I haven't read the paper but do they define what they mean by "westernized"? China is very much the east, does acne vulgaris have the same prevelance in countries in Asia and the middle east?
"Herein we report the prevalence of acne in 2 nonwesternized populations: the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay." They also mention reports from an Inuit community as it transitioned from a traditional diet/lifestyle to a more industrialized one, and the concomitant rise of acne.
The speculation is that low-glycemic load diets are related, possibly through insulin sensitivity/resistance. So probably an industrialized Chinese diet with a relatively high proportion of refined rice (or other grains) is also prone to acne.
From a quick skimming of The Fine Article, it seems to mean people living in "modern" environments — like, e.g., plumbing. If I had to guess, diet is probably among the most salient characteristics, with lessened sun exposure from spending time indoors also being material.
Diet, time inside/outside, exercise, environmental pollutants, stress, water supply (drinking and bathing), consumer products with (often untested) chemicals...
I'd say there are plenty of western/Western attributes that could have a cumulative (?) impact.
yep - anecdotally, my family members living in both China and Japan experienced some bad bouts of acne during their adolescence and up through young adulthood. given that the paper's study population were hunter-gatherers and islanders, it would probably make more sense to frame it as "modern industrialized society" versus "hunter-gatherer" rather than "western" against "non-western
The speculation is that low-glycemic load diets are related, possibly through insulin sensitivity/resistance. So probably an industrialized Chinese diet with a relatively high proportion of refined rice (or other grains) is also prone to acne.