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Relationship Between Food Security and Receiving Carbohydrate with High Glycemic Index with Acne Infection (Case Study – Control)

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Relationship Between Food Security and Receiving Carbohydrate with High Glycemic Index with Acne Infection (Case Study – Control) Vol. 102, No. 12; December 2013 NATIONALPARK-FORSCHUNG IN DER SCHWEIZ (Switzerland Research Park Journal) Relationship between Food Security and Receiving Carbohydrate with High Glycemic Index with Acne Infection (Case Study – Control) Mohadeseh Aghasi1, Ahmadreza Dorosty Motlagh1, Mohammadreza Eshraghian2, Parvin Mansouri3 1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran (Corresponding Author) 2Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 3Dermatologist, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Abstract: Acne is one of the most prevalent chronic inflammatory skin diseases; especially in juveniles which mostly continues till adulthood. Maturity is the major factor beginning acne. Other factors inducing acne include inheritance, tension, hormonal changes, and diet. On the other hand, food insecurity is one of the factors affecting diet. Food insecurity can be defined as “the limited or unreliable provision of adequate and healthy food or limited or unreliable affordance for gaining acceptable foods from acceptable social ways”. Regarding the wide outbreak of food insecurity and acne in Iran and with respect to the existence of relationship between these two factors and the fact that no studies are done on the relationship so far, the present study is conducted to determine the relationship between food insecurity, food reception, and acne in the individuals under study. The study was done on 70 women with acne and 70 intact women between 18 and 30 years of age in case-control form. Food receptions of individuals using 147-item questionnaire showed the quasi-quantitative frequency of food. General and socio-economic specifications and food security status were examined using the USDA public questionnaires of socio-economic factors and food security status of household. Statistical analyses were done by SPSS16. Food security and carbohydrate reception with high glycemic index were significantly higher in case group compared to test group (P<0.01). Keywords: Acne, food security, carbohydrate with glycemic index, women, Iran 1-Introduction Acne is one of the most prevalent chronic inflammatory skin diseases; especially in juveniles which mostly continues till adulthood. The consequences of the disease are beyond what it 1986 seems to be on individuals’ faces and it must be given prime attention. This is because the disease can bring about adverse mental and social effects on the infected person including low confidence, isolation, depression, mental disturbances, and embarrassment (14,20). Maturity is the main factor beginning acne resulted from androgen hormone increase. It is demonstrated that androgen or manly hormone leads to both fat production increase and keratosis actinic trend acceleration (15). Other factors of acne include inheritance, tension, hormonal changes, and diet (8,11,12). Different studies conducted on diet have shown various results. In many studies, the relationship between acne and diet is evaluated. Results showed that receiving milk increases the intensity and outbreak of acne (3). Also, a positive relationship was observed between taking foods with high glycemic index and acne. Accordingly, dairies and foods with high glycemic index can affect the manifestation of acne (22). On the other hand, food insecurity is one of the effective factors regarding diet. Studies have shown that food insecure individuals have higher carbohydrate reception (2); while no studies have done on the relationship between food insecurity and acne across the world. Food insecurity can be defined as “the limited or unreliable provision of adequate and healthy food or limited or unreliable affordance for gaining acceptable foods from acceptable social ways” (21). Recent studies indicated the extensive outbreak of insecurity in Iran; namely, the outbreak of insecurity is reported as %37 in Isfahan, %44 in Shiraz, and %52 in Shahr-e-rey (22,23,27). Considering the high outbreak of food insecurity as well as acne in Iran and regarding the probability of the existence of relationship between the two and no studies in the country on the issue, the present study is conducted to determine the relationship between food insecurity, food reception, and acne in the individuals under study. 2-Materials and Methods This is a case-control study. Sample size is determined based on the presumption that if food glycemic index mean received by case (women with cane) and control (intact women) groups have at least 15-unit difference, it might be possible to reject the hypothesis on the null effect of glycemic index on acne infection at probability level of the first type error =0.05 with exponent 1- =0.8. Based on the similar studies, the amount of glycemic index SD was taken as =31 (24). The sample size is 70 women in each group including 70 women suffering from acne admitted at Imam Khomeini Hospital and 70 intact women (referring with patients to kin clinics as well as those referring for the bite, urticaria, itching of their recent days) between 18 and 30 years of age. Diagnosing acne and its intensity was done by skin specialist. Sampling was conducted based on the entrance criteria including mild or medium acne, the first reference to physician, being lady, and being between 18 and 30 years of age. The non-entrance criteria included having less than 18 and/or over 30 years of age, hormonal problems, taking any kind of medicine, and having any type of disease, and, the exit criteria included non-cooperation till the end of survey. Then, after giving explanation required and taking the conscious consent of people, design surveyor used Food quasi-quantitative Frequency Questionnaire (FFQ) for assessing food reception. The questionnaire consisted of 148 food items with a standard size of each food. The reliability and validity of the questionnaire were assessed and approved in Tehran by Ismailzadeh et al (2004). The individuals under study were asked to mention the amount of their consumption frequency of each food during the last year. Although the frequency was considered for each food, their consumption frequency was questioned based 1987 on the consumption of each material on a day, in week and/or month. Then, the values mentioned for each food was turned into gram using domestic scales guidance. Determining and classifying carbohydrates with high glycemic index (GI>70) were done using data related to Iranian foods glycemic index (33). Food security in women under study was assessed using the questionnaire of the household socio-economic status and food security of the US Department of Agriculture (USDA). The questionnaire assessed the household food security status during the last 12 months via holding interviews with women. The questionnaire was assessed in USDA and approved for epidemiological studies. The validity of the questionnaire was examined and measured in another study on Shiraz households (Ramesh et al, 2008). Scoring the 18- estatement questionnaire using Bickel et al method is as follow: responses “most of the time correct”, “sometimes correct” in questions 1 to 3 and 11 to 13, “almost every month”, and “some months” in questions 5, 10, and 16, and “yes” in questions 4 and 6 to 9, 14, 15, 17, and 18 are scored 1 and responses “is not correct”, “does not know or avoids”, “only once or twice a month”, and “no” are scored 0. And, final score is calculated based on the number of positive responses (Bickel et al, 2000). Data was analyzed using SPSS and Nutritionist3 (software designed in a study on glucose and lipid in Tehran). 3-Results Table 1: Absolute and relative frequencies of qualitative variables in case and test groups Test Case Indices P-value No. (%) No. (%) 0/003 39 )55/7( 21 )30/0( Food secure Food security 31 )45/7( 49 )70/0( Food insecure status 0/003 23 )32/9( 38 )54/3(Diploma and associate Education 32 )45/7( 28 )40/0( BS 15 )21/4( 4 )5/7( MS and above 36 )51/4( 53)75/7(Poor (weak) and Economic <0/01 medium status 34 )48/6( 17 )24/3( Good (rich) 34 )48/6( 19 )27/1( Household <0/01 36 )51/4( 51 )72/9( <3 people dimension 1988 Table 2: Mean and standard deviation in food groups (case and test) P-value Test Case Quantitative variables SD± Mean SD± Mean < 0.001 94.83 ± 87.18 304.75 ± 221.35 Dairy < 0.001 15.52 ± 31.20 48.45 ±58.89 Yellow vegetable < 0.001 258.08 ± 74.68 166.06 ± 72.83 Other vegetables < 0.001 125.69 ± 47.16 54.71 ± 42.43 Grains 0.01 12.47 ± 9.59 21.27 ± 19.08 Potato 0.01 514.99 ± 364.57 305.43 ± 381.23 Whole grains < 0.001 446.56 ± 270.63 651 ± 313.13 Refined grains 198.41 ± 253.61 429.02 ±328.393Food with high glycemic < 0.0001 index ( 70) 542.14 ± 387.04 255.50 ± 339.44Food with high glycemic < 0.0001 index ( ) 4-Discussion The present study indicates that there is a statistically significant relationship between acne and food insecurity in women (Table 1). Food insecurity was significantly higher in women with acne compared to women in control group (P=0.003). Based on the studies done, this study is conducted for the first time in Iran. Other studies done on the whole individuals of the society (including individuals with acne and without acne) showed that food insecurity percentage were reported as %30.5 in Yazd, %36.6 Isfahan, %50.5 Shahr-e Ray, and %36.3 Asadabad, Tabriz (12-15). The outbreak gained in the present study is higher and indicates higher food insecurity outbreak in women with acne. Ground reasons like low economic status and its consequent food insecurity lead the individuals to the reduction of costs for buying food, food reception, and change in the type of food consumed.
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