cea Diet

March 18, 2002

(from brady)

> There is enough evidence that a diet high in sugar and

> carbohydrates is a significant tripwire for rosacea even though the

> National cea Society does not recognize this, nor do medical

> authorities. However, one day a clinical study will prove this

> beyond doubt, if someone with the credentials who has money, power

> and courage will objectively investigate this. The

> cea Diet Users Support Group gives enough evidence of this.

> Most rosaceans do not want to change their diet lifestyle, but

> prefer pills, topical treatments, IPL, and any treatment allowing

> them to keep eating and drinking their current food and drink, so

> this does not appeal to the vast majority of rosaceans. But, you

> may be interested in researching this yourself.

I don't know about your diet in particular, Brady -- please let me

know if I'm missing something -- but in general the relationship

between diet and the immune system is fairly well documented in the

medical literature, both as a way of modulating the inflammatory

response and in the area of food allergens.

While certainly effective in decreasing chronic inflammation like

rosacea, immune modulating diets (that strongly limit sugars, among

other things) are notoriously difficult to stay on. ly, it's

also easy to imagine untold long term health effects if these diets

work by causing a decrease in general immune response, not just

chronic inflammation.

A person on an immune modulating diet who eats chocolate, for

example, may well experience increased inflammation, but I wouldn't

call that a rosacea trigger. I would view that as a return to normal

manifestion of inflammation.

Foods, drinks, and manner of cooking that increase facial flushing

are rosacea triggers, and avoiding them makes obvious sense. That's

not a food allergy, since allergies are stereotypic responses.

Allergic rashes can sometimes be difficult to diagnose, especially

when several rashes are present at the same time. But good allergists

can tell with only a glance what's an allergic reaction on the face

and what isn't.

Thank you for your email, and I appreciate your letting me know about

your diet.

Marjorie

Marjorie Lazoff, MD

March 19, 2002

I agree that the extreme high protein low carb diets are not good. I

have adhered to a modified Sugar Busters type diet for about 3 years

now, because I was having serious blood sugar drops and felt tired

all the time on the standard high carb diet. Most people don't

realize how toxic processed simple carbs (white bread, pastries, even

bagels) are. I do eat whole grain carbs and avoid any enriched or

bleached flours. But I also eat fewer servings than I previously

had.

I believe this diet has improved, not compromised my immune system.

In the 3 years I've been following it, I have not had one single

illness, not even a cold. I tend to agree with those who think yeast

has a negative impact on rosacea.

> Hi,

>

> I was reading through your response below and was interested in

your

> saying that a high protein, low carbohydrate diet decreases general

> immune response. I know that following such a diet causes ketosis.

> Were you referring to that? I've tried following a high protein,

low

> carb diet and felt terrible. I think I was going through ketosis -

> felt very dizzy and constipated. It was horrible. I didn't notice

> much of change in my skin.

>

> Nonetheless, I do follow a moderate protein and moderate

carbohydrate

> diet. I get about 60 grams of protein a day (which is the rda for

my

> height and weight) and eat 6-7 servings of whole grains a day. I

also

> eat 9 servings of fruits and vegetables a day, along with 25% of my

> calories coming from fat, mostly olive oil and nuts. I eat salmon 3

> times a week. I also try to abstain from sugar. I don't add any to

my

> meals and avoid processed foods with them. I do eat desserts about

2-

> 3 times a week. I do notice that my skin is less reactive when I

> follow that type of diet. I am also hypothyroid, and eat like this

to

> gain more energy. That's why I started eating this way in the

first

> place, and I did notice a change in my skin. Dr. Nase has discussed

> the role of simple sugars triggering flares.

>

> Some people do have issues with food allergies triggering rosacea

> flares. For me, I don't think this is an issue. I believe if I had

> food allergies, I would get more symptoms than a flare on my face.

I

> might get swollen lips, eyes, tongue or worse suffer from

> Anaphylaxis. (I have had those symptoms occur in the past, and my

> skin has looked great.) I believe food allergies are caused by

> histamine being released and causing IgE antibodies to form. I

think

> most people who react to histamine releasing foods with rosacea

don't

> have IgE antibodies forming and don't have food allergies. I think

> that the damaged blood vessels in their face get dilated with the

> extra amount of histamine in their bodies. If they didn't have

> damaged blood vessels, they would not see a problem at all like non-

> rosaceans do. The flushing would not occur. Some people are

bothered

> by histamine-releasing foods (the NRS and the NIH have lists)

causing

> flares. Some of those foods do that for me while some don't. For

some

> people, they aren't bothered by any foods at all. They have other

> triggers - cold temperatures, excessive heat, etc.

>

> Taking all of these issues into consideration, I'm looking at page

> 101 of Dr. Nase's book where he discusses " Substances Can Cause

> Widespread Dilation and Trigger Facial Flushing...Foods,beverages,

> medications and supplements contain natural dilator substances, and

> can release dilators after being broken down in the

gastrointestinal

> tract. These are both normal events which occur in all humans. If

> these substances reach high enough concentrations, they can cause

> widespread dilation of blood vessels and trigger facial flushing.

> This form of food flushing is, by far, the most common in rosacea

> sufferers(normal byproducts of ingested substances causing

dilation).

> The hyper-reactive facial blood vessels of rosacea sufferers just

> can't handle these substances, even at normal concentrations. Some

of

> the most important foods, beverages, medications, supplements that

> can cause dilation include: Foods that contain or release histamine

> (a potent dilator)...;foods or supplements that contain or release

> dilator prostaglandins. The most common example is niacin...;eating

> large amounts of simple sugars...can cause glucose levels in the

> blood stream to rise quickly and trigger skin flushing...

>

> Anyway, sorry to go off on this tangent. There's been discussion on

> this board about food allergies and rosacea. Some people have it,

> but you don't have to have food allergies to react to histamines-

> releasing foods as Dr. Nase points out. I would guess the majority

of

> people with rosacea who react to foods (many with rosacea don't

react

> to any foods at all) do not have food allergies. The minority

> probably can list food allergies as a trigger. There's also been

> discussion of simple sugars causing flares. I've noticed it in

myself

> and Dr. Nase does discuss this.

>

> Take care,

> Matija

>

March 19, 2002

> My understanding for rosacea triggers is what the NRS says,

> " Factors that may trigger rosacea flare ups, "

> [ see http://rosacea.org/trip.html ] with the list of factors.

Right, a list of factors that may (or may not) be triggers.

> I am saying that a trigger causes a rosacea flareup.

That's how I understand the term. When we say, " x is a trigger, " we

really mean that " x may be a trigger to some people under certain

circumstances, " or " x is a trigger for me. " Without those qualifiers,

there's a risk of exaggerating the importance of that trigger within

the overall management of rosacea.

You picked up a source of my confusion as well. I sometimes get the

impression here that " trigger " also means anything that vasodilates

or potentially causes facial flushing. In a way that makes sense;

it's easy to understand how those concerned about their rosacea

and/or embarrassed by their blush may try to avoid substances and/or

situations that cause flushing, even if it wouldn't actually trigger

a rosacea flare.

I don't know whether someone answered this yet, but I always assumed

a blush is a facial flush caused by emotions.

> I am confused that an immune modulating diet causes a

> DECREASE in general immune system response.

> What are you talking about?

Unfortunately I've confused others, not just you. Immune modulating

diets have nothing to do with allergies or triggers or popular diets

on the market. I brought up immune modulating diets only as an

example, to illustrate how major manipulations of one's diet can

impact one's immune system and so decrease chronic inflammation, but

no one easily recommends such diets because they aren't healthy.

I know you sell your diet and I respect that, but would you summarize

in a few concise sentences its philosophy, general features and

goals?

Marjorie

Marjorie Lazoff, MD

March 20, 2002

Hi Dr. Lazoff,

About IgG, I was simply asking the poster for more information about

it. I tried to look up information on it and just found something

from a researcher from the National Institutes of Health.

It seems you didn't read my reply that closely. From what you say

below, you misinterpreted my reply to the poster. I think you need to

ask the original poster about it rather than myself.

About the eating plan I have, I wasn't asking for feedback from you.

I was simply saying that the eating plan I was following for another

reason seemed to help decrease the pinkness on my face. It is

anecdotal, I know. However, it does work for me.

Take care,

Matija

> Regarding another thread -- my understanding is that delayed

> hypersensitivity reactions are mediated through T cells, not IgG.

> Perhaps I missed what you were referring to? (This was in reference

> to another poster expressing his belief that rosacea is a delayed

> hypersensitivity to food allergy.)

>

> Matija, I truly regret if my reluctance to provide feedback on

> personal information is disappointing. I hope you understand.

>

> Marjorie

>

> Marjorie Lazoff, MD

March 20, 2002

Hi Dr. Lazoff,

I don't understand the connection with flushing related to food

allergies and celiac disease. In Dr. Nase's book, he tends to discuss

food allergies and celiac disease as being able to dilate damaged

blood vessels. He does state that the majority of rosaceans don't

have either issue.

I don't think he had any references on how food allergies/celiac

sprue could cause this. I don't have my book with me so I can't

check. I will when I get home. I believe there are references to how

histamine-releasing foods can cause flushing in some rosaceans. I

know some rosaceans are lucky enough not to flush from histamine-

releasing foods.

I respect your point of view as a physician to question some of the

things I and other people on the board say. I do like hearing all the

opinions and anecdotes though I may not believe them based on my own

experience or they may ring true with me. I'm grateful people have

taken the trouble to let me know.

In the medical community, much is unknown about rosacea and there are

contradictions. When I was first diagnosed with rosacea in '94, I

requested to be put on the NRS mailing list. I remember how they used

to say that they didn't believe food had anything to do with rosacea

flares, but some of their respondents did have the problem. Now,

they do say it can happen probably because a study proved it in the

interim. Just a quick search of Medline will give you one journal

article on how the eradication of h. pylori does relieves the

symptoms of rosacea and another article on how the eradication of h.

pylori does nothing to relieve rosacea.

Further, I've been told and heard that derms suggest using mild

cleansers for rosacea like Cetaphil or Purpose. Both those burned my

skin. I looked to this board for any suggestions and I received a few

that were helpful. I asked my derm for any suggestions and he didn't

know what else to tell me if those cleansers caused problems.

I know you would agree that medical science does not have all the

answers. I hope that medicine can provide the answers for rosaceans

someday. I welcome that and want it. But I don't see many studies out

there about rosacea and the facets of it that are discussed here. If

I followed my derm's advice about Metrogel and the cleansers, my face

would be pertually red and feel like it was burning. I don't have

that anymore due to some suggestions that I read here. I'm glad to

hear anecdotal stories because they might help. If the poster has it

wrong or is completely offbase, that's ok. Sometimes they hit the

mark with me. Sometimes not with me, but with others. If it's

something that can harm a person's health, then I will speak up. If

it doesn't cause any harm and can help the person with rosacea, then

that's great.

Anyway, I hope you get Dr. Nase's book soon and let us know what you

think of it.

Take care,

Matija

>

> > About IgG, I was simply asking the poster for more information

> > about it. I tried to look up information on it and just found

> > something from a researcher from the National Institutes of

Health.

>

> I'm with you, then, because I'm not familiar with IgG-related

delayed

> food allergies either. I don't really understand the connection

> between allergies and rosacea. Whether the presence of histamine or

> other immune-mediated substances triggers rosacea flare or facial

> flush, it seems to me an allergy or food intolerance should be

> identified if possible in its own right.

>

> If my ignorance is due to lack of factual knowledge I hope someone

> will point me (all of us) to online references.

>

> It's hard to discuss beliefs that are based on gut feelings or

> personal experience, because even when everyone is thoughtful and

> polite it can feel hurtful when others don't validate those

beliefs.

> That goes for me as well -- my beliefs are based on what I've

> experienced in science and medicine, so it's hard for me to

> understand others who don't prioritize factual information or

logical

> deduction as a basis for knowledge. It's not the only kind of

> knowledge, of course, but we're discussing here real things in the

> material world. But I know many people don't.

>

> Humans are by nature imaginative beings, and a few isolated facts

and

> unexplained connections can sometimes take our imagination to

> insightful ventures, though not always. I'm in an email discussion

> group where sometimes we talk about conspiracy theories for fun,

but

> I know there are people in the group who seriously believe them. (I

> always tease them extra hard. ) Some of what gets posted here

> reminds me of that kind of creative energy, though of course this

> topic is very serious to many people here.

>

> > It seems you didn't read my reply that closely.

>

> I did mess up the IgG reference, I'm sorry. Some of my replies to

you

> (like the above) are intended as general comments and not directed

to

> you specifically, I hope you know that. It's my way -- I enjoy e-

> groups, but it's not a comfortable medium for me as a physician,

> there's so much potential for misunderstanding, in all directions,

> and worse if I make personal replies. And I don't always have the

> free time I've had the past few days.

>

> It's nice to know that your diet works so well for you.

>

> Marjorie

>

> Marjorie Lazoff, MD

March 20, 2002