Does enhancing epidermal barrier function with moisturizing topical products improve acne vulgaris in adult patients compared to non-moisturizing products or non-intervention?

Introduction: Acne is a common skin disorder with multifactorial causes that can persist beyond adolescence or appear for the first time in adulthood. Treatments of varying potency exist, ranging from over-the-counter face washes and creams to prescription topical and oral treatments. Current treatment guidelines target sebum production, exfoliation of excess skin cells, and the bacteria Propionibacterium acnes. Research as early as 1995 suggests dysfunctions of the skin barrier, such as abnormal ceramide levels and increased water loss, play a role in the pathophysiology of acne and are not addressed by current treatments. This review analyzes the role of moisturizing products (I) in improving acne (O) in adult patients (P) compared to standard non-moisturizing treatments (C). Methods: A literature search was conducted in PubMed, Journals@Ovid and Google Scholar in the fall of 2018 using the terms “skin barrier”, “acne”, and “adult” joined with the MeSH term “AND.” A total of eight articles including randomized controlled trials, case-control, and cohort studies were analyzed. The five most relevant articles are reviewed in this paper. Results: When moisturizers were applied in conjunction with standard acne treatments, participants showed visible improvement in acne appearance as well as improved treatment tolerability and reduced transepidermal water loss (an indicator of skin barrier health). Visible improvement was also seen when moisturizers were used as part of a dermatologist designed skincare routine or in a novel treatment formulation. Discussion: Moisturizers reduce the appearance of acne and improve skin barrier health markers such as transepidermal water loss and ceramide levels when used as part of an anti-acne regimen or in conjunction with standard treatments. However, moisturizers are consumer products and most studies are funded by skincare or pharmaceutical companies with an interest in the product’s success, leaving the research open to bias. Conclusion: The connection between skin barrier health and acne is unclear, however, moisturizers that improve skin barrier health markers may be beneficial when used in conjunction with standard acne treatment regimens. Moisturizers are a safe, readily available adjuvant treatment that improve standard acne treatment tolerability and help improve the appearance of acne-affected skin

Is There a Role for Plant-Based “Meat” in Cardiovascular Disease Prevention?

Diet is an established risk factor for cardiovascular disease. The American Heart Association recommends following a whole-food, minimally processed diet emphasizing fruit and vegetables to reduce cardiovascular mortality. Recently, processed plant-based meat substitutes, such as Beyond Meat® and Impossible™ foods have become easily accessible to consumers and are advertised as a healthful addition to a plant-based diet. However, these products are highly processed and contain high amounts of saturated fat and sodium. The purpose of this research is to investigate the effect of processed plant-based meat diets on adverse cardiovascular events compared to animal-based meat diets and minimally processed healthful plant-based diets. Health outcomes are dependent on micronutrient content Plant-based diets with the highest levels of serum beta-carotene and other micronutrients are associated with lower overall cardiovascular disease and mortality, as well as better metabolic markers.1,7,8 Plant-base meats reduce TMAO levels and improve cardiovascular disease risk factors Animal-based diets are associated with higher serum levels of trimethylamine N-oxide (TMAO), which is associated with an increased risk of heart attacks, vascular disease, and stroke. 2,9,10 Consumption of plant-based meat alternatives has been shown to reduce TMAO levels by 31.9% while reducing LDL and blood pressure and increasing HDL levels. Many studies found that highly processed diets are associated with negative health outcomes, regardless of plant-based content. Unhealthful plant-based diets are associated with greater cardiovascular disease risk factors and mortality compared to healthful plant-based diets. Lastly, it was found that computer modeling predicts adherence to a minimally processed diet containing animal products will result in lower rates of cardiovascular disease, ischemic heart disease, and diabetes, compared to a moderately processed plant-based diet