The Role of Glycemic Load, Dairy, and Fatty Acids in Acne Disorders: A Systematic Review and Meta-Analysis

Authors

  • Claudia Felicia Limanda Department of Medicine, Universitas Udayana, Bali
  • Asya Mathlubaa Latin American School of Medicine, La Habana
  • Ferdian Harum Istikanto Siloam Hospital Kelapa Dua, Tangerang, Banten
  • Sisca Universitas Kristen Krida Wacana, Jakarta
  • Yusra Nabila Universitas Airlangga, Jakarta
  • Shania Rizky Amalia Emergency Department, RS Pusura Candi Sidoarjo / Universitas Muhammadiyah Malang, East Java
  • Syafira Ayudiah Syah Putri Universitas Sriwijaya, Palembang, South Sumatera
  • Tasya Khalis Ilmiani Universitas Lampung, Lampung
  • Ericko Hartanto General Practitioner, Siloam Hospitals Semarang, Central Java
  • Melinda Nurfadhila Universitas Gunadarma, Jakarta

DOI:

https://doi.org/10.19166/med.v15i1.10771

Keywords:

Acne, Glycemic load, Dairy, Fatty acids

Abstract

Background: Modern dietary patterns characterized by high glycemic load, dairy consumption, and imbalanced fatty acid profiles may aggravate acne through insulin, IGF-1, and inflammatory pathways. However, findings across studies remain inconsistent. This systematic review and meta-analysis aimed to evaluate the associations between dietary glycemic load, glycemic index, dairy intake, and fatty acid composition with acne disorders.

 

Methods: Following PRISMA 2020 guidelines, PubMed, EMBASE, and Scopus were systematically searched to September 2025. Eligible human studies assessing quantitative relationships between these dietary exposures and acne risk or severity were included. Random-effects meta-analyses were performed using the Hartung–Knapp–Sidik–Jonkman method, with effect sizes expressed as standardized mean differences (SMD) or risk ratios (RR).

 

Result: Five studies encompassing 716 participants (426 acne, 290 controls) met the inclusion criteria. Pooled estimates indicated no significant associations for glycemic load (SMD = 0.09; 95% CI −0.30 to 0.49), glycemic index (SMD = 0.09; 95% CI −0.30 to 0.49), fatty acids/adiponectin (SMD = 0.11; 95% CI −0.74 to 0.97), or dairy consumption (RR = 1.04; 95% CI 0.25 to 4.25). Heterogeneity ranged from moderate to high (I² = 65–90%). Certainty of evidence was moderate for glycemic and dairy outcomes, and low for fatty acids.

 

Conclusions: No significant pooled associations were observed between dietary glycemic load, dairy intake, or fatty acids and acne risk. Despite biological plausibility linking diet to acne via hormonal and inflammatory mechanisms, evidence remains inconsistent. Larger, controlled trials are warranted to define the role of nutritional interventions in acne management.

References

1. Vasam M, Korutla S, Bohara RA. Acne vulgaris: A review of the pathophysiology, treatment, and recent nanotechnology based advances. Biochemistry and Biophysics Reports. 2023 Dec;36:101578. https://doi.org/10.1016/j.bbrep.2023.101578

2. Kim H, Jang JH, Kim HR, Cho JH. Novel-designed antimicrobial peptides with dual antimicrobial and anti-inflammatory actions against Cutibacterium acnes for acne vulgaris therapy. Biochemical Pharmacology. 2025 Feb;232:116708. https://doi.org/10.1016/j.bcp.2024.116708

3. Vasam M, Korutla S, Bohara RA. Acne vulgaris: A review of the pathophysiology, treatment, and recent nanotechnology based advances. Biochem Biophys Rep. 2023 Dec;36:101578. https://doi.org/10.1016/j.bbrep.2023.101578

4. Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD Int. 2022 June;7:95–112. https://doi.org/10.1016/j.jdin.2022.02.012

5. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. 2009 Oct;18(10):833–41. https://doi.org/10.1111/j.1600-0625.2009.00924.x

6. Marbini MH, Amiri F, Sajadi Hezaveh Z. Dietary glycemic index, glycemic load, insulin index, insulin load and risk of diabetes-related cancers: A systematic review of cohort studies. Clinical Nutrition ESPEN. 2021 Apr;42:22–31. https://doi.org/10.1016/j.clnesp.2021.02.008

7. Ryguła I, Pikiewicz W, Kaminiów K. Impact of Diet and Nutrition in Patients with Acne Vulgaris. Nutrients. 2024 May 14;16(10):1476. https://doi.org/10.3390/nu16101476

8. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. https://doi.org/10.1136/bmj.n71

9. Whiting PF, Rutjes AWS, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011 Oct 18;155(8):529–36. https://doi.org/10.7326/0003-4819-155-8-201110180-00009

10. Quilodrán C, Kirmayr M, Valente B, Pérez-Bracchiglione J, Garegnani L, Franco JVA. The GRADE approach, Part 2: Evidence to decision frameworksoutlining decision-making in health. Medwave. 2021 May 7;21(4):e8182. https://doi.org/10.5867/medwave.2021.04.8182

11. LaRosa CL, Quach KA, Koons K, Kunselman AR, Zhu J, Thiboutot DM, et al. Consumption of dairy in teenagers with and without acne. Journal of the American Academy of Dermatology. 2016 Aug;75(2):318–22. https://doi.org/10.1016/j.jaad.2016.04.030

12. Kaymak Y, Adisen E, Ilter N, Bideci A, Gurler D, Celik B. Dietary glycemic index and glucose, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein 3, and leptin levels in patients with acne. Journal of the American Academy of Dermatology. 2007 Nov;57(5):819–23. https://doi.org/10.1016/j.jaad.2007.06.028

13. Ismail NH, Manaf ZA, Azizan NZ. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC Dermatol. 2012 Aug 16;12:13. https://doi.org/10.1186/1471-5945-12-13

14. Çerman AA, Aktaş E, Altunay İK, Arıcı JE, Tulunay A, Ozturk FY. Dietary glycemic factors, insulin resistance, and adiponectin levels in acne vulgaris. Journal of the American Academy of Dermatology. 2016 July;75(1):155–62. https://doi.org/10.1016/j.jaad.2016.02.1220

15. Burris J, Rietkerk W, Woolf K. Relationships of Self-Reported Dietary Factors and Perceived Acne Severity in a Cohort of New York Young Adults. Journal of the Academy of Nutrition and Dietetics. 2014 Mar;114(3):384–92. https://doi.org/10.1016/j.jand.2013.11.010

16. Burris J, Rietkerk W, Shikany JM, Woolf K. Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne. Journal of the Academy of Nutrition and Dietetics. 2017 Sept;117(9):1375–83. https://doi.org/10.1016/j.jand.2017.03.024

17. Caputo M, Pigni S, Agosti E, Daffara T, Ferrero A, Filigheddu N, et al. Regulation of GH and GH Signaling by Nutrients. Cells. 2021 June 2;10(6):1376. https://doi.org/10.3390/cells10061376

18. Sánchez-Pellicer P, Navarro-Moratalla L, Núñez-Delegido E, Ruzafa-Costas B, Agüera-Santos J, Navarro-López V. Acne, Microbiome, and Probiotics: The Gut-Skin Axis. Microorganisms. 2022 June 27;10(7):1303. https://doi.org/10.3390/microorganisms10071303

19. Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. A low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007 July;86(1):107–15. https://doi.org/10.1093/ajcn/86.1.107

20. Okoro OE, Camera E, Flori E, Ottaviani M. Insulin and the sebaceous gland function. Front Physiol. 2023;14:1252972. https://doi.org/10.3389/fphys.2023.1252972

21. Barrea L, Verde L, Annunziata G, Antiga E, Camajani E, Caprio M, et al. Medical Nutrition Therapy in Dermatological Diseases: A Joint Consensus Statement of the Italian Association of Dietetics and Clinical Nutrition (ADI), the Italian Society of

Dermatology and Sexually Transmitted Diseases (SIDeMaST), the Italian Society of Nutraceuticals (SINut), Club Ketodiets and Nutraceuticals “KetoNut-SINut” and the Italian Society of Endocrinology (SIE), Club Nutrition, Hormones and Metabolism. Curr Obes Rep. 2025 May 13;14(1):42. https://doi.org/10.1007/s13679-025-00630-2

22. Reynolds RC, Lee S, Choi JYJ, Atkinson FS, Stockmann KS, Petocz P, et al. Effect of the glycemic index of carbohydrates on Acne vulgaris. Nutrients. 2010 Oct;2(10):1060–72. https://doi.org/10.3390/nu2101060

23. Vlachos D, Malisova S, Lindberg FA, Karaniki G. Glycemic Index (GI) or Glycemic Load (GL) and Dietary Interventions for Optimizing Postprandial Hyperglycemia in Patients with T2 Diabetes: A Review. Nutrients. 2020 May 27;12(6):1561. https://doi.org/10.3390/nu12061561

24. Das P, Dutta A, Panchali T, Khatun A, Kar R, Das TK, et al. Advances in therapeutic applications of fish oil: A review. Measurement: Food. 2024 Mar;13:100142. https://doi.org/10.1016/j.meafoo.2024.100142

25. Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol. 2015;8:371–88. https://doi.org/10.2147/ccid.s69135

26. 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. https://doi.org/10.1016/j.jaad.2004.08.007

27. Luque-Luna M, Sidro-Sarto M. [Translated article] RF-The role of diet in the management of acne. Actas Dermo-Sifiliográficas. 2024 July;115(7):T734–6. https://doi.org/10.1016/j.ad.2023.06.026

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Published

2025-10-01

How to Cite

Limanda, C. F., Mathlubaa, A., Istikanto, F. H., Sisca, Nabila, Y., Amalia, S. R., … Nurfadhila, M. (2025). The Role of Glycemic Load, Dairy, and Fatty Acids in Acne Disorders: A Systematic Review and Meta-Analysis. Medicinus, 15(1), 96–108. https://doi.org/10.19166/med.v15i1.10771

Issue

Vol. 15 No. 1 (2025): October

Section

Clinical Article

License

Copyright (c) 2025 Claudia Felicia Limanda, Asya Mathlubaa, Ferdian Harum Istikanto, Sisca, Yusra Nabila, Shania Rizky Amalia, Syafira Ayudiah Syah Putri, Tasya Khalis Ilmiani, Ericko Hartanto, Melinda Nurfadhila

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