Below are answers to questions we’re frequently asked.
Are you dermatologists? What makes you experts?
We are not dermatologists. But we would like to think of ourselves as experts in getting rid of our acne for good, through diet, because that’s what we did. 🙂 And thousands of people on YouTube and social media have told us they got rid of their acne following the same diet we teach. In addition, we put on a pilot study, supervised by Steve Lawenda MD of Kaiser Permanente, of 130 individuals with moderate to severe acne. Most participants were able to stop their acne with the diet. We document and show examples in our book.
What is the biggest benefit of the diet?
Without a doubt, the most important benefit we’ve experienced is taking control of our lives. If you have bad acne, then you know it can make you feel like you want to become a hermit. The Clear Skin Diet can give you your life back. Clearing your skin puts you back in control of the person you want to be.
Do you have to eat this way the rest of your life in order to keep your acne away?
It’s an individual issue. Once you clear your acne using the diet, you can add back foods you like one at a time if you wish, to see whether you get a breakout. We detail how to do this in the book. The bottom line: some people add back foods and immediately break out. Others can add back nuts, oils, other foods – and have no breakouts whatsoever. Everyone is going to be a little different. Use the diet to clear your acne, and then you can experiment, if you wish, to see what specific foods may be your triggers, or whether you can safely add some foods back.
I prefer to eat gluten free. Is that possible with this program?
Yes. Virtually all the recipes in our book can be made gluten free. We provide gluten free options.
Is there research that shows eating a diet this low in fat is safe?
We discuss this in a lot of detail in our book, but the healthiest, longest-lived cultures in the world (where there is no acne, by the way) eat this way. Our diet is similar to the way people eat in certain “Blue Zones” where people live longer – and are healthier all their lives than people eating any other way. The Okinawans, whose diet was studied extensively in the 1940s and 50s, consumed around 6 percent of calories from fat. (This is lower than our diet.) The Okinawan population has more centenarians (people over age 100) than any other culture in the world – and these centenarians don’t require wheelchairs or assisted living. Most live independently all their lives.
There are many examples of populations eating plant-centered diets with the amount of fat we recommend – or less – and these peoples are among the healthiest and most active until very old age, in addition to avoiding acne. Not just the Okinawans, but the Tarahumara Indians of northern Mexico, who eat around 10 percent of calories from fat, and run every day into their 80s and 90s, and regularly live past age 100. It includes the diets shown in published studies to be successful at reversing heart disease (Ornish, Esselstyn, McDougall, Pritikin), the diet consumed by elite Kenyan runners (who have won a lot of Gold medals), diets shown in medical literature to reverse diabetes (Barnard), reverse prostate cancer (Ornish), the diet of the Vilcamba in the Andes of Ecuador, who enjoy long lifespans, agility in old age and are mentally sound throughout their lives. There are more examples – please see our book.
But don’t we need more “good” fats? Do I need an Omega 3 supplement, like DHA or EPA?
No. The amount of fat in the Clear Skin Diet is plenty. It’s important to understand that vegans actually have more omega-3 fats in their blood, compared to people who eat fish, meat and a lot more fat. This is because when your intake of healthy fats like DHA and EPA are either low or nonexistent, your body can easily up-regulate its ability to synthesize more of these on its own. Here is a recent study which underscores this point:
Women on Vegan Diets Have More Long-Chain Omega-3s, Compared with Fish-Eaters
Women following vegan diets have significantly more omega-3 “good fats” in their blood, compared with fish-eaters, meat-eaters, and ovo-lacto vegetarians, according to a new report from the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Levels in vegan men were not quite as high as in vegan women. Despite zero intake of long-chain omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and substantially lower intake of their plant-derived precursor alpha-linolenic acid (ALA), vegan participants converted robust amounts of shorter-chain fatty acids into these long-chain fatty acids. The study included 14,422 men and women aged 39 to 78.
Welch AA, Shakya-Shrestha S, Lentjes MAH, Wareham NJ, Khaw KT. Dietary intake and status of n-3 polyunsaturated fatty acids in a population of fish-eating and non-fish-eating meat-eaters, vegetarians, and vegans and the precursor-product ratio of a-linolenic acid to long-chain n-3 polyunsaturated fatty acids: results from the EPIC-Norfolk cohort. Am J Clin Nutr. 2010;92:1040-1051. LINK TO STUDY
What this study clearly shows is that as the amount of DHA in one’s diet goes down (from fish eater > meat eater > vegetarian > vegan) the amount of DHA in one’s body does not change because your conversion rate increases – your body converts ALA into more omega-3. In fact, this study showed that the conversion rate for vegans was 200% greater than of that of a fish-eater. So the conversion is up-regulated in a your body to maintain the needed levels of fat when the supply is low.
This study also goes hand-in-hand with another recent study showing there was no evidence of harm in vegetarians and vegans from lower DHA intakes:
“There is no evidence of adverse effects on health or cognitive function with lower DHA intake in vegetarians. In the absence of convincing evidence for the deleterious effects resulting from the lack of DHA from the diet of vegetarians, it must be concluded that needs for omega-3 fatty acids can be met by dietary ALA.” LINK TO STUDY
What about fat soluble vitamins? I’ve heard that they can only be absorbed with an adequate amount of fat in the diet, like adding nuts or fats when you eat a salad, so you absorb enough vitamins and minerals.
Good news – there’s no need to be concerned about absorption of vitamins or minerals relating to how much fat you’re consuming. The studies you’re referring to were marketing research funded by the salad dressing, avocado and nut industries – called “commercial science” – to try to market their products. One way to sell oily salad dressings is to design research showing that people eating a raw salad with oil absorb more nutrients than someone eating the same salad without oil on it.
The Procter & Gamble company (Kraft salad dressings), the California Walnut Commission, and the Hass Avocado Board are the companies that came up with and paid for these studies. After all, they are looking for any claims they can make to try to increase sales and profits. These companies have been successful at pushing this non-issue in order to sell more of their products. Even some vegan outlets have grabbed onto this marketing nonsense.
If the salad dressing industry were going to design a fair study, they would have not just the two groups that ate salads, one with oil and one without – but a third group, that represents the kind of healthy eating we see in the whole food plant-based world, which is simply eating more fruits and veggies. What they would no doubt find, is the group eating the most healthy diet, with lots of plant-foods, has absorbed far more vitamins and minerals than other groups eating a much less healthy diet but adding some fat to their salad. Remember that these commercial studies were done on very unhealthy people eating the Standard American Diet, not on people eating a healthy diet.
While it’s true that if two people eat salads, the one who has added oil or nuts will absorb more of certain nutrients – it doesn’t mean that the person who didn’t use oil or nuts is somehow “deficient.” Moreover, there is zero evidence that people getting more of certain nutrients by using salad dressing or nuts is in any way healthier than anyone else, or more protected from disease, or will live longer. In fact, there is little to no evidence to back up the “more is better” notion which the food and supplement marketing world live by.
Last we checked, no one is being rushed to the ER or dying in the hospital due to “macronutrient deficiency,” much less people eating a very healthy plant-based diet. This might in part be because when you cook vegetables, you also absorb many more nutrients. So adding fat to absorb nutrients, or eating some cooked food – you’ll get all the nutrients you need and more on a plant-based diet. No need to fall for the scaremongering that you need “more and more” nutrients to be healthy.
When you look at nutrient intake of the Okinawans back in the 1930s, 1940s, and 1950s before they got Westernized, they were eating around 6% calories from fat. Now some people who promote salad dressing, avocado and nut industry-funded research might say, “These people must have been deficient! They were not absorbing as much nutrients they would if they had been adding nuts or oil to their salads!”
And yet those Okinawans who have eaten that way are now the longest lived population with more people over age 100 than anywhere in the world. They mostly ate cooked sweet potatoes, and got everything they needed nutritionally. Were the Okinawans “deficient” by some definition? If they were, it hasn’t stopped them from living longer than anyone else on the planet. The same hold true for the Taramhumara and Pima Indians in the Sierra Madre mountains of Mexico and for the original Hawaiians – they all ate less than 10% of calories from fat, and they were all known for their health and longevity. These are facts published in mainstream medical journals. The other thing to remember is that when medical experts re-create these diets and put people on them today (such as the McDougall, Esselstyn and Pritikin diets), those people experience dramatic improvements in their health, very quickly – and acne (if a person has it) begins to fade as well.
Someone said your diet didn’t work for them. Does it work or not?
When we started our pilot study, one participant told us she had already tried our diet and it hadn’t helped her acne. When we asked more about what she ate, she admitted she had actually been following the diet “maybe 80 or 90 percent.” She was still eating oil and high fat foods every week or two. When she did follow the guidelines fully, her acne receded. When people have told us it didn’t work, we always ask questions, and it usually turns out they weren’t actually following our guidelines, even though they may have thought they were. That’s a big reason we wrote this book.
Some people in our pilot study had their acne disappear very quickly – within a couple of weeks. Other people, meanwhile, did not see much improvement at first. Some were discouraged seeing how fast others were getting results and figured the diet might not work for them. But when they kept with it – as well as our skin care and other recommendations – almost all of them found their acne disappearing by the third or fourth month. We have so many posts on our Acne Intervention Study Group of people saying, “Keep with it! My skin finally started clearing three and a half months of doing this diet and I am thrilled!”
Remember that dermatologists advise patients that Accutane can take four months or more before it begins to work. The same can be true for using the anti-inflammatory Clear Skin Diet. You may be a tougher case, and your body is just going to take longer – but it can get there if you really stick with it.
In case the diet didn’t work for you, we include detailed instructions in our book for an Elimination Diet, which is a simple, temporary diet you follow to resolve your acne, eating from an extremely limited group of foods, prepared in a certain way. Once your breakouts stop, you begin to add back foods one at a time, to find which exact foods are causing your breakouts. Some people have unusual trigger foods, and this approach has helped a number of them with stubborn acne who didn’t initially get results. Using the Elimination Diet they were able to discover what foods they personally needed to avoid so they could also become and remain acne-free. Everyone can be a little different – see book for more detail.
Do you take any supplements or protein powders?
No. We only take Vitamin B12 because we have been vegan all our lives. Actually, B12 causes breakouts in a small percentage of people, and we cover this in our book, in case it happens to you, and we discuss the whole question of supplements. We may have a protein shake once in a while, but only because we like the taste and enjoy it, and not because we have any deficiencies or feel some need for it.