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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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July 03, 2017

Dear Mark: HDL, Probiotics for Acne, and Artificial Sweeteneners and Weight Gain

By Mark Sisson
17 Comments

Inline_DM_07.03.17For today’s edition of Dear Mark, I’m answering three questions. First, is HDL all it’s cracked up to be? Is HDL always good? Is it the savior? Or is the story a bit more complicated? Next, what are some good probiotic options for treating acne? Do any exist? And last but not least, what’s the relationship of artificial sweeteners, insulin, appetite, and weight gain?

Let’s go:

Carine Dubois wondered:

I am slightly concerned about the age old acceptance of HDL as the good cholesterol in light of the recent failures of HDL potentiating drugs failure to decrease CVD. Could there be more to the story such as good and bad sub fractions as with LDL …. many more studies have to be done using up dated technology before accepting the AHA recommendations as dogma

Great insight, Carine. I feel very similarly. All the HDL-boosting drugs, like torcetrapib, have failed. And not just failed to protect against cardiovascular disease and death, but actively increased the risk of disease and death. They’ve been real disasters.

However, here’s why I think the coconut oil-induced HDL increase is different than the torcetrapib-induced increase:

HDL is “good” because the actions and behaviors and foods that increase it are “good” and the actions and behaviors and foods that decrease it are “bad.” The former include exercising, eating olive oil and avocados, losing weight, and lowering excess carb intake. The latter include smoking and gaining weight. These things aren’t good or bad because of the HDL effect. They’re good or bad for dozens of reasons. Thus, absent HDL-boosting pharmaceuticals, higher HDL is “good” because you have to do “good” things to raise it.

You’re also right that HDL isn’t just HDL. There are different ways to measure. And even with HDL particle number, there’s more to the story than “higher” or “lower.” For instance, small, dense HDL particles tend to be more protective and possess more antioxidative potential than large, buoyant HDL particles. While a pharma exec might take this to mean we should be pumping out drugs that make HDL particles smaller and denser, a person like Carine would take a more nuanced exploration.

Maybe a preponderance of small, dense HDL particles indicates a large inflammatory load that needs quelling. Maybe a shift toward larger, less dense HDL particles indicates an improvement in inflammatory status. After all, the body actively manufactures HDL particles to reduce oxidative damage.

David asked:

Hi Mark, in this article

How to Support Healthy Skin Bacteria


you mentioned that a lotion containing Enterococcus faecalis SL-5 was
shown to be effective against acne. Any idea where one could buy this
bacteria (or bacteria-containing lotion) on the web? My initial
searching was not encouraging. Thanks for all you do!

Unfortunately, I, too, have been unable to track down a good source of Enterococcus faecalis SL-5. I doubt anyone else has had any real luck. The mixture used in the study was made specifically for that study. They isolated E. faecalis from human feces (the bacteria is a normal resident of the human gut) and added it to a regular lotion. I’ve never seen it replicated or a commercial version released. Too bad. I’m sure something is coming down the pipe.

That’s not all you can do, however.

In 2012, topical application of a 5% Lactobacillus plantarum extract reduced acne lesion size. There are patents for topical L. plantarum extracts, but I haven’t seen any products.

A more recent study found that oral supplementation with a liquid probiotic containing Lactobacillus rhamnosus SP-1 reduced inflammation and adult acne. An Italian pharmaceutical company named Biodue SpA provided the materials. I can’t speak for the sourcing of course, but here’s some for sale on eBay. Also, here’s bulk Lactobacillus rhamnosus SP-1 for sale. I haven’t found any from regular sources (Amazon, etc).

AOBiome is currently running in-house trials to determine if their Mother Dirt probiotic skin spray can fight acne. Anecdotes are promising, if preliminary.

Stephen Schlepmo asked:

It’s known that artificial sweeteners don’t stimulate insulin (right?) but do they somehow stimulate appetite? Hence compromising fat reduction goals?

Let’s look at the various sweeteners.

Does aspartame induce an insulin response? No:

What about sucralose (Splenda)? Nope:

As for the others, a review of in vivo studies concluded that “low-energy sweeteners” do not have any effects on insulin or appetite hormones.

Yet, observational studies continue to find links between artificial sweeteners and obesity. Maybe it’s reverse causality—being overweight causes diet soda consumption. Overweight people are more likely to drink diet soda because they think it’ll help them lose weight, and intent to lose weight does predict artificial sweetener usage. But this 2016 study attempted to minimize the effect of reverse causality, and they still found strong links between artificial sweetener consumption and the risk of abdominal obesity. Those who drank the most diet soda had the biggest bellies.

And we know how bad Splenda can be for the gut biome, which plays its own role in the risk of obesity.

It’s hard to say, but I err on the side of “avoid”—even if the reason has nothing to do with insulin or appetite.

What’s easier to say is that the non-caloric-yet-natural sweeteners, like stevia or monk fruit, are better choices. Take stevia, for example. In one study where it was compared to sugar or Splenda, stevia actually reduced postprandial insulin levels, and those who ate the stevia didn’t increase calories to make up for the missing sugar calories.

All that said, there’s one surefire way non-caloric sweeteners—even natural ones—can compromise fat loss and and stimulate appetite: by compelling you to eat treats you’d otherwise shun.

Say you eat a good Primal dinner. You’re done. You’re quite full. You’d never consider tucking into a sugary bar of milk chocolate—unless it was sweetened by stevia or monk fruit or one of the sugar alcohols.

Before you know it, you’ve eaten an entire sugar-free chocolate bar that you would have ignored if it had sugar. You’ve just tacked on a few hundred calories to your total, all thanks to the stevia.

That’s it for today, folks. Take care and be well.

Let me know if you have anything to add or ask down below.

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17 Comments on "Dear Mark: HDL, Probiotics for Acne, and Artificial Sweeteneners and Weight Gain"

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Elizabeth
2 months 18 days ago

Great questions! Totally agree with the sweetener thing. Lately I’ve stopped putting stevia in my blended coffee in the am. I just felt like starting my day with something sweet led to sweets cravings later. And coming from someone who suffered from acne for decades, I know that adding probiotic foods (sauerkraut and Kombucha mostly) definitely helped me. But the biggest thing was just cutting out all the inflammatory carbs.

Kyle Sullivan
2 months 18 days ago

Re: sweeteners – I think it’s important to remember that while these sweeteners may not spike your insulin, they continue to condition your brain to expect over-sweetened foods and may diminish your ability to taste natural flavors as sweet (like carrots). Plus there are the other psychological ‘reward’ type of triggers that say “Oh, I was good eating the sugar free version, so I can be bad now in this other way”

Katie
2 months 16 days ago

I agree. In the past I’ve had the tendency to go overboard with the paleo/primal treats- I had a hard time stopping when I started. I gave up sugar and all sweeteners (even Stevia) six months ago and my palate has completely changed. I can’t believe how sweet vegetables are now.

I never thought it would be possible, but I managed to lose my formerly controlling sweet tooth. It feels like freedom!

Kyle Sullivan
2 months 16 days ago

Well done! Oh, that has to be a pet peeve of mine “Oh, that’s great for you, but I have a sweet tooth”. We should try to get rid of this ‘sweet tooth’ idea which seems to accept overindulgence in sugar and make it seem like people are helpless to their flavor preferences

Rick A
Rick A
2 months 18 days ago

I have a somewhat gross but I believe reasonable question regarding probiotics and how to increase their numbers where ever you want them. Specifically, when it comes to increasing the intestinal flora of the colon, we are told that most of the bacteria we swallow never make it past the small intestine because they get digested. With that in mind, and thinking about the success of fecal transplants for changing a sick person’s gut bacteria, why wouldn’t a probiotic enema be a reasonable method of putting the bacteria exactly where you want them to be?

Shary
Shary
2 months 18 days ago
Regarding adult acne, which I’ve had occasional problems with for years… I read an interesting article that completely flies in the face of conventional wisdom. Everything that’s preached by the dermatologists centers around avoiding oily products at all costs and, instead, using harsh chemicals on the skin. Basically, this article (link below) says to stop washing one’s face with any kind of product and simply rinse with plain water, steaming the skin gently for a few seconds with a warm wet washcloth, followed by a light application of (gasp!) sesame oil. With some trepidation, I decided to try this routine.… Read more »
crcr
crcr
2 months 18 days ago

Oil Cleansing Method is wonderful! I like castor oil for dissolving impurities. Olive oil is very easy to wash off. And actually, coconut oil is fantastically soothing and cleansing for the skin. As long as you rinse long enough to get it all off, any food grade oil can cleanse your skin.

After cleansing, try moisturizing with jojoba or argan oil, or a 50/50 mix of the two. Just 2-3 drops of all spread over damp skin is all you need.

Ross
Ross
2 months 18 days ago

I only use soap on my underarms, and use aqueous cream (non-SLS) everywhere else. For a face wash I simply rub a little cream between my hands, dissolve it in the hot water, then rub my face with a flannel.

I moisturise with Nivea sensitive shave balm (even when not shaving). It contains witch hazel and is fantastic.

James
2 months 18 days ago

Hi, Mark. I love the questions that come up on your blog. I was recently diagnosed with Factor V Leiden after my second DVT. I’m a 50 year old male, am in reasonably good shape but I do travel a lot for my job and it is a pretty high-stress environment. I’m taking a blood thinner (Xarelto) and am being told that’s for life. I’m wondering if you have food or exercise recommendations to help mitigate my risk for future blood clots. Thanks!

Treeman
Treeman
2 months 18 days ago

“I’m sure something is coming down the pipe” in an article about fecal bacteria!

Deliberate or did it just slip out?

Alex
Alex
2 months 18 days ago
RE: Acne and probiotics – I have found that probiotics were able to very effectively treat my acne, to the point where I no longer get any as long as I don’t eat my two triggers, which are chocolate and wheat (and even then, it’s much milder). I have used many brands (and I’ve tried many other treatments), and the two most effective treatments for my acne (which was severe in scope but not inflammation) were accutane (isotretinoin) and Elixa probiotics (half dose every other day). I was quite surprised by the efficacy of the probiotics; they also have other… Read more »
Shary
Shary
2 months 17 days ago

I thought Accutane had been taken off the market.

Zach Rusk
2 months 17 days ago

As a healthy dessert business owner, I am sometimes concerned with the mental ramifications of consuming sweetened foods. The phenomenon mentioned above isn’t exactly the worry though. The issue I hear more about is the desensitization of taste buds and craving sweet things merely due to habitually consuming products sweetened with natural, calorie-free plants like stevia, monk fruit…
I think it’s just a choice consumers have to make.
If anyone is in Austin and you chose to consume sweeter products, check out my site for Earthchurn Ice Cream 🙂
IG: Earthchurn
Fbook: Earthchurn Ice Cream
Thanks!

Caitlin Lee
Caitlin Lee
2 months 17 days ago

For David:

if you have a lactating friend, sister, wife, etc, maybe they might be able to give you some breastmilk. This stuff is crazy. Antibiotic, probiotic, and prebiotic all in the same substance.

I actually started adding breastmilk to some of my relaxing baths and it made my skin feel so soft. I also add it to my kid’s as he has some eczema. It seems to help him too.

We Pull Up
2 months 16 days ago

Firm believer that consuming a solid primal dinner doesn’t keep me curiously consuming stevia or splenda desserts

http://dujour.com/beauty/bluemercury-founder-barry

Wonderful staff and service, Great attitude and they actually know their products (unlike another beauty shop close by…). I feel there must be some training that goes on before the workers hit the sales floor. They don’t try to talk you into any unnecessary purchase

Bob Geary
Bob Geary
2 months 8 days ago
All I have to add is anecdotal* evidence: I’ve tried “getting serious” about losing weight several times over the past decade, but pretty much the only success I’ve had has been in the past few months. My diet & exercise levels have stayed about the same – the only big change I made was to avoid artificially-sweetened drinks. I was doing a fair amount of diet soda, and a LOT of Diet Snapple (free at work :-)) – now it’s just water, coffee, tea, and those just-barely-flavored seltzers. Obviously I could add a little more rigor to this investigation by… Read more »
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