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. 2022 Mar 29;7:95–112. doi: 10.1016/j.jdin.2022.02.012

Table I.

Observational studies on the effect of glycemic index/load on acne

Source; country Study design; no. of participants Participant characteristics Measures Outcome summary Strengths Limitations Quality of evidence
Bett et al,20 1967; United Kingdom Case-control study; 16 patients with acne, 29 controls 15-27 y olds recruited from 2 clinics. Age/sex-matched controls recruited from a clinic and a factory/office. Questionnaire on daily sugar intake.
Physician-diagnosed acne.
No significant difference in daily sugar intake between patients with acne and controls. Well-defined case selection. Appropriate control selection. Low sample size. Potential bias in exposure classification 5
Kaymak et al,19 2007; Turkey Case-control study; 49 patients with acne, 42 controls 19-34 y olds recruited from outpatient clinics. Questionnaire on the frequency of food consumption and dietary intake. Dermatologist-assessed acne severity. No significant difference in GI between patients with acne and controls. No significant difference in glycemic load between patients with acne and controls. Well-defined case selection. Appropriate control selection. Low sample size. Potential bias in exposure classification 7
Koku Aksu et al,21 2011; Turkey Cross-sectional study; 2230 13-18-y-old adolescents from multiple schools. Questionnaire on dietary intake and personal history of acne. Dermatologist-evaluated acne severity (Pillsbury diagnostic criteria). Frequent sugar intake (aOR, 1.3 [1.06-1.82]) and frequent sweet consumption (aOR 1.2 [1.16-1.43]) associated with acne. Appropriate sample size. Unbiased exposure classification. Potential biases in outcome classification 7
Burris et al,22 2017; New York City Cross-sectional study; 64 18-40 y olds with moderate/severe and no acne recruited by advertising. Dietician-instructed 5-d food and beverage record. Dermatologist-evaluated acne severity. Bloodwork at study conclusion. Moderate/severe acne group had a higher glucose load than participants without acne (137 ± 41 vs 117 ± 41, respectively; P < .001). No association between GI and acne. Well-defined outcome classification. Unbiased exposure classification. Low sample size. Potential bias in recruitment. 7
Huang et al,23 2019; China Cross-sectional study; 8197 18-19-y-old students from 353 cities. Questionnaire on dietary intake. Dermatologist-assessed acne history and severity (Pillsbury diagnostic criteria). Soft drink sugar intake ≥100 g/d significantly associated with moderate-to-severe acne (aOR 3.12 [1.80-5.41]). Appropriate sample size. Well-defined case selection. Potential bias in exposure classification. 7

aOR, Adjusted odds ratio; GI, glycemic index.