【注】本文翻译自麦考拉医生的文章，英文部分为原文。欢迎指出错误和不当之处，谢谢。

原文链接：Foods to Avoid If You Have Acne 翻译：小甲鱼

By Dr. Mercola

Nearly 85 percent of people have acne at some point in their lives, making acne the most common skin disorder in the US.1 While acne typically begins during puberty, it's not restricted to adolescents and may impact any age group – even into your 50s and beyond.

在美国，几乎85%的人在一生中的某个时刻都会长痘，这使得长痘变成了最常见的皮肤疾病。痘痘经常萌发自青春期，然而它并不局限于青少年也有可能会影响到其他年龄段的人们——甚至会在你50多岁或者更老的时候。

While not physically dangerous, acne can take a considerable psychological toll. Some sufferers become so self-conscious and embarrassed that their professional and personal lives suffer, leading to increasing feelings of alienation, depression, and social withdrawal.

尽管它不会导致身体上的危害，却会给患者带来极大的心理影响。有些患者会变得非常自我和尴尬，这导致他们的工作和个人生活受到影响，甚至产生疏离感，抑郁和远离社会的情绪。

Many mistakenly believe acne is mostly an aesthetic problem, but it is actually a sign of deeper imbalance in your system, often in your gut. Most physicians miss this connection entirely, instead prescribing acne drugs and other topical treatments.

很多人错误的认为痘痘仅仅是美观的问题，但是它实际上是你的身体系统的深层次的失调标志，通常是你的肠道。大多数医生彻底忽略了这之间的联系，只是开痤疮药物和其他的一些局部治疗。

Americans spend more than $2.2 billion every year on acne treatments, including prescription and over-the-counter products,2 but many will turn out to be useless if you ignore the foundational cause of most acne – improper diet.

美国人每年在痤疮治疗上的花费超过22亿美元，包括处方和非处方产品，但是大多数被证明是无用的，因为你忽略了导致痤疮的根本原因——不恰当的饮食。

Desperate to Clear Your Skin? Stop Eating Gluten and Grains

想清理干净你的皮肤吗？那就停止食用含有麸质蛋白和谷物的食品

Full-blown celiac disease, which is an extreme form of gluten sensitivity causing both the adaptive and innate immune system to attack your small intestine, affects an estimated 1.8 percent of people in Western cultures. But non-celiacgluten sensitivity may actually affect as many as 30 to 40 percent of the population, and according to Dr. Alessio Fasano at Massachusetts General Hospital, virtually all of us are affected to some degree.3

乳糜泻——一种极端形式的对麸质蛋白过敏导致的小肠不适应以及先天免疫系统对小肠的攻击，影响着大约1.8%的西方人。但是，实际上，对麸质蛋白过敏没有达到乳糜泻程度的人也占到了总人口的30%到40%，据马萨诸塞州综合医院医生阿莱西奥法萨诺说，实际上我们所有人在一定程度上都会对麸质蛋白过敏。

This is because we all create a substance called zonulin in the intestine in response to gluten. Glutinous proteins, found in wheat, barley, and rye, known as prolamines can make your gut more permeable, which allows partially digested proteins to get into your bloodstream that would otherwise have been excluded, any of which can sensitize your immune system and promote inflammation, which can contribute to worsening acne.

这是因为我们的肠道里面产生了一种叫做连蛋白的物质来应对麸质蛋白。这些麸质蛋白主要存在于小麦，大麦和黑麦中，其中的醇溶蛋白会导致我们的肠道高渗透性，这会允许那些本来不包含在内的被部分消化了的蛋白质进入我们的血液，这其中任何成分都会使我们的免疫系统更加敏感并且会促发炎症，这会使痘痘更加严重。

Once gluten sensitizes your gut, it then becomes more permeable and all manner of gut bacterial components and previously excluded dietary proteins—including casein and other dairy proteins—have direct access to your bloodstream, thereby further challenging your immune system.

一旦麸质蛋白使你的肠道更敏感了，你的肠道就会具有更高的渗透性从而肠道里的各种细菌成分和先前提到的不包含在麸质蛋白里的膳食蛋白质（包括酪蛋白和其它膳食蛋白质）都会直接进入你的血液，从而给你的免疫系统带来更大的挑战。

If you have acne, you should try eliminating gluten and other lectin-containing foods, although I actually recommend that everyone following my beginner nutrition plan eliminate all gluten from their diets.

如果你有痤疮，你应该尝试没有麸质蛋白和外源凝集素的食物，尽管事实上我建议所有遵循我“初学者营养计划”的人都把麸质蛋白从他们的膳食中去掉。

Among the most important to avoid are those grains that contain the sticky, hard to digest prolamine proteins, such as wheat, barley, rye, and yes, even oats, rice, and corn. However, I don't recommend you stop there…

在众多食物中最重要的是要去避免那些包含粘性的难以消化的醇溶蛋白质的谷物，比如小麦，大麦，黑麦以及，是的，甚至包括燕麦，大米和玉米。然而，我不建议你仅仅只是做到这一步而已。

Avoid All Grains (and Sugar) If You Have Acne

如果你有痤疮，请避开所有谷物和糖

While glutinous grains should certainly be eliminated if you struggle with acne, I recommend you avoid all manner of refined carbohydrates as well. Acne is much less of a problem in non-Westernized societies, where refined carbohydrates and sugar are consumed in much lower amounts.4 Diets high in sugar and refined carbohydrates are one of the primary causes of acne.

如果你在抗争痤疮的话，含有麸质蛋白的谷物当然是要避开的，但其实我也建议你避开所有形式的精制碳水化合物。痤疮的问题在非西方社会很少，那里精制碳水化合物和糖消耗的非常少。高糖高精制碳水化合物的饮食是痤疮的主要原因之一。

When you eat grain carbohydrates and sugar/fructose, it causes a surge of insulin and insulin-like growth factor called IGF-1 in your body. This can lead to an excess of male hormones, like testosterone, which cause your pores to secrete sebum, a greasy substance that attracts acne-promoting bacteria. Additionally, IGF-1 causes skin cells known as keratinocytes to multiply, a process that is also associated with acne.

当你吃下谷物中的碳水化合物和糖或果糖后，这回导致你身体里的胰岛素和胰岛素样生长因子（简称IGF-1）激增。这会导致雄性激素过量，比如睾丸激素，它会导致你的毛孔分泌皮脂——一种油腻的物质，会吸引促进痤疮生长的细菌。此外，胰岛素样生长因子会导致你的角质细胞大量增值，这也是一个与痤疮生长有关的过程。

Additionally, these very same foods -- refined carbs, such as fructose, sugar, and grains -- will also increase inflammation in your body, which may trigger acne, and at the same time they will also wreak havoc on the makeup of your intestinal bacteria, as mentioned above.

另外，这些非常相像的食物（精制碳水化合物食品，比如果糖，食糖和谷物）也会在你的身体里引发炎症，这也可能会导致痤疮，与此同时，如上所述，它们也会破坏我们肠道细菌的构成。

In fact, in 2007 a study published in the American Journal of Clinical Nutrition found that young men (ages 15 to 25) with acne problems who were placed on low-glycemic diets for 12 weeks showed significant improvements in acne and insulin sensitivity.5 Research published last year also found that a high-glycemic diet and frequent dairy consumption are linked to acne.6

事实上，在2007年，一项研究发表在了美国临床营养学杂志上，这项研究表明有痤疮问题的15到25岁的年轻人在低糖饮食12周后在痤疮和胰岛素敏感度方面有显著改善。去年公布的一项研究也表明高糖饮食和频繁的乳制品消费也与痤疮有关系。

Indulge in Vegetables, Limit Processed Foods to Control Acne Flare-Ups

钟情于蔬菜，限制食用加工食品可以控制痤疮的发作

Any meal or snack high in refined carbohydrates (i.e. grains and sugars) will generate a rapid rise in blood glucose. To adjust for this rapid rise, your pancreas secretes the hormone insulin into your bloodstream.

只要你的正餐或是点心里的精制碳水化合物（比如谷物类和糖类）含量很高就会导致你的血糖水平快速上升。为了适应血糖水平的快速上升，你的胰腺就会分泌胰岛素进入你的血液。

High blood sugar levels cause repeated surges in insulin and this causes your cells to become "insulin-resistant," which leads to the production of even higher levels of insulin, and, eventually insulin resistance, another key factor linked to acne. Prolonged excessive insulin secretion can also eventually burn out your pancreatic beta cells which produce it, leading to "double diabetes," a mixture of type 2 and type 1.

高血糖水平会引起胰岛素的重复波动，而且这会导致你的细胞变得“胰岛素抵抗”，这又导致了更高水平的胰岛素的产生，最终胰岛素抵抗成为了导致痤疮的另一个关键因素。长时间的胰岛素分泌过量最终会把你的分泌胰岛素的胰腺贝塔细胞消耗殆尽，同时会导致“双重糖尿病”——即1型糖尿病和2型糖尿病。

This is why, if you struggle with acne, you want to avoid all foods that contribute to insulin resistance (namely sugar and grains), not just the gluten-containing grains. The best way to know if you are insulin/leptin resistant is to measure your fasting insulin level. If it is below 3, you are not likely resistant.

这就是为什么如果你在和痤疮抗争的话，你需要避开所有那些会导致胰岛素抵抗的食物（主要是糖类和谷物类），不仅仅是含有麸质蛋白的谷物。最好的办法来判断你是否有胰岛素（或廋素）抵抗就是去测量你的空腹胰岛素水平。如果它小于3，你就不可能有胰岛素（或廋素）抵抗。

However, if you are overweight, have high blood pressure, diabetes, cancer, or abnormal cholesterol levels, it is likely that you have some element of insulin/leptin resistance and you would likely benefit from restricting your intake of sugars and grains until the conditions resolve.

然而，如果你超重，有高血压，糖尿病，癌症，或是不正常的胆固醇水平，这很有可能是你有胰岛素（或廋素）抵抗的元素，并且你很有可能从限制糖类和谷物类食品摄入中受益，直到问题解决。

You'll be happy to know that simply eliminating grains, sugars (particularly fructose), cereals, potatoes, corn, rice, pasta, processed foods, etc., radically improves acne for most people. Fruit contains a fair amount of fructose, so it should be consumed in limited quantities if you are predisposed to acne. Or, at least focus on the low-sugar, high-nutrient-dense fruits like berries.

你会很高兴的知道简单的排除掉谷物，糖类（特别是果糖），谷物类植物，土豆，玉米，大米，面食，加工食品等等，大多数人可以彻底的改善痤疮。水果里面含有大量的果糖，所以如果你经常长痤疮的话，应该有限制地食用它们。或者，至少专注于低糖高营养密度的水果上，比如浆果类。

And fruit juices should be strictly avoided since the sugar is very concentrated in them, without the buffering effect of fiber, pectin, and other food cofactors present in whole, raw, organic fruit. Fresh vegetable juices are great, though, especially green juices, as are most vegetables, which are slow to break down into simple sugars, with minimal insulin impact.

果汁一定要很严格的避开，因为糖份都集中在里面，没有了纤维素的缓冲作用，没有了果胶酶，也没有了其它食物的辅酶因子——它存在于完整的，原味的，有机水果里面。新鲜的蔬菜汁就很好，特别是绿色蔬菜汁，正是因为大多数蔬菜分解为单糖的速度很慢，所以对胰岛素的影响非常小。

Why Optimizing Your Gut Health May Help with Acne

为什么尽可能的使你的肠道健康可能有助于你的痤疮问题

When you clean up your diet as described above, your gut health will naturally improve. You can further support it by consuming fermented foods regularly, to encourage the growth of beneficial microorganisms, which will benefit your skin health in multiple ways.

当你像如上所诉那样清理你的饮食后，你的肠道健康会自然而然的有所改善。你还可以经常地食用发酵食品来进一步的支持你的肠道健康，发酵食品可以促进肠道益生菌的生长，这会多方面的有益于你的皮肤健康。

For starters, signals from your gut microorganisms are sent throughout your body and interact with organisms in your skin and gut mucosa. Researchers are looking into how these interactions can help with skin conditions like dryness, improve collagen, or stabilize the microflora on your skin to help with irritations. As noted by researchers in Gut Pathogens:7

由于来源于你的肠道微生物的发令员或者说是信号可以通过你的身体与你皮肤里和肠道黏膜里的有机物相互作用。研究人员正在研究这些相互作用是如何有助于皮肤条件的，比如干燥，提高胶原蛋白，或是稳定你皮肤上的微生物群来有助于你的情绪。正如研究人员在《肠道病原菌》中记录的：

"The lines of communication, as mediated by gut microbes, may be direct and indirect -- ultimately influencing the degree of acne by a systemic effect on inflammation, oxidative stress, glycemic control, tissue lipid levels, pathogenic bacteria, as well as levels of neuropeptides and mood-regulating neurotransmitters. …there appears to be more than enough supportive evidence to suggest that gut microbes, and the integrity of the gastrointestinal tract itself, are contributing factors in the acne process."

“由肠道微生物介导通信的方式可能是直接的也可能是间接的，最终都会通过某些方面的全身效应来影响痤疮的程度，比如炎症，氧化应激，血糖控制，组织脂质水平，致病细菌，或是神经肽类和情绪调控的神经递质水平。......有太多的支持这方面的证据都表明肠道微生物，以及胃肠道本身的完整性，都为痤疮生长的过程做出了贡献。”

Another interesting connection is via your emotional health, as stress may, too, cause acne via your gut-brain connection. Research by dermatologists John Stokes and Donald Pillsbury conducted more than 70 years posited that your emotions could alter the microflora in your intestines, which could therefore contribute to systemic inflammation that could exacerbate acne and other skin conditions. In 2021, researchers validated this connection, noting:8

另外一种有趣的联系是通过情绪健康，比如像压力可能也会导致痤疮通过肠与脑之间的某种联系。一份由皮肤病学家约翰·斯托克斯和唐纳德·皮尔斯伯里进行的超过了70年的研究假设我们的情绪可以改变肠道微生物群，因此它也可以有助于全身炎症的改善，而炎症正是加重痤疮和其它皮肤疾病的罪魁祸首。在2021年，研究人员证实了这一点，并指出：

"Experimental studies show that psychological stress stagnates normal small intestinal transit time, encourages overgrowth of bacteria, and compromises the intestinal barrier. SIBO [small intestinal bacterial over growth] is strongly associated with depression and anxiety, while eradication of SIBO improves emotional symptoms. Although the frequency of SIBO in acne vulgaris has not yet been investigated, a recent report indicates that SIBO is 10 times more prevalent in those with acne rosacea vs. healthy controls. Correction of SIBO leads to marked clinical improvement in patients with rosacea."

“实验研究表明心理压力会使得正常小肠转运时间停滞，并促进细菌的过度繁殖从而损害肠道屏障。SIBO（小肠细菌的过度繁殖）与抑郁和焦虑紧密相关，而SIBO的根除可以改善情绪的症状。虽然SIBO在普通痤疮患者中出现的频率还未得到调查，但是，最近的一份报告表明在红斑痤疮患者中出现SIBO是健康对照组的十倍。SIBO的纠正给红斑痤疮患者带来了显著的临床改善。”

Controlling Acne Takes a Whole-Body Approach

控制痤疮要采取一种全身的方法

Your skin is your body's largest organ, and an organ of elimination (e.g. sweating), which is why problems on its surface are often a sign of underlying issues. Your complexion is a reflection of your overall health, which is why topical (or worse, systemic) acne drugs will not heal the problem (and may result in serious side effects). Treating acne takes a whole-body approach that will nourish and heal your skin from the inside out, so don't forget to incorporate these essential factors into your acne-busting plan:

你的皮肤是你身体里的最大的器官，是一种排出物质的器官（比如出汗），这就是为什么皮肤表面的问题经常是更深层次问题的标志。你的肤色是你的整体健康的反应，这就是为什么局部的（或更糟糕，全身的）痤疮药物不能解决问题的原因（并且可能会导致严重的副作用）。对待痤疮要采取一种全身的方法，这会由内到外的滋养和治愈你的皮肤问题，所以不要忘记去落实这些关键因素在你的破坏痤疮的计划里面：