Stress is a proven precipitator of acne. Yes, men also suffer from stress, but because of their hormonal differences, adult women are much more adversely affected. Recent statistics from the American Dermatology Association report that the median age for patients suffering from acne has been gradually increasing. Earlier it used to be 20.5 years, whereas now it is approximately 26.5 years or age. More than 17 million adults are diagnosed with acne in the US, of which 50 % are adult women and 25% are adult men.

It is a sad but true fact that acne often rears its ugly head at the most inopportune times possible. Acne has an uncanny knack for flaring up just in time for that big date, job interview, wedding day or other special event in our lives. This happens with alarming frequency – far too often in fact to chalk it up to “bad luck” or coincidence. There is a physiological reason for these untimely flare-ups and its name is stress.

Of all of the physical conditions we experience, stress is the most deadly. Many circumstances create stress in our daily lives. Arguing with family, friends or colleagues, not getting enough sleep, worrying, working too hard or even playing too hard can all create stress. Weekend warriors, who try to make up for a week of inactivity by spending hours engaged in strenuous physical sports, raise their stress levels to an unhealthy degree. Any activity that is practiced without moderation can lead to a stress response. This is extremely important to remember if you hope to gain control of your acne flare-ups.

For those of you familiar with my work in the anti-aging field, you know that elevated levels of the hormone, cortisol (also referred to as the ‘death’ hormone) are very destructive to the body. Elevated cortisol levels cause an increase in blood sugar. This in turn causes an instant response from our cells as they enter an extreme pro-inflammatory mode. Because acne is a systemic, inflammatory disease, any increase in inflammation will result in an increase in the length and severity of the outbreak.

Mars vs. Venus, Androgens and Acne
When our blood sugar and insulin levels rise, whether from a poor diet or from stress, we experience a serious increase in inflammatory chemicals at a cellular level. This causes inflammatory diseases such as acne to worsen dramatically. Cortisol and other adrenal steroids can act as androgens and stimulate the sebaceous (oil) glands resulting in a flare-up of acne. Although men are affected by stress and pro-inflammatory cortisol response, women suffer from both the pro-inflammatory cortisol-sugar-insulin connection, as well as the effect of the male-type hormones. Men are not affected from high levels of androgens in the same way that women are. Women are most susceptible to adrenal hormone stimulation because most of the women’s androgens are synthesized in the adrenal glands. The stimulation of the oil glands results in changes such as the clogging of the pores and increased secretion of pro-inflammatory fatty acids. These pro-inflammatory fatty acids release the chemical messengers known as cytokines, and so the inflammatory fire is fed. Men with high levels of androgen circulating do not suffer from the androgen affect like women.

The Top Ten

But the news is not all bad. We can learn how to lower cortisol levels and stop acne before it starts. Follow these simple rules and you will enjoy lowered stress levels, increased energy, elevated moods and sense of well-being and clear, radiant skin.

1. Follow the anti-inflammatory diet,
2. Make sure that you get enough sleep
3. Try to minimize stress in your life
4. Don’t drink coffee. Coffee contains many organic acids which affect our blood sugar and cortisol levels. It is not specifically because of the caffeine because you can drink a cup of decaffeinated coffee at 8 AM and your cortisol levels will still be measurable at 10 PM –the same effects as a cup of regular coffee.
5. Set aside time for meditation, prayer or a walk in Nature. It is a well- established fact that people who do this have significantly lower cortisol levels. Long term benefits include keeping our skin clear, maintaining a healthy immune system and preventing age-related diseases, such as diabetes, cancer or cardiovascular disease
6. Consider learning some simple Yoga exercises. Substitute green tea for coffee.
7. Make sure that there are plenty of essential fatty acids in your diet because essential fatty acids can decrease cortisol levels.
8. Take nutritional supplements including alpha lipoic acid, zinc, DMAE, pantothenic acid.
9. Add essential fatty acids such as borage and evening primrose oil which are rich in linoleic acid. Acne sufferers have a low concentration of linoleic acid in their sebum and the levels decrease as the acne increases.
10. Adopt a loving, non-judgmental pet

I have often wondered how so many of Hollywood’s most stunning faces manage to have such clear complexions, given the high level of stress in the entertainment industry. The answer may be that a great many of them are huge pet lovers. Think Oprah, Jessica Alba, Heidi Klum, Rachael Ray, Paula Abdul, Jessica Biel, Julia Roberts, Demi Moore, Elizabeth Taylor, just to name a few. Perhaps this is the ideal ‘prescription,’ for beautiful, luminous, acne-free skin.

As an active researcher, I welcome your comments and suggestions.

View PerriconeMD acne products here

By Nicholas Perricone, MD, FACN, CNS

There are many reasons to embrace Paul McCartney’s suggestion for “No-meat Mondays/giving up meat one day a week.” In fact, unless you are eating 100% grass-fed meat, I recommend cutting back on overall meat intake. This is not just environmentally sound, it is sound from a health/longevity viewpoint. Grain-fed meat lacks CLA, which influences body fat and lean muscle, and the omega-3 fatty acids, which are as close to a health, beauty, longevity and weight-loss magic bullet that we can get. Grain-fed meat is also high in pro-inflammatory saturated fat. Consuming a lot of these saturated fats leads to the accumulation of visceral fat. 

The Truth about Body Fat

This past decade has seen a turnaround in the way scientists regard white adipose tissue—better known as body fat, perhaps two of the most dreaded words of our generation. There are many theories as to why so many people are afflicted with excess body fat today, when twenty or thirty years ago this was not the case. Instead of feeling guilty and depressed, we need a basic understanding about the danger of excess body fat and to be vigilant in our food choices. 

Dirty Little Secret #1

There are two types of fat: subcutaneous (under the skin) and visceral (found in the abdomen and surrounding vital organs). Visceral fat is of greater concern because it surrounds vital organs and is metabolized by the liver, which turns it into blood cholesterol. Consuming large amounts of saturated fat and/or performing little physical activity results in high stores of visceral fat.

Dirty Little Secret #2

We now know that body fat is not just an inert deposit of fat cells, stored as the result of overeating. These areas of fat storage are actually an active endocrine organ. 

Dirty Little Secret #3

Body fat produces hormones, as does our pancreas, thyroid, parathyroid, adrenals, pineal and pituitary glands and testes/ovaries, the organs that comprise the endocrine system. These secreted hormones, known as adipokines, can contribute to systemic, low-grade, chronic inflammation.

Dirty Little Secret 

Body fat, as a group of cells, communicates with other organ systems such as the brain, the liver, the bone marrow, skeletal muscle, the adrenal cortex, the sympathetic nervous system and the complete immune system.

Dirty Little Secret #5

This agglomeration of fat cells, now an active endocrine organ, has the unique distinction of being the only endocrine organ to send pro-inflammatory and destructive signals to all organ systems, creating a spectrum of problems in every organ system, from bone growth to sexual reproduction.

Dirty Little Secret #6

Body fat directly impacts appetite, energy and our immune system. 

Dirty Little Secret #7

Body fat itself controls how much body fat is going to be stored, and the greater the amount of fat we have stored, the greater its negative influence on the entire body—an extremely destructive, inflammatory influence.  

Dirty Little Secret #8

A large storage of body fat can be so overwhelming to the system that the fat cells have to secrete hormone-like substances to increase blood vessel growth necessary to feed the accumulation of fat. 

Dirty Little Secret #9

Blood vessel growth cannot keep up with the rapidly growing mass of fat cells, which then begin to become oxygen-starved. These oxygen-starved cells start releasing inflammatory chemicals to further trigger blood vessel growth. 

Dirty Little Secret #10

When we are obese, muscle is constantly converting to fat.

The Alpha and the Omega

The truth about body fat reads like a frightening 1950’s pulp science fiction story, like Steve McQueen’s memorable debut film, The Blob. But, in fact, an escape from this real-life horror story is detailed in The Perricone Weight Loss Diet (Ballantine Books 2006)—and although there is plenty of science, there is no fiction about it.  

This is why it is critical to take a powerful anti-inflammatory approach to dieting. It is the inflammatory chemicals, such as NfkB, that block the effects of insulin—whether it is to metabolize blood sugar or to nourish muscles with amino acids. 

Excess insulin and high blood sugar put a lock on body fat, ensuring that those fat cells are going nowhere. Avoid pro-inflammatory, sugary, starchy foods and beverages, body fat’s greatest allies. The high omega-3 content found in wild salmon, anchovies, sardines and other cold-water fish, along with fish oil capsules, will help eliminate this toxic fat. Their essential fatty acids have tremendous anti-inflammatory properties and are key in sensitizing our cells to insulin. Omega-3 EFAs also inhibit the production of the enzyme fatty acid synthase, which plays a role in the storage of calories as body fat. 

Alpha lipoic acid, a powerful anti-inflammatory nutrient, accelerates the removal of glucose from the bloodstream, improves insulin function and decreases insulin resistance, making its use another critical strategy in the fight against body fat.

Chromium is also critical in controlling and reducing body fat. It effectively lowers blood sugar and insulin levels—the key to the anti-inflammatory weight-loss diet. Chromium helps decrease inflammation, thereby unlocking the enzymes that aid in fat metabolization, while normalizing blood lipids such as triglycerides and cholesterol, increasing levels of the “good” HDL cholesterol and lowering total cholesterol and triglycerides, making it cardio-protective.

The general population of the United States is deficient in chromium—and low levels of chromium are associated with type 2 diabetes and cardiovascular disease. Studies have also been published noting that increased consumption of sugar depletes our body stores of chromium, placing us at further risk for hyperglycemia and hyperinsulinemia (too much blood sugar, too much insulin). 

As an active researcher, I welcome your comments and suggestions.

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Dear Dr. Perricone,

I have followed the Perricone Prescription on & off since my mother-in-law gave me the book. How do you feed a 6’4″ and 220 lbs. man this kind of diet? I know he would feel better so any suggestions on how to slowly change his diet would be appreciated. What other foods or recipes are there & salmon is not one of his favorites is there an alternative?

Thanks for your help!
Nora

I often get asked this very question. Since I have a number of celebrity patients, many people think that the Perricone anti-inflammatory diet is geared toward women—especially actresses and models. But men often crave foods that they perceive to be more satisfying—especially a big, juicy steak.

However, while eating a lot of fish and fresh fruit and vegetables is ideal for creating beautiful skin and eliminating body fat, in essence it does much more, making it ideal for men as well. In fact, if your goal is a physique that rivals Matthew McConaughey, Brad Pitt, Usher, Taye Diggs, Christian Bale, David Beckham or Mark Wahlberg, then following the Perricone program is for you. As you will discover, the good news is that you don’t have to forgo that steak to keep your diet from being pro-inflammatory and thus, age-accelerating.

Keep on the Grass

Most men that I know enjoy eating red meat. But they are told to steer clear (no pun intended) because of high levels of pro-inflammatory saturated fats. However, there is a healthy alternative to the meat found on most grocery store shelves, and that is 100% grass-fed, pasture-raised beef and lamb. When it comes to lamb, all New Zealand and Australian lamb is grass-fed. When it comes to beef, we have to be a little more creative—but just about every state in the union has farms that raise beef on grass and hay as opposed to grain. Here in New England, The Stannard family farm in beautiful Benson, Vermont is a great resource and will deliver, for more information visit them at www.vermontnaturalbeef.com. Other sources can be found on www.eatwild.com.

Part of the rise in obesity can be attributed to the changes in the way we raise beef and other animals. Grass-fed beef is up to three times leaner than grain-fed beef, and can have up to 15 fewer calories per ounce than meat from a grain-fed cow. Grass-fed meat also provides more balanced omega-3s and omega-6 fatty acids, which help guard against a variety of ailments.

Like wild salmon, grass-fed beef is an excellent source of high quality omega-3 essential fatty acid, as well as conjugated linoleic acid (CLA). CLA is a fatty acid that has number of health benefits. But because of the dietary change from grass to grain, levels of CLA dramatically decreased in meat and dairy products. In addition to the antioxidant, anti-inflammatory and insulin-sensitizing actions of CLA, many studies show that CLA helps prevent muscle loss and weakness associated with aging and disease.

Safety Profile

Researchers have also compared key antioxidants in meat from pasture-fed and grain-fed cattle. The grass-fed meat was higher in vitamin C, vitamin E and folic acid. It was also ten times higher in beta-carotene. These health benefits decline significantly after just three months of grain feeding, even if the grain is organic.

In an article published in the magazine Mother Earth News, Jo Robinson, author of Pasture Perfect stated: “

“. . . . mad cow disease has never been found in grass-fed beef, which is also far less likely to contain dangerous E. coli bacteria. Grass-fed beef has “no extra hormones and no traces of antibiotics and is both cleaner and more wholesome than ordinary beef by far.” Feedlot cattle may eat …all kinds of products in addition to grain, including chicken manure, chicken feathers, newsprint, cardboard and municipal garbage waste.”

I also recommend organic, free range chicken, and organic omega 3 eggs from free-range chickens.

Many people feel that spending a little more on organic foods is not worth it—but the health benefits are both immediate and long-term.

With the re-introduction of pasture-raised beef and free-range chickens, we can now eat more like our grandparents and earlier generations—a time when obesity, diabetes, cancer, Alzheimer’s and many other diseases were much less prevalent.

In creating the anti-inflammatory diet, I have discovered that the greatest gift I can give my readers and viewers is permission to eat healthy and delicious food.

As as avid weight lifter and runner since the age of 16, keeping body fat down, while maintaining muscle mass has been an important goal. This applies to both men and women, because as we age we gain 10 lbs. of fat and lost 5 lbs. of muscle with each decade.

We can reverse this trend, and it starts with the foods we eat. Every day we need to make sure that our diet includes the following:

• high-quality protein, like that found in fish, shellfish, poultry, grass-fed beef and lamb and tofu;
• low-glycemic (will not provoke a glycemic response when consumed in moderation) carbohydrates including colorful fresh fruits and vegetables and whole grains such as old-fashioned oatmeal, legumes such as beans and lentils;
• healthy fats, such as those found in cold water fish (especially wild Alaskan salmon, halibut, sardines, herring, anchovies, etc.), nuts, seeds, and olive oil
• 6 – 8 glasses of pure spring water per day.
• Anti-oxidant rich beverages such as green tea

As an active researcher, I welcome your comments and suggestions.

Nicholas Perricone, MD, FACN, CNS

Sugar and foods that rapidly convert to sugar when eaten cause sudden spikes in blood sugar levels, resulting in the release of insulin into the blood stream, that then cause us to store, rather than burn fat. However, that is not the only negative byproduct.

As these sugars and starches are eaten, they cause a burst of inflammation throughout the body.  The sugar molecule can also permanently attach to protein, such as the collagen present in our skin and other parts of the body.  This process is known as glycation.

At the point of attachment, there is a small mechanism creating inflammation, which then becomes a source of inflammation in its own right.  This inflammation produces enzymes that break down collagen, resulting in wrinkled, sagging skin.  In addition to inflammation, glycation also causes cross-linking in our collagen, making it stiff and inflexible where it was once soft and supple.

But it is not just the skin we have to worry about.  These “sugar-bonds” can occur throughout the body as we age.  The sugar molecule attaches itself to our collagen as well as our arteries, veins, bones, ligaments, even our brains, resulting in the breakdown of organ systems and the deterioration of the body. Glycation creates “free radical” factories known as advanced glycation end products (AGEs), which also increase cellular inflammation.

Sugar consumption can also affect acne.  When our blood sugar and insulin levels rise, whether from a poor diet or from stress, we experience a serious increase in inflammatory chemicals at a cellular level. This causes inflammatory diseases such as acne to worsen dramatically.  Cortisol and other adrenal steroids can act as androgens (male hormones) and stimulate the sebaceous (oil) glands resulting in a flare-up of acne.

If you are concerned about your health, and not accelerating the aging process, it is best to avoid all forms of refined sugar as well as chemical artificial sweeteners.  There are natural sugars found in fruits and vegetables that should be our only source of sugar.  These foods are high in anti-inflammatory anti-oxidants, help stabilize blood sugar, and nutrients that promote beautiful skin and a healthy body.

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· A visible increase in radiance and glow to the skin. This is the result of their powerful anti-inflammatory activity, as well as their effects on blood circulation and cell metabolism.
· An increase in firmness, as the neuropeptides aid in collagen production
· Improved appearance of the skin’s resilience, tone, and texture.
· Decreased appearance of fine and deep lines and wrinkles.
· Decreased appearance of tiny veins and capillaries.
· Maximized regeneration and hydration of the skin

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1. Alpha Lipoic Acid (ALA)
   Alpha lipoic acid, often referred to as ‘the universal antioxidant,” is a potent antioxidant and anti-inflammatory found naturally inside of the energy producing portion of the cell known as the mitochondria. Alpha lipoic acid enhances our ability to metabolize food into energy. ALA is a unique antioxidant because it is both fat and water soluble. This means it can go to all parts of the cell, including the lipid (fat) portions such as the cell plasma membrane, as well as the interior of the cell (known as the cytoplasm) where water soluble chemicals reside.
2. DMAE (dimethylaminoethanol)
   DMAE is a naturally occurring nutritional substance with powerful anti-inflammatory properties; it is found in fish including wild Alaskan salmon, anchovies and sardines. DMAE is important in the production of neurotransmitters, which are essential in the communication from one nerve to another and between nerves and muscles. Taking DMAE as a supplement will not only improve your cognitive function by improving memory and problem-solving ability, it will help increase skin firmness and muscle tone—important for anyone on a weight loss or antiaging program.
3. Glutamine
   Glutamine is the body’s most abundant amino acid. It plays an important role in keeping the muscles functioning properly and helps reduce muscle deterioration. Glutamine literally drives muscle-building nitrogen into the muscle cell where it is synthesized for growth. It is also converted into glucose when the body needs more energy. When the body is in a highly inflammatory state, it breaks down our muscle tissue to get the extra glutamine needed, resulting in muscle mass loss.
4. Carnitine
   Carnitine and its derivative, acetyl L-carnitine, are two of the most important nutrients for weight loss. Carnitine is critical for energy formation and an active metabolism. Carnitine transports the fatty acids from our blood into the cell for this energy production. Thus, for carnitine to have optimum effect, we must have adequate essential fatty acids, such as omega 3’s, present in the diet.
5. Acetyl L-carnitine
   Acetyl L-carnitine acts as an antioxidant, a natural anti-inflammatory that enhances the affects of the other antioxidant systems within the body. These anti-inflammatory properties protect the cell plasma membrane (the cell’s first line of defense) and prevent the conversion of arachidonic acid into pro-inflammatory chemicals. Although exercise will naturally increase our levels of acetyl L-carnitine, if we are obese, over thirty or have other health problems, it will not raise them to therapeutic levels, therefore supplementation is necessary.
6. Coenzyme Q – 10
   Coenzyme Q-10, also called ubiquinone, is a powerful antioxidant/anti-inflammatory with many benefits for treating and preventing obesity. It acts similarly to acetyl L-carnitine in that it assists in energy production within the mitochondria. CoQ10 enhances the metabolism, giving us greater energy and endurance, a greater ability to lose body fat, preventing the energy decline seen in aging cells. CoQ10 also maximizes the burning of foods for fuel, helping to normalize fats in our blood.
7. Conjugated Linoleic Acid (CLA)
   Conjugated linoleic acid is a fatty acid found in many of the foods we eat. At one time, beef and lamb were exceptional sources; however when their diet was changed from grass to grain, levels of CLA dramatically decreased in the meat and dairy products. CLA has powerful antioxidant/anti-inflammatory activity. It decreases body fat, especially in the area of the abdomen and helps block the absorption of fat and sugar into fat cells (adipocytes). It also helps the insulin receptors remain intact, thus increasing insulin sensitivity.
8. Chromium
   Because Chromium is an essential nutrient for normal sugar and fat metabolism, it is critical in our effort to control and reduce excess body fat. Chromium supplementation effectively lowers blood sugar and insulin levels and can also increase levels of the ‘good’ HDL cholesterol. This lowers total cholesterol and triglycerides, thus playing a key role in regulating appetite, reducing sugar cravings, and lowering body fat.
9. Gamma Linolenic Acid (GLA)
   Gamma linolenic acid is an important omega-6 essential fatty acid. The average American diet causes a deficiency of GLA because of the large amounts of trans fatty acids, sugar, red meats and dairy products. The body rapidly converts GLA into dihomo-gamma-linoleic acid, the precursor of prostaglandin E1, a powerful anti-inflammatory hormone-like compound that helps to regulate inflammation, blood pressure, and many other bodily processes.
10. Maitake Mushroom Extract
    Studies show that maitake mushroom extract enhances insulin sensitivity for controlling blood sugar levels and may serve as a safe and reliable weight loss supplement—even without additional behavior modifications, such as decreased caloric intake and increased exercise. It is established as a powerful tool in preventing a dangerous quartet of metabolic imbalances that increase our risk of cardiovascular disease and diabetes called Metabolic Syndrome. Metabolic Syndrome consists of high blood pressure, elevated levels of insulin, excess weight (especially around the abdomen), and dyslipidemialow, or low levels of HDL (good) cholesterol, high levels of LDL (bad) cholesterol, and high levels of triglycerides. Read more about Maitake Mushroom benefits.

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Here is a list of 10 Superfood groups to support a healthy weight loss and management program.

Super Food Groups
Each group is followed by a list of its primary functions in fighting weight gain, and the “STAR” and “Runners Up” foods in it.

1. Rich Cold-Water Fish: Anti-inflammatory Omega-3 Fats
   TOP CHOICE:  Wild Alaskan Salmon
   Runners up:  Sablefish, Sardines, Anchovies, Herring, North Atlantic Mackerel, Trout, Tuna
2. Favorite Fruits: Fiber, Anti-inflammatory Antioxidants, and other Phytonutrient Obesity-Fighters
   TOP CHOICES:  Apples, Grapefruit
   Runners up:  Berries, Pears, Peaches, Plums, Prunes, Cherries, Oranges
3. “Back to Mono” Fruits: Fiber, Anti-inflammatory Antioxidants, Anti-inflammatory/Anti-Adiposity Fats, and other Phytonutrient Obesity-Fighters
   TOP CHOICE:  Avocado
   Runners up:  Olives, Coconut, Acai
4. Hot Calorie Burners: Anti-inflammatory Antioxidants, Fiber, and other Phytonutrient Obesity-Fighters
   TOP CHOICE:  Chili Peppers
   Runners up:  Cayenne, chili powder
5. Nuts and Seeds: Fiber, Anti-inflammatory Fats, and other Phytonutrient Obesity-Fighters
   TOP CHOICE:  Sesame Seeds and Sesame Butter (Tahini)
   Runners up:  Flaxseed, Walnuts, Cashews, Filberts, Pumpkin seed, Hemp seed
   
6. Low-Fat Probiotic Dairy Foods: Nutriceutical Obesity-Fighters
   TOP CHOICE:  Low-Fat Yogurt
   Runners up: Low-Fat Kefir, Low-Fat Probiotic Milk
7. Beans (legume family): Fiber, Anti-inflammatory Antioxidants and other Nutriceutical Obesity-Fighters
   TOP CHOICES:  Chana Dal (AKA Bengal gram dal or chholar dal), Lentils, Chickpeas, Mung Beans, Hummus (chickpea puree)
   Runners up:  Kidney Beans, Navy Beans, Pinto Beans, Black Beans
8. Heritage Whole Grains: Fiber, Anti-inflammatory Antioxidants, and other Phytonutrient Obesity-Fighters
   TOP CHOICE:  Oats
   Runners up:  Hull-less Barley, Buckwheat
9. Spicy Sugar-Stabilizers: Anti-inflammatory Antioxidants and other Phytonutrient Obesity-Fighters
   TOP CHOICES:  Cinnamon, Turmeric
   Runners up:  Cloves, Fenugreek
10. Anti-inflammatory Vegetables: Fiber, Anti-inflammatory Antioxidants, and other Phytonutrient Obesity-Fighters
    TOP CHOICES:  Spinach, Kale, Chard, Collards, Root Vegetable Greens (Turnip, Mustard, Beet)
    Runners up:  Brussels Sprouts, Broccoli Florets, Broccoli Sprouts, Bell Peppers, Onion-Garlic (Allium) Family, Eggplant, Green or Red Cabbage (red has the higher anti-oxidant potential), Aromatic Culinary Herbs (e.g., parsley, mint, rosemary, thyme, basil, oregano), Lettuces (various types), Wheat and Barley Grasses, Blue-Green Algae and Spirulina