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Ep40: The Superfoods to Eat for Healthy Skin
Dr.Teo: Hi everyone and welcome back to another episode of Dermatologist Talks: Science of Beauty. I’m Dr. Teo Wan Lin of TWL Specialist Skin & Laser Centre and today we’re going to talk about the role of functional foods and superfoods – how it plays its part in the ageing process as well as its specific effects on skin.
Chesea: Yes! In this health-conscious era of self care, there has been more and more research into the functional foods and superfoods. They have been traditionally associated with good health, but are now backed up by data. For those of you who are unfamiliar, superfoods are mostly plant-based foods, with the exception of fish. They are nutritionally dense and good for one’s health. Well we know that these superfoods are beneficial for health, but can they act as anti-aging foods as well?
What is happening when our body ages?
Dr.Teo: Inflammaging is a well-established cellular process that is influenced by environmental factors. These environmental factors can be summarized as what we term the skin exposome concept. This encompasses a variety of environmental and lifestyle factors. These include stress levels, disruptions to the circadian rhythm of the body (sleep-wake cycle), environmental pollution, exposure to harmful pollutants can change the microbiome signature of the skin for example. Also, the role of one’s diet in the inflammaging process is another key factor in the skin exposome concept.
If you look at studies on inflammaging in other organ systems which is where the bulk of research comes from rather than in the field of dermatology, you’ll realize that there is this accompanying immunosenescence with a cellular senescence. We describe this as a falling asleep process where the cells become less and less able to perform their functions of immune system modulation as well as cell repair. This leads to chronic inflammation, inflammaging associated with organ ageing.
Chesea: Well how can our diet, or the incorporation of ‘anti-aging foods’ help with this process of aging?
How does diet play a role in the aging process?
Dr.Teo: The basis of nutraceutical intervention in the anti-skin aging strategy is that the skin is a composite of the entire body’s organ systems. Therefore, the health of your body, your internal organs, will translate into the health of your skin. To what extent this should replace aesthetic dermatology treatments. I feel that the general advocacy for ageing strategies has been leaning towards what we term as positive aging. This is a much more holistic approach rather than a single-minded targeted treatment with just in-office treatments that modify or reverse the physical signs of skin ageing with these aesthetic interventions. In many cases, these have a temporal effect such as the use of botox and toxins.
A more sustainable approach
This approach is much more sustainable in the long run. What we understand about current inflammaging cell, animal, and clinical models, is that specific molecular pathways such as the telomere, telomerase, sirtuins, mTOR, mMPK and insulin-like growth factors, play a role in the process of free radicals scavenging by cells, as well as the ability to repair damaged DNA. We have a lot more understanding now about functional super foods that are good for your skin. Essentially, these superfoods are high in nutrients and low in calories. Studies also show that caloric restriction forms a key role in preventing inflammaging. Plant polyphenols, carotenoids, these are also cytoprotective. They protect the cell against biological aging and in the case of skin cells, photodamage.
Chesea: Wow ok so there’s lots of promising research in functional foods that are good for your skin. In that case, what do you think of hair, skin and nail supplements that are currently available on the market. How useful do you think these are on top of regular skin care regimes and treatments? For example collagen supplements – this is a popular skincare ingredient and supplement that people take. We also know that the natural collagen in our skin makes it appear more plump and youthful. In that case, theoretically it would make sense to ingest these collagen supplements for better skin benefits.
What are your thoughts on supplements for skin and hair?
Dr.Teo: In terms of the existing skincare and haircare supplements available. There are very limited peer-reviewed studies that support the use of these supplements for the treatment or prevention of skin ageing. Let alone intervention for skin disease. Many studies that are performed, for example, with collagen supplements, are actually very small in nature. These are with less than 100 participants. Additionally, the ethnicity of these individuals is very restricted. For example, it doesn’t account for the genetic tendency of Asian women to display lesser physical signs of physical ageing. As compared their Caucasian counterparts because of the presence of melanin which is photoprotective. So these studies on collagen supplements can be confounded by the fact that they’re mostly done in Asian women only.
However, because there are a few studies which do show a positive benefit in terms of skin hydration levels, as well as the reduction in skin wrinkles. This was in a group that took the supplements in comparison to the placebo arm. I think it is worthwhile for further research to continue. However, as of now, it’s very difficult for dermatologists to endorse these as a true value-added treatment on top of your current recommended skin treatment which is evidence-based.
The science behind this is essentially we should be able to obtain all the nutrients we need from our diet. If you live in a developed country, it is highly unlikely that you will be malnourished. How collagen supplements will work is basically on this premise, they are essentially peptides that are further digested when ingested. These peptides work on a cellular level to stimulate collagen production by your skin cells. However, this is the theoretical part of it. We don’t think that it is possible to direct whatever you ingest to localise it to a certain part of your body. For example, in this case, the idea behind it is that when you ingest these collagen supplements it will localize to your skin in the dermis – resulting in more fullness and plumpness is ideal. However, we are really not sure of its effects.
Chesea: For centuries, Chinese women have viewed collagen as a fountain of youth. From consuming fish collagen to pig’s feet to shark fins – all in the hopes of smoothing wrinkles on skin and keeping joints healthy. In 2020, consumers in the US were expected to spend $293 million on collagen supplements. In spite of the limited research and lack of quality control in the studies, people have not been deterred. Expert projects that the global market for collagen to reach $6.5 billion by 2025!
Can collagen supplements be a substitute for my skincare routine?
Dr.Teo: Traditionally, what has been best borne out by scientific research is the topicals that you apply, which have a good effect on collagen production on your skin. So for treating pigmentation for example, we have additional options such as non-prescription cosmeceuticals, botanicals and other dermocosmetics. These act directly on the surface of the skin when they are absorbed through the skin barrier, penetrating the stratum corneum. In that case, we know for sure that when you apply that cream, it is going to act in that specific area.
Whether what you’re ingesting will lead to specific cell effects, we are not entirely sure. Nonetheless, tt should definitely be an adjunct to what you’re applying rather than replacing it. In that case, for patients suffering from eczema who think that just by popping a collagen supplement they don’t have to apply their moisturisers or seek treatment, that is in fact a very dangerous idea.
Chesea: Well on the flip side, since research on their efficacy is still in its infancy.
Can ingesting beauty supplements actually be harmful?
Dr.Teo: I don’t think that there is a danger in most of these supplements. So if it is something that interests you, you are okay with spending money on it and if you personally find that you have positive benefits, then why not? In the dermatology community, I think it is worthwhile for us to remain open-minded. In the meantime, we have to do a little bit more research with more data so that it’s possible for us to make a fair assessment on this topic. But if you have dry sensitive skin, eczema, or thinking that you’re going to take this collagen powder is going to make your skin better and avoid medical treatment, skip the application of your ceramide dominant moisturizers, then I think it is potentially harmful and strictly not evidence-based.
At this moment, dermatologists will not be recommending beauty supplements. Especially if they’re being marketed as oral ingestible moisturizers that replace topical moisturizers. When people actually think that it is a substitute for proper medical treatment of skin diseas, that is something that may cross over to the part where it becomes a harmful practice.
Chesea: There are a few super foods that are good for your skin. Natural ingredients such as fish oil, soy-based products, apple cider vinegar, to name a few, which have also been touted as beneficial in the hopes of achieving glowing skin. What is your opinion on these?
How do superfoods benefit the skin?
Dr.Teo: In terms of superfoods, I feel that we must first define it according to correct concepts in nutritional science. Over the last decade or so, colorful fruits and vegetables have been identified as super foods that are good for your skin.
In particular, from the Brassica Oleracea family, which encompasses vegetables such as cauliflower, broccoli, kale. These have been identified to contain potent antioxidants that can reduce free radical damage and are foods that are good for your skin. In fact, research shows that broccoli is one of the vegetables that can directly inhibit the growth of cancer cells. On this level, it is very helpful for individuals who are keen to adopt a nutraceutical-based intervention. This helps them on overall health level. Additionally, knowing that it will translate to skin benefits as well because of the enhanced benefit to combat oxidative stress.
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Plant-based foods that are good for your skin
The basic principle here is that plant-based foods are generally filled with important micronutrients as well as specific pigments, which cause the food to be colourful. For example, blue or purple foods contain anthocyanins and red and orange vegetables contain carotenoids. In cell studies, they show that these extracts exert positive effects on skin cells.
In terms of foods such as fatty fish, which are rich in omega three. First of all, these are essential for the functioning of the brain. Secondly, it can also encourage a healthy skin barrier. Because, our stratum corneum – the outermost layer of skin – is actually held together by ceramide molecules which are derived from fatty lipids. Therefore, it is very important that if you wish to have healthy skin, that you maintain your overall health with a diet that contains antioxidants which is mainly from plants.
Additionally, it’s important to maintain overall good nutritional status. This comes from a variety of foods that are good for your skin. Sufficient protein can come from plant sources as well. It does take a bit of planning, but for myself, I have transitioned to a mostly plant-based diet with some fatty fish consumption since early last year. Tofu, for example, has estrogen-like benefits. Besides being a rich source of protein and iron, it is also a phytoestrogen. Certain studies published in nutritional science journals have shown that individuals who consume tofu can actually see positive benefits in terms of their skin elasticity and reduction of skin wrinkles.
Can consuming these superfoods help with eczema?
For individuals who suffer from eczema, it is important to understand that it is not a cosmetic issue. It is a true medical condition that needs to be treated. However, maintaining a healthy nutritional status when you have eczema is critical. In a chronic case of eczema, the body loses a lot of protein because of the scaling – the body is in a catabolic state. It is important to take that into consideration when planning for individuals who suffer from eczema. We also know that tudies show consumption of fatty fish rich in omega-three or plant sources from plant seed oils or even evening primrose oil can improve skin barrier function.
Is apple cider vinegar good for the skin?
Apple cider vinegar is a prebiotic. On the topic of prebiotics, its a concept that links to the gut-skin connection. So it’s beneficial to your gut – it is a precursor of active prebiotics which benefits your gut. But, in terms of how it directly affects your skin, I think there really needs to be more research. However, we do have early data on the gut skin microbiome. This is how the health of the gut relates to the health of your skin.
Chesea: In your practice, apart from prescribing medications and topicals,
What are some dietary tips you usually give to patients?
Dr.Teo: Yes, I do offer dietary advice to my patients. If they are acne-prone, I advise them to completely cut out dairy products. Because, that has been shown in a few studies to have an adverse impact on the acne treatment progress. If they tend to have oily seborrheic type skin, then reducing fatty food intake like fried foods or trans fat in their diet will certainly help. For overall skin health, there are a few dietary principles that we can follow. First of all, ensure that you have a sufficient intake of your fruits and vegetables. There are various guidelines from either the US FDA or in Singapore, we have our local regulatory boards that recommend how your plate should look like. Typically, a quarter of your plate should be your fruits and vegetable serving of the day.
However, I go a step further when planning a plant-based diet. This includes other sources of protein and micronutrients such as from the fungi kingdom. I’m a huge fan of mushrooms. We also know that ergothioneine, which is a potent anti-inflammatory active nutrient, is found in high concentration in mushrooms and is also a source of vitamin D for mushrooms that have been exposed to sunlight. If you’re able to get your protein from plant-based sources like tofu, when you are planning your plate, you will be able to get additional antioxidant benefits that are present in plants rather than just protein alone.
The importance of a sustainable diet
And of course, there are a lot of ethical issues with animal-based products. With COVID-19 still rife all around the world, I think it is a good time for us to consider how we can engage the environment in a more sustainable way. This also includes humane treatment of animals. For example, when you ingest tofu, it will not just help your overall health – your cellular metabolism – but also have an impact on your skin cells. Finally, let’s just try to appreciate that our skin is an organ just like your heart or your lung. So how healthy you are will also translate into the health of your organs, and eventually it will show up in your skin.
What are some specific foods that are good for your skin?
Dr.Teo: Another tip I have is to take a variety of coloured fruits and vegetables. Off the top of my head, we associate the color red with tomatoes, strawberries. These are commonly found on our supermarket shelves. Capsicum, as well, have a very bright red external flesh. The reason for this coloration is due to the presence of micronutrients. For red, yellow, and green-colored foods, they also contain an active ingredient known as carotenoids and flavonoids as well. For purple-colored foods, we can think of grapes for example. In particular, for grapes, we know that it’s a source of the potent antioxidant – resveratrol. Blue-colored foods, the blueberry. These are very rich in anthocyanins.
Beetroot is also a functional superfood rich in a compound known as betalaine. Betalaine itself has been shown to increase the ability of the body to oxygenate blood. Therefore, it is highly recommended for professional athletes. Overall, it is an excellent antioxidant that combats inflammaging. Foods that are purple or blue and colour such as blueberries and grapes, will be high in a pigment compound known as the anthocyanins. Those which are orange or red, will be high in carotenoids. These have all been shown in various cell studies to have a positive effect on ageing skin cells.
Chesea: On the topic of well known foods that are good for your skin, you mentioned the brassica oleracea family of vegetables that are very beneficial in our diet. What is it specifically in the brassica oleracea group of vegetables that have such important cellular effects?
Benefits of Brassica Olarecea family of vegetables for the skin
Dr.Teo: Brassica Olarecea, we mentioned very briefly before in this episode. What’s so important about this group of plants and why it has rightfully gained its reputation as one of the top superfoods that you must include in your diet is because it’s been very well studied in the field of oncology to have cancer-fighting properties.
The active ingredients are primarily glucosinolates, the sulforaphane. Besides being able to fight cancer cells, they are also antimicrobial.
Antimicrobial effects of Brassica Oleracea
You may wonder why we even care that our ingested food has antimicrobial properties. The key thing here is the link with the gut microbiome. Additionally, various diseases of inflammation including inflammaging, the key process that we feel accounts for the ageing process for every single organ of the body. We briefly touched on mushrooms in the earlier part of this podcast. I want to explain now how these plant polysaccharides from the fungi kingdom can actually regulate the bacterial flora in your gut when ingested. These are a form of prebiotics. For brassica oleracea, it has been found to be able to stabilize the gut microbiome as well.
Increasingly, and I believe we will find it more and more obvious in the studies we do in the future, a link is established between the gut and the skin in terms of bacteria. Just a point to note, such an approach with nutraceutical interventions with superfoods has also been shown to improve certain chronic disease states. Such as in diabetic patients, it improves insulin sensitivity which enables better control of the blood sugars and also reduces the chances of getting organ damage as a result of diabetes itself.
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Chesea: We’ve focused on a lot of fruits and vegetables. But what about when it comes to meat? I do know that beef, lamb, pork – these are all high in saturated fat. You mentioned the benefits of fatty fish briefly above, can you tell us more about the benefits of that?
Benefits of fatty fish
Dr.Teo: I want to emphasise it is important to have good fats in your diet. Bad fats are saturated fats which come from meat. I personally have stopped taking animal-based products as well as dairy, because of the inherent ethical implications of animal farming. Additionally, because the science currently tells us that plant-based diets and plant-based sources of protein, can be a lot healthier, as well as containing antioxidants which are good for maintaining your cellular health from your organs all the way to your skin cells.
The fats that I would recommend to include in your diet would be polyunsaturated fats. These are found in fish oils, tree nuts, and seeds. They also have the 4 properties of functional foods that are good for your skin: antioxidant, anti-inflammatory, chemopreventive and photoprotective properties. Polyunsaturated fats also contain specific types of lipids such as ALA, DHA, EPA. These function in the barrier repair of the skin
Chesea: Well that’s it for today’s episode. We’ve covered the science behind inflammaging and the role of functional foods that are good for your skin and superfoods in this aging process. We’ve also talked about the evidence – or lack thereof- behind beauty supplements for our skin, and shared about specific superfoods you can incorporate into your diet, and the science behind how they can benefit the skin and overall health. You can follow Dr. Teo on instagram @drteowanlin for more podcast updates, and remember to check out our website at www.scienceofbeauty.net for the full podcast transcript.