heart disease, and eating disorders were kicked out, or in other words, people with serious illnesses that could distort the results.
This is what they found…
In the acne group, dairy consumption was significantly higher for almost every type tested. The starkest difference was whole milk, where 41.9% of acne patients drank it 3 or more times per week, compared with just 22.9% for controls. Drinking milk three times weekly plus pumped up the risk of acne 2.36 fold. For low-fat milk, the risk was smaller but still there, increasing 1.95 fold, scoring 28.3% for acne patients and 21.9% for controls.
Cream of milk was equally acnetastic, scoring 19.7% and 10.8% for acne patients and controls respectively, while cheese achieved 41.9% and 28.0%. Your local ice cream van was revealed to secretly be an acne van, scoring 33.3% and 15.1%. Only yogurt farmers escaped with their moneymaking schemes intact, with only a minuscule difference.
The scientists gave an unambiguous conclusion: “this study showed an association between high intakes of dairy products and acne in adolescence suggesting that dairy intake may be a factor contributing to acne.”
The data for other suspicious acne foods
While some results were surprising, others just piled onto mounting acne evidence elsewhere. When you think of pizza, two images come to mind: a) a fine dinner in an Italian restaurant, or b) a greasy, untidy person slouched in front of the TV with pizza boxes everywhere (which is undeniably a joy of life). It was discovered that acne-prone Afghans ate pizza/bolani (a pizza-like traditional Afghan dish) significantly more than clear skinned. Another bombshell was potato chips, at 62.7% thrice weekly or more versus 35.8%.
Next came the result that thousands of Swiss businessmen will try to hush up. The figures for chocolate were 76.3% for acne and only 50.5% for clear-skinned. It sounds like the end of civilisation as we know it, but all will be explained later.
Cake did its pimple-giving duty, scoring 43.7% and 30.8% but more unexpected was eggs, the mineral-rich, cornflake dodging breakfast stable. 58.4% of acne patients ate them thrice weekly or more versus 36.9% for clear-skinned.
Cooked vegetables were surprisingly feeble, as controls only inched across the line, at 86.4% versus 84.6% for acne. Fresh vegetables were superior, scoring 82.8% (controls) versus 71.3% (acne). For fresh fruit the figures were 49.1% and 49.8% for acne and clear-skinned. The only expected detail was that fresh fruits defeated the notoriously sugary dried fruit at 19.7% vs 11.8%.
Red meat had a small correlation with acne (17.6% vs 10.4%), and as for KFC? Their world dominance is now assured, as 35.1% of the clear-skinned group ate chicken thrice weekly or more, compared to just 17.9% for acne patients.
The scientists also found that acne was reduced by “regular” physical exercise, 3 sessions or more of 30 minute exercise per week that resulted in sweating. Then they staggered into the choking mists of the smoking debate, observing no connection to acne. Obesity had a slight but insignificant association with acne, whereas conventional wisdom regards fatness as a shield.
Predictable or shocking?
Assuming that this study is a shining example of scientific research, how much does it rip apart our previous clear skin instructions? Is a KFC season pass the way forward?
Milk’s problems were no surprise as it naturally contains numerous dodgy nutrients for acne. There’s lactose, but also food-based IGF-1 (you produce your own as well), which accelerates acne processes like dead skin cell turnover, and pro-inflammatory A-1 beta casein proteins. The bitter controversy is over 1) peoples’ massively varying sensitivity to those compounds, and 2) how much the beneficial vitamins and fats in milk balance them out.
The grim results for cheese fit in, because cheese processing fails to eliminate the suspicious milk compounds. Likewise for cream of milk, and the inclusion of ice cream was just a joke. Was that pure ice cream, or was it sugary, strawberry flavoured ice cream man ice cream? Was it a pingu shaped restaurant dessert?
Yogurt was the only neutral dairy food. Its superiority was right on schedule, as the fermentation can reduce IGF-1 by 80% and add billions of CFU of good bacterial strains. The surprising part though, was its complete lack of benefits for acne. That’s why while the outline was expected – yogurt safer, other dairy riskier – the overall picture was shifted surprisingly negatively.
Luckily though, yogurt still has the sugar and flavour question looming over it. The scientists were surely smart enough to acquire freshly farmed natural yogurt, but you never know; a neon yellow, apricot flavoured children’s pot could have slipped in.
The question with the cheese is soft versus hard. “Cheese” can encompass so many scenarios for acne. Harder ones like cheddar are denser in nutrients like vitamin A compared with the fresh, gooey delights of mozzarella, while the freaky, blue-veined cheeses that resemble an alien habitat are fermented and missing IGF-1.
This study is missing several important details that would tell us more.
Afghan dairy – almost certainly bottom of the barrel
An even bigger question is the nutritional quality of Afghan dairy. Westerners have the same dilemma: were they happy black and white cows eating their natural grass diet while walking almost vertically up a mountainside, or imprisoned cows force fed corn and soy?
Grass-fed is dramatically denser in acne nutrients (more omega 3s, vitamin A) and luckily, Afghanistan has acres after acres of undeveloped, virgin pasture, unlike its war-torn desert image. In the north, it even has snowy mountains. The problem is that because of incompetence, Afghanistan still import 80% of its dairy, led by Iran and Pakistan.
Iran is the heartland of shady dairy. Their 8.5 million dairy cows are almost all packed in tight stalls, and have no opportunity for grazing even in summer. They’re fed imported feeds consisting of concentrated cornmeal and soy, while the most popular homegrown cow feed is also cornmeal.
It’s a different story to Iranian sheep and goats, who roam the land freely, even if they starve during droughts. Iran’s milk production has steadily risen from 4 million tonnes in 1998 to 6.8 million in 2013, while Afghanistan’s is a rollercoaster ride.
What really seals Iran’s fate is the near constant economic crisis of the 2010s. The name of the game is therefore cutthroat efficiency, which is easy when exporting to starving Afghanistan. Unlike in Europe and America, Iranian farmers have few organic-hungry customers to appeal to.
Pakistan’s dairy, meanwhile, is actually superior, because 95% of their milk is produced by small-scale farmers (as of 2003) with just two or three cows. Pakistanis also feed their cows unnatural corn crop leftovers, but the amount of grazing is higher, ironically because the dairy industry is less professional than in Iran. Pakistan does have a sneaky problem with milk adulteration, like adding maize (corn) for thickening and ice cubes made with dirty, infected water for long-haul transportation.
What does all this mean? Essentially, a good 50% of Afghanistan’s dairy is acne persona non grata. Dairy is inherently controversial anyway, so acne patients simply must experiment with the best type.
Because this study probably isn’t examining “true dairy”, it isn’t adding any evidence to this neverending acne debate.
The weirdly disastrous result for eggs is a mirror image. Afghanistan’s egg industry is actually expanding, but 82% are imported, and 99% from Iran, Pakistan, India, Turkey and Turkmenistan.
Once upon a time, there was great joy when India announced its first brand of free range eggs. The problem is, that was only in 2018. The statistic for India alone is 80% battery chickens, and their diet is soyameal, or when supplies dry up, cottonseed and rapeseed “cakes” (this aint a cake you wanna try) glued together with xanthan gum.
Explain free range eggs to an Iranian businessman and you would probably witness a glazed, glassy eyed expression. Iran has actually been accused of undercutting Afghanistan’s higher quality farmers by dumping their eggs on the market.
Chocolate, chicken and cigarettes analysed
Problems are aplenty with the other results too, but maybe they’ve a glimmer of potential…
Chocolate – before you leave earth to become an exile on a remote jungle planet, please understand that this “bombshell” result is useless. Why? Because the words dark, milk or white are missing. We have no knowledge of the chocolate’s sugar content. If the Afghans were fed very dark chocolate (85% cocoa plus), we could worry, but as it is, it tells us nothing. All is well in the universe.
Smoking – no connection in the study. The biggest villain with cigarettes is their free radicals, which causes both acne itself by depleting antioxidants, and the grey, clammy tone of a cigarette addict. Smoking’s connection to acne is definitely indirect, but perhaps it’s very indirect. Cigarettes may be a glow ghoul rather than an acne baron. The methodology wasn’t explained, but had no obvious flaws.
Fruit and vegetables – surprisingly weak for clear skin, but like chocolate, the specific foods weren’t mentioned. Melons and pomegranates are two of Afghanistan’s most popular fruits, but melons are sugary and vitamin-less, while pomegranates are an antioxidant machine. Likewise, cucumbers and peas are an Afghan staple, but devoid of acne nutrients. Afghanistan’s beloved potato is technically a vegetable, but their real use is as a clean carbohydrate source, not skin-enriching, magical veggie goodness like broccoli.
If the teenagers were shovelling in spinach, tomatoes, and green lettuce thrice weekly, it would dent the acne credentials of vegetables, but if the study tested potatoes, iceberg lettuce, and cucumber, the weak benefits wouldn’t be surprising. That said, if the Afghan teenagers did eat an assortment of powerful and weaker skin-clearing vegetables, with no ruthless organisation like we advocate, it would make sense to average out at just a small reduction in acne.
Cake – what is there to say? It’s packed with sugar, wheat and flavourings. The results make perfect sense. Only eat cake if your grandma has baked you one in the shape of your favourite Pokemon.
Chicken – it’s undoubtedly rich in commonly deficient acne minerals like zinc and magnesium, but this is easily the most confusing result. Maybe chicken has miraculously escaped detection as the secret elixir of clear skin and this study has finally discovered it, but it’s unlikely given KFC’s control of America.
It has to be a phenomenon specific to Afghanistan. It’s possible that impoverished Afghans rely strongly on protein-light crops such as barley, cheaper as they are. Therefore, when they can afford chicken meat, its amino acids and minerals are like a life tonic which revitalises their skin completely. It helps that chicken meat is Afghanistan’s least imported protein source, 49% in 2014 compared to 82% for eggs, blessing them with more acne-friendly meat.
Red meat – there’s no known reason why red meat should be the bane of clear skin. We can’t rule out a hitherto unknown acne-causing compound, but the meat was probably imported from the same grain-fed Iranian cows that made their milk.
Physical exercise – all in alignment. Exercise pumps blood to the skin, suppresses insulin, and soothes chronic inflammation, with harmless short term spikes after intense exercise, which reconstruct broken muscle fibres, making them bigger when you wake up.
Conclusion
When you first read it, this is a really interesting study. It has figures for some of the most controversial acne foods, whether it be chocolate, cheese or milk.
However, its methodology is just too flawed to really make a difference. Perhaps their techniques were actually perfect, and we would have some revelations if they let slip the full sugariness of the chocolate, or the farming quality of their dairy.
As it stands, we still have new evidence that 1) yogurt is among the safest dairy products, 2) fresh fruits are likely superior to dried fruits, and 3) pizza is an acne-causing weapon devised by Italian chefs. It also shows that in certain circumstances, a dose of extra protein like chicken can enhance your skin, but maybe derail it if from the wrong source, like poorly farmed eggs.
The study is just highly frustrating. It’s interesting to read, but is missing key pieces of the puzzle.
Thanks for reading!