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Adjusted OR for family history, level of education, frequencies of milk and ice
cream consumption.
** Significant difference, p <0.01.
Table 7 Comparison of milk and dairy products, chocolate and nuts intake frequencies between cases and controls
Milk and dairy products Frequencies Cases(n=44) Controls(n =44) p value Odds Ratio (OR) 95% Confidence
Interval
n (%) n (%)
Milk Once a week 38** (86.4) 27 (61.4) 0.008 3.988 (1.391 - 11.434)
0 - <Once a week 6 (13.6) 17 (38.6)
Yoghurt Once a week 10 (22.7) 8 (18.2) 0.597 1.324 (0.467 3.749)
0 - <Once a week 34 (77.3) 36 (81.8)
Cheese Once a week 10 (22.7) 4 (9.1) 0.080 2.941 (0.846 10.229)
0 - <Once a week 34 (77.3) 40 (90.9)
Ice cream Once a week 25** (56.8) 10 (22.7) 0.001 4.474 (1.777 11.266)
0 - <Once a week 19 (43.2) 34 (77.3)
Chocolate Once a week 9 (20.5) 6 (13.6) 0.395 1.629 (0.526 5.044)
0 - <Once a week 35 (79.5) 38 (86.4)
Nuts Once a week 9 (20.5) 5 (11.4) 0.244 2.066 (0.613 6.558)
0- <Once a week 35 (79.5) 39 (88.6)
** Significant difference using Chi-Square test, p<0.01.
Ismail et al. BMC Dermatology 2012, 12:13 Page 6 of 8
http://www.biomedcentral.com/1471-5945/12/13
not the cause and effect of diet on acne vulgaris. The se-
verity of acne vulgaris condition should also be taken
into account through acne lesion counts on patients in
order to relate specific types of food and the frequency
of their consumption. Furthermore, a retrospective food
frequency questionnaire would be the most appropriate
tool to determine the association between dietary intake
such as dairy products and acne development. Repeated
3 day food records would have been a better method to
calculate glycemic load and determine its association
with acne. However, a 3 day food record was used in this
study to measure the glycemic load due to the limited
study duration. Additionally, this study did not measure
the amount of consumed dairy protein, which may be
the most important determinant for the acne-promoting
effects of milk. Other confounding factors such as stress,
inadequate sleep, smoking, alcohol consumption and fa-
cial hygiene care should also been taken into account in
future studies. Despite these limitations, the findings
from our study have provided further support to the
existing evidence for the role of diet in acne vulgaris
occurrence.
Conclusions
In conclusion, dietary factors particularly high glycemic
load diets as well as higher frequency of milk and ice
cream intake were positively associated with acne vulgaris
development. Findings from this study further support the
hypothesis that dietary factors play a fundamental role in
acne vulgaris occurrences. Randomized clinical trials are
needed to confirm the role of food items such as peanuts,
chocolate and dietary fat in acne occurrence.
Competing interest
The authors declare that they have no competing interests.
Authors contributions
NHI managed the literature searches, data collection and statistical analysis,
and wrote the first draft of the manuscript. ZAM designed the study,
developed the protocol, undertook the data interpretation and improved the
manuscript. NZA was involved in assessing acne severity, development and
improvement of the protocol, and improvement of the manuscript. All
authors contributed to and have approved the final manuscript.
Acknowledgements
We are grateful to all the participants involved in this study. We would also
like to thank the staff members of Department of Dermatology, Hospital
Kuala Lumpur and others for facilitating the study.
Author details
1
Dietetic Program, School of Healthcare Sciences, Faculty of Health Sciences,
Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala
Lumpur, Malaysia.
2
Department of Dermatology, Hospital Kuala Lumpur,
50300 Kuala Lumpur, Malaysia.
Received: 30 January 2012 Accepted: 9 August 2012
Published: 16 August 2012
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doi:10.1186/1471-5945-12-13
Cite this article as: Ismail et al.: High glycemic load diet, milk and ice
cream consumption are related to acne vulgaris in Malaysian young
adults: a case control study. BMC Dermatology 2012 12:13.
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