Mediterranean Diet Linked to Lower Odds of Adult Acne in New Study

Greater adherence to a Mediterranean-style diet was associated with significantly lower odds of adult acne, particularly among women, according to a cross-sectional study of more than 228,000 UK Biobank participants published online September 24, 2026, in the Journal of the European Academy of Dermatology and Venereology.¹

In adjusted analyses, each 1-point increase in the alternate Mediterranean diet (aMED) score was associated with 7% lower odds of current acne (adjusted odds ratio [aOR], 0.93; 95% CI, 0.87-0.99; P = .021). The association was stronger among women (aOR, 0.90; 95% CI, 0.83-0.97; P = .007), while higher adherence to low-carbohydrate dietary patterns was associated with increased odds of acne among men.¹

The findings suggest that overall dietary quality may play a role in adult acne, although investigators emphasized that the associations were modest and the observational design does not establish causality.

Researchers led by Bochen Li, of the Department of Nutritional Sciences at King's College London, analyzed data from UK Biobank participants recruited between 2006 and 2010 to examine associations between dietary patterns, specific food groups, and adult acne, including potential differences by sex.¹

The analysis included 228 757 participants aged 37 to 73 years at recruitment, of whom 1603 (0.7%) were classified as having current acne and 223,048 had no recorded acne diagnosis. A broader group of 5709 participants (2.5%) had a recorded history of acne. Current acne was defined as a first-recorded diagnosis within 10 years before baseline, based on self-reported information and linked healthcare records using ICD-10 code L70.

Participants with current acne were younger than those without acne (mean age, 50.2 vs 56.6 years), and women accounted for 71.2% of the current acne group compared with 54.3% of those without acne. Most acne diagnoses were identified through primary care records.¹

Dietary intake was assessed using food frequency questionnaires and repeated 24-hour dietary recalls. Investigators examined multiple dietary quality indices, including Mediterranean-style, low-carbohydrate, plant-based, and Dietary Approaches to Stop Hypertension (DASH) patterns.

Multivariable logistic regression models adjusted for age, sex, ethnicity, socioeconomic status, physical activity, smoking, alcohol consumption, sleep disturbances, supplement use, and body mass index (BMI).

Mediterranean Diet Association Stronger Among Women

Among the 54 644 participants with sufficient 24-hour dietary recall data for the primary diet quality analysis, including 414 with current acne, higher aMED scores were associated with significantly lower odds of acne after adjustment for potential confounders.¹

In exploratory sex-stratified analyses, each 1-point increase in the aMED score, measured on a scale of 0 to 9, was associated with 10% lower odds of current acne among women (aOR, 0.90; 95% CI, 0.83-0.97; P=.007). No corresponding association was observed among men.

Component analyses suggested that a higher ratio of monounsaturated to saturated fatty acids and lower alcohol consumption were important contributors to the inverse association among women.

A higher alternative Healthy Eating Index score was also associated with lower odds of current acne among women, with each 10-point increase corresponding to a 10% reduction in adjusted odds (OR, 0.90; 95% CI, 0.82-1.00; P = .046).

In contrast, higher low-carbohydrate diet scores were associated with greater odds of current acne among men (aOR, 1.04; 95% CI, 1.01-1.08; P = .018). A similar association was observed for animal-based low-carbohydrate dietary patterns (aOR, 1.04; 95% CI, 1.00-1.07; P = .023).¹

Investigators noted that the sex-specific findings were exploratory and do not establish distinct biological mechanisms or support different dietary recommendations for men and women.

Vegetable, Dairy Intake Show Differing Associations With Acne

Additional analyses identified associations between several individual food groups and adult acne.

In the full food frequency questionnaire cohort, greater consumption of cooked vegetables was associated with lower odds of current acne (aOR, 0.88; 95% CI, 0.79-0.98; P=.023), while more frequent pork consumption was associated with higher odds (aOR, 1.10; 95% CI, 1.00-1.21; P=.038).¹

Cheese consumption frequency was also inversely associated with current acne (aOR, 0.96; 95% CI, 0.92-0.99; P=.015), although the association was not replicated in analyses using quantitative 24-hour dietary recall data.

Dairy-related findings varied by product type. Each additional 50 g/day of yogurt consumption was associated with 12% lower odds of current acne (aOR, 0.88; 95% CI, 0.78-0.98; P=.023).

Conversely, greater consumption of milk-based desserts was associated with higher odds of current acne (aOR, 1.21 per 50 g/day; 95% CI, 1.05-1.39; P=.006). Skimmed or cholesterol-lowering milk consumption was also positively associated with current acne (aOR, 1.05 per 50 g/day; 95% CI, 1.00-1.11; P=.040).¹

No significant associations were observed for semi-skimmed or whole milk, suggesting that relationships between dairy intake and acne may differ according to product type rather than dairy consumption overall.

Implications for Adult Acne Management in Primary Care

The findings add to growing evidence linking dietary patterns with acne pathogenesis, potentially through metabolic and inflammatory pathways involving insulin, insulin-like growth factor 1 (IGF-1), androgen signaling, and mammalian target of rapamycin complex 1 (mTORC1).

Investigators noted that Mediterranean-style dietary patterns, characterized by greater consumption of vegetables, fruits, whole grains, legumes, and unsaturated fats, may influence these pathways, while diets high in refined carbohydrates and added sugars could contribute to increased insulin and IGF-1 signaling.

However, the study did not directly measure these biological mechanisms, and the authors cautioned against interpreting the findings as evidence that individual foods cause or prevent acne.

For primary care physicians managing adults with persistent acne, the findings suggest that assessing overall dietary patterns may be more informative than focusing exclusively on eliminating specific foods. Discussions about nutrition may complement established acne treatments, particularly among patients interested in lifestyle approaches to symptom management.

Several limitations warrant consideration. The cross-sectional design prevented investigators from establishing whether dietary behaviors preceded acne development. Additionally, acne diagnoses were derived largely from routine healthcare records rather than contemporaneous dermatologic examinations, introducing the possibility of misclassification, particularly between acne and rosacea in middle-aged and older adults.

The investigators also lacked data on acne severity, lesion counts, and treatment intensity. Furthermore, the relatively small number of participants with current acne in the dietary recall analyses, along with the modest effect sizes, limits the clinical interpretation of the findings.

The authors concluded that greater adherence to a Mediterranean-style diet was modestly associated with lower odds of adult acne, particularly among women, while higher low-carbohydrate dietary pattern scores were associated with increased odds among men.

They emphasized that prospective and interventional studies incorporating detailed dermatologic assessments are needed to determine whether improving dietary quality can meaningfully influence adult acne outcomes and inform future treatment recommendations.

Reference

1. Li B, Xu Y, Zhang R, et al. Associations between diet quality and adult acne: a cross sectional study in the UK Biobank. J Eur Acad Dermatol Venereol. Published online September 24, 2026. doi:10.1111/jdv.70747