Health influencer Paul Saladino incorrectly attributes acne to autoimmunity

In an Instagram reel published on 24 January 2026, wellness influencer Paul Saladino claimed that acne “is absolutely autoimmune” and that the condition can be triggered by vegetables, adding “Leaves are the most defended parts of plants and are full of defense chemicals that can trigger autoimmune reactions for a lot of people”.

The same video was also posted to TikTok and X. In total, the video received more than half a million views.

Saladino is a board-certified psychiatrist and prominent advocate of the carnivore diet, which is a diet comprising mostly or only animal-based food. According to Saladino, people should avoid consuming vegetables because they contain “plant defense chemicals” that are responsible for health issues ranging from joint pain to stomach issues. He has expressed this belief on multiple occasions over the years (see examples here, here, and here). Interestingly, Saladino stopped his carnivore diet regimen according to an interview he gave in June 2020.

While Saladino is correct in claiming that plants contain many chemicals to deter predators from eating them, the scientific evidence doesn’t support Saladino’s claim that these chemicals trigger autoimmunity in humans, as we’ll explain below.

Acne is inflammatory condition, not autoimmune

Firstly, Saladino’s claim appears to confuse autoimmunity with food allergy and intolerance. But these conditions are distinct from each other. It’s important to use these terms correctly to avoid perpetuating misinformation about these conditions.

Food intolerance occurs when a person has difficulty digesting certain foods, which can lead to issues like diarrhea, bloating, and stomach pain. While these symptoms can be uncomfortable, food intolerance isn’t life-threatening.

Food allergy, on the other hand, occurs when the body’s immune system reacts to harmless compounds in our food, like egg protein. This can lead to diarrhea, vomiting, eczema, hives, and swelling on the lips and tongue.

The two conditions are easy to confuse since their symptoms can sometimes overlap. One critical difference is that unlike food intolerance, food allergy can be severe and potentially lethal (anaphylaxis).

Neither of the above conditions is due to autoimmunity, however. Autoimmunity occurs when the body’s immune system attacks the body’s own cells by mistake. Simply put, it is an immune response against self and not foreign substances. Some examples of autoimmune diseases are type 1 diabetes, lupus, and multiple sclerosis.

Acne is distinct from all the conditions discussed above. It’s caused by clogged sebaceous glands, also known as oil glands. These glands produce sebum, which helps keep our skin moisturized and protects it from damage caused by friction.

Sebum normally travels up hair follicles to reach the skin surface. However, under certain conditions, dead skin cells accumulate in the follicles, causing sebum to be stuck there. This provides the perfect breeding ground for the bacterium Cutibacterium acnes, which is a normal part of the microbiome on the skin surface, to start growing inside the follicle, triggering inflammation.

Some risk factors for acne are hormonal changes, such as those seen during puberty and during the menstrual cycle, exposure to oil and grease (such as during cooking), and certain medications like lithium and corticosteroids.

Certain disorders that cause autoimmunity and autoinflammation, like SAPHO syndrome and PAPA syndrome, are associated with severe acne. But these are very rare conditions and therefore do not account for the majority of acne cases. Moreover, these disorders aren’t treated by removing vegetables from the diet, but with anti-inflammatory drugs.

Experts don’t recommend removing vegetables from one’s diet to treat acne. On the contrary, the American Academy of Dermatology notes that several published studies from different countries found that a low-glycemic diet, which includes “most fresh vegetables, some fresh fruits, beans, and steel-cut oats”, can reduce acne. Foods that are low on the glycemic index raise blood sugar more slowly, whereas foods high on the glycemic index produce a large and quick spike in blood sugar, which some studies show is associated with a greater risk of developing acne^[1].

No evidence plant chemicals cause lasting health problems

Saladino previously claimed that chemicals in plants (phytochemicals) are toxic to humans. Among the chemicals he singled out are ​​sulforaphane, an isothiocyanate found in cruciferous vegetables like broccoli, kale, and cauliflower, as well as lectins which are found in foods like beans and peanuts.

However, he presented no credible evidence to support these claims. Studies about the effects of isothiocyanates like sulforaphane in humans are limited, but the evidence that we do have from animal studies doesn’t suggest that they’re harmful. On the contrary, researchers found that isothiocyanates exert anti-inflammatory and antioxidant effects that could help reduce cell damage.

Lectins are naturally occurring proteins present in many plants. They are generally harder for our digestive system to break down, and lectin consumption can trigger unpleasant symptoms like nausea, bloating, and gas in some people. They can also interfere with the absorption of minerals like calcium and iron.

Lectins have been vilified by some wellness influencers, Saladino among them, who claim that lectins are harmful to health and advocate consuming a lectin-free diet. One example of such a diet is the “Plant Paradox” diet, promoted by cardiologist Steven Gundry.

But evidence is lacking for these alleged harms and medical experts in general don’t encourage most people to exclude lectins from their diet, since many foods that contain lectins, like whole grains and lentils, also contain many nutrients that are beneficial to our health.

Moreover, the downsides of lectin consumption are easily mitigated. Lectins are water-soluble and normally found on the outer surface of food, so soaking them in water helps remove most of them, and cooking notably inactivates most lectins.

The European Food Safety Authority states:

“Most lectins are harmless. Some lectins, mainly found in raw pulses, can cause gastrointestinal symptoms and immune effects. Consuming properly processed and prepared pulses does not pose any risk related to lectins”

And like sulforaphane, there’s some evidence that lectins could be beneficial to health, with some studies noting that lectins have antioxidant effects, which protects against cell damage caused by free radicals.

Finally, large-scale epidemiological studies looking at the effects of diets rich in whole grains and vegetables haven’t found evidence of health harms but of potential benefits instead^[2,3].

We reached out to Saladino for comment and will update this review if new information becomes available.

Conclusion

The claim that acne is caused by an autoimmune reaction is incorrect. Acne is an inflammatory condition triggered by the bacterium C. acnes. As it doesn’t involve the body’s immune system attacking the body’s own cells, it’s not an autoimmune condition.

Many plants do produce chemicals to deter predators from eating them and some of these chemicals can produce gastrointestinal discomfort in a subset of people. But there’s a lack of scientific evidence showing that these chemicals are responsible for chronic health problems in general, as some wellness influencers claim. On the contrary, epidemiological studies show that consuming a diet rich in whole grains and vegetables is associated with better health, including a lower risk of heart disease and mortality.

References:

1. Meixiong et al. (2022) Diet and acne: A systematic review. Journal of the American Academy of Dermatology International.
2. Morze et al. (2021) An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. European Journal of Nutrition.
3. Aune et al. (2016) Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ.