Skin aging and acne: What you should do | Dr Justine Kluk and Dr Sarah Berry

here's something that most people get wrong what we eat affects our skin because of this concept of the gut skin connection or the gut skin axis this is pretty crazy the two are not operating independently of each other so the food we eat will impact our skin Health welcome to Zoe science and nutrition we're World leading scientists explain how their research can improve your health [Music] wonderful well I'm very excited to do this one and I have to admit a little nervous so great to see you great to be here I'm even more nervous so that makes you feel better and poor Sarah stuck in the middle of us I'm loving it I've got like we can gang up on him Justine we always do this I can get him back for like the last year of podcasts all right so I'm not feeling any more relaxed now um I'm gonna try and take a little bit more of a back seat today uh and so Sarah is actually going to start with the quick fire round of questions from our listeners yep so Justine we start all of our podcasts with quick fire questions the rules are you can say yes no or one line only if you had to say one line okay yeah okay so there's six questions first one is can your skin tell you about the health of your whole body yes great it does what I eat matter for my skin yes wow that's good news for us at Zoe can Dairy make acne worse yes and we'll talk more about why and how much great is it possible to reverse skin aging we can't reverse it we can slow it down fabulous um our collagen supplements a waste of money it remains to be determined okay that's allowed okay I can simplify possibly okay probably now the last question you're allowed one to two lines and what I want to know is what's the most unexpected thing you've discovered about skin through working with your patients think the impact the really huge impact that having a skin condition can have on people's psychological and emotional well-being I think that is something that really drives me to um to want to share with you guys and with your audience why it's so important that we pay particular attention to our skin health amazing so as I Was preparing for today's podcast I was thinking two things so firstly I was thinking I have to be really careful what I say today or I'm going to be in trouble for weeks and the second is actually thought back to um uh Justine in my very first date and I asked something really stupid which for those of you who know me won't be very surprised like Justine why did you decide to specialize in skin rather than all those like much more interesting things you could do as a doctor and Justin explained to me that I was an idiot and that basically skin was the most interesting thing in the world uh and so I thought actually that would be a brilliant place to to start could you tell us like what skin does and why it's so important for us all and while you went on that second day as well I think sometimes I sometimes lost myself the same question no um Jonathan Jonathan was sparkling and witting all the good things even back then yeah so um now just exposed to a bigger audience which is annoying but um I thought it was just for me um why do I think skin is the most uh interesting thing um on a personal note I had acne myself as a teenager as Jonathan knows in fact still do still take treatment for it so for me it's been a 30-year Journey with a skin condition so I think having had that experience and found a really difficult at times I really want to prevent other people from going through the same so I think one of the reasons why I think skin is so important is it's visible okay and that can be a good thing it also means it's accessible so if we want to study the skin we can access it easily we can take swabs we can take biopsies but I think going back to basic principles why is the skin so interesting and important I think I can distill it into three points which is hard for me because I'm quite verbose but the first is that there's the Skin Barrier function which we'll come and talk about in in a moment but the skin is our outer Shield it's our first point of communication with the environment and so um our skin does provide some vital functions for example regulating heat and water loss protecting us from UV from infection from things we're exposed to around us the second thing is um and your you guys will be interested in this is It's home to our skin microbiome um and we definitely will be talking about that I hope um and the third thing which I think is one of the reasons why I was really interested in becoming a dermatologist is our skin tells us a lot about what's going on inside our bodies and gives us clues about the health of our internal organ systems and so one of the cool things about being a dermatologist is basically we're like super detectives and so you know there are I think 3 000 different Dermatological conditions my colleagues might be listening to this and think you know they're actually two thousand so if I'm over inflating it it's because I want to really represent Dermatology here today but you know two thousand different ways of looking at red spots so you have to be really good as a dermatologist at looking at patterns and looking for Clues and our skin does give us a sort of window into things that are happening inside so that's why I think skin is interesting and why I will say it is the most important part of the body but of course it's connected to everything so we can't think of it in isolation yeah I think it's fascinating that it is like a window because I I must say it's something that I had never thought of before and there was a study that someone had highlighted to me where they had twins and people were asked to age these twins according to their skin okay and the twins that they aged as being older according to their skin actually went on to die and develop disease a lot sooner than the other twin just based on them detecting their age based on their skin that really surprised me that is really fascinating I think maybe when we get into what are the factors that influence aging you'll see that there may be some common things between what influences skin aging and what influences aging of our other organ systems and so um you can't separate these things out and I think it's something that you guys have talked about on the podcast quite a lot and I've certainly heard Tim says that we can't think of different parts of our bodies different compartments separated from each other it's something I talk about in my clinic quite a lot all of this is connected we have a noise understood how science is starting to apply gaps so we understand now about the microbiome we understand a lot more about hormones but all of these bits are connected and so you can't just think about trying to address one in isolation you have to and and there are of course therefore will be factors that influence the health of multiple organ systems so yeah great and you talked about the microbiome which is one of Zoe's uh real areas of interest and we talk a lot on our podcasts about the gut microbiomes all of the trillions of bacteria that live inside our garden impact our health but I've recently started hearing about the skin microphone I know nothing about it Jonathan probably does because he's probably heard you talk about it but I wonder if you could tell listeners a little bit about what the skin microbiome is in the first place what functions it has what we do know and maybe what we still don't know about it so um I'll start with the last question which is we know a lot less about it than we know about the gut microbiome which might surprise people because I've said that the skin is so much more accessible so you would think it's the obvious place to start investigations on the microbiome but um but that isn't the case so we know that we have all of these microbes living in our gut we also have millions of microbes living on the surface of our skin something that I think is really fascinating is there's an argument always about what is the largest organ in the body and it's often said to be the skin and so dermatologists take a lot of pride in that I've actually recently learned that's not exactly true okay okay if anyone who's interested by weight it's the musculoskeletal system and by surface area it's actually the lungs and the Airways the sort of gas exchanging surfaces are the largest bat what's really cool about the skin is if you were to kind of roll it out flat to two square meters okay okay that's not that big okay Jonathan's going to say to me for the Americans I need to give 10 square feet so I don't think she was thinking that way yeah I think we were thinking different metrics has never been my really strong point but there are millions of these appendages so dips and divots in the surface of the skin because of our hair follicles and our sweat glands and our sebaceous glands which are oil producing glands and so actually the real surface area of our skin that our microbes can inhabit is 10 times that at least 10 times that so some some say sort of 25 square meters so it's huge so it's it's pretty a football pitch I'm diagnostic I don't know I'll have someone that's in football maybe like a tennis court or something like it's definitely getting big so there are yeah there are lots of them and there are good and bad ones something that's really interesting is a bit like Tim talks about is sort of there being these like mini pharmacies that the microbes he Compares into many pharmacies and they got sending out signals to the rest of their body the same is true of the microbes on our skin and so they interact with our immune system this is really important particularly in early life um we should talk about the hygiene hypothesis I think which is um the idea that um we often think about small children babies in particular being vulnerable to infection and they are because their immune system is yet to mature and develop so the theory in the past was that you should keep everything clean around small children so that um you don't expose them to this risk of infection and what we've learned is that that unfortunately by not exposing kids to dirt and animals and you know all of this other stuff we we actually reduce the diversity of the microbes that live on their skin and therefore um this um affects the development of the immune system and actually increases the risk of people developing allergies and inflammatory skin disorders and how do you do about letting your own children get really dirty in those first few years of life I mean Jonathan knows that this is definitely a sort of do as I say not as I do yeah and I think it's something actually that I thought quite a lot about since having our daughter who's now four because I was you know I've trained in a hospital environment where sterility and cleanliness are king and so that often gets translated into home life so you know my family you know will laugh when they hear this but you know my my like you could eat off the floor in my home I would say to my daughter you can eat off the floor here but nowhere else um but we know that this is not great for kids and actually there have been you know a lot of recents a lot there have been some recent studies showing that actually exposing children to the natural environment so there is this scheme called play and grow where kids um I think there were two to five year olds and they were sent to go and play with leaves and soil outside for a number of weeks and what's amazing is they found the the researchers found that the kids were less stressed and less angry they had higher gut serotonin levels than the control group um they felt more connected to Nature so by that they like were more prepared to eat vegetables afterwards and were interested in in the environment um and they had greater abundance and variety of microbes on their gut samples at the end of at the end of the study and when you were studying um Dermatology and again were you taught anything about the microbiome at that point no I think the first time I heard the word microbiome was as a Dermatology trainee so I was already pretty advanced in in my career so but it's relatively new even in nutrition it's only the last 10 years that we're talking about it and Justin something we often talk about is how can we change the microbiome in our gut to make us more healthy given the link between the gut microbiome and health can you change your skin microbiome so you talked about there's different bugs that are associated with different skin conditions can someone change their microbiome on their skin and most importantly does that then alleviate some of the symptoms or conditions that you talked about we're only really starting to get into it Sarah and I think often people would think that there's more real science here than there is because I think um I'm going to be cynical but there's a commercial opportunity to sell skin care products that say they're going to balance your microbiome and and supplements okay so uh cream that you can put on that will change your microbiome yeah so like a probiotic cream yeah creams containing probiotics and really yeah so I mean this is this is not new it's been you know for the last I don't know five plus years there are these products out that they say they can balance your microbiome they contain probiotics Etc but if you actually you know I think people might be surprised because if they are into skin care or beauty and have been into a um a skincare store and looked at the shelves there are lots of products that have these claims now but if you look at the science actually it's still in its infancy and um it's it's not nonsense that there are um some studies where people have been given oral or topical probiotics and there have been some favorable changes in um reducing some of these pathogenics and these bad microbes that can take over but I think the sort of magic bullety type things that say you know probiotic cream is going to balance everything I'd be a bit skeptical about those things still okay so I've got a question that I think a lot of listeners might be thinking or maybe I'm just crazy but we know that yogurt for example is a probiotic and it's going to be a lot cheaper than any of these creams what about slathering yogurt on your face [Laughter] has anyone done that um I'm sure they have done I I don't know of any trial where people have put the yogurt on their skin but I think it goes back to you know dermatologists are used to telling people not put toothpaste on their spots like there are things that are designed for a specific purpose yeah so okay you know eat your yogurt um and in terms of practical things that you could do um to potentially support Your Skin Barrier and reduce dysbiosis on the skin these are things like for example using a gentle cleanser on the skin so I like a cream or a gel cleanser for for washing the face morning and evening if we over wash our skin we might disrupt the microbiome on the skin if we use very harsh um soapy cleansing products we might disrupt the microbiome on this or does it strip the microbiome if you use quite a tough like I like what one that really scrubs off everything that's got all grains in it and will that strip it or does it just reduce it it can do inferior and I think we've got to remember that it is quite individual right so you know some people might say I use this you know exfoliating cleanser and actually that's fine for me I have no problems with it if it's fine for for you and it's not disturbing your skin and you have no skin problems it's probably okay um but the the microbes on our skin like certain conditions and um so if someone has an inflammatory skin condition and is thinking how can I kind of support the good microbes on my skin I would say think about this um soap free gentle cream your gel cleanser if your skin is inflamed so in my acne clinic for example I tell people not to use those scrubs or exfoliating cleanses because if you think of an inflamed surface and then you're going to go and scrub something over the top of it you're going to increase inflammation in the area so that wouldn't be a good idea I'd actually love to take that opportunity to move on to sort of two of the skin topics where we had a huge number of questions a huge number of questions from our Zoe listeners which is acne and skin aging and I'm actually love to start with acne maybe just start by telling us like why does acne matter so it's a big problem okay um acne is the eighth most prevalent disease globally so not the eighth most prevalent skin disease the eighth most prevalent disease you know full stop so big problem nine point four percent of the population have acne so just think I almost one or two people yeah it is a lot and um it is the most common reason for people to come and see a dermatologist It's associated with higher rates of depression and suicide It's associated with scarring which can become permanent in in more people than you think so maybe um this is a kind of something that stays with people even after the inflammatory phase has gone and um 90 of teenagers will have acne of some severity so if they're lucky that will be very mild they may just get have a few you know blackheads and a couple of pimples but for some people it's very much more severe than that and they have you know these deeper red swellings and cysts in the skin and they're more likely to get the scars and I think it's I always think it's quite cruel that the time at which people are most likely to develop acne is in puberty because of the rapid change in the hormones and this is also where you know kids are so vulnerable because they are developing their social identity they're trying to become more independent they're navigating personal relationships and they've got exams and all of this pressure that they didn't have when they were younger and then they've got to contend with this very visible and painful um skin conditions so I mean I could keep going Jonathan but that those are some of the reasons why I think is it just is it just teenagers because I know that's actually not most of the people who see you no so for sure it's much more common in the teenage years and then acne is much more common in males than females in the um adolescent years and in the early 20s but beyond sort of early to mid 20s it is much more common in females and so a rough sort of rule of thumb is that um half of females in their 20s will have acne a third of females in their 30s and a quarter of females in their 40s which is huge isn't it it's a half of all women in their 20s to the third in their 30s and what about menopause as well we hear lots of people talk about getting spots you know around menopause I'm at that perimenopausal phase and I've I've never had spots I've been really fortunate but I've started to notice I've got a few of my spots I get on my chest I get a few here and you hear anecdotally a lot of women say join the perimenopause suddenly acne returns and spots return so just to reassure people if we look at age alone you are much less likely to develop acne for the first time or to continue having it um in your 40s or 50s so the chances of having acne do decrease with time however at any time of hormonal shift you may be more vulnerable to having spots and so we do see it around the time of of the menopause we also see it around pregnancy and of course the classic time for having acne is during puberty and is it more common than it used to be yeah it is and I think we haven't really always understood why acne has been becoming more common over you know the last few decades but I think there are two leading thoughts at the moment and the first is the adoption of the western diet and the second is increased stress levels um so and could we talk a little bit about the impact that diet might have on acne because I know lots of of my friends her parents have children that suffer from acne often will say or say well what should they be eating and I can't tell them what they should be eating but I know that lots of people will go on elimination diets you know I must avoid all dairy or avoid gluten Etc and you know when I was growing up acne was blamed on eating sugar and chocolate I'm pleased you mentioned elimination dice we should come back to that in a moment because it's one of the most worrying things I see in clinic is people coming in and having read that various Foods can contribute to acne and have taken that further and started excluding all sorts of things from their diet and of frankly malnourished when they turn up in clinic and also have developed I think disordered eating as a result of I think misinterpreting information about food and acne and especially for adolescents that's such an important time to make sure that you're eating you know wide variety of nutrients you know the the prevalence of iron deficiency anemia and you know in adolescence is huge and so if people are avoiding certain foods that's a real problem correct and I think of you know my steps and so we have a 15 year old at home who'll be absolutely dying that he gets mention today but um dying of embarrassment that is not excited exciting but you know you they they have to sleep so much right in their teenage years because they need all this you know conserving energy for growing so actually we do need to think about fueling ourselves properly um and not restricting things particularly when there is insufficient evidence to to suggest it would be helpful so you know what what do we know um we know that um diets with high glycemic content are associated associated with increased severity of acne and so can I just tell people what we mean and I'm not a nutritionist so I would rather you explain what it means we haven't had podcasts talking about it um but when we talk about high glycemic foods we mean foods are typically high in really refined carbohydrates so white red white um pasta potatoes that kind of thing that cause a really rapid increase in blood sugar so you eat these kind of foods about 15-20 minutes later you've got this big peak in blood sugar and it also stimulates lots of hormones like insulin and Insulin like growth factor and um so a little bit about acne so people understand how the sort of pathway is connected is that what basically underlies acne is an increase in oil production in the skin blockage of the pores where the oil is supposed to come out onto the surface of the skin by dead skin cells and then this creates a delicious feast for this particular bacteria C acnes that feeds on this and this triggers inflammation and underlying this is a particular group of hormones called androgens testosterone is the classic one which increases the oil production and the poor clogging and we can connect food to this because these sugary foods and these very refined carbs um your blood sugar Rises then your insulin Rises and Insulin like growth factorizes igf-1 and this increases these Androgen hormones so it kind of we can connect all the different dots along the the pathway okay you also talked about inflammation which is something Jonathan particularly loves talking about yeah and I I quite like talking about it with him we know as well from our own Zoe predict research that the food that we eat is associated with I've got microbiome that's also associated with lots of inflammatory factors we also know if we consume really high glycemic index food it actually initiates an inflammatory response now this is inside our blood this is inside our gut would any of that be related to the kind of inflammation you're talking about that's going on at the level of the skin the answer is yes because there is a connection between our gut health and our skin Health we call this the gut skin axis and so for sure um the same sort of principles will uh apply that sugar is the most important one Dairy is one of them and people often um will see an association with eating dairy and their skin getting worse or certainly will have read about it from an acne perspective and there is some evidence now mainly there aren't any rcts as far as them where there's mainly observational studies showing that in Western populations Dairy can aggravate acne particularly milk because there seems to have a greater impact on insulin than other things like cheese potentially because of the Whey contents or whey supplements can be problematic for acne sufferers as well so the two areas of nutrition where there's been most research and evidence of their impact is is dairy and and the sugary stuff so Justin what would your practical advice be to help people with acne because a lot of people listening to this who would love to know okay what can I do for myself or maybe they're thinking you know about their teenage children what would you say I'd say the first thing is do go and get expert help if it's something that you're not able to manage yourself at home I'm going to start with that because I think there is a big spectrum of severity with acne there's very mild acne which can be self-managed at home with some of the tips I'll give you in a second but there are people who have much more severe acne it may be affecting their mental health it may be causing scarring and I think in that circumstance please go get some support from your family physician your GP or a dermatologist and do these other things on top of that but I wouldn't want to delay people getting appropriate treatment and I think there are some skin care tips I would give thinking about supporting the Skin Barrier and also um you know in inverter commas helping to balance the skin microbiome but you know to create a healthy environment for the skin microbes that are beneficial to us moisturizing the skin is important so moisturizing the skin reinforces Skin Barrier function and it makes the skin a happier healthier place if you have acne people often avoid using moisturizer because they're worried about clogging their pores up more look for the words non-comedogenic on a package that means non-pore blocking and that is something that you might find helpful vitamin A retinol retinoids this group in topical form is really good for reducing pork clogging in the skin and can also reduce inflammation to a degree more so for the prescription forms in the over-the-counter forms but I think what is really important is choose one and Incorporated in your skin routine so I would say cleanse your skin or tell your teenager if this if you're going to be relaying the information cleanse your skin with a non-stripping product twice a day moisturize the skin with a non-comedogenic product twice a day put a non-comedogenic sunscreen on in the morning and choose one active ingredient or one product with these active ingredients in to incorporate into your routine and introduce it slowly because again you can sometimes do more harm than good if you're too aggressive and overzealous with these active ingredients try to combine too many of them together try to use too much too soon I mean I remember as a teenager being given a cream for acne and thinking this is the answer to all my problems and like squirting half the tube out and putting it on overnight and of course nothing happens immediately and you think my acne is going to be gone tomorrow and then you wake up the next morning and you're like you can't smile because your face is red and it's gonna crack and it's really sore and so you know I always say to my patients you know I'm glad you're excited about using this but you know you do need to you know you do need to incorporate it gradually into the routine because you can actually end up doing more harm than good if you are you know not uh slow and steady so Justin you've talked us through top tips of what you can apply to your skin and your understanding of nutrition and acne so if I could just summarize back from a practical perspective based on what you've said about nutrition you're suggesting that foods are high glycemic index are going to be a problem so this is where this perception that for example Sweets chocolate might be bad but also therefore perhaps people should be reducing the amount of these refined carbohydrates so for example the white bread the white rice the pasta the potatoes and any other kind of Rapid carbohydrates that increase blood sugar and would you say that that would be a good diet tip that we could also give people yes and I think one of the things you said in this podcast before that I think is like really helpful and practical is even if you do nothing else you can just switch having your white red white rice or white pasta with wholemeal versions of that you don't have to change your lifestyle or any of the other thing things that you do that so sort of simple switch that you could make as a starter for 10 or add Protein healthy proteins or healthy fibers or fibers healthy you can add healthy proteins fiber or some healthy fats as well which will kind of reduce that blood sugar response yeah exactly and I would also say just life is about balance and it is okay to have treats and I wouldn't want the take-home message for anyone you know to be that you know if they're at a restaurant on their birthday they can't have the pasta as it's served or they can't have a pudding that night like it's okay to do that as long as that's you know that is the treat and not the norm I would say okay so while we're talking about food I'd quite like to quiz you a little bit about Jonathan so Jonathan is obviously incredibly well behaved in everything he does so my perception is is that Jonathan follows the Zoe recommendations to a tea so I'm not even convinced that he would go and have his birthday cake at a restaurant if it didn't score higher on this area school have you noticed his diet change since he started the whole Zoe program and also I'd be curious to know how yours has changed so I'd say Jonathan's diet changed before the Zoe program a little bit and I'm sure this is why he you know went on to um to perform Zoe um Jonathan's talked a bit about you know having had issues with his gut in the past Etc I hope you don't mind me saying that Jonathan and so had already started making Sanjay some changes to the way he ate before we even met but I mean you know he does live it at home and I think actually after you know a couple of years of being told you know the um what was our life like after I did Zoe and before how do I say that before you did sorry honey we actually we have questions and now I want to know what Justin was going to say the fact that she's thinking twice about how to say it okay so you know I think we have a sort of you know there are lots of jobs we share in the house we both work we both have young children and the sort of split is normally I've prepared the food during the week and Jonathan does it on the weekend so that's how we do it Justine I have seen on your Instagram account uh the pictures you've been posting of your meals they look incredibly healthy they all look like they will would score above eight at Zoe but most importantly they look really tasty so this is just sort of part of the thank you Sarah this is the kind of part of the evolution so Jonathan was kind of the early adopter and he was you know doing Zoe and um I would be preparing the food during the week and I think it would be fair to say we were having the same thing on repeat every week because I'm time poor I've never had very much confidence in my ability to cook my mum is an amazing cook and somehow I think I always felt overwhelmed it seemed like quite a lot to do and didn't get into it so after a couple of years of having the same Foods on repeat every single week the same five things on rotation and Jonathan's saying be really nice if we could have you know a bit more a few more plants or I'd have you I am I then did Zoe myself last year and I was really excited about it I you know I am a science geek and I love the idea of you know putting on the CGM seeing what was happening to my blood sugar in real time I had some Shockers things that I was eating that I thought were really good for me caused massive blood sugar spikes um I love doing this sort of at-home poop test and all of that the sort of science experiment at home but but having then you know these results that arrived that were personalized to me I was then much more invested in actually making some changes so it felt less like Jonathan nagging me to do things because you know it was good for him or he thought it was healthy for us as a family Jonathan Knack never I I don't know who you would be talking about it sounds so plausible so you know I kind of felt like you know this was something that um that I could get on board with as well and then I think the the biggest surprise to me was actually getting into cooking because this was something I was like I can't cook won't cook person and I've worked out for myself that there are a lot of things I can do even without the app now so I know that if I just have a load of beans tin you know canned beans red kidney beans Pinto beans cannellini beans or what have you in the cupboard I have some chopped tomatoes and I have an onion um you know in the in the fridge somewhere if I have these staples I can basically do a bunch of stuff you know I can always feed us and and how much have you changed your diet quite a lot actually I would say lots yeah quite a lot actually I think that what I love by the way is that I said all of this stuff for the previous couple of years having obviously Taken part in the early studies and getting my results and just things like whatever just gonna ignore you because obviously I say all sorts of stuff all the time that might not always be right and um it was anyone who actually did Zoe yourself and got your own results and guidance right that that made the shift it was really interesting that then it was like for you it wasn't just your husband nagging at you and actually I wasn't expecting Justin to change very much I think you had a very clear view that you knew what was good for you and what was healthy and this happened has really changed her diet which is great for me because it means the whole family's diet has um has shifted dramatically as a result I think there's something very convincing about seeing your own data absolutely I think that's that's really what it boils down to that and for me also that I the fact that preparing food doesn't have to be as difficult as as you think it is and incorporating you know if you have as I say a few of the Staples in your cupboard at home you can do this with very little effort and time and I know because I have a four-year-old and I run a clinic and I have a very demanding husband [Music] because Justin does most of the cooking now so she's much more than she did before because she's really got into it out of this which again was not on at all like an expected um by-product we've slowly learned to eat a lot of things I think like you know we would never eat any sort of bean ever right like that's sort of like you eat baked beans when you're a child and I think there's no doubt there's been a sort of shift and what's interesting I think I'm fascinated by is um you eat some of these things first I mean I don't even I don't like this very much I'm eating this because it tells me that it's healthy and what is really interesting is you know if you can stick with that for a month it's like your whole taste buds change don't you find and suddenly you start to think actually this is really nice and it's almost like you're somehow shrugging off a lot of whatever you're you've been learning from this Ultra processed food and maybe your microbes are changing a bit with it and I feel taste buds change so like with salt for example which we're over consuming in the UK and it's a big problem how much we're consuming but you become desensitized to it and so they say that you've got to gradually wean yourself off it and your taste buds will then start to appreciate it more um I'm really conscious of time and I think it would be great to talk about a topic that I'm really interested in which is as a 46 year old woman I myself and all my friends are interested in skin aging and so you said in a quick five questions we can't reverse signs of aging but we might be able to slow it down there may be some people listening to this scientists who say we can reverse aging but I think let's talk about some of the Practical things that we we know for sure at this point can can so perhaps we could start by talking about what actually causes skin aging so we know what potentially we can avoid and then some great tip tips from you on how we can actually slow it down as well okay sure so I think when we think about skin aging we divide it into sort of two categories there's intrinsic aging so this is the passing of time so chronological aging and genetics and I think a lot of people would expect that those have the greatest influence on how our skin ages so you mean for example if your mum your mum's or father skin aged well you might think well that's fine I'm gonna have great skin as well so yes correct and also that you might expect that someone who is 70 looks older than someone who is 60. okay so there's also the sort of chronological age then we have the second category which are um extrinsic influences on Aging meaning the so meaning things that impact our skin from um the environments environmental exposures and actually um the the most influential of these is sun exposure and we call that photo aging and people will probably be amazed to hear that 80 percent of visible skin aging is attributable to sun exposure eighty percent so if I had which I didn't unfortunately stayed out of the sun put Sun cream on religiously up until now and I've only just started wearing sun cream since I've been watching you on Instagram talk about how important was if I'd have slathered myself in Sun cream up until now could my skin look could you look even more youthful than you do already could I look like my 20 year old self possibly so the you know the evidence is that sun protected behaviors and part of that is sunscreen part of it is also you know staying out of the sun between 12 and 2 when you know the sun is directly overhead wearing a hat um you know covering up in the Sun so it's not sunscreen is part of the the armamentarian but it's not everything but yes the answer is that protecting your skin in the sun can for sure slow signs of aging and I think this is quite empowering because we can all do this it's not control exactly it's not very difficult I remember Justin and I went on this amazing holiday to Japan uh early in our relationship when I was trying to convince her to like stay with me and um we saw all these um women there right of all ages basically with umbrellas um and it's not raining it's like a sunny day yeah and so you see like this huge Focus there on managing skin exposure and Justine was like this is part of why they all look so incredibly young isn't there yeah and actually that reminds me of something you know that's also very interesting is that um how we age um so you know the the manifestations of Aging may be slightly different actually in different populations as well so in um more sort of European populations wrinkling maybe the predominant thing and in a Asia so you were talking about Japan um brown marks or brown spots dark spots whatever you want to call them these pigment changes may be the predominant Hallmark of Aging but you know sometimes people wonder what we mean when we say skin aging what are we talking about and we're basically talking about the skin becoming drier over time we lose more moisture through our skin we we lose collagen this sort of protein in our skin that makes it firm and and reduction in collagen causes the skin to wrinkle more and to Sag more um and then the other thing that we get is these dark or brown spots on the skin and so lots of people I know are taking collagen supplements on the belief that they will enable their skin to stay younger look more youthful do they work the the jury really is still out Sarah I mean am I recommending these in my clinic no is the answer are there other doctors recommending them yes um people might want to know what we're talking about when we say collagen supplements these are this is sort of collagen that people take in I guess capsule form um they're broken down into peptides absorbed in the intestine and it has been proven they do find their way into the bloodstream about an hour after they've been eaten and then they accumulate in the skin and the idea is that they trigger increased collagen production in in the skin which makes the skin firmer that they may trigger elastin in the skin which is this other protein that makes the skin more springy and also improve hydration in the skin and there have been some studies that show favorable effects when people have taken collagen supplements there's others that show less of a benefit the difficulty with interpreting the data is that a lot of the studies are sponsored by companies who make supplements so they have an interest in presenting the data in a way that would show you know that there's a favorable effect and a question I always have is um we know that we tend to absorb these nutrients better when we get them in food so do we really need to take a collagen supplement couldn't we be thinking more about you know the Mediterranean diet and um and getting these um getting these nutrients in our food so before going and shelling out a lot of money on collagen supplements because that's the other thing the Studies have shown that the effects don't last when you stop taking the collagen supplements so um this is something that if you were deciding that you were going to take on board you'd have to keep on doing that could end up being awfully expensive so why don't we think about the inexpensive easily accessible things that we can do that have lots more evidence behind them and that's the sunscreen retinol um so retinol comes from vitamin A and um it's a it's available in topical form for improving signs of skin aging something you put on your skin in the evenings usually because it can make the skin a bit more sensitive to to the Sun and that can boost collagen production in the skin making the skin firmer and can also help with reducing the appearance of some of these brown marks that appear on the skin as well so that would be something that's real is it because I remember when I first met you I'm like this is all potions isn't it isn't everything that you put on your skin is all fake that's real I often say there are three things if you want to think about skin aging that you can incorporate into your daily routine and sunscreen is number one number two is using retinol at night and for anyone who's listening to this who may be pregnant or trying to get pregnant that's not the time to use retinol it shouldn't be used um at that point in life um and the third thing is thinking about antioxidants that you can apply to the skin and vitamin C is the most studied one and so we know that if you apply Vitamin C to your skin in topical form that this increases collagen synthesis it helps to boost your own collagen production it helps to reduce dark marks on the skin so we make make fewer of these and it also protects us from inflammation in the skin as well so so vitamin C topical vitamin C is important and there are other antioxidants so things like Resveratrol um coenzyme Q10 so you know there are other antioxidants that are important but but basically these three groups antioxidants sunscreen and retinol are the the key things and I wonder if I could ask you two top nutrition skin myths that I have seen doing the rounds on social media they might not be myths so you're the person to ask one is that polyphenols are our own natural sunscreen is that correct because I I've seen this as headlines just eat loads of polyphenols you don't need to apply sunscreen I would say why don't you do both okay so I think we're not yet at a position in a position where we can say that there is something that you eat that is going to protect catch your skin well enough so that you don't need to rely on sensible sun protection behaviors staying in the shade wearing a hat covering up with clothing if you are someone who doesn't like using sunscreen there are other things that you can do I personally am very comfortable putting sunscreen on exposed sites and um and I wouldn't rely on on these um oral polyphenols but it's not total it's not total nonsense in that there is um there is there is Theory there so for example if you think about a carotenoid like lycopene may have some photo protective effects omega-3 might have some photo protective effects but I definitely am not swapping my sunscreen for those okay great the other thing that I've seen in lots of headlines is intravenous antioxidant vitamin drips it will make you look ten years and feel but make you look 10 years younger and this is a growing craze I think amongst a niche community and for those of you listening Justin is shaking her head ever more vehemently as Sarah is saying this and just not even going to talk about yeah no I I don't believe in those okay so I often use the word nutribolics to talk about nonsense when it comes to nutrition and what you're saying is intravenous antioxidant drips to make your skin 10 years younger it's nutribolics but polyphenols in acid potential sunscreen isn't advisable but there is some science behind why it might be photo yeah I maybe even have sounded much more strong on the polyphenols or sun protection than I intended to what I'm saying is I wouldn't dismiss it and I keep you know keep an eye on the space but for sure we're not at a position yet where I would say swap your sunscreen for that and the antioxidant drips I'm always like in you know when you work in science or in medicine you have to keep an open mind because things change and prepare to be convinced that those are a good idea but I'm not at the moment and I have to ask a follow-up question because it impacts my life how important is it in fact that you apply uh sun protection it is important okay and I think we've talked about skin aging here and um but you know there are other things right like your risk of skin cancer increases with age um and with cumulative UV exposure with sunburns that increases your risk of skin cancer too and not to you know you know not least because also they're uncomfortable at the time so protecting your skin in the sun is more than preventing your skin looking older earlier it's also about reducing risk of things like skin cancer so just before we run out of time I mean we've talked a lot about food we've talked a lot about um sort of skin care routines is there anything else that a listener can do that can really affect the health of their skin yeah so absolutely um stress is is Mega and um and sleep and so actually in the clinic when I counsel people about how we're going to manage their skin condition I would start with genes and hormones and then we talk about skin care habits we talk about the food we eat we talk about stress and sleep these are the sort of the key things we touch on but something that I think people might be really interested to know is I mentioned earlier about people with acne having high rates of depression and suicide um did you know that some of our stress hormones so thinking about this brain and skin connection some of our stress hormones actually get released in the sebum the oil from our oil producing glands in the skin and literally bathe the surface of our skin so the connection we are like bathed physically in stressed when we're stress correct so so it is there is definitely a really strong connection between um between the brain and the skin in ways that people might not expect yeah it's really interesting because I've always thought of the skin as just this inert outer layer like we started you know when we started talking but talking to you now and obviously you know having listened to lots of your Instagram posts is fascinating how it is a living part of us absolutely and it's got you know we've got this this community of all these bugs living on us as well so um it is very much a sort of uh reactive dynamic organ and there's so much more we're still going to learn about it but you know I hope I've convinced you know people often think about you know going back to Jonathan's original point about how when he met me he wondered why I wasn't you know a kidney physician or something like this and um you know skin is absolutely it is absolutely fascinating and there's as I said so much more we're learning about it um so I hope I've convinced everyone else of the same I wouldn't be allowed home if I didn't say yes allowed to answer any other way amazing thank you very much Justine I'm going to try and do a little summary and I really have to get this one right yeah so Jonathan before you do yourself I'm not going to do the summary but before you do your summary um I have been subjected to a year of quick fire questions from you Justine has been subjected to about six years of quick fire questions so we have some quick fire questions for you we have five questions oh no I wasn't prepped for this at all that's very unfair okay go on Sarah five questions okay the fifth question is going to be tough are each of our fifth question is tough so you get two points so you can get a maximum of 12 points all right okay very competitive so I'm heading for the 12. if you don't get 10 out of 12 there is going to be a forfeit so the forfeit is if you don't get 10 out of 12 you will either have to drink a Diet Coke right or you'll have to eat a McDonald's and we're going to let your son Zach decide which of those you're going to have to do oh well I can't do either of those so better score 10 okay now my questions are going to test just how much you listen to me okay um and how much you've listened to the podcast okay okay wow ready yes okay oh this is a controversial one I'm going to start with are all Ultra processed foods bad for you foreign know if you use the Nova classification well done should we all be taking Omega-3 supplements no because you can also get it through diet okay great does Diet improve menopause symptoms yes okay who do you prefer doing podcasts with Tim or me that's like cheesy between your parents I love them both equally oh Jonathan Daniel take a point away for that Tim's not here I prefer you Sarah I want to get just in case I get nine points um yeah I would have deducted a point for them okay now this is the challenge this is the two point question okay all right okay now it's quite tough but I've talked about this so often on our podcast okay okay so what percentage of energy is not absorbed when you eat nuts oh so this is so this is for people listening this means by what percentage back a pack labeling overestimating the energy content I'll let you go I think it's about a third oh my goodness well done that's six out of six oh you see it I always I always listen to you now we're over to Justin all right I'm more scared about this one yeah you don't have to be scared actually I'm testing your truthfulness here because I know the answer to some of these questions so um have to help me keep counting his error so number one is going to be um is acne more common in males or females uh I know at least for adults it's more common with women correct but it's more common in men earlier so exactly so so over the age of 25 more common in females and in adolescence in males well done what I Can't Tell You by the way how nervous I am right now I've had years of your quick fire questions I realize it's a lot easier to ask them than to have to answer them I have more sympathy now with all my guests okay so question two is what is the minimum SPF I would consider um uh buying for a sunscreen product that we keep at home 500. no that was a joke 50. so I would say 30 or higher okay Justin says let him have that point no because the reality is she says that but we never buy one that doesn't say 50 on it so okay hold on it's yes or no you're now uh explaining your answer I think we can accept 50. Okay um the answer is 30 though um and the next question is which meal or food do you most associate with happy times and I know the answer uh gelato ice cream okay I thought that was what he was going to say so um for context for people who uh you know who don't know um Jonathan um family have been going to a particular place in Italy uh in the Summers for I'll say I was going to say centuries excellent skincare skincare yeah and I know that Jonathan one of Jonathan's big passions in life is gelato and this is something that Tim might say it's a heritable trait and this is something that uh that my stepson is definitely inherited um my next question was what is the Zoe inspired meal that I've made that you've most enjoyed oh this is question four yeah that's um I think that um the one I have most enjoyed is when we actually had um uh will ball switch who many people in the podcast know and Sharon who's our head of marketing round uh for dinner and they're both vegan and you made this sort of um bean stew which was absolutely fantastic and if you had said to me 10 years ago that I would have eaten like a vegan bean stew and said that it was amazing I'd have been like what but like where's the Steak so that would be my favorite and the only person who didn't enjoy that meal was my stepson exactly okay and so I've got one more question you've got one more question this can be the one that is the bonus question but he's doing fine so he's not going to get a full film fortunately damn it okay I was going to say Star Wars or Princess Bride oh that's so tricky oh well I'm going to really divide the audience you see I feel like that's really like being asked to choose your favorite child so this was one that we when Sarah said we're going to do some quick fire questions and by the way you can see I'm obviously not used to the quick fire question because they've taken a bit longer however we had to have a consultation at the dinner table last night so Jonathan Jonathan was out last night so the family sat around the table and this was the question that we chose together I think I'm ultimately gonna go Star Wars but I mean I've I could it's I can't go Star Wars okay well Zach still talk to me I mean I don't know Well Done Jonathan you've scored 12 out of 12. you do not have to eat McDonald's and you do not have to have a diet cake wonderful which will keep my skin looking um healthy for longer let me do a quick summary um of uh of today's session where we covered a lot of stuff I think first thing we said is like skin is really important you know it's not just this impure impermeable barrier we now know it has its own microbiome of these millions of bacteria and the interestingly lots of skin conditions that we have actually linked to sort of individual sort of bad bugs in that context uh we talked about acne which is one of the big topics that our members want to talk about apparently half of women in their 20s instead of a third of women in their 30s um have acne so it's not just something that you go through as a teenager that it can have really life-changing impact you talk about people even you know committing suicide which is really terrible interestingly there is some evidence that food can be um uh can have an influence and specifically Dairy and sort of food causing these big high blood sugar spikes can be an issue but there's also a danger of people going to this like cutting all their diet out and that's even worse so to sort of be cautious as one approaches that that we had some great sort of um practical tips so gentle cleanser don't strip your skin moisturizer you can do if you have acne and none of these devices that are sort of scraping at your face and Justine described you know using her fingertips um which I can tell you is is indeed how she does this then we talked about anti-aging um so Sarah wants to know how to continue to look 30 forever which I think is uh uh definitely should I keep coming on the podcast because it keeps saying nice things and what Sarah said is that I'm sorry what Justine said is actually sun exposure is 80 of your skin aging so really it isn't about your genes it's about things that are under your control so so that means sunscreen and just not being in the sun you know like all the time is is really important but there are some real things that you can do and you mention retinol and an antioxidant like vitamin C both of which I refuse to do because it's too much effort but I know that Justine does religiously um and then finally we talked about sort of what else can you do so firstly bin those collagen supplements bin all these other supplements like in terms of the amount of money this is isn't worth the way worth it and a lot of it I think there's very little evidence on the other hand interestingly stress can have this huge impact so if there's things you can do that reduce stress it really can affect um your skin and amazingly apparently if you are really stressed you're actually bathing your skin in it which I'd never heard before is slightly terrifying because I get stressed quite often at this idea that you're sort of marinating it is is amazing um but also sleep and even just going into nature might be able to do something for all of you who are listening to this working from home therefore is so like keep listening to the podcast but walk out into nature and improve your skin Sarah and Justine thank you so much thank you that was fun enjoyed it me too thanks for having me oh it's a real pleasure and I've got through it without anything too disastrous so I'm pretty happy Sarah you obviously didn't know the right questions to ask thank you all bye-bye pleasure thank you Justine and Sarah for joining me on Zoe science and nutrition today if you want to understand how to support your body with the best foods for your skin and your gut health then you may want to try Zoe's personalized nutrition program you can learn more and get 10 off by going to join zoe.com podcast as always I'm your host Jonathan wolf Zoe science and nutrition is produced by yella hewings Martin Richard willin and Alex Jones see you next time [Music]

Channel: ZOE

Views: 260,053

Keywords: zoe, zoe podcast, gut health, ultra processed foods, tim spector, gut health diet, ultra processed foods documentary, ultra processed food, skincare routines 2023, skincare routines dermatologist, skincare routıne for dry skin, dr justine kluk, justin kluk, justine kluk, justine kulk, sarah berry, dr sarah berry, sara berry, acne, aging, ageing, microbiome, gut skin axis

Id: LJC0igfCywE

Length: 60min 54sec (3654 seconds)

Published: Thu Aug 31 2023