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Akne und Ernährung

Acne and diet

  • Leitthema
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Zusammenfassung

In industrialisierten Ländern tritt Akne als eine epidemische Zivilisationskrankheit des Talgdrüsenfollikels Jugendlicher und junger Erwachsener auf, assoziiert mit erhöhtem Body-Mass-Index und Insulinresistenz. „Westlicher“ Ernährungsstil, gekennzeichnet durch hohe glykämische Last und vermehrten Konsum insulinotroper Milcheiweiße, spielt in der Pathogenese der Akne eine bedeutende Rolle. Nahrungsinduzierte metabolische Signale werden auf zellulärer Ebene durch den metabolischen Transkriptionsfaktor FoxO1 detektiert und durch die Kinase mTORC1 integriert. mTORC1, der zelluläre Hauptregulator der Protein- und Lipidbiosynthese, des Zellwachstums und der Zellproliferation, wird durch Insulin und IGF-1 sowie verzweigtkettige essenzielle Aminosäuren, vor allem Leucin, aktiviert. Das Verständnis der Signaltransduktion westlicher Nahrung mit überhöhter mTORC1-Aktivität begründet die diätetische Aknetherapie mit Verminderung der glykämischen Last und übermäßigen Milcheiweißkonsums. Geeignet zur Abschwächung überhöhter mTORC1-Aktivität ist eine paläolithisch betonte Ernährung mit reduziertem Konsum von Zucker, hyperglykämischen Getreiden, Milch und Milchprodukten, jedoch erhöhtem Konsum von Gemüse und Fisch.

Abstract

In industrialized countries acne presents as an epidemic disease of civilization affecting sebaceous follicles of adolescents and young adults, associated with increased body mass index and insulin resistance. “Western style” diet, characterized by high glycaemic load and increased consumption of insulinotropic milk proteins, plays an important role in acne pathogenesis. On the cellular level, nutrient-derived metabolic signals are sensed by the metabolic transcription factor FoxO1 and integrated by the regulatory kinase mTORC1. mTORC1, the central hub of protein- and lipid biosynthesis, cell growth and proliferation, is activated by insulin, IGF-1 and branched-chain essential amino acids, especially leucine. The understanding of Western diet-mediated nutrient signalling with over-activated mTORC1 offers a reasonable approach for dietary intervention in acne by lowering glycaemic load and consumption of milk and milk products. A suitable diet attenuating increased mTORC1 activity is a Palaeolithic-like diet with reduced intake of sugar, hyperglycaemic grains, milk and milk products but enriched consumption of vegetables and fish.

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Melnik, B. Akne und Ernährung. Hautarzt 64, 252–262 (2013). https://doi.org/10.1007/s00105-012-2461-5

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