Food

Rosacea versus foods is an interesting but complicated topic. A lot of people with flushing, burning, redness and/or skin outbreaks notice that their choice of foods can have some affect on it. But not everyone! And there seems no strict list of good and bad foods either; what is a trigger for one, can seem harmless for someone else. 

For me personally, diet is important if I want to keep my skin inflammation and redness down; sugar, chocolate, fried foods to name a few can increase inflammation levels in the body and when I eat such foods all week, my skin will be a lot more red, painful and flushed. Unfortunately! Not everybody has food triggers though, so you best set up an elimination diet phase for yourself if you want to find out if your rosacea is influenced by diet. It is a tiring business to figure out, but it could be worth it in the long run. I was very busy eliminating foods back in 2004-2006 when my rosacea flushing and redness and burning were very bad. I was 50 kilo's, sometimes dropping to 48 (and I'm 1.70 tall so I was skin and bones at that point). I didn't dare to eat anything but chicken, some rice, green peas and some salad back then. It was madness to be honest and at my thinnest, my rosacea was at its absolute worst. But I had no appetite due to the high stress levels I experiences, and because I flushed so badly I just shied away from any other food. People say that being overweight can negatively affect your hormones and inflammation levels and worsen rosacea, but in hindsight I was at my very worst when being underweight. I eventually went to a dietitian on the advise of my GP, who helped me get a healthy diet back on track, while respecting my rosacea trigger foods. She advised me back then to start with 3 safe foods, in my case rice, chicken and lettuce. And then every week I had to add ONE new food item. So in the 2nd week I added broccoli. No bad skin reaction. So broccoli was on the menu ever since. Then the 3rd week I had to add minced meat. And so on. Now I eat a lot more of everything. All meats except for pork. Fish once a week. Butter, olive oil, almost all vegetables and fruits except those high in histamine. Gluten free carbs such as sweet potatoes, rice flour and rice pasta (whole grain). Olives, dark chocolate now and then, full cream products, rice milk, all sorts of cheeses and mozzarella, but not fermented or very aged cheeses (histamine). I no longer have vitamin deficiencies and am at a healthy weight again, and my rosacea is a lot calmer actually....

So I found out what my trigger foods are. Keep in mind that they are very personal, but some foods have a higher incidence of being trigger foods for people with rosacea than others. For instance; old cheeses that are very ripened have a lot more histamine than young cheeses. And thus they are more prone to cause a skin flare up, as histamine is a blood vessel dilator. The same goes for fermented foods. Sauerkraut is very healthy and all for the bowel, but it gives me a bad flush. Canned fatty fish like mackerel is also high in histamine and makes me flushed too. Fresh white fish on the other hand and fresh tuna are no problem for my rosacea. Other foods high in histamine that cause my rosacea to flare are tomatoes, avocado's, egg white, vanilla and strawberries. Fruits very high in vitamin C trigger my overactive immune system my immunologist figured out, so I avoid mango and papaya and citrus fruits, but I eat all other fruits minus strawberries. Spices and 'hot' foods (sambal, spicy Indian foods) are No Go for me and deep fried foods also make my skin more red and inflamed. So no chips, crisps and such. I also am having the most calm skin when avoiding sugar and foods high in simple carbs. I do eat carbohydrates, but ideally from sweet potatoes, whole grain rice products, vegetables and fruits. I also eat some chocolate often, mostly every day unless I have a skin flare due to hormones or the weather or something, then I skip the chocolate for a few days. I use olive oil and olives with every meal. I do eat dairy products, but not very often. I try to limit my dairy to butter and goats cheeses. But when I eat ice cream or whipped cream or cakes now and then, it's not a problem as long as I take my antihistamines in advance. I just can't keep a calm skin after eating such foods for days in a row. So Saturday is my binge day :D I eat whatever I want, usually chocolate cake and cream and such, or pizza, and then the rest of the week I stick to my regular diet and some chocolate before bed. 

So, if you have the time I would advise you to set up a food test in the way my dietitian learned me, and if you don't have the time, energy or willpower to go rigorous with an elimination diet, you could also see how your skin reacts to cutting out very specific food groups from your diet. And keeping a food diary. It can help to experiment with cutting down on the sugar intake for instance. Or in some cases eliminating gluten or grains or dairy can help some people as well. Ideally, you shouldn't cut out foods like wheat and dairy unless you are really sure that they are negatively affecting your skin, so it is probably best to only cut out one of those mentioned at the time, and for a long enough period to be sure it does or doesn't affect your skin. Then reintroduce it, see what happens, then take it out again for a period of time, until you pinpointed exactly if it flares your skin yes or no.. You could be totally fine with eating gluten or dairy though. It is a thing of these times that people in general want to live as healthy and possible, and some develop complete phobias for perfectly fine foods. This is not good, obviously. But when it comes to skin inflammation, or general inflammation in the body, unfortunately grains could, for some, play a factor in keeping inflammation up. And dairy has natural hormones that can also affect your skin.. Cutting down on processed foods can always be a thing to try. Try cooking fresh foods, plenty of colourful vegetables, some fish and meat, olives, natural oils, rice. Not too many (simple) carbohydrates. Such a diet can reduce inflammation.

Most people with rosacea will know of at least some foods that cause their skin to worsen, although this isn't the case for everybody (haha I can't stress that enough as you will surely be able to tell!). What makes it difficult, is that most also have slightly different food triggers. Mine are partially correlating with how active or inactive my rosacea is; the worse it is, the more foods make me flush. Rule of thumb could be that most people who are dealing with inflammatory skin diseases have the least problems with most vegetables and some fruits. Fruits that can trigger flushing would be those high in histamine - for instance strawberries, banana's- or salicylates -> certain berries. Often vitamin C can help strengthen blood vessels, but for some of us (especially with underlying auto immune diseases), high levels of vitamin C can actually trigger flushing by stimulating the immune system. If you suspect this is the case for you, you can best test it, and have some fruits high in vitamin C (like papaya, mango and citrus fruits), and see how your skin reacts. With a delayed skin response, you might need to stretch the amount of test days. Fruits like pears, most blue types of berries, peaches and nectarines have lower levels of vitamin C. I can handle apples, pears, mango, cherries, apricots well and the occasional banana and I also make berries smoothies. Vegetables are usually fine and not a rosacea trigger, but some people have trouble with garlic and unions (can be pro-inflammatory in atopic skin conditions), while it helps others! Both act as natural antibacterial and fungal agents and some rosaceans write that eating unions and garlic helps them keep clear and calm skin, but others claim the opposite (mainly that they cause flushing for them). The Chinese doctors I visited between 2000-2004 mostly all said that I have too much heat in my organs and body and need cool foods; garlic, unions, pork, spices, coffee, alcohol, predator fish types and some other items were on the Red Danger List and I should avoid them they said. Avocados are high in histamine and can be a trigger, tomatoes as well. Most people handle meat pretty well, but pork meat is high in histamine and I cant handle it. Then again, there are also people with rosacea who say they do a lot better skin wise when they stay clear from meat, especially red meat. Forum user Drums does best when he avoids all fats, including meat.

Gluten can be a trigger, but not necessarily. You can do an elimination diet to figure out if they are for you or not. I do eat gluten and wheat now and then, but I have colitis and my bowel will swell up from wheat products and make me look slightly pregnant, so I mostly try to eat vegetables (organic) meats, sweet potatoes, some rice now and then and some fruits. Potatoes are fine with me, but are of the night shade family which is linked to some atopic skin disease flares, eczema for instance, so some people might find them troublesome. Legumes like lentils and beans are high in histamine and niacin typically and can cause flushing for some. Some people have an issue with dairy products but for me organic yogurt and goats cheese cause no problems.

A rule of thumb would be to be cautious with the following foods, as they cause vasodilatation:

• alcohol (red wine the baddest of the bunch)
• hot spices
• foods high in nitrites and sulfites; used for instance as preservatives for meats and fruits (dried peaches etc,  nitrites are used to preserve wines, which are also found in foods).
• Thermally hot foods 

Products high in caffeine can also dilate blood vessels and cause redness and flushing problems. There are also foods that can contribute to chronic inflammation in the body, including in the skin. Both wheat and corn are for instance considered inflammatory and can contribute to the manifestation of chronic inflammation and autoimmune diseases (Pubmed source).

I personally avoid: 

*pre packed stuff with additives (yep, means back to the kitchen :)
*soda's/soft drinks
*overtly sugary stuff too often
*artificial E-numbers in food, especially when they are preservatives
*coffee, candy, spices, citrus fruits -> oranges, grapefruits, lemon etc.
(so avoid meals like this one haha :)
*Chocolate can be fine for some and trouble causing for others.
*pizza, food with lots of cheese and tomatoes
*deep fried stuff, the deep frying causes bad chemicals to be formed and they are very inflammatory and bad for your skin.
*Nuts and seeds are great for your health but I have to be careful with them, as they are naturally high in histamine, which is a vasodilator for some and also for me, unfortunately. I do love pistachio and cashew nuts a lot.
*And of course Nutella ;)

I try to not have too many deserts but do love them. Some dark chocolate is always ok. Love to make all sorts of icecream at home. Or I make my own apple or pear pie, with a base from rice flour, sunflower oil, stevia for sweetening and some water. There is also nice gluten free puffed pastry I use at times. Put that in the oven to make a base, then simmer and bake the wedges of pear/apple on the stove and caramelize them, then add the two together (you can glaze it with some honey) and have an additional 5 minutes under the grill. I also make flour-free brownies sometimes, with dates and figs in it, or cake from almond flour. Sometimes I do eat gluten, like something from the bakery (I have a sweet tooth) but not often as it makes my stomach bloat and cramp typically and ultimately gives a red face for me. I cook with olive oil or sunflower oil, or sometimes coconut oil or butter.

My typical breakfast either fruit, apples, pears or melon for instance. Sometimes vegetable stir fry leftovers from the night before, sometimes rice noodles or sweet potatoe products. On a good day I can choose to make gluten free pancakes or apple pie.

Lunch  smoothie of frozen fruits (for instance apples, pears, cherries, peaches, melon, berries, apricot, lychee, coconut, mango or berries) with rice milk or occasionally lactose free milk (available at health shops). Depending on how hungry I am, it could be the same as for breakfast, or something more hearty, meat, salad, vegetable stir fry for instance. A big salad. Or a grilled piece of (organic) meat with salad and olives. I also eat most types of white fish, tuna and salmon (but not herring, mackerel and very intense tasting fish types - they also tend to be higher in histamine content). I can make anything from most vegetables, but not legumes and beans (make my belly swell up). I do eat carrots, broccoli, courgettes, fennel, pumpkin, mushrooms, cucumber, lettuce, yellow and red peppers (paprika we call them here), asparagus, brussels sprouts, cabbage, artichokes, butternut and sweet potatoes. Also like rice products, including rice pasta. I also love home made pizza with a base from gluten free dough. 

Dinner: stir fry of vegetables (usually courgette's, carrot, broccoli, fennel, potato, black olives) with chicken breast or tuna or beef or lamb. Beef meat balls. I always eat organic meat, but its very pricey so I eat meat like 4 days a week. Goats cheeses or other young cheeses. Gluten free pasta with fish and lots of vegetables. Olive oil to cook with and olives or capers to go with most meals. I sometimes eat cooked lentils, chickpeas (they can make my belly swell though) or occasionally polenta. But corn products seem to make me more red, so this one is very occasionally. I love baked potatoes as well. 

Trip down memory lane - I wrote back in 2006 on The Rosacea Forum the following:

January 5, 2006 - "I have a recipe for a great vegetable soup!! It might sound like a very stupid subject, but after 6 years of very debilitating rosacea (severe flusher/ neuropathic burning and inflammation from it) and troubles with so many foods, I do like to share this with all you guys. Just for a bit of fun, but it is genuinely nice AND very cheap AND very healthy and VERY EASY to make. All you do is the following: boil 2 normal potatoes and one sweet potatoes, cut in 4 pieces each, in a pan half full with water. If potatoes make you flare, take small ones. Sweet potatoes (with white instead of yellow flesh) make me far less flushy then normal ones, but they are more expensive.. Add pieces of carrot with it after approximately 7 minutes and add fine cut pieces of broccoli after another 5 minutes. Cook everything for 20 minutes or something in total, and cook some brown rice in between, separately. Bake it crispy in a separate pan after it's been fully cooked. Just add a little bit of olive oil or coconut oil in a baking pan and bake it golden brown on a medium/high fire. When your big soup is cooked, take a kitchen machine and blend everything till you have a smooth soup. Add the baked rice, stir, some salt. You can also add green beans or other type of beans/ veg. I have irritable bowel problems, so tend to be careful with beans etc. If you can have herbs, use some rosemary for instance. In the water you can also cook pieces of chicken, for a chicken variation, or turkey. You do need a piece of meat with the BONE, for the taste. You can get the bones out later and then add the potatoes and start where I just started. Very tasteful, very cheap and delicious. It's a smooth, healthy, thick soup. I love it especially chilled from the fridge. Some roasted meat or bread (if you can take that, I can't unfortunately) with it and it's great.  I feel like a mama now, serious: I'm only 26 :)  N."


Histamine

I find also that taking antihistamine medication is helping to me tolerate more foods than before. Scroll down to the bottom of this article for more detailed information on histamine versus skin redness and flushing. There are foods that are high in histamine, or that trigger a histamine release in the body. Histamine release will cause the blood vessels in the body to dilate, and this can make rosacea worse or cause a flare. It can also result in a stuffed and runny nose or asthma attack for people who are allergic to any of such foods, and this also comes down the same principle of dilation of the blood vessels, but in different problem zones. Not everyone has a problem with them, or with some of the food items listed below, but it is a good idea to have a careful look if they might add to the problem when you are dealing with active rosacea at the moment. Taking an antihistamine might help you to be able to tolerate more of these foods without blowing up with flushing or outbreaks. Foods that are fermented also contain high(er) levels of histamine.

Liver Yogurt (fermented) Sour cream Cheese -except cottage cheese (fermented) Chocolate (high in histamine) Vanilla (high in histamine) Soy sauce (fermented) Yeast extract (fermented) Vinegar (fermented) Eggplant (high in histamine) Avocados (high in histamine) Spinach (high in histamine) Broad-leaf beans and pods, including lima, navy or pea  nuts eggs (especially egg white) Citrus fruits, tomatoes, bananas, red plums, raisins or figs (high in histamine or salicylates) Other foods high in histamine, like left overs that have been stored for numerous days in the fridge, canned meat and fish (the canning proces adds histamine), fish like mackerel, herring and sardines. Porc meat has higher histamine levels than veil. Any red meat can be a trigger for some however, while others have no problem with it.

Pro-inflammatory foods

Then there are foods that can cause inflammation in the body, like sugars. Chinese medicine beliefs that some foods are inflammatory to the body, and others are non inflammatory. It associates inflammation with heat, showing itself either in a very apparent way when you have an infection or in a less obvious way, when it causes subtler symptoms such as a mild sensation of feeling warm,  chronic thirst for cool drinks, irritability, lots of sweating, restlessness, and constipation. red skin of course. Heat also occurs from stagnation in Chinese medicine.  This simply means that when things don’t move well, it creates a buildup that causes heat.  In your body, anything from your energy or digestion to your emotions can stagnate.  If you’ve ever seen someone get hot with anger, that’s an emotional stagnation causing a little heat. Fats are strongly linked to inflammation, because your body makes prostaglandins from fatty acids.  Similar to Chinese food theory, the fats that promote inflammation include partially hydrogenated oils/fats, and polyunsaturated oils, such as corn, peanut, and safflower.  Also, trans-fats, such as margarine or vegetable shortening, and saturated fats, as found in animal products (except fish) promote inflammation. It takes experimenting for each individual to find out whether or not they have a problem with these foods. For me it works, by staying on a ´clean´ and neutral diet for a week or more and then only add the one food item you want to research. Eat it on top of the neutral diet and only add this food item, not two or more, and then stop eating it again for a day or two. When you see no change, you can add the same food item again then and observe what happens. This way you have one changing factor and it is easier to get a sort of objective view on it all. Although it is by no means a random double-blind study yet, as there might be other factors at play, like the weather, changing stress level etc etc.

Examples of Pro-inflammatory foods:

• alcohol
• chocolate
• wheat products (especially white flour products)
• deep fried foods
• fats and trans-fats (many oils and butter)
• honey and sugars (raw cane sugar being the least problematic)
• porc and lamb
• garlic and unions (note that this is only according to Chinese medicin)
• corn

IowaDavid wrote an interesting reply on the Rosacea forum about pro inflammatory foods:

"Your rosacea and IBS may be linked as two signs that your systemic inflammation is too high. I know it sounds strange, but some of us get the "fun" genes and we can't handle some of the things we put in our bodies--namely sugar, gluten, dairy products, lots of refined carbohydrates. (I don't know what your diet is like--I'm not trying to criticize you from a position of ignorance.) The thinking in a functional medicine approach is that all diseases are basically rooted in a systemic inflammatory response. Wherever we're weakest (genetically speaking) as in rosacea, is where you'll begin to see failure of your body to keep up with this chronic inflammatory response. But you see it occur in other organ systems or body parts: arthritis, neurological disorders, cardiovascular, pulmonary, etc. 

If you have two inflammatory disorders in two different body systems already at age 17, you may want to do some research on changing your diet to an intensive nutritional approach while minimizing those foods that cause inflammation. I know, I know--this sounds a bit crazy at first and some will think it's fringe back-to-the-earth fad nonsense. I imagine you're already careful about your diet, but perhaps not in the way that would best serve your symptoms. Check out www.terrywahls.com as a start. I hope you like your green veggies and bone broth! Seriously, though, it took me about a year of *kind of* following her program (and those of other like-minded doctors) to eat to reduce the systemic inflammatory load on my body. Once I got strict about not eating gluten, no dairy, no sugars/ carbs, within a couple of weeks my asthma symptoms have started to really clear up. It's been nothing short of remarkable in terms of the correlation (I would say "cause and effect" but that may be imprecise given the data set I have to work with). Funnily enough, I didn't ever test as allergic to dairy or gluten--this is how insidious these inputs can be that produce inflammation. Chronic inflammation, at a low level, can build on itself and antagonize your weakest points (your facial blood vessels in rosacea, the lining of your colon for IBS) over an extended period until they're so sensitized, you're really stuck for answers and suffering. I'm not going to say that changing your diet along the guidelines given by Dr. Wahls will solve ALL your problems. I would bet, however, that if you learn to adopt them and can stick with it, you will feel much, much better.  I'll also add that for your rosacea specifically, I would read up on low-level red light therapy, which is a way to control the inflammatory response in your face from the outside. Red light therapy (RLT) has been a huge help for my case, and I was EXTREMELY subtype 1--flushing, burning, reacting to everything. I really wish someone had been able to tell me about RLT back when I was 18 or 16 years old and pre-rosacea, so I could have halted the disorder's progress and saved myself a lot of trouble and wasted months not being able to leave my house, form or maintain relationships, or hold down a job. I have been in that world of living inside, hooked to the outside by a computer, because of this disorder, man. It sucks. It's no way to live. You can and will find the best way to treat your concerns and get your life back on track." (Source)

Other potential Trouble foods

I respond pretty strongly to chemicals in food, like chemical preservatives, colourings and aromas. Fast food is a fast ticket for a flare up for me. Also the chemical colorings and preservatives in some Chinese (fast)foods (monosodium glutamate (MSG) are very problematic. Some artificial food additives like aspartame and monosodium glutamate (MSG) reportedly trigger inflammatory responses, especially in people who are already suffering from inflammatory conditions. Dairy products are also a potential problem factor. It is claimed that as much as 60% of the world’s population can’t digest milk. In fact, several researchers think that being able to digest milk beyond infancy is abnormal, rather than the other way round. Milk is also a common allergen that can trigger inflammatory responses, such as stomach distress, constipation, diarrhea, skin rashes, eczema, acne, hives and breathing difficulties, in susceptible people. It is worth trying a lactose and/or dairy free diet for a while. But when you find no impact on your rosacea symptoms, it might be not worth the trouble I found personally. Nightshade vegetables like potatoes can be a trigger for some.



And then there are salicylates... 

When you get a flush or a red face after taking aspirin, there is a chance that you are sensitive for salicylates.. Salicylates are a natural chemical produced made by plants. They are naturally related to the chemical compound, salicylic acid, found in aspirin. A diet high in salicylates may offer the same type of protection against heart disease as a daily aspirin. However, some people have difficulty tolerating large amounts of salicylates and have to avoid foods containing high amounts. Symptoms include eczema, asthma, sinusitis, flared skin and stomach aches. Fruits tend to contain the highest amounts of salicylates. Dried fruits tend to have higher concentrations of salicylates because of the removal of water. Fruits with relatively high amounts of salicylates are raisins, prunes, apricots, blackberries, blueberries, dates, guava, cantaloupe, granny smith apples, cherries, red grapes, mandarin oranges and tangelos. Fruits with moderate to low amounts of salicylates include kiwis, lychees, nectarines, watermelons, plums, green grapes, mangoes and passion fruit. Fruits with negligible amounts of salicylates include bananas and pears.

Vegetables which contain higher amounts of salicylates are green peppers, olives, mushrooms, tomatoes, radishes, chicory, spinach, alfalfa, broccoli, cucumbers, fava beans and spinach. Vegetables with moderate amounts include asparagus, lettuce, cauliflower, onions and fresh mushrooms. Vegetables with negligible amounts of salicylates include green peas, green beans, cabbage and celery. Nuts and seeds with high amounts are almonds, peanuts, pine nuts, macadamia nuts and pistachio nuts. Brazilnuts, pecans, peanut butter, sesame seeds, hazelnuts and sunflower seeds are less problematic and cashews contain a negligible amounts of salicylates. Many herbs and spices are significant sources of salicylates. In fact, it is believed that tomato sauce has high amounts of salicylates because of its seasonings. Herbs and spices suspected to have high amounts of salicylates include curry, cumin powder, dill, oregano, hot paprika, rosemary, thyme, turmeric and vegemite. Fennel, vinegar and soy sauce contain moderate amounts. Garlic, parsley and chives have only negligible amounts.



About Vitamin supplements

If you eat a balanced healthy diet, I don't believe you need to take vitamin supplements. Unless you have a vitamin deficiency that shows up in a simple blood test from the doctor. Synthetic vitamin pills are not always digested and absorbed by the body in the same way as vitamins from foods and the sun is. I don't believe in combining bags full of different types of vitamins and supplements.. If you mix and match too many, you might end up with too high levels of vitamins, and you won't know anymore then which of them might cause your skin to improve or deteriorate.. When you start taking more than one supplement or medication at the same time, if often becomes difficult to pinpoint later what it or isn't helping you. It can help then to try one thing first, to give it a good few weeks to start working (unless it makes you flush like mad straight away of course). Try to not eat weird things or face too many other triggers during your trial time, to be able to really evaluate in an honest way. And when you start adding more supplements, make sure you either do a proper google search on possible interactions, or ask your pharmacist or doctor about it. Besides, as I wrote, with a balanced diet most people seem to get all the needed vitamins. If you suspect a vitamin deficiency, please have your blood levels tested by your local doctor. Vitamin D is one vitamin that is often too low in people with rosacea, especially if they avoid the sun. It is wise to try to keep your vitamin D levels in a healthy range, because it plays a role in the protection against all sorts of cancers. And low vitamin D levels are also linked to auto-immune diseases, including multiple sclerosis, rheumatoid arthritis, type 1 diabetes mellitus, and systemic lupus erythematosus (SLE). A new study conducted at Monash University in Australia has now shown that low vitamin D3 status in SLE was associated with higher disease activity while an increase in serum vitamin D3 levels reduced SLE activity. This study provides hope that many patients with SLE and other autoimmune disorders may benefit from vitamin D3 supplementation.

LINKS

-Interesting blog by a woman with rosacea about anti inflammatory foods and recipes
-Interesting thread about food triggers for rosaceans on the rosacea forum
-Another diet discussion on the rosacea forum
-How to deal with rosacea food triggers?
-Top ten antioxidant fruits and nuts

Food allergies and intolerance or coeliac disease

Flushing associated with food

Eating spicy or sour foods can cause facial flushing. This gustatory flushing is caused by a neural reflex involving autonomic neurons linked to the trigeminal nerve. This type of flushing may be unilateral. Flushing can happen in response to monosodium glutamate (MSG), which is a food additive often found in Asian food for instance- or other dietary agents, such as nitrites and sulfites (additives in many foods), thermally hot foods and beverages, and alcohol. Scombroid fish poisoning (tuna and mackerel) is caused by the ingestion of fish that was left in a warm temperature for hours. In addition to flushing, patients with scombroid fish poisoning experience sweating, vomiting, and diarrhea. These symptoms are caused by intoxication with histamine, which is believed to be generated by histidine decarboxylation by bacteria in spoiled fish.

Food allergy flushing 

Many patients with rosacea have other symptoms that suggest the diagnosis of food allergy. A red nose, cheeks, and red ears may act like warning lights that turn on when a food reaction starts. Rosacea patients should identify the reactive foods when this flushing or vascular dilation occurs. Often, it is the symptoms of food allergy that motivate people to start diet revision and an improvement in their rosacea condition is noted along with improvement in other symptoms such  as gastrointentestinal disturbances, migraine headache, sinusitis, and fatigue. As mentioned earlier, rosacea redness can be partially caused by high calorie carbohydrates (pastas, breads) and sugar spiking from all sweet foods. Quite different are the foods that are blood vessel dilators such as vinegars, hot spices, and various other spicy seasonings, hot sauces, peppers (including black pepper) and meat marinades. Tomatoes, citrus fruits, and related juices, bananas, and red plums, raisins, figs, pasta, cheese, and chocolates are some of the worst offenders to many. Other very common known flushing foods are liver, yogurt, sour cream, vanilla, soy sauce, yeast extract, eggplant, avocados, spinach, broad-leaf beans and pods, including lima, navy or peas. Allergies to malt and yeast beverages, and fermented alcohols also exist. Stimulants such as coffees, teas, soft drinks with caffeine, alcohol beverages, and chocolates stimulate the system resulting in more facial redness or dilation.

Alcohol flushing

The best way to avoid this type of flushing is to not drink any alcohol! Alcohol is a vasodilator. All alcohol is fermented, but because beer and wines (red wine being the worst) are not further distilled, they can cause the symptoms of allergy facial skin redness for many rosacea sufferers. Red wine also contains tannin's and sulfates which can make you even more flushed and red than from the alcohol itself. Alcohol is a diuretic which pushes water out of the body cells. In this state of dehydration, the body is prone to skin redness and flushing. Alcohol is a concentrated source of calories and is metabolized very quickly. This causes the blood vessels to dilate causing facial redness symptoms. If you feel you need to drink alcohol at social functions or to relax, here are some recommendations to minimize the flushing effect: some people avoid beer also because it is higher in carbohydrates. However, if you like beer, drink domestic beer from your own country as it is usually sold within six weeks of production. Foreign beers imported into your country usually have preservatives which make for more redness. Domestic 'light beer' usually does not have as many carbohydrates and less alcohol content making it the beer of choice. Wine is heavy in carbohydrates and even higher in preservatives/sulfides and alcohol causing more flushing with the red wines usually being the worst for most of us. If you prefer wine, a white wine would be best. It is better to drink small amounts of gin, vodka, or whiskey, diluted with water instead of sugared soft drinks or mixes which also can stimulate the cardiovascular system. A good choice would be a Long Island Ice Tea substituting the mix with water and diluting it. Small amounts of gin are frequently less stimulating than vodka or whiskey. You should "chase" any alcoholic drink with water. Although these recommendations can help to minimize facial skin redness/flushing, the best advice is to not drink any type of alcohol at all. In this Rosacea Forum post, patients rate their top alcohol triggers. (Source, this girl has a blog about gluten allergy, but described flushing from alcohol in this picture).

Gluten allergy 

Acne rosacea has been brought in connection with gluten allergy, also called Celiac disease, and with gluten intolerance. Celiac disease is an auto-immune disease. People respond badly here to a protein in certain grains, mostly wheat, barley and rye.The gluten itself is a protein made up of two protein parts, gliadin and glutenin. The gliadin part is responsible for the abnormal immune reaction that causes gluten sensitivity and celiac disease. Between 0.5 and 1% of the world’s population suffers from gluten-sensitivity. Gluten sensitivity is not the same as a gluten allergy. The gluten proteins of corn and rice lack the gliadin part and do therefore not cause any sensitivity. The immune system’s overreaction to wheat’s gluten causes celiac disease, in which the lining of the small intestine becomes chronically inflamed. Anecdotal evidence suggests that those following a gluten-free diet can sometimes reduce flare-ups of rosacea (source). Many rosacea patients who are diagnosed with gluten intolerance or celiac disease have noticed that the gluten-free diet clears up much of the redness apparent with rosacea. While there is not much medical evidence yet to link the two conditions, it is possible that there is a connection. It is possible that the inflammation of the intestines contributes to an overall stronger inflammatory response in the facial skin of rosacea patients. Symptoms of gluten sensitivity or celiac disease include chronic diarrhea, cramps, bloating, bowel disturbances, changes in stool, flatulance, weight loss, weakness, fatigue, joint pain, headaches, depression, abnormal menstrual cycles and malabsorption of essential nutrients, which could result in  secondary symptoms such as psychological and neurological problems. The gluten sensitivity makes it difficult for the body to absorb vitamins, in particular vitamin D. Read more on wikipedia-gluten sensitivity or wikipedia coeliac disease.

This is an article about gluten sensitivity; it explains gluten intollerance and -allergy and the other grains that might cause problems for your system and why: "(Quote) Two years ago, at the recommendation of a nutritionist, I stopped eating wheat and a few other grains. Within a matter of days the disabling headaches and fatigue that I had been suffering for months vanished. Initially my gastroenterologist interpreted this resolution of my symptoms as a sign that I perhaps suffered from celiac disease, a peculiar disorder in which the immune system attacks a bundle of proteins found in wheat, barley and rye that are collectively referred to as gluten. The misdirected assault ravages and inflames the small intestine, interfering with the absorption of vital nutrients and thereby causing bloating, diarrhea, headaches, tiredness and, in rare cases, death. Yet several tests for celiac disease had come back negative. Rather my doctors concluded that I had nonceliac “gluten sensitivity,” a relatively new diagnosis. The prevalence of gluten sensitivity is not yet clear, but some data suggest it may afflict as many as 6 percent of Americans, six times the number of people with celiac disease. (...) Lately, however, some researchers are wondering if they were too quick to pin all the blame for these problems on gluten. A handful of new studies suggest that in many cases gluten sensitivity might not be about gluten at all. Rather it may be a misnomer for a range of different illnesses triggered by distinct molecules in wheat and other grains.“You know the story of the blind man and the elephant? Well, that’s what gluten-sensitivity research is right now,” says Sheila Crowe, head of research at the gastroenterology division at the School of Medicine at the University of California, San Diego."

Lactose allergy 

Lactose intolerance, also called lactase deficiency and hypolactasia, is the inability to digest lactose, a sugar found in milk and to a lesser extent dairy products. People who are lactose intolerant have lower levels of lactase -an enzyme that is needed to break lactose down into  glucose and galactose in the digestive system-, which may be genetic or environmentally induced.  Lactose, a disaccharide molecule found in milk and dairy products, cannot be directly absorbed through the wall of the small intestine into the bloodstream so, in the absence of lactase, passes intact into the colon. Bacteria in the colon can metabolise lactose, and the resulting fermentation produces copious amounts of gas (a mixture of hydrogen, carbon dioxide and methane) that causes the various abdominal symptoms. The unabsorbed sugars and fermentation products also raise the osmotic pressure of the colon, causing an increased flow of water into the bowels (diarrhea). When people with this eficiency do consume enough amounts of lactose, this usually causes symptoms like abdominal bloating and cramps, flatulence, diarrhea, nausea, rumbling sounds coming from the stomach or vomiting. The severity of symptoms typically increases with the amount of lactose consumed; most lactose-intolerant people can tolerate a certain level of lactose in their diet without ill-effect. Some studies have produced evidence that milk consumption by lactose intolerant individuals may be a significant cause of inflammatory bowel disease. Wiki states that most mammals normally stop to produce lactase, and will naturally become lactose intolerant after weaning, but some human populations have developed lactase persistence, in which lactase production continues into adulthood. (Perhaps this is because humans began to drink milk as part of their normal diet at some point in time, and evolution then made us produce lactase for a longer period of time?). It is estimated that 75% of adults worldwide show some decrease in lactase activity during adulthood. The frequency of lactose intolerance ranges from 5% in Northern European countries (England, Scotland, Ireland, Scandinavia, and Iceland) to 71% in Italy (Sicily) to more than 90% in most African and Asian countries. This distribution is now thought to have been caused by recent natural selection favoring lactase-persistent individuals in cultures in which dairy products are available as a food source. Small intestine problems that can cause lactose intolerance include bacterial overgrowth, celiac disease and Crohn's disease.

Important note  
Also for those who do not suffer from an actual allergy, cutting down on dairy might be something to at least hear about. In this article, a scientist with recurrent breast cancer did research why in China breast cancer hits 1 in every 100,000 women only, whereas in the UK this is 1 in 10 (and in The Netherlands even 1 in 7). She concluded it is because of dairy products. Interesting read and a quote from the article here: "Professor Plant believes while going dairy-free helped her breast cancer, it could prove beneficial for those patients diagnosed with colorectal, lymphoma and throat cancer. 'We have all been brought up with the idea that milk is good for you,' Prof Plant told the Telegraph. 'But there is evidence now that the growth factors and hormones it contains are not just risky for breast cancer, but also other hormone-related cancers, of the prostate, testicles and ovary. 'Cows’ milk is good for calves – but not for us.' Scientists understand cancer-causing genes may not become active until particular conditions arise in the body, to effectively switch them on. Equally, the science suggests those that can be switched on, can also be switched off. Therefore this means that what a person eats can have a genetic impact. Scientists believe cancer cells are hypersensitive to chemical messenger proteins called growth factors, as well as hormones, including oestrogen. Growth factors are produced by the body, and perform vital tasks such as making cells grow. The risk of cancer comes when we have abnormally high levels of growth factors in the blood, circulating the body. Professor Plant and her co-author, Professor Mustafa Djamgoz, state the same growth factors and hormones responsible for the growth of cancer cells, are found in food that comes from animals. They say certain foods provide the 'fertiliser' cancer cells need to grow, with the main protein in cows' milk being considered the most dangerous. A leading U.S. nutritional scientist, Professor Colin Campbell at Cornell University, has aruged that cows' milk should be regarded in the same category as oestrogen, as a leading carcinogen. Professor Plant told the Telegraph: 'Cow's milk has been shown to contain 35 different hormones and 11 growth factors.' For those patients already diagnosed with cancer or those shown to be at high risk of developing the disease, she advocates, among other things, cutting out all dairy – from cows, sheep and goats, and whether organic or not."

Testing for lactose intolerance

Your doctor may suspect lactose intolerance based on your symptoms and your response to reducing the amount of dairy foods in your diet. Your doctor can confirm the diagnosis by conducting one or more of the following tests: *Lactose tolerance test. The lactose tolerance test gauges your body's reaction to a liquid that contains high levels of lactose. Two hours after drinking the liquid, you'll undergo blood tests to measure the amount of glucose in your bloodstream. If your glucose level doesn't rise, it means your body isn't properly digesting and absorbing the lactose-filled drink. *Hydrogen breath test. This test also requires you to drink a liquid that contains high levels of lactose. Then your doctor measures the amount of hydrogen in your breath at regular intervals. Normally, very little hydrogen is detectable. However, if your body doesn't digest the lactose, it will ferment in the colon, releasing hydrogen and other gases, which are absorbed by your intestines and eventually exhaled. Larger than normal amounts of exhaled hydrogen measured during a breath test indicate that you aren't fully digesting and absorbing lactose. *Stool acidity test. For infants and children who can't undergo other tests, a stool acidity test may be used. The fermenting of undigested lactose creates lactic acid and other acids that can be detected in a stool sample (source).


What foods to avoid when you want to stop consuming lactose? 

Lactose is present in two large food categories—conventional dairy products, and as a food additive butter, however, contains very little lactose and is safe for most lactose-intolerant people. Dairy products that are "reduced-fat" or "fat-free" generally have slightly higher lactose content. People can be more tolerant of traditionally made yogurt than milk, because it contains lactase produced by the bacterial cultures used to make the yogurt. Frozen yogurt will contain similarly reduced lactose levels. With cheese, fermentation and higher fat content contribute to lesser amounts of lactose. Traditionally made Emmental or Cheddar might contain 10% of the lactose found in whole milk. In addition, the ageing methods of traditional cheeses (sometimes over two years) reduce their lactose content to practically nothing. Commercial cheeses, however, are often manufactured by processes that do not have the same lactose-reducing properties.  You can read more on lactose intolerance on wikipedia. (casein, caseinate, whey), which may contain traces of lactose. If you want to avoid eating lactose, the prime product to avoid is milk. Lactose is a water-soluble substance. Most lactose is found in the water-based portions of dairy. Milk for instance. Less lactose will be found in the fatty contents of dairy products, like butter. The butter-making process separates the majority of milk's water components from the fat components. Lactose, being a water soluble molecule, will largely be removed, but will still be present in small quantities in the butter unless it is also fermented to produce cultured butter. 

Forum posts from rosacea patients about food allergies or - intolerance

Scully555 wrote on September 19th 2009: "I had very similar rashes that I lived with for many years that were so severe I stopped going out with friends on the weekends and avoided social contact with anyone but my closest friends because I was tired of the "What's wrong with your face?" comments and having people say EEEEEEIIIIIIIIIWWWWW. After years of misdiagnosis from two or three "specialists" I finally did what a coworker suggested. I read all the labels on my bath soap packaging and on my hair care products. It turns out I was using a heavily medicated dandruff shampoo loaded with "tar" that was only supposed to be used a few times a week when dandruff appeared and once or twice a month when dandruff was not visible, as a preventative measure. I was using it daily and sometimes twice a day for years. When I stopped using the shampoo, my face cleared up 100% within a few weeks and never came back. So, either 3 or 4 years of expensive creams and prescription drugs with little to no affect all of a sudden kicked in on one particular two week period for no apparent reason, or, my shampoo was loaded with a chemical additive that introduced way too much heavy tar into my skin that the skin could not handle causing flush, swollen and very irritated blotchy areas on my face, neck and forehead. I highly recommend that if your only symptoms are a red face with a bulbous nose and big lumpy chunks of swollen skin mass on your face or neck that you pleeeeaaasssse, read all the labels and accompanying warning disclaimers on everything that comes in contact with your face and hands, including clothing labels, dish washing soap, bath soap, hair care products laundry soap, everything that you use on a daily or otherwise regular basis that comes in contact with your skin unless you have properly been diagnosed with anything at all through the proper and comprehensive testing from a very competent doctor. Without proper testing please do not assume that your doctor has made the correct diagnosis. My doctor looked at my skin from 4 feet away and asked me three questions. How long have you had this rash? Is the rash more severe in the sun? Does it get worse when you drink pop or alcohol? Yes, Yes and Yes. Boom, you have Rosacea. Please proceed to the pharmacist and pay the nice man there and we will see you in three months for some new and improved (and more expensive) treatment. Sorry if I sound bitter but I have no idea what I have (had) but it took several years out of my social life and yes, I am pissed that my so called specialist did not take the time to do any tests of any kind whatsoever." - There are countless forum posts on food, diet, gluten allergy, lactose intolerance and the likes, so I invite you to go the the Rosacea Forum and go to the search bar in the top right and look for the topics you are interested there (you can make a topic search there and find all the posts related to it).

RedAwkward wrote on February 23rd, 2015: "My skin has looked the best in years! Hi all, I have been suffering from rosacea for several years now , symptoms started to develop at age 17 and have been getting progressively worst with my baseline redness constantly increasing. I was treated initially treated with Roaccutane because I also suffered from severe acne vulgaris, my face was bright red and covered with spots. Also prescribed topical treatment of metronidazole gel, which many of you are most likely using. As you can imagine, life has been painful and heartbreaking to say the least, during these tender years I have had moments in which my skin looked relatively normal if the severe scarring from acne vulgaris can be ignored, but these moments would only last when I began manipulating my diet for "cutting", a term used in the bodybuilding community to lose body fat. When I was cutting I would reduce carbohydrate intake significantly and rely mainly on fat and protein. What happened was that my skin started to calm down in redness, and began to drastically improve my overall complexion. However when I stopped cutting and began to eat a calorie surplus in which I had large amounts of pasta, my skin started to deteriorate. I was getting depressed because of this, my skin was bright red all the time, I found it hard to look in the mirror. Often I would ask myself what I had done to deserve this. My complexion was only getting worse. So after some research online, I discovered something called Candida, a fungal infection in which many of the symptoms match with my issues. Thrush on my tongue, Headaches, Low energy, Rosacea. I then decided to pursue this diet. Today I have only been following this diet for two days, but the difference in my skins redness has been drastic to say the least. By following advice and guidelines by this website. My confidence is up from before and I feel great, maybe its the food I am eating or perhaps it's because I can see how my face looks like without the redness. But whatever it is, it has been positive and I feel the need to share to other Rosacea sufferers, perhaps this could be a solution to your troubles. Your Rosacea could be caused by other issues that may not be related to your stomach, but if you are not sure I would definitely give this diet a try. Here is my Current diet from breakfast to Dinner. I would not suggest you eat exactly what I eat because I have a high calorie requirement due to weightlifting. I am a 20 year old male, 172cm and 80kg. 12% bodyfat. So calorie intake will definitely be much lower for less active individuals.

Breakfast 3 Eggs + 420g Beans

Snack 100g Almonds + Celery

Lunch Chicken (thyme, Bell Pepper, Onion, Spring Onion) +100g Mixed nuts

Snack Spinach with Bean sprouts

Dinner Chicken (thyme, Bell Pepper, Onion,Spring Onion) + 3 eggs

Snack 100g Mixed Nuts

In terms of the quantity of vegetables that I consume daily:

100g – Spring onion

2 Medium – Bell Peppers

225g – Celery

1 Medium – Brown Onion

100g – Spinach

200g – Bean Sprouts

In conjunction to this I am using a 10 billion CFU probiotic, along with wild oregano Oil, grape seed extract and caprylic acid. I hope this helps anyone suffering from rosacea, as I know from experience this is an emotional painful illness to have despite being considered superficial due to it being not life threatening. But in my eyes, rosacea stops you from being who you are, reduced confidence, embarrassed to go in public. It is a life crippling disease. Wish you all the best in your process to treat this aliment. Regards RedAwkward"

Pollen and contact flushing
Spring in most countries is the time for pollen and mold spores with the result that it affects many rosacea sufferers. However, some areas have enough warmth and proper vegetation for pollen and mold spores year around. You may even see mold spores growing in your bathtub or shower. Other allergies can also stir up rosacea flushing, for instance dust mite allergy or cat dander allergy.

Thermally hot foods and drinks can also cause vascular dilation or flushing in non-rosaceans. Avoid all hot foods and drinks until they have cooled to body temperature or better yet cooled well below body temperature. The best way to drink a small amount of coffee, tea, or soft drink is refrigerator cold as this will not cause as much vascular dilation. Food allergies are common in causing nasal membrane mucous resulting in vascular dilation causing reddening or facial flushing for many. This condition gets the same response (but for very different reasons) as the common cold or influenza which often causes facial flushing due to a bacterial and virus infection. Aspartame and NutraSweet in soft drinks, jellos, and other foods causes noticeable flushing in 30% of rosaceans. Try a 60 day non-aspartame period to watch your facial skin redness improve. After all the foods that cause more vascular dilation or blushing, a bonus is that cherries, blackberries, and blueberries which are vascular constrictors actually assist in reducing the symptoms of facial skin redness.

Susybranch wrote on June 5th 2014 on The Rosacea Forum: "I had type 2 on my nose, with seb-derm, and occasional papules. It could be tamed -- somewhat -- by Oracea and Metrogel, but these were a band-aid, and I was also having stomach issues and began to suspect food intolerance. As many on this board know, some of us who have Rosacea have found a connection to our digestive systems. In my case, I turned out to have so many mild -- but across the board-- food allergies, that the doctor diagnosed me with Leaky Gut syndrome. My immune system was reacting to all these irritants by upsetting my stomach, and my skin. Rather that randomly cutting out food groups, my allergy test let me know exactly what to avoid. (The doctor says that in a few weeks my system should start to "re-set" and I will probably be able to eat most of those foods again.) Between the new diet and the Prosacea, occasional Histame, along with some digestive enzymes and probiotics, I am almost entirely clear. I can even drink a little vodka -- not on my "verboten" list! I urge you all to get a full allergy workup, rather than shoot in the dark about what foods to avoid. I spent a bit of money but saved myself years of guessing."

Heavy meal and high sugar/carb flushing 

Facial skin flushing or vascular dilation can be caused by stress on the digestive system (eating heavier meals), resulting in a higher blood flow to the digestive system with the residual blood being heavier to the face (hence; more blood flow circulation to help digest all that food, and therefore also more blood that circulates to the face area, causing more flushing issues). The digestion process itself also produces some heat and increased temperature in the body, a bit more for women and children than it dores for men. You can limit this type of flushing, by eating smaller meals, spaced out over the day, with some healthy snacks to keep your blood sugar level stable and prevent the digestion system from being 'bombarded' all at once with a massive meal. This will also maintain the proper blood sugar content for energy to prevent fatigue or exhaustion. The type of food that you eat is also very important as various foods stimulate blood flow differently. Simple carbohydrates such as donuts, sugars, alcohol, etc. enter the blood stream quickly causing hyperglycemia (high glucose spikes.) However, in the next paragraph things will get more messed up and complicated, because complex carbs actually also heat the body up when they get digested.... Why is all this so complex for us rosaceans?? This rapid influx of sugar into the blood stream is a potent vasodilator. Carbohydrates are needed for energy and as a part of every meal; however, try to switch from simple to complex carbohydrates. For instance, sweet potatoe, apples or quinoa. Fiber intake decreases the amount of food that the stomach has at one time and prolongs digestion; therefore, it prevents the sudden influx into the blood stream with the resultant facial skin flushing. (source).

Sugar
A high sugar diet can aggravate the balance of sex hormones which then causes spots and skin outbreaks. Sugar is also an inflammatory substance on cell level and can worsen inflammation of the skin and redness.

Here are some other info sources:
Rosacea and Gluten
A rosacea blog about gluten
Does rosacea always get worse? Forum thread
Acne forum; is eliminating dair the answer? 
Acne help, rosacea and SIBO
Is gluten free helping? Rosacea forum 
Gluten-wheat free diet, Rosacea Forum  
Gluten intolerance, the culprit, Rosacea Forum
Does a low carb, no sugar or dairy help with skin burning and irritation?   
Should I give up dairy?

Foods that can make you thermally hotter

Ice cream It turns out the fat content in ice cream actually makes your body warmer. Foods that contain more fat, protein, and carbohydrates often heat the body up a little bit while digesting food. The sheer temperature difference gives a cooling sensation, but when your body starts to digest, you feel warm because your body has to provide energy to digest that food product. Fat is notorious for moving slowly through the digestive system so it takes more energy to digest that fat. Anytime you are putting more energy through the system, whether it be digestion or weight lifting, your body has a tendency to heat up.

Brown rice Complex carbohydrates like rice and other whole grains are also harder to digest, making the body warmer during the process. Anything with a lot of complex carbohydrates and processed foods like rice and cereal products can be more warming than cooling.

Beer Alcohol can dehydrate you and make your body flushed - a process called vasodilatation, which is caused by the widening of blood vessels. This can cause your skin to heat up. When the body starts to vasodilate, you can flush pretty heavily. It is going to be warming, especially in the surface capillaries in your face.This also depends on how much alcohol you consume in one sitting. The more alcohol someone drinks, the more flushing will occur. (source)

Foods That Make You Cooler

Watermelon As a general rule, the higher the water content in a food, the more likely it will keep your temperature down. Watermelon is chock-full of water, which slows down digestion and takes less energy from the body. Note that melons are high in salicylate, another substance that can worsen  some rosaceans flushing, for those sensitive to salicylates. If you flush from aspirin, you might also flush from high contents of salicylates in food.

Leafy greens Most raw fruits and vegetables are 80-95% water, and anything that contains a lot of water is very easy to digest and goes through the digestive system very quickly, giving you a cooling sensation. Easy digestion means less energy and heat.

Peppers Spicy foods can make you sweat, which provides a cooling sensation. Peppers are often consumed in countries close to the equator because they are perceived as cooling foods primarily because they influence the body when you perspire, and through evaporative cooling, you feel cooler. It doesn’t cool you to the core, but it cools the skin. Note, this is obviously not wise to eat for anyone with rosacea and flushing issues. This tip only applies to the general population with normal skin I think.

Inflammatory foods
Internal inflammation can happen for a host of different reasons: high temperatures when cooking food, eating processed foods, fried foods, sugar, trans fats, etc. A high level of inflammation within the body can cause many health problems and stir up both rosacea and facial flushing. Inflammatory foods include corn, sugar, pork, processed food, any food that went into the deep fry, alcohol. According to the Traditional Chinese doctors I visited, garlic, unions, ginger, spices, predator fish types, lamb, citrus fruits, tomatoes, strawberries, chocolate and dairy and wheat products also cause internal inflammation in the skin.

Top 10 inflammatory foods

 These foods have been linked to obesity, increased risks of numerous diseases and can elevate inflammation levels in the body and worsen auto-immune diseases
1. Sugar: Sugar is everywhere. Try and limit processed foods, desserts and snacks with excess sugar. Opt for fruit instead.
2. Common cooking oils: Safflower, soy, sunflower, corn, and cottonseed. These oils promote inflammation and are made with cheaper ingredients.
3. Trans fats: Trans fats increase bad cholesterol, promote inflammation, obesity and resistance to insulin. They are in fried foods, fast foods, commercially baked goods, such as peanut butter and items prepared with partially hydrogenated oil, margarine and vegetable oil.
4. Dairy: While kefir and some yogurts are acceptable, dairy is hard on the body. Milk is a common allergen that can trigger inflammation, stomach problems, skin rashes, hives and even breathing difficulties.
5. Feedlot-Raised Meat: Animals who are fed with grains like soy and corn contain high inflammation. These animals also gain excess fat and are injected with hormones and antibiotics. Always opt for organic, free-range meats who have been fed natural diets.
6. Red and Processed Meat: Red meat contains a molecule that humans don't naturally produce called  Neu5GC. Once you ingest this compound, your body develops antibodies which may trigger constant inflammatory responses. Reduce red meat consumption and replace with poultry, fish and learn cuts of red meat, once a week at most.
7. Alcohol: Regular consumption of alcohol causes irritation and inflammation to numerous organs, which can lead to cancer.
8. Refined Grains: "Refined" products have no fiber and have a high glycemic index. They are everywhere: white rice, white flour, white bread, pasta, pastries... Try and replace with minimally processed grains.
9. Artificial Food Additives: Aspartame and MSG are two common food additives that can trigger inflammation responses. Try and omit completely from the diet.
10. Fill in the Blank: Do you constantly have headaches or feel tired? Do you feel flushed every time you eat a certain food item? Sometimes, you may develop an allergy to a food and not even know it. Coffee, certain vegetables, cheese... there might be a trigger you aren't even aware of. Or you are not actually allergic to the food, but intolerant to it (sensitivity that will cause you symptoms, but that won't show up in a standard blood test for allergies). Try and take a few foods out to see how you feel  and slowly incorporate them back in to see if there might be a hidden culprit lurking in your diet!

Top 10 anti-inflammatory foods

1. Wild Alaskan Salmon: Salmon contains anti-inflammatory omega-3s (wild is better than farmed) and has been known to help numerous ailments. Note, fish can be high in histamine and heavy chemicals like mercury and can actually worsen flushing for some. Its trial and error with what fish types your rosacea tolerates and which not.
2. Kelp: High in fiber, this brown algae extract helps control liver and lung cancer, douses inflammation, and is anti-tumor and anti-oxidative. Kombu, wakame and arame are good sources.
3. Extra Virgin Olive Oil: The secret to longevity in Mediterranean culture, this oil provides a healthy dose of fats that fights inflammation, can help lower risks of asthma and arthritis, as well as protect the heart and blood vessels.
4. Cruciferous Vegetables: Broccoli, brussel sprouts, kale and cauliflower are all loaded with antioxidants. Naturally detoxifying, they can help rid the body of possible harmful compounds.
5. Blueberries: Blueberries not only reduce inflammation, but they can protect the brain from aging and prevent diseases, such as cancer and dementia. Aim for organic berries, as pesticides are hard to wash away due to their size. Note that blueberries are high in salicylate, another substance that can worsen some rosaceans flushing, for those sensitive to salicylates. If you flush from aspirin, you might also flush from high contents of salicylates in food.
6. Turmeric: This powerful Asian spice contains a natural anti-inflammatory compound, curcumin, which is often found in curry blends. It is said to have the same effect as over-the counter pain relievers (but without their side effects). Note that turmeric is a spice and while it helps some rosceans, it can worsen symptoms as well for some (for me it did when I tried it with bromelaine).
7. Ginger: Ginger contains a host of health benefits. Among them, it helps reduce inflammation and control blood sugar. Ginger tea is a great addition to any diet. Note that ginger is a spice and while it helps some rosceans, it can worsen symptoms as well for some. My traditional Chinese doctors warn against it, as it can heat the body up they say, for people with inflammatory skin diseases.
8. Garlic: Though a little more inconsistent (in terms of research), garlic can help reduce inflammation, regulate glucose and help your body fight infection. Note that garlic might help some rosceans, it can worsen symptoms for some. My traditional Chinese doctors warn against it, as it can heat the body up they say, for people with inflammatory skin diseases.
9. Green Tea: Like produce, this tea contains anti-inflammatory flavonoids that may even help reduce the risks of certain cancers. Note that some people react to the tannins and other chemicals in some types of green tea, and that a good alternative is to make tea from rosemary or thyme, both have anti inflammatory substances in them.
10. Sweet Potatoe: A great source of complex carbs, fiber, beta-carotene, manganese and vitamin B6 and C, these potatoes actually help heal inflammation in the body. Note, I love sweet potatoes! My rosacea handles them well, in moderation.

Rosacea, treating it with diet changes,
avoiding inflammatory foods.
German doctors give advice.
Translated by me into English:

Pictures of foods I made and eat

 

Update

Some people reported good results with THE GAPS DIET. For many GAPS patients, the diet should be followed for two years at least.  The book Gut & Psychology Syndrome will provide recipes and more explanation about the diet. The best foods are eggs (if tolerated), fresh meats (not preserved), fish, shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil.  Apart from eating vegetables cooked, it is important to have some raw vegetables with meals, as they contain vital enzymes to assist digestion of the meats.  Fruit should be eaten on their own, not with meals, as they have a very different digestion pattern and can make the work harder for the stomach.  Fruit should be given as a snack between meals. It is very important to have plenty of natural fats in every meal from meats, butter, ghee, coconut (if tolerated) and cold pressed olive oil.  Animal fats on meats are particularly valuable.  Fermented foods (sauerkraut, yogurt, and kefir) are also a very important part of this diet in addition to homemade meat or fish stock.  It is recommended to take a cup of warm meat or fish stock with every meal as a drink as well as soups and stews made with the meat or fish stock.  The stock, kefir and fermented vegetables will over time restore the stomach acid production, which will improve digestion. It is best to avoid processed foods (any packet or tinned foods).  They are stripped from most nutrients that were present in the fresh ingredients used for making these foods.  They are a hard work for the digestive system and they damage the healthy gut flora balance.  On top of that they usually contain a lot of artificial chemicals, detrimental to health, like preservatives, colorants, etc. Try to buy foods in the form that nature made them, as fresh as possible. Here you can read all the foods that are allowed in the Gaps diet.

Bumpy Face found that sticking to an anti Candida diet improved her rosacea symptoms a lot: "Of course. I would say the redness is about 80% improved. I suffered from pustules and a constant ruddiness on my cheeks, chin, forehead and nose. I didn't suffer from flushing unless I was working out quite strenuously and then I would flush a deep purple from neck to head.  Basically, sugar, wheat, alcohol, preservatives, etc. feed the yeast. You want to kill the yeast with herbs, replace the healthy bacteria with probiotics, and starve the yeast all at the same time. That means no juice, you aren't even really allowed fruit but I will eat the occasional apple. I basically drink water and unsweetened iced green tea all day. I do drink coffee in the morning though the milk I add would be considered a cheat, no dairy. For breakfast I eat eggs and ham. I occasionally supplement with these gluten and sugar free muffins I make. I read somewhere that you can make French toast using eggplant instead of bread, but I haven't tried it yet. On weekends I will eat gluten free pancakes I make from scratch with my kids. For lunch I usually have a sweet potato and a green vegetable with olive oil and butter. Switch to Celtic sea salt if you can. For dinner I have chicken/fish/red meat, salad, veggies. Homemade soups are also great. Another good lunch idea is to make single serve meat-loafs in a muffin pan and freeze them. I often pop one in the microwave to pair with a veggie. You also want the highest quality proteins, organic, grass-fed, etc. For dessert I have a bit of dark chocolate (90% cocoa). I eat this way 100% during the week and allow myself a few cheats on the weekends. It sounds harder than it is. Once you give this stuff up, you lose the cravings for it. I also roast Kale chips and chic peas for snacks."


This author/blogger wrote the article "Fifty shades of rosacea", with rosacea details how diet changes helped her skin
"I changed my diet quickly and dramatically, cutting out all refined sugars, gluten, dairy, red meats, processed foods, yeast, white starchy carbs, coffee and alcohol. Basically anything that contradicted boosting my immune system. Much to my surprise, the diet started to have an effect. The bumps on my cheek became less red, smoother and started to disappear. I followed this strict regime for three months and by then the rosacea (which at this stage was only on my left cheek) had almost gone. This was September 2013. That September I went on a long trip to Thailand and I ditched my health regime in favour of my old sugar-ridden diet! After all, the rosacea had gone, I was feeling good and I wanted to enjoy myself! The rosacea remained at bay for a few months. My life at this point became increasingly more stressful – my partner was very sick, work was constant (which I loved but it also came with stress and pressure which I laid heavily upon myself), my diet was poor and I was drinking alcohol regularly and in large quantities. As you’ve probably guessed, the rosacea returned. This time on my right cheek and progressed very quickly into a burning red, itchy, invasive patch. Within a few weeks it had also returned on the left cheek as well. This was horrifying to me. I felt like I was not in control of my own body and all I could see when I looked in the mirror was ugliness and an unhealthy person. The rosacea was back full force and worse than I’d ever seen it before. I had also developed flushing when I ate in the evenings. This is a most unpleasant symptom where my face became burning hot and flushed bright red across the cheeks, nose and forehead. This was happening whenever I ate anything; peculiarly though, not in the mornings. It was enormously distressing to feel like I had no control over my body. I had to make a change again.

Over night I changed my diet. This time though, it was more of a conscious permanent change rather than seeing it as a quick fix. I began reading anything I could find about rosacea along with researching how nutrition effects your health and how stress impacts your body. One website in particular jump started my journey into understanding how my body reacts to stress and poor diet and what I could do to help change my health. I recommend taking a look at foodmatters.tv and watch their documentary Food Matters. One month in, after cutting out all refined sugars, meat (except organic, sustainable fish), gluten, chemicals and preservatives, processed foods, dairy products, coffee and other stimulants, alcohol and following a daily meditation and yoga plan, my skin looks like this"

Update October 2013

In this article, the author explains which foods play a role on inflammatory auto immune diseases like arthritis, and also potentially an inflammatory (and presumably autoimmune) disease like rosacea. It states that polyunsaturated fats from meat and linoleic acid, from corn, sunflower and mixed vegetable oils, encourage inflammation. Better options are to eat less animal fat products and to use olive oil (or other oils that are higher in monounsaturated fats). Supplements: Omega 3 fats and supplements with gamma linolenic acid (GLA) produce anti-inflammatory effects. Good sources are cold water fish, other types of fish and fish oil, flaxseed oil, borage seed oil black current oil and evening primrose oil. The GLA in these oils can be coverted into dihommo gamma linolenic acid, which can then be converted into anti-inflammatory PG-1 eicosanoids. The author states that he thinks that a supplement combining 400 mg each of fish oil, flaxseed oil and borage oil is the ultimate EFA supplement for autoimmune patients. He recommends 3-6 capsules per day. Certain antioxidants help with the synthesis of anti-inflammatory substances: vitamin B6, C, E, selenium, magnesium and beta carotene.


He also names some herbal supplements that have anti-inflammatory actions: 
*white willow extract
*ginger
*boswellia
*curcumin
He recommends a combination of them, 1-3 capsules, three times per day, to achieve control of their inflammatory condition. "These natural agents work in a similar was as aspirin, ibuprofen, COX-2 inhibitors and some other non-steroidal anti-inflammatory drugs, but without the risks of gastrointestinal bleeding, or liver and kidney toxicity.  

I had a thorough series of blood tests done by an immunologist 2 years ago and was actually tested on the substances the author names:
*Tumor Necrosis Factor Alpha:  serum levels should be below 8,1, mine was 5,6 pg/mL, so in the normal range.
*Interleukin 1, 6, 8: I only had 6 tested: serum levels should be below 5,9 and mine were 2,0, so in the normal range. I wonder if that means I have no inflammation issue on paper. I know I have in reality however (diagnosed with colitis, Raynaud's syndrome, Rosacea, light arthritis in knees). Anyway, it might never hurt to take such supplements for people with rosacea, IF they can handle them of course. Fish oil is high in histamine and I get very flushed from it so that one is no option for me, but I know people who swear by it.

Update October 2013 

Someone wrote: The 5:2 diet been great for my rosacea so far. Hey All,

I've had very bad skin/rosacea for ages (10 yrs plus.) Last year to try reduce my rosacea I started juicing Carrot, Celery and Cucumber juice every day. My skin showed some improvement alright but still had regular flare ups, etc... Was generally in better condition but still had spots, and ugly ugly skin from time to time. Then horizon on BBC put out a magnificent show last year called 'Eat, Fast and Live Longer.' it was about the health benefits of fasting. Very interesting stuff. One of the approaches described in the show was to eat 500 calories 2 days in the week and just eat a normal diet on the other 5 days (hence the 5:2 diet). This triggers mechanisms in your body that alter certain hormones and switch your cellular activity from growth to repair. To cut a long story short, I heard positive things about the diet from friends of friends I decided to give it a shot. I've been at it now for around 6 weeks and the change in the condition of my skin has been remarkable and sustained. So much so that other people are commenting on it, like 'wow you look great' and stuff like that. Even to the touch my skin feels soooo much smoother, and normal!! Generally I feel my health is better too, more energy, etc...

I'm only putting this out there because it genuinely may be of real help to others. Google the BBC show and read a bit about how it works. I didn't expect it to heal my skin too but it is really really encouraging so far. I've also continued juicing, making around 1 litre of Carrot Celery and Cucumber juice around 3 times per week. I think that can't hurt too.

JUST BE CAREFUL OF THE DIET THOUGH!!! I HEARD OF A FRIEND OF A FRIEND WHO TRIED IT AND DIDN'T KNOW SHE WAS DIABETIC. SHE COLLAPSED AND HAD TO GO TO HOSPITAL BECAUSE HER SUGARS DROPPED... SO BE CAREFUL. Otherwise, I recommend this strongly and sincerely wish you the best and hope you get similar results to those I've had so far. Thank you BBC and Michael Moseley (the presenter) for an amazing and potentially life changing bit of TV. Vinny

FYI... my fast day diet is generally
13:00 - small bowl of porridge (200 calories)
17:30 - big salad (lettuce, beetroot, balsamic vinegar, small bit of Feta and Olives - 70 calories)
20:00 - boiled egg and slice of brown bread (soda bread) toasted - 160 calories
20:30 - a peach or a plum (50 calories)
Lots of green/black tea
total: around 480 calories, it's tough but worth it so far.

AND, I've reintroduced foods that normally used to cause flare ups without any repercussions, e.g. Curry, Red Wine, Cheese, Coffee.... yum yum yum."

MasK wrote about his rosacea diet: "I have a very low carb diet, and to balance the fact that I eat not enough calories, I eat more fats. Olive oil, coconut oil (raw organic virgin). Don't worry about fats intake, they're not so bad for your health if you choose them from good sources. It helps a lot, and now my weight is perfect even if I don't eat any carbs except vegetables, and a banana a day, some honey. So my diet looks like : meat (no red meat), fish (fatty fishs like mackerel, salmon,...), vegetables (all of them), home made yogurt (not from cow milk, I prefer sheep or goat), bananas, honey,... I also drink kombucha tea which is delicious and good for health. I take vitamin D3 (5000 IU/day), and triphala (ayurvedic digestive cleanser). I follow this routine for about 4 years now (some changes now and then). I have IBS and rosacea for some years, and this helps control both of the problems. Let's say I spend about 2 months without too much trouble, then one week with all the symptoms back (it starts with bad heartburn, then pimples, digestive issues and pain), then again 2 months, etc. You have to find the adjustments that will fit for you but this could be a good start."

Links to the documentary and another great one on diet and health are:

       

LINKS
-Here is more about inflammation and food.
-And here is a blog from a woman with chronic inflammatory disease and her findings on diet and how her diet improves her symptoms.
-Here is an article about how to treat candida naturally through diet
-Here is an interesting blog about rosacea versus gluten

Update December 2013

The Gut’s Microbiome Changes Rapidly with Diet (link). A new study finds that populations of bacteria in the gut are highly sensitive to the food we digest. Micro-biologists have known for some time that different diets create different gut flora, but previous research has focused on mice instead of humans, leaving the actual relationship between our food and our stomach bacteria unclear. A new study, published Wednesday in Nature, indicates that these changes can happen incredibly fast in the human gut—within three or four days of a big shift in what you eat. “We found that the bacteria that lives in peoples’ guts is surprisingly responsive to change in diet,” Lawrence David, assistant professor at the Duke Institute for Genome Sciences and Policy and one of the study’s authors, says. “Within days we saw not just a variation in the abundance of different kinds of bacteria, but in the kinds of genes they were expressing.” (Scientific American is Eugene Chang, a professor of medicine at the University of Chicago who specializes in gastroenterology agrees that the speed is surprising. “One of the major points of this study was that in contrast to what we thought might take days, weeks or years began to happen within hours,” says Chang, who was not part of the study. They also observed changes in the amount of bile acid secreted into the stomach, and found that bacteria native to our food—microorganisms used to produce cheeses and cure meats—are surprisingly resilient, and colonize the gut along with species already in our microbiome. But why do we care about which critters are helping us digest our food? “The incredible quickness of this shifting is interesting,” David says, “for at least two reasons:” The first is evolutionary. These rapid changes, he says, could have been very useful for ancient humans. For hunters and gatherers, diet could be altered quickly and with little transition—weeks of nuts and seeds might be broken up by a sudden influx of meat from a successful hunt—and the ability to rapidly change the microbiome would ensure maximum nutrient absorption from even the most unfamiliar foods. For modern humans, the rapid shift could be less adaptive. The 10 participants in the study switched to either a plant- or animal-based diet, with the former avoiding animal products and the latter eating milk, cheese and meat. In the subjects eating animal products the researchers saw a significant uptick in Bilophila wadsworthia, a bacteria known to contribute to colitis, a variety of inflammatory bowel disease, in mice. But the link hasn’t been studied in humans, so David does not think that cheese-lovers are necessarily eating themselves sick. “We’re anticipating that people will try to draw conclusions about which diet is better from this,” David says, “and we want to address that it’s very difficult to come to any health-related judgment based on this study.” Without measurements of host health during the study, like inflammation in the gut or immune system responses, David says, such a connection is impossible to make. Chang, who has worked on the connection between B. wadsworthia and colitis in mice, agrees that the new study does nothing to prove the same for humans. But he thinks there may be something there. “This study shows how sensitive the body is to dietary change,” he says. “For the lay public, it underscores the importance of diet in health and disease. People should pay more attention to what they eat. But it rests on scientists to recognize that dietary discipline has these varied effects, and to understand what each component does so we can design healthier diets.” Dramatic changes in our diet, he says, could very well be the cause of “Western disorders” such as inflammatory bowel disease and obesity. Still, David says, his study was not meant to change the way we eat. Follow-up research could monitor host health to support a connection between certain bacteria and disease. Whereas the initial study was small, David says the research team is unlikely to repeat it with a larger group. The results were consistent from one individual to another, so although more participants would add statistical support, he doubts they would see a change in the bacterial activity. “I should also point out,” David says, “that it’s fairly difficult to get even 10 people that will radically change their diet and then track themselves so regularly.” Instead, he anticipates that future studies will explore how things like food preparation change which flora flourish in the gut.

This is what a friend of mine eats, who has rosacea and flushing issues:
"Thanks so much for the details of what you eat! Sounds like you are low on fats though? Animal fats or ghee are really good for us, but I do find that I'm retaining some weight eating a lot of fat whilst on the mirtazapine. I've put on well over a stone in the last year, which is previously unheard of for me. I haven't been able to tolerate fruit of late sadly. I eat:
- first meal: cooked carrots, courgettes, cabbage in coconut oil + an animal fat (ghee or goose fat) + one or two eggs (soft boiled), drizzled w/ lots of olive oil. Sometimes cucumber as well. I cook the veggies down for about 20 minutes until they're really soft. Thinking about it the histamine in the egg whites prob aren't doing me good but oh well, saturated fat is good for us.
- second and third meal: either a soup w/ chicken stock or coconut milk containing a few veggies (green or stringless beans, celeriac, cauliflower, green/orange/yellow peppers, kale, celery, squash, fennel, etc ) or a couple of veggies just steamed (green beans + celeriac, say) with meat or fish (chicken, trout, salmon, sea bass, etc.)
- I used to eat a lot of rice cakes too until my stomach got too upset by them, and I eat cashew nut butter for a snack at night. Probably not such a good idea because of the histamine content but nuts are really good for you and it's sweet and I like it. :)"

This is an article on the effects of a low carbohydrate diet on depression

"Proponents of low-carbohydrate diets claim that restricting carbohydrate-rich foods, such as bread, pasta, fruits and vegetables, promotes weight loss and wellness. Low-carb diets can pose many physical and emotional risks, however, ranging from nutrient deficiencies and increased cholesterol levels to depressive moods. Since no singular diet works for everyone, discuss your dietary and wellness goals with your doctor or dietitian.

Cause/Effect
Limiting carbohydrates may cause or exacerbate depressive symptoms. Dampened moods have become so commonplace among low-carb dieters, that they've been coined the "Atkins Attitude," according to Judith Wurtman, director of the Women's Health Program at the Massachusetts Institute of Technology. By restricting carbohydrates, your brain may not produce sufficient amounts of feel-good brain chemicals, such as serotonin. If your serotonin levels plummet, your moods are likely to suffer, too. Serotonin deficiencies can also damage your sex drive and ability to sleep properly, according to Cheryle R. Hart and Mary Kay Grossman, authors of "The Feel-Good Diet." You may also feel deprived of some of your favorite foods, such as breads, cereals and baked goods, while following a low-carb diet or experience lethargy and reduced motivation."

Although this article states that only people who are already prone to depression and anxiety, may be at risk while on the low carb diet:
"Wurtman, who advocates a diet high in complex carbohydrates for weight loss and stress relief, says her studies on rats have shown a connection between a diet low in carbohydrates and low levels of serotonin—a neurotransmitter that promotes feelings of happiness and satisfaction. In her research, rats placed on a ketotic, or low-carbohydrate, diet for three weeks were found to have lower levels of serotonin in their brains. The same rats binged once starch was reintroduced into their diets. Wurtman believes that same effect occurs in humans on low-carb diets and leads to pronounced feelings of depression and sadness, even rage. "People feel very angry, and their antidepressants don't work well, either," she says. Granted, dieting isn't easy no matter how one does it, but many think low-carbohydrate approaches are particularly hard on your happiness. Wurtman goes so far as to call them dangerous for those who already struggle with depression or bipolar disorder. Other researchers disagree. In fact, Wurtman's assertions are in direct contrast to what advocates of low-carbohydrate diets promise—an end to mood swings and fatigue. Indeed, many who have success on these diets say their moods have never been better. "It's a very hard effect to sort out," says Frederick Samaha, chief of cardiology at the Veterans Administration Hospital in Philadelphia. In one study by Samaha, he compared a low-carbohydrate diet with a low-fat diet. "We didn't notice any difference in mood between the two groups. What we found, overall, was that people [on either diet] felt good because they were losing weight and becoming healthier," Samaha says. "But there was a high drop-out rate, around 40 percent, and it may be that those folks left because they didn't see any improvement in their quality of life."Other researchers believe a low-carb diet may have an adverse effect only on those prone to low moods. Philip Cowen, chief of psychiatry at Oxford University in the U.K., reported in a study published in the British Journal of Psychiatry that the mood problem with low-carb diets was measurable but mild in women fighting depression. "We routinely use a low-carbohydrate diet, which does produce evidence of changes in brain-serotonin function," says Cowen. "In people with a history of depression—but not in those without—this diet lowers subjective ratings of ‘happy' slightly." So what is a low-carber to do? Robert Thayer, professor of psychology at California State University, Long Beach, and author of Calm Energy: How People Use Food and Exercise to Regulate Mood, says the best advice is to closely monitor mood after experimenting with food. "If you don't have enough energy to function effectively and meet the demands of your day, that's going to create tension." I personally get too down and anxious from cutting carbs out entirely, but I like sweet potatoes and quinoa and pears and apples and don't find them too bothersome for the rosacea  (as far as I can tell of course). But low carb seems to help a lot of people with rosacea. I have weeks where I eat very low carb and feel that my skin is less inflamed actually. But I find it hard to stick to as I just feel hungry and tired on a diet of only protein and vegetables :/ I try to not eat too many carbs though (but I love them!).

May 2014 update
This is part of an email from me to a friend, about food: "How would you say the US has mostly changed with the decades? I saw some very interesting documentaries on the food industry in your country recently. They explained how the fat epidemic started and how in the 70's they started to find better use for the left over corn, making it into corn syrup and slowly replacing all normal sugar with it. How this stuff causes obesity because of the way it is digested by the body and how more profits were made with streamlining the fast food industry and up-sizing the portions. In the 50's they had only normal sized drinks and portions of food, later they found that by doubling the size, they made a lot more profit and the bodies of the costumers adapted and they kept coming back for more. I guess that's the stuff capitalism can also create. Do you notice this super size problem in Texas? It really speaks to the imagination of Europeans I think. How everything in the US is big; their cars, their people, their meal sizes, their landscapes. When I was in New York I either saw big people or very slim/pedicured/manicures sex and the city type of people. And huge meals indeed. I gorged on cheese cake every day and later found out one portion has around 800 calories, and I would have 2 some days + normal meals :) In that docu they also said that in most supermarkets, the healthy unprocessed food is least subsidized and most expensive. That's terrible.. And all that couponning that is going on from what I saw on docu's is great for savings, but you still end up with a ton of unhealthy products usually." I do have a new found understanding and respect for people struggling with their weight now though. You might have read it on the forum, but I used to be effortlessly skinny, but since starting remeron to cut down on my flushing (and it helps!), my whole metabolism and fat storage changed and it's now a reall challenge to now eat healthy and a lot less than I normal would + to exercise. I used to think that fat people ate french fries and chocolate all day, and I now know that when you use certain medication, or have a not so fabulous metabolism rate for whatever reason, that you can be overweight even when you just eat healthy things..

May 18th 2014 update
On The Rosacea Forum, a member called Scot Viking has been posting some interesting stuff about how his diet has eliminated his rosacea symptoms (LINK). Although I am not a massive fan of his -at times- antagonizing way of going about and his grand ways of expressing himself, he does have a very interesting approach. He starts the (long) thread with this: "I had Papopustular Rosacea, red flushing cheeks, swelling nose, and ocular rosacea (all four basic types for the most part). The only thing which was effective at controlling my rosacea in the past (since the new wheat hybrid was released in 1995) for me prior to this was doxycycline. This lifestyle has been 100% successful in getting me off doxycycline and eliminating my rosacea and the side-effect/symptomatic distraction of "triggers." :)

Morning:
1. Early in the day (and just after dinner) one must obtain a complete and non-toxic protein source, to allow the body to execute its biological and mental functions throughout the day (or night), without anxiety, cravings, hunger or feeling bad. The protein source must have as close as possible to all 18 human proteins (meat only has 5 typically - vegetables have all 18). Forget the word "protein" - start learning about each one..... they are all different and are used for different functions. 2. The protein source cannot contain whey, casein, dairy, peanut, soy, canola, corn, alfalfa, super greens, or wheat. Avoid creatine as it will only cause you to swell up artificially and retain water. Your body makes this on its own. Ignore the baloney about essential and non-essential proteins. There are only 3 truly non-essential proteins, and it is not worth it to focus in that fashion on them - JUST GET ALL 18. Eating a clean, non-toxic, complete array of all 18 proteins is the first key. What I use: A pea, hemp, rice and chia seed protein powder. I use 1 Scoop, and then to this: 3 capsules of key proteins: L-Argenine, L-Ornithene, Glutamic Acid, Aspartic Acid, Leucine, Isoleucine, Valine, Lysine, Proline, and Glycine. These are the proteins which the body demands the most. This will reduce your anxiety through the day, allow you to focus, drink less coffee, reduce your weight, and allow the body the full set of nutrients which are critical for antibody synthesis. It also relaxes the blood barrier so that the body no longer has to make compromises in what it takes in, in terms of toxins, in order to desperately get the proteins it so needs. The body is neither a perfect creation, nor is it a fluke of evolution - it is a highly complex and interleaved system. It knows what it is doing - it just cannot suffer protein malnutrition and toxin ingestion. Those things will damage its systemic functions. 3. My morning carb, fat, sugar and natural protein array: 1 tsp each of Coconut flour, hemp hearts, quinoa flour, amaranth flour, ground chia and ground flax, 1/2 an apple, 3 pitted prunes and 1 tsp of instant coffee and 14 ounces of spring water (no chlorine or fluorine tap water) . The coffee acts as an antihistamine, and as well reduces the cohesiveness and hydrophobic characteristics of the protein powder (allows for more complete blending). Blend items 2 and 3 together in a high speed blender to liquify and drink 1/2 first thing, then the other half around 11 am or so, just before lunch. After you drink this, you will feel alert, fantastic and not hungry for 3 hours. Like a new person. 4. Morning non-protein supplements (all are critical): 1/2 tsp turmeric (to reduce colon inflammation and general anxiety), 5000 IU Vitamin D, a multivitamin, MSM (2 capsules), Thyroid Support with Iodine (1 capsule) , Selenium, 1/2 tsp Maca powder, an acid/HCL/bile digestion ease tablet (x3)

Lunch
5. Drink the other half of your protein shake from breakfast, and add to that fruit, salad and if eating meat, a 1/2 portion. Watch out for sneaking in of whey, wheat based preservatives, cheese, corn, soy, or canola oil.

Snacks
6. V-8 juice, almonds, walnuts, prunes, pickles, sauer kraut, rice bread, rice cracker. Lots of Water. If you are low on blood sugar: 6 ounces of almond milk. REMINDER TO AVOID AT ALL COSTS: WHEAT, DAIRY, SOY, CANOLA OIL, CORN, BARLEY, ALFALFA, SUPER GREENS - Not even 1 serving...... 7. Workout, 45 minutes, and one which is intense enough to CAUSE THE FACE AND SCALP TO SWEAT.....

Dinner
8. Two green vegetables, and one lean meat of either turkey, chicken or fish. One potato in moderation.

Post Dinner Support/Evening Boost or Snack
9. Vinegar with the mother, sauer kraut, and 1 tsp of psylium with 8+ ounces of water. Lots of water.
10. Repeat of the #2 and #3 protein shake and #4 supplements, but a 1/2 serving of everything instead of the full recipe. This will completely eliminate the late night cravings - which are protein malnutrition and anxiety derived. And that is it. I suspect that Rosacea is simply the tip of the iceberg. When one eats bad food, toxins, and suffers malnutrition (one can be fat and suffer malnutrition) THE FACE is the first signal flag - that something is wrong. The real reason to do this is for your over all health, sense of wellbeing, and enjoyment of life. Rosacea is just the tip of the iceberg........"

He also lists the worst food offenders in his experience:

Wheat, Dairy, Soy, Corn Oil, Corn, Wheat Based Preservatives, Whey, Cottonseed Oil, Corn Sugar, Alfalfa, Super Greens, Spring Wheats, Soybean Oil, Canola Oil. 

I also personally find that sticking to my diet, somewhat similar to his, makes my skin tons and tons better. It's a day and night difference really. Like, the last week I only ate some pears and quinoa during the day and then organic vegetable stir fries (fennel, courgette, broccoli, carrots, yellow pepper) with chicken or beef and some dates and figs and my skin was super. Then yesterday on a day on the fair I gave in to frozen yogurt and cashew nuts and I was flushed and burning and red within 30 minutes and skin is a red mess still this morning. Its pretty clear to me at least that there is a major influence, and its exactly the diet that a renowned (no boasting here lol, for real, traveled 4 hours to the west for this man) Chinese medicine doctor gave me to limit inflammation in the body. Plus it makes sense in terms of inflammation triggering and histamine release (the 'bad' foods all score high on one or both factors). I posted in the Ongoing post about Day to Day stuff more about this Scot Viking, as the communication in this thread got a bit out of hand and I feel strongly about it. More to be read there, in the update of May 18th 2014, for those interested of course (as it's really besides the rather interesting conventional stuff he has to say). :)

May 21st 2014 update
I went to a traditional Chinese medicine doctor back in 2002. This couple is very well known in medical circles and have a blooming practice in Rotterdam. They put me on an anti inflammatory diet and also on herbal teas. My  belly got so swollen I looked pregnant on those teas, severe bowel problems and cramps from it too. They readjusted the tea ingredients for months but decided in the end my system is too sensitive for the teas. Its made from herbs, cooked, simmered, then turning into some muddy bitter foul drink but I came there through a good friend. She also studied law and had severe eczema. Since childhood. I think she was covered in it for 75%, no exaggeration, also her face. Beautiful Chinese girl but always scratching and broken out. After a lifetime of eczema she went to this doctor too and after a year of the teas and the strict diet, she was as good as clear from eczema. Now, 12 years later, she still is clean but has to stay away from these pro-inflammatory foods. I noted the full list of food items to avoid in a diary at the time, but since we still have so many things stored in boxes in this new big old house, I haven't found it back yet. I will though. But from memory, the foods on the list to avoid were pork, garlic, unions, predator fish (have to find out which are predators but I think salmon was amongst them and macrel and some others). Lamb meat. Not too much other red meat. No alcohol, beer, no heat inducing things like spices, ginger, no caffeine, no sugar no chocolate. Try to avoid soy I think, definitely avoid corn and wheat. The doctor told me that sometimes patients are on the road to recovery and eat lots of garlic again and go back to zero, they say garlic and unions etc are heat inducing and bad for inflammatory diseases. It stuck with me as I thought garlic was good (anti bacterial etc). BUt that's the theory behind it., A lot of the foods on the list are high in histamine I think and vasodilators. There were also some weirder food items on the list, I think apples were on them and some fruits. But need to find the diary back to be sure. Will update as soon as I find it.

Some more foods I ate recently

(No i didn't eat the cat lol!)

July 26th 2014
Diet. I stay away from dairy mostly. Realized at some point that the more frozen yogurt I made in my ice machine, the more flushed and red I became. Milk and dairy products like yogurt have a lot of natural hormones from the mother cow in them, and they tend to be of the estrogen type. I assume that those hormones might stir the flushing up somehow for me. Or perhaps it has to do with some inability to digest lactose properly for me, I don't know. Just know that sticking to almond and rice milk works better for me. I now eat this usually; breakfast, a pear or peach, lunch; I make a pancake from wholegrain rice flour, almond milk, an organic egg and I put appelstroop on it, a Dutch thing, made of apples and sugar beet, its very nice, would compare it to a type of fruit marmalade. Dinner is usually a stir fry of vegetables like sweet potato, courgette, broccoli, carrot, and I add olives and some dried prunes plus some organic minced beef or chicken. Occasionally fish like tuna steak or salmon. Then I every now and then make my own chocolate, or choco-milk, with pure cocoa powder. The home made chocolate; melt some coconut oil, add some rice flour on the stove in ir, add almond milk, sugar and cacao, keep stirring. I add a bit of tapioca to it for cohesion. Then let is warm and stir it for a good 5 minutes, then I let it cool down and out it in the freezer and in an hour or so you have great chocolate with not too much sugar and no rubbish. Read that dark chocolate has anti inflammatory properties but eating too much makes me flush so I stick to a little bit at night and skin has been calm. Loving the taste of it too :) I try to avoid gluten but when I do eat bread ever so now and then, I have no skin reaction from it. I avoid hot drinks, sugary drinks, fruit juices, multivitamins, vitamin C, zinc (they all make me flushed), coffee, spices and pork. I tend to eat things from scratch, not prepacked and always try to avoid preservatives in food.

On The Rosacea Forum a woman posted about her rosacea success with diet, after suffering from it for decades:
"What has helped me rid my rosacea after more than 30 years of suffering. Hi, I am new to this thread and couldn't find how to post an entirely 'new' thread so replying to this persons despair with Rosacea. I am a woman in my 50's and suffered with rosacea since I was 27. I basically have been on and off doxycycline during this time to control flare ups. The extended use of doxy has given me lots of problems with my gut and so a few years ago I decided cold turkey to stop the doxy and try to live with this horrible condition. It got worse and I almost didn't want to show my face any more. Then one day I went to a skin specialist for more doxy and he said to me, have you tried cutting out tea, coffee, alcohol and chocolate. I told him I ate occasional (well maybe more than occasional) chocolate, drink decaf coffee and don't drink alcohol. He said any coffee will trigger it also hot tea. He then added do you eat cheese and yoghurt. I am lactose intolerant but did consume cheese sometimes with pizza or sandwiches, and yoghurt was something I ate 'every' morning with my cereal. I went away deciding I would really take this seriously and remove all these foods from my diet. I had one month of doxycycline to clear it up initially and then nothing. It is now three years later and I have no rosacea at all and no use of doxycycline or any other antibiotics, my skin has remained clear. Last year I went gluten free which I think may have been another trigger, but now I can say I have really lovely skin with not a problem. Whatsmore,.... I can now eat a small amount of chocolate and cheese with no problem but no more than maybe once per month. If I get the sign of a bump or redness then I immediately go back to the strict elimination and the condition doesn't progress. I never eat yogurt, I think it was one of my main triggers. The specialist said that usually these foods affect women of my age. I wish I could have known about this all those years ago so I could reverse the damage long term antibiotics do to our gut system but that is not to be. I am now trying to resolve chronic dry eye/MGD which has happened over the past couple of years and although the doctors say it is a chronic disease I will have for the rest of my life. I know that one can find help through diet with these conditions as I did with my rosacea, and so I am now pursuing the path to healing my MGD. I would say that anyone wanting to try to help their skin, try eliminating these foods, if it doesn't start to improve after a few months then try taking out foods with gluten too. However, for me the triggers were definitely the cheese, chocolate, yogurt, coffee and tea. and if you drink alcohol, that is another one to remove. I do hope this information helps someone. What works for one doesn't necessarily work for another but I have found out recently through trying to heal my dry eye syndrome that we must try what works for others and if they don't work for us, then look for something else. I truly believe however that this is what healed my skin and gave me back beautiful skin again after so many years of struggle. Forums like this are a Godsend to people with chronic conditions."

February 5th 2015
Here is some interesting information on wheat and gluten. It is discussed in this Rosacea Forum thread. 'Here’s What Happens To Your Brain When You Give Up Sugar For Lent'. February 23, 2015 | by Jordan Gaines Lewis - Anyone who knows me also knows that I have a huge sweet tooth. I always have. My friend and fellow graduate student Andrew is equally afflicted, and living in Hershey, Pennsylvania – the “Chocolate Capital of the World” – doesn’t help either of us. But Andrew is braver than I am. Last year, he gave up sweets for Lent. I can’t say that I’m following in his footsteps this year, but if you are abstaining from sweets for Lent this year, here’s what you can expect over the next 40 days.

Sugar: natural reward, unnatural fix
In neuroscience, food is something we call a “natural reward.” In order for us to survive as a species, things like eating, having sex and nurturing others must be pleasurable to the brain so that these behaviours are reinforced and repeated. Evolution has resulted in the mesolimbic pathway, a brain system that deciphers these natural rewards for us. When we do something pleasurable, a bundle of neurons called the ventral tegmental area uses the neurotransmitter dopamine to signal to a part of the brain called the nucleus accumbens. The connection between the nucleus accumbens and our prefrontal cortex dictates our motor movement, such as deciding whether or not to taking another bite of that delicious chocolate cake. The prefrontal cortex also activates hormones that tell our body: “Hey, this cake is really good. And I’m going to remember that for the future."Not all foods are equally rewarding, of course. Most of us prefer sweets over sour and bitter foods because, evolutionarily, our mesolimbic pathway reinforces that sweet things provide a healthy source of carbohydrates for our bodies. When our ancestors went scavenging for berries, for example, sour meant “not yet ripe,” while bitter meant “alert – poison!"Fruit is one thing, but modern diets have taken on a life of their own. A decade ago, it was estimated that the average American consumed 22 teaspoons of added sugar per day, amounting to an extra 350 calories; it may well have risen since then. A few months ago, one expert suggested that the average Briton consumes 238 teaspoons of sugar each week. Today, with convenience more important than ever in our food selections, it’s almost impossible to come across processed and prepared foods that don’t have added sugars for flavour, preservation, or both. These added sugars are sneaky – and unbeknown to many of us, we’ve become hooked. In ways that drugs of abuse – such as nicotine, cocaine and heroin – hijack the brain’s reward pathway and make users dependent, increasing neuro-chemical and behavioural evidence suggests that sugar is addictive in the same way, too.

Sugar addiction is real
“The first few days are a little rough,” Andrew told me about his sugar-free adventure last year. “It almost feels like you’re detoxing from drugs. I found myself eating a lot of carbs to compensate for the lack of sugar.” There are four major components of addiction: bingeing, withdrawal, craving, and cross-sensitisation (the notion that one addictive substance predisposes someone to becoming addicted to another). All of these components have been observed in animal models of addiction – for sugar, as well as drugs of abuse. A typical experiment goes like this: rats are deprived of food for 12 hours each day, then given 12 hours of access to a sugary solution and regular chow. After a month of following this daily pattern, rats display behaviours similar to those on drugs of abuse. They’ll binge on the sugar solution in a short period of time, much more than their regular food. They also show signs of anxiety and depression during the food deprivation period. Many sugar-treated rats who are later exposed to drugs, such as cocaine and opiates, demonstrate dependent behaviours towards the drugs compared to rats who did not consume sugar beforehand. Like drugs, sugar spikes dopamine release in the nucleus accumbens. Over the long term, regular sugar consumption actually changes the gene expression and availability of dopamine receptors in both the midbrain and frontal cortex. Specifically, sugar increases the concentration of a type of excitatory receptor called D1, but decreases another receptor type called D2, which is inhibitory. Regular sugar consumption also inhibits the action of the dopamine transporter, a protein which pumps dopamine out of the synapse and back into the neuron after firing. In short, this means that repeated access to sugar over time leads to prolonged dopamine signalling, greater excitation of the brain’s reward pathways and a need for even more sugar to activate all of the midbrain dopamine receptors like before. The brain becomes tolerant to sugar – and more is needed to attain the same “sugar high.”

Sugar withdrawal is also real
Although these studies were conducted in rodents, it’s not far-fetched to say that the same primitive processes are occurring in the human brain, too. “The cravings never stopped, [but that was] probably psychological,” Andrew told me. “But it got easier after the first week or so.”

In a 2002 study by Carlo Colantuoni and colleagues of Princeton University, rats who had undergone a typical sugar dependence protocol then underwent “sugar withdrawal.” This was facilitated by either food deprivation or treatment with naloxone, a drug used for treating opiate addiction which binds to receptors in the brain’s reward system. Both withdrawal methods led to physical problems, including teeth chattering, paw tremors, and head shaking. Naloxone treatment also appeared to make the rats more anxious, as they spent less time on an elevated apparatus that lacked walls on either side. Similar withdrawal experiments by others also report behaviour similar to depression in tasks such as the forced swim test. Rats in sugar withdrawal are more likely to show passive behaviours (like floating) than active behaviours (like trying to escape) when placed in water, suggesting feelings of helplessness. A new study published by Victor Mangabeira and colleagues in this month’s Physiology & Behavior reports that sugar withdrawal is also linked to impulsive behaviour. Initially, rats were trained to receive water by pushing a lever. After training, the animals returned to their home cages and had access to a sugar solution and water, or just water alone. After 30 days, when rats were again given the opportunity to press a lever for water, those who had become dependent on sugar pressed the lever significantly more times than control animals, suggesting impulsive behaviour. These are extreme experiments, of course. We humans aren’t depriving ourselves of food for 12 hours and then allowing ourselves to binge on soda and doughnuts at the end of the day. But these rodent studies certainly give us insight into the neuro-chemical underpinnings of sugar dependence, withdrawal, and behaviour.

Through decades of diet programmes and best-selling books, we’ve toyed with the notion of “sugar addiction” for a long time. There are accounts of those in “sugar withdrawal” describing food cravings, which can trigger relapse and impulsive eating. There are also countless articles and books about the boundless energy and new-found happiness in those who have sworn off sugar for good. But despite the ubiquity of sugar in our diets, the notion of sugar addiction is still a rather taboo topic. Are you still motivated to give up sugar for Lent? You might wonder how long it will take until you’re free of cravings and side-effects, but there’s no answer – everyone is different and no human studies have been done on this. But after 40 days, it’s clear that Andrew had overcome the worst, likely even reversing some of his altered dopamine signalling. “I remember eating my first sweet and thinking it was too sweet,” he said. “I had to rebuild my tolerance.” And as regulars of a local bakery in Hershey – I can assure you, readers, that he has done just that. This article was originally published on The Conversation. Read the original article.

August 9th 2015
Emz wrote on August 6th 2015: "Sorry to hear you're having a flare up at the moment. I'm in the same boat as my face seems to have been really sensitive since I tried vitamin D. I've increased my dose of grapeseed extract to 200mg twice a day. It's really helped me with the pain. I don't know a lot about probiotics. I've tried them but not for long and I didn't see an effect but I know lots of people have. I'm day 3 of a gluten and dairy free diet which I hope will help. I'm going to miss pizza!!!  I don't think I could go sugar free as well but I've cut down. Does anyone have tips on the best milk substitute for coffee? I was trying almond milk but it seems to have made me flare up. Oat milk is off the menu and I don't like soy milk."

Faith1989 wrote on August 7th 2015: "Honestly if I eat gluten or dairy (even a splash of cream in my coffee) I will flare that day or the next day. I cannot tolerate either! I'm trying to eat the Wahls paleo diet with lots of vegetables! Eating clean foods and avoiding gluten, dairy, grains and sugar really helps. But I need to be more strict!"

Emz replied on August 7th 2015: "I'm sticking with it but it's frustrating as my skin is actually worse. How can I possible be better off eating pizza? The texture of my skin is awful today and the redness is the worst it's ever been although not overly flushing today. Has anyone else had this? Feeling like I should give up already!"

Mistica replied on August 7th 2015: "If you have abnormal gut flora in your gut and you cut out the food groups which were fuelling them, they will die in great numbers and you will see this effect in your face. This is especially the case with the die off of gram negative bacteria which release lipopoly-saccharrides. You could also develop other symptoms elsewhere. Also, if you have greatly reduced your glucose intake your body will take some time to adjust. It took me around 3 or 4 weeks to adjust on the GAPS diet. Going very low carb for an extended period of time is not advisable for many people. It can mess up your thyroid function, to name one issue, and also, vasodilation can be triggered by low glucose. Damaged cells require a certain amount of glucose to function properly and undertake repair. Thus, facial redness and/or flushing can worsen. If you are cutting out food groups you need to make sure you are getting the right amounts of nutrition from other sources. Reactions to vitamin D in our group are common. I have a lot of trouble with it each time I modify the dose. I have been all the way up the scale in dosage (to 10,000IU) and back down again. A good blood serum level for most people is around 40 to 50ng/mL. I am currently increasing my dose by 250IU. That is how sensitive I am. I have to cut the tablets in quarters.

Vitamin D works better and with less side effects if it is provided with it's partners. I was negligent in this area the first time I embarked on a vitamin D journey. So, if you have cut out dairy, you need to decide where you are going to get Vitamin A. Can you eat egg yolks? (Generally safer than the whites for a number of reasons). K2 is also a part of this particular partner group. Where are you going to obtain that? Cod fish for iodine if you don't want to supplement. All the minerals are important and this is where many of us are lacking. I find the following website a useful tool for determining nutritional factors, and for identifying any deficits. Struggling bodies due to illness often benefit from a little help with appropriate supplementation, but I'd see what happens without it first."
http://nutritiondata.self.com/facts/...products/113/2
http://www.wheatbellyblog.com/2015/03/mary-lous-dramatic-wheat-belly-facial-transformation/

When we discussed the article I added below on the Rosacea Forum, Brady wrote:
Brady Barrows: "She advocates way too much fructose, which is a rosacea trigger."

I replied: "Thank you Brady! I have to say, with low carbs intake I get depressed and lethargic soon, at least eating pears and some other fruits prevents some of that. How can you not get the physical carb withdrawal symptoms when you also avoid fructose? And what about the many vitamins in fruits? "

Brady replied: "Obviously, diet is probably one of the more controversial subjects to discuss, up there with religion and politics. Everyone can eat whatever they want, which is a universal right not stated anywhere, it is simply universally understood as a basic right. Vitamins are usually thought to be essential nutrients. Fat is an essential nutrient.  Protein is an essential nutrient.  However, carbohydrate, which is simply different kinds of sugar is not an essential nutrient. Glucose, which is the sugar used by the cells in our body, particularly the brain, is essential for survival. However, the body can break down glycogen, triglyceride, fat, protein for glucose. So you can eat the fruit for vitamins but along with the fruit you will get a rich bounty of fructose which is a rosacea trigger (along with any sugar). There are other ways to obtain vitamins such as, in green vegetables that are lower in sugar, or simply take vitamins from tablets or capsules."

I replied: "Thank you Brady. I understand that fruits contain fructose, one of the natural sugar types out there. And that no fructose/sugar is better on paper to limit inflammation symptoms. I just wonder if cutting it out entirely isn't causing some other very worrisome symptoms, like increased depression. Something most of us here deal with already anyway.

Tokyolulu wrote on January 10th 2016: "I completely agree! Diet is really key! It can be challenging to start though - I didn't cook before but now I'm cooking my own meals at home (there's added cost here) but for the sake of my sanity, and everyone here can identify I'm sure, it makes me feel better overall that I'm doing something proactive (that actually works) to improve my skin. You can always start small - if you have a lot of gluten in your daily diet - try to cut that out and find easy replacements and sub stuff out. It's in a lot of everyday things: cake, pasta, bread.

❥ Google lists of things that commonly have gluten in them, or how to get started.
❥ Stick to it not just for a week but make it a substantial lifestyle change and part of your diet from here on out.
❥ These days if it's not fresh or not from the fresh produce aisles or butcher, I don't eat it because as you said, it's hard to track what you're eating even if you keep a food diary. The general rule of thumb though is that you should always aim to do most of your grocery shopping on the outerlying aisles, i.e. fresh produce, meats and fish - and cut out processed food as much as possible i.e. anything in a box, bag, anything that doesn't require refrigeration or can doesn't expire in a week or two isn't something you want to be putting in your body either.
❥ Dairy is another thing I've almost completely cut out. Might be hard to do this in the UK, but you can always try gluten first - which like Officialstevenb said, is a really common firestarter, and try cutting down others like dairy, red meat, sugar once you get a hang of it and if you want to try it. Nothing to lose, and everything to gain!"

April 21st  2015
This article explores the effect of diets that are low (or lack) sugar and some other bad foods, and the effect this had on skin aging signs and redness. They show special scans, showing reduced redness while on the diet, and diet tips. Might be of interest for us :)  We discuss it also here on The Rosacea. "While we have long known that sun damage and cigarette smoke speed up skin ageing, dermatologists have recently pinpointed the biggest ageing trigger of all — destructive molecules called Advanced Glycation End products (or AGEs). Top nutritionist and skin specialist Karen Fischer has designed a 28-day diet to a youthful appearance. Picture posed by model. As we revealed in our Sugar Detox series earlier this year, too much sugar in the blood causes glucose molecules to attach to the proteins in collagen (the glue that holds your skin together) to form AGEs. These sticky brown compounds stiffen the otherwise elastic fibres in the skin, creating lines, blotches and wrinkles. But sugar is far from the only ageing culprit in our diet. For her new book, Younger Skin In 28 Days, Fischer has scoured hundreds of scientific studies to name and shame other common foods and cooking methods that contain  high levels of AGEs or contribute to the  AGE-making process in the body.

THE DAILY DIET LIMITS
"Rather than calorie counting, we should be AGE-counting — consuming no more than 5,000-8,000 kilounits (kU) a day (Western diets contain an average of 15,000). Given a 100g piece of pan-fried steak contains 10,000 kU, and a fried egg 1,000 kU more than a poached egg, it’s easy to see how quickly the toxins — and the wrinkles — accumulate. But dark- purple and red fruits and vegetables, such as purple sprouting broccoli, red cabbage, beetroot, aubergines and berries, contain powerful antioxidants called anthocyanins that help protect against AGE-formation. Eat several portions a day and swap green salad leaves for purple ones, white onions for red onions, and rice for red quinoa. Her message is clear. If you have prematurely ageing skin, dullness, discoloration, deep lines or drooping jowls, you could be unwittingly eating too many AGEs — which are common in animal products, and increase exponentially when food is fried, grilled, pasteurised or smoked. Here comes the good news: you can protect your skin, and even reverse some of the damage by consciously minimising your intake of AGE-increasing foods — such as red meat, dairy products, processed food and all forms of sugar and sweeteners — and filling your diet with foods that have natural skin-boosting properties — such as purple, red or black fruit and vegetables, beans  and wholegrains. The best weapon against skin ageing is your fork,’ explains Fischer. ‘Eating the right foods supplies your skin with the nutrients it needs to produce new collagen, fight AGEs and look healthier and younger.’ Indeed, her 28-day plan is so timed because, she says, it takes 28 days for your body to produce new skin cells in the deeper layers of the skin and for them to travel to the surface. So, can eating the right foods really take years off your appearance in just a few weeks? We decided to put Fischer’s fast-track plan to the test by asking two women to try the diet for 28 days while continuing their usual skincare routine. Before they started, we assessed theirskin using both a Visia scanner — which measures wrinkles, sun damage, redness and pore size — and a TruAge scanner, which is clinically proven to measure levels of AGEs in the body. We repeated the tests at the end of the month to see if there were marked improvements. The results were astonishing — as you’ll see in our two guinea pigs’ stories (bottom of article)."

THE PLAN
"The diet kicks off with a three-day detox — no meat or caffeine but unlimited fruit and vegetables (raw if possible) — before easing into a pattern of healthy eating; re-introducing small amounts of caffeine, poultry and fish but steering clear of dairy, sugar and alcohol. After a hearty breakfast, Fischer recommends filling half of your lunch and dinner plates with vegetables, one quarter with low-AGE protein, such as chicken, fish, beans or lentils, and the other quarter with low-AGE carbohydrates, such as sweet potato, basmati rice, quinoa or spelt. For dessert, she favours anti- oxidant-rich fruits such as pomegranate, guava, banana, papaya or any berries (frozen are fine). In addition to changing your diet and drinking eight glasses of water, herbal tea or fresh vegetable juices, Fischer recommends daily supplements of omega 3, calcium, chromium, magnesium, manganese, zinc, and vitamins D, C, B3 and B6, (available from biocare.co.uk), and a daily shot of purple juice from blueberries, cherries and olives."

SKIN-SAVING COOKING
You can potentially halve your AGE intake by changing the way you prepare food in the first place:

l COOK SLOWLY
The searing heat used in baking, grilling, barbecueing and frying causes browning, which increases AGE formation, especially in foods that are rich in protein and fats. Cooking with liquids at lower temperatures makes a big difference, so switch to poaching, boiling, steaming and making soups, curries, stews and casseroles.

l MARINATE IN LEMON AND LIME
Marinating meat and fish in acidic ingredients — like fresh lemon or lime juice — before cooking protects the food from forming too many AGEs during the cooking process. You can also add the juices to drinks and salad dressings.

l SPICE THINGS UP
Turmeric, cumin, ginger, cloves and cinnamon are are all excellent at inhibiting AGE formation. Add them to casseroles and curries, pop a piece of fresh ginger or a few cloves into your tea, and sprinkle cinnamon on porridge or add to smoothies.

l ADD APPLE CIDER VINEGAR
Unlike other vinegars, studies show apple cider vinegar can lower blood sugar, which reduces AGE production. Dilute a tablespoon in water and add to soups and stews, or use it to make salad dressings.

My skin’s softer and brighter
OLD SKIN AGE: 39
NEW SKIN AGE: 33
Kate Habberley, 42, works  for a small communications consultancy and lives in Oxfordshire with her  husband Jeremy and their  two young sons. "Busy mum Kate was used to starting her day with toast, butter and  marmalade. For lunch she’d typically have a cup of soup and oatcakes, followed by an afternoon of snacking on biscuits, crisps and chocolate. For dinner, she’d eat whatever her husband was cooking — usually man-sized portions of pasta. Before starting the 28-day plan, she said: ‘I’m overeating on a  regular basis, and am indulging in far too much unhealthy food. ‘I am a stone overweight, and I think my skin feels and looks older than my years — it is lacklustre  and dull with an infuriating combination of wrinkles, blemishes and frequent breakouts.’ Kate is not a big meat-eater or wine lover — but she did miss dairy products and her beloved sugar while she was on the diet. ‘I was becoming a proper sugar addict — I’d happily work my way through a packet of Hobnobs or chocolate digestives, and end most days with a whole packet of wine gums or a chocolate bar,’ she says. ‘Quitting sugar took some getting used to. ‘I had a major strop about two weeks into the diet when we were out as a family and everyone else was tucking into tea and cakes. Because the cafe didn’t have soya milk, I had to endure black coffee and a smoothie.’ But it was worth the effort. At the end of the 28-day experiment, Kate’s TruAge score dropped six years to just 33 (meaning the AGE activity in her body is like a 33-year-old’s) and her Visia scan showed a 9   per cent reduction in redness, fewer enlarged pores and an improved skin texture."

Impressed: Kate Habberley's skin has fewer enlarged pores and a 9 per cent reduction in redness

"As an added bonus, the weight fell off. When she jumped on the scales at the end of the trial she’d lost nearly 12lb — much of it from around her tummy. She told us: ‘I’m absolutely thrilled with the results. And as the month progressed, I found it increasingly liberating not to be dogged by sugar cravings." ‘I’ve really enjoyed the salads and the soups, discovering the joys of pomegranate juice and the delicious taste of sweet potato when roasted with lemon juice and a brush of olive oil. ‘I feel much, much healthier. My energy levels have soared, I’m sleeping better — and I didn’t need the scan results to tell me my skin is softer, brighter and clearer.’ The change is so significant that Kate plans to stick to the basics of the diet long-term. She says: ‘I might be tempted by the odd slice of toast now and again, and nothing is going to convince me that quinoa is my friend, but I’m happy to stick to soya milk rather than cows’ milk and keep an eye on my sugar intake. ‘I wouldn’t want to go back to my old way of eating and its impact  on my skin.’ My red blotching has gone."

OLD SKIN AGE: 49
NEW SKIN AGE: 46
Debra Cull, 54, a florist,  lives in Buckinghamshire  with her husband John. "Debra's old diet was, in her own words, a toxic mix of burnt toast (‘the more burnt the better — with lots of butter!’) and deli meats (‘I love a tapas-style supper of chorizo, salami and cheeses, washed down with a glass of wine’). But she was conscious that her fair, freckled skin was rapidly showing signs of age. Before embarking on the 28-day plan, she said: ‘I really love gardening and I spend a lot of time outdoors. Although I wear sunscreen when it’s hot, I  don’t wear a hat as often as I should, which I’m sure has contributed to premature ageing of my skin. ‘I hope the diet will slow down the wrinkling a bit, and perhaps reduce the redness I get from hot flushes.
‘In fact, I hope the diet might help settle my errant hormones and calm those flushes, as they’re beginning to dog my days and nights.’ After just one week on the plan, Debra was already seeing results. ‘My skin seemed fresher, clearer — not so ruddy or crepey around the eyes,’ she said. Spurred on by the changes, she stuck to the diet rigidly, even making her own spelt flatbreads and ‘experimenting with purple foods I didn’t even know existed’. At the end of the 28 days, Debra’s TruAge had dropped three years to 46, and the Visia scan showed a 6   per cent improvement in her  skin texture, an 11   per cent reduction in open pores, and a significant drop in redness. She was also delighted to discover she’d lost 5lb over the month. Most exciting of all, she says, was that the hot flushes she was regularly experiencing during the day and night stopped completely for the duration of the experiment."

Relieved: Debra Cull is overjoyed that her hot flushes have vanished and the redness on her face has reduced

‘I am really pleased with the impact this diet has had,’ she says. ‘Not only do I feel healthier — my energy levels have noticeably increased — but I can see that  my skin looks healthier, too. And  the absence of flushes has been quite a revelation. ‘I thought I’d miss my crispy toast and grilled steaks but I’ve been quite happy switching to porridge topped with blueberries for breakfast, and lunches of purple sprouting broccoli with poached eggs on top. ‘I’ve also been eating a lot of poached chicken and salmon, and far, far more vegetables and salads than I used to. I’m now much more aware of what I eat, and I’m really keen to keep the diet going as much as I can. ‘But even though I’m sure quitting alcohol has been one of the most significant factors in my skin’s improvement, life is too short to stop drinking wine for ever!’



YOUR SEVEN-DAY ANTI-AGEING MENU

DAY ONE
Breakfast: Quinoa porridge (red or white quinoa cooked for 15-20 mins with soya or almond milk, water and a splash of vanilla essence) topped with berries or banana and sprinkled with cinnamon and linseeds or chia seeds. Lunch: Sweet potato salad (above). Brush a sweet potato with lemon juice and olive oil then roast until soft. Serve with a large salad dressed with a lemon juice and apple cider vinegar dressing, sprinkled with black sesame seeds. Dinner: Shitake vegetable soup. Simmer finely diced red onion, celery, carrot, fresh ginger and shitake mushrooms in organic vegetable stock. Add some  chopped parsley and a squeeze of lemon juice.

DAY TWO
Breakfast: Quinoa porridge. Lunch: Sweet potato soup. Simmer red onion, garlic, curry powder, sweet potatoes and dried red lentils in organic vegetable stock, then blend until smooth. Dinner: Spiced dahl. Briefly sauté chopped red onion, garlic and curry powder with a splash of water. Add red lentils and organic vegetable stock. Simmer for 20 mins. Serve with fresh coriander. Bowl Of Watercress Soup

DAY THREE
Breakfast: Quinoa porridge. Lunch: Watercress soup. Simmer potato and red onion with garam masala and fresh ginger in organic vegetable stock until soft. Add a large bunch of watercress. Cook for a few minutes, then add a squeeze of lemon juice and  blend until smooth. Serve with a dollop of hummus and a sprig  of watercress. Dinner: Sweet potato salad.

DAY FOUR
Breakfast: Two scrambled eggs  on a bed of watercress with wholemeal bread. Lunch: Mixed salad and tinned tuna in a wholemeal/spelt wrap. Dinner: Parcel-baked skinless chicken breast (pre-marinade briefly in lemon or lime juice) with sweet potato and vegetables. Grilled Salmon with Steamed Vegetables

DAY FIVE
Breakfast: Omega muesli. Soak porridge oats and a teaspoon of linseeds overnight in water with a sprinkle of apple cider vinegar; rinse and drain then add almond milk. Top with berries and cinnamon. Lunch: Beetroot and carrot salad. Grate carrots, apples and fresh beetroot. Top with pomegranate seeds, lemon juice and black sesame seeds. Serve with spelt flat bread. Dinner: Steamed fish (marinated in coconut milk, lime and ginger) with vegetables and a fruit smoothie (blend frozen banana and berries with almond milk, fresh mint leaves and either flaxseed oil or whole linseeds).

DAY SIX
Breakfast: Berry porridge. Cook oats with almond milk, linseeds  and berries. Lunch: Two poached eggs on  purple-sprouting broccoli with wholemeal bread. Dinner: Vegetable curry with basmati rice.

DAY SEVEN
Breakfast: Fruit smoothie. Lunch: Rocket salad. Combine 2 handfuls of rocket, 1/2 sliced avocado, a sliced spring onion and 4 cherry tomatoes halved. Dress with apple cider vinegar, honey and olive oil. Top with fresh figs if available. Sprinkle with black sesame seeds. Dinner: Spicy chicken balls. Minced chicken with red onion, lemon and spices in tomato and onion sauce with wholemeal pasta.

DAILY SNACKS
Unlimited raw vegetables (carrot, pepper, cucumber, celery, broccoli) with hummus.
Handful of raw almonds or  2-4 Brazil nuts.
One fresh vegetable juice.
Unlimited herb/fruit tea.

What is histamine

Histamine are chemicals which your immune system makes. Histamines act like bouncers at a club. They help your body get rid of something that's bothering you -- in this case, an allergy trigger, or "allergen." Histamines start the process that hustles those allergens out of your body or off your skin. They can make you sneeze, tear up, flush or itch -- whatever it takes to get the job done. They are part of your body's defense system. When you have allergies, some of your triggers -- such as pollen, pet dander, or dust -- seem harmless. But your immune system sees them as a threat and responds. Your body's intention -- to keep you safe -- is good. But its overreaction gives you those all-too-familiar allergy symptoms, which you then try to stop with an antihistamine. Histamine also has some good (as in normal) functions: it takes part in the regulation of local blood circulation, in capillary permeability, contraction and relaxation of smooth muscles and blood vessels, secretion of hydrochloric acid in stomach, immediate hypersensitivity responses, allergic processes, inflammatory ones as part of the immune response to external pathogens, tissue healing, and its action has also been observed as neurotransmitter in the nervous system. Therefore it is also indispensable for the efficient functioning of many metabolic processes in the body. And histamine is also present in foods, depending on the food how high or low the histamine content is. Some foods are also naturally high in histamines. These include aged and fermented foods and alcohol (especially red wine). Some people may be sensitive to that. Hence, why some foods are more prone to cause an allergic reaction to people than others. If you eat foods high in histamine or have an allergy and are exposed to an allergen, this is what happens: First, it sends a chemical signal to "mast cells" in your skin, lungs, nose, mouth, gut, and blood. The message is, "Release histamines," which are stored in the mast cells. When they leave the mast cells, histamines boost blood flow in the area of your body the allergen affected (in our rosacea case it boosts blood flow to the skin of the face, making us more red, hot and even itchy). This causes inflammation, which lets other chemicals from your immune system step in to do repair work. Histamines then dock at special places called "receptors" in your body.

I found an article explaining how a histamine-related disease called Mastocytosis can cause facial flushing

It explains that mast cells are cells of the immune system that are found around blood vessels in the skin, gastrointestinal tract, respiratory tract, and genitourinary tract. They contain several substances, the most common of which is histamine. They are released in response to contact with certain foreign substances. In the most common form of mastocytosis, there are a greater number of mast cells in the tissues. These mast cells cause a typical skin response called urticaria pigmentosa in which a hive immediately develops after stroking the skin with a blunt object (I don;t have this). People with mastocytosis also experience symptoms throughout the body caused by the release of large amounts of histamine and other chemicals. The flushing occurs suddenly on the face and upper trunk. Many patients cannot identify a trigger that causes the flushing, but some identify exercise, heat, or emotional anxiety as a possible trigger. The red, hot face is often accompanied by palpitations, low blood pressure, dizziness, chest pain, explosive diarrhea, nausea, or fatigue. Medications such as opioid narcotics like morphine and codeine, and aspirin or other non-steroidal anti-inflammatory drugs like ibuprofen or naproxen can also start a flushing attack. And as Y-gwair explained in a comment I added below in this blog post:

"Also many don't understand the difference between mastocytosis (which is where your bone marrow produces increased number of genetically altered mast cells) and mast cell activation (where you have a normal number of mast cells which have become abnormally over-reactive)."

But it is also possible that someone who flushes a lot does not in fact have mastocytosis (or anything other than rosacea and faulty functioning blood vessels), but instead Mast cell activation Syndrome Mastocytosis causes too many mast cells in your body, but Mast cell activation Syndrome does not create statistically more mast cells in the body, but instead makes the normal number of mast cells malfunction, being hyper-reactive and causing symptoms such as flushing, hives, burning feeling, easy bruising, itchiness, lightheadedness/dizziness, diarrhea, headaches and brain fog. To name a few symptoms. 

Mast cell activation Syndrome

It is also possible that someone who flushes a lot does not in fact have mastocytosis (or anything other than rosacea and faulty functioning blood vessels), but instead Mast cell activation Syndrome Mastocytosis causes too many mast cells in your body, but Mast cell activation Syndrome does not create statistically more mast cells in the body, but instead makes the normal number of mast cells malfunction, being hyper-reactive and causing symptoms such as flushing, hives, burning feeling, easy bruising, itchiness, lightheadedness/dizziness, diarrhea, headaches, pain and redness of the eyes and brain fog. To name a few symptoms (check the rest of the possible symptoms out here). This is what my doctor thinks I have. My tryptase blood test came back negative, so I don't have mastocytosis. But he does suspect a histamine component to my flushing, as I flush from foods high in histamine, from pollen, from perfume and many other triggers that can be linked to histamine release in the body - which then in turn dilates the blood vessels. I am currently trying medication aimed to control Mast cell activation Syndrome: Montelukast (Singulair), ranitidine and Xyzal. 

DAO deficiency

DAO deficiency means there is not enough of the specific digestive enzyme present in the body, which is responsible for breaking off the histamine that is in food. Diamine oxidase enzyme or DAO is located in the intestinal mucosa mainly, and starts working during the digestion of food. When there is an alteration in the metabolism of histamine and there is not enough DAO activity, the imbalance between ingested histamine and histamine released from the storage cells leads to histamine accumulation in the blood, which causes health symptoms such as flushing, sneezing and itching, but also possibly: migraine, headaches and/or dizziness. Irritable Bowel Syndrome (diarrhea, constipation), Crohn disease, stomach pain, nausea and/or vomiting. Hypotension, hypertension and/or arrhythmia. Hives, oedema, atopic skin, eczema and/or rach. Nose congestion, rhinitis, asthma and/or sneezing. Muscle pain, fibromyalgia and/or fatigue. Bone pain. It has been observed that most patients with low functional DAO activity present other related symptoms, especially migraine. 20% of patients experience 1 or 2 of these associated symptoms, 41.3% of patients experience 3 or 4 of these symptoms and 33.8% present more than 5. Migraine is always the most highlighted syndrome when interviewing the patients due to its disabling character. With DAO deficiency, unlike with a food allergy, the occurrence of symptoms or adverse effects is not linked to the intake of specific food; by contrast it can be related to a wide variety of food with different histamine contents (even to foods with low histamine levels). A special blood test can detect the DAO enzymatic deficiency. Once confirmed, the treatment consists in a diet low in histamine and other amines that enhance its accumulation.

Y-gwair wrote:  Quote Originally Posted by lilyian. "If you did actually have a mast cell problem, it is easily controlled with prescription histamine blockers. Best thing to do is to get checked out my an allergist. People with these illnesses don't really have allergies, but the source of the problem is still mast cells which are what cause allergy problems." This is not true, H1/H2s will only control SOME symptoms caused by release of histamine (like itching), but mast cells actually produce about 60 different vasoactive substances which antihistamines have no effect on. It's true that mast cell activation is not a true allergy, but there are still many allergy doctors that don't understand this and only test the limited parts of the immune system that they know about. Also many don't understand the difference between mastocytosis (which is where your bone marrow produces increased number of genetically altered mast cells) and mast cell activation (where you have a normal number of mast cells which have become abnormally over-reactive). The kind of doctor you need to see with these disorders is an immunologist specializing in allergic disease. Ideally they will test tryptase (which is a substance that stimulates the production of extra mast cells in mastocytosis), Diamine Oxidase, which is an enzyme that breaks down histamine, histamine levels in urine/blood. They also look to see if you vitamin D levels are low, as this is also a marker for high circulating histamine. If you are in the US, they will also test for prostaglandin D2 and leukotrines. They should also do a very detailed investigation of your immune system, breakdown of all immunoglobulins, rheumatological markers and many other relevant things. After quite a few misdiagnoses, I've finally found the true reason for my flushing, which is deficiency in Diamine oxidase, linked to mast cell activation causing high levels of unknown vasodilatory and neurological irritant substances. If I'd listened to my idiot dermatologist, I'd still be mucking around with clonidine and betablockers, both of which were making my condition worse. Doxepin is a tricyclic, which are a group of medications that cause mast cell degranulation, along with many, many other common medications including virtually all painkillers except paracetamol."

July 5th 2020

Thank you to Gunther, who sent me a link to this German program about a woman with rosacea, who gets tips on how diet can help her skin become less red and inflamed. I realize that diet is not a rosacea trigger for everyone. I read often about people who have not identified dietary skin triggers, despite all sorts of elimination diets. This video and info is therefore not necessarily for everybody with rosacea. But I think diet can play a role sometimes in finding improvement. Maybe more so in subtype 2 rosacea, with background redness and skin outbreaks and pimples. But from own experience I can say that even in subtype 1 rosacea, with skin flushing, burning and redness, diet changes can sometimes give some improvement (not a cure for me though, not even close...). I notice a pretty significant improvement in my skin as well, like the woman in this video - although she sees bigger results than me - when I stay clear of sugar, wheat, dairy and any spices. In my case there is also an issue with histamine rich foods, which does include quite a long list of food items. But, when I eat lots of vegetables (except tomatoes, eggplant and a couple of other vegetables high in histamine), and stick to carbs like potatoes, as well as eating organic beef or chicken and foods like olives, unions and fruit, my skin is really less red and less inflamed. It also takes more for me to flush then. Although I still flush very easily, even then. But my skin has a base colour which is a bit more pale then. It is much easier to stay cool. My weaknesses are chocolate, bread and pastries, as well as some sugary things pr pizza. I rarely give in to such foods, but when I do it's a good amount of sinning. Not just one square of chocolate :)  

The past weeks for instance, I stuck to the healthy diet and had nothing to sin with in the house; no chocolate, no bread, no sugary things. No crisps either. Then came that moment of boredom with the same safe foods day in and day out. I stuck it out some longer but by the time the new weekly shopping had to be done, I bought some chocolate, a chocolate pastry and some almonds covered in chocolate. I purposely bought small quantities, no large bars or anything, because I ate it all today. I guess it's supposed to be a reward for sticking to the low calorie, low carbohydrates, low on fun foods for as long as I did. But the 'reward' came in the shape of a flushed hot red face for most of the day and evening now. Damnit. And the effects are there right away, within half an hour. I always curse myself then and vow to never eat this crappy food again. Until the next time of course. Anyway, I just wanted to share this video with you, again thanks to Gunther for linking me to it. And I took the time to put English subtitles under the German video. To anyone German out there who may view it, please forgive me if I translated 1 or 2 muffled words incorrectly. I was poor at German in school..