Dietician's Corner

Milk thistle is a flowering plant from which, silymarin, a type of plant-based flavonoid antioxidant is extracted from its fruit and seeds. It is this extract that gives milk thistle its skin health properties. Milk thistle has long been used to help treat liver diseases. However, recent research has shown promise for this plant-based antioxidant to help with inflammatory conditions like arthritis and skin cancer.

Recent research reveals that the policosanol level of the milk thistle extract gives it these anti-arthritic and antioxidant properties. The immature seeds of milk thistle are thought to contain the highest levels of policosanol, which is a mixture of alcohol compounds derived from various natural sources.

So, how does this plant help your skin?

The skin health properties of this plant stem from findings that milk thistle extract helps repair DNA skin cell damage caused by UVB radiation sun exposure. Not only that, but this mechanism has also been shown to reduce skin inflammation caused by such UVB exposure.

Therefore, milk thistle, most commonly consumed in capsule form, is safe to consume to help provide antioxidant benefits. Milk thistle that is made of 70 to 80% silymarin, is safe in doses up to 420 milligrams a day in divided doses, for up to 41 months, or nearly 3.5 years, according to current safety research. However, before starting any new supplement, be sure to talk to your pharmacist to be sure any current medications you are taking do not interact with milk thistle such as the hepatitis C medication simeprevir. Milk thistle teas are also available but may not contain silymarin in its most bioavailable form.

It is important to remember that dietary supplements for photoprotection should be used concurrently with a topical mineral-based zinc oxide sunscreen for optimal UV protection. The dietary supplements alone should not be relied upon to keep your skin safe from UV damage.

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References:

Drugs.com (September 18, 2017) “Milk Thistle.” https://www.drugs.com/npp/milk-thistle.html

Harrabi, S., Ferchichi, A., Bacheli, A., and Fellah, H. (2018) “Policosanol composition, antioxidant and anti-arthritic activities of milk thistle (Silybium marianum L.) oil at different seed maturity stages.” Lipids in Health and Disease, 17:82.

Singh, R.P. and Agarwal, R. (2005) “Mechanisms and preclinical efficacy of silibinin in preventing skin cancer.” European Journal of Cancer, 41(2005): 1969-1979.

ACHIEVE YOUR SKIN GOALS WITH CLEAR DERM WITH PROBIOTICS

There are so many contributing factors to a clear complexion that it is hard to talk about every herbal remedy that could potentially benefit the skin. However, there are a few herbal remedies that stand out as contenders in the skin healthcare sector.

Turmeric: The polyphenol in turmeric, known as curcumin, is well-known for its effectiveness as an herbal remedy in various inflammatory diseases like arthritis and inflammatory bowel disease. However, its benefits also extend to skin health. Curcumin has been shown to reduce inflammation in cases of psoriasis and has been found to improve wound healing.

Grape seed extract: In the extracts of grape skin and seeds is a powerful antioxidant known as oligomeric proanthocyanidin (OPC). It is this antioxidant property that provides grape seed extract with its ability to protect the skin from UVB radiation exposure-induced skin diseases.

Camellia sinensis: Also known as tea, Camellia sinensis, is a healthy part of any lifestyle due to its antioxidant properties. An animal study looked at the effects of water extracts of white, black, and green tea on skin of mice. Study results show that the polyphenol antioxidants in tea reduced epidermal thickness and increased collagen and elastin content of the skin, which shows a protective effect against UVB-induced skin aging. Furthermore, a 2017 study revealed green tea extract to be a protective herbal remedy against UV radiation-induced skin aging.

Echinacea: Commonly linked with helping relieve cold symptoms, Echinacea also has potential for a skin care herbal remedy. Echinacea has been found to exhibit ani-inflammatory properties as well as immune system stimulating properties that show promise for application in skin care. Studies have shown positive results in studies of wound healing and acne as well as UV photoprotection of the skin. Upon further clinical study in humans, Echinacea may be an integral herbal remedy in skin care.

Therefore, it may be time to add some herbs to your skin care regimen. However, when going out in the sun, be sure to use any herbal remedies alongside of a mineral-based zinc oxide sunscreen for optimal UV protection.

References:

Di Nardo, V., et al. (January 2018) “Use of Curcumin in Psoriasis.” Open Access Macedonian Journal of Medical Sciences, 6(1): 218-220.

Katiyar, S.K., Pal, H.C., and Prasad, R. (October 2017) “Dietary proanthocyanidins prevent ultraviolet radiation-induced non-melanoma skin cancer through enhanced repair of damaged DNA-dependent activation of immune sensitivity.” Seminars in Cancer Biology, 46: 138-145.

Lee, K.O., Kim, S.N., and Kim, Y.C. (December 2014) “Anti-wrinkle Effects of Water Extracts of Teas in Hairless Mice.” Toxicological Research, 30(4): 283-289.

Pazyar, N., Yaghoobi, R., Rafiee, E., Mehrabian, A., and Feily, A. (2014) “Skin wound healing and phytomedicine: a review.” Skin Pharmacology and Physiology, 27(6): 303-310.

Roh, E., et al. (May 2017) “Molecular mechanisms of green tea polyphenols with protective effects against skin photoaging.” Critical Reviews in Food Science and Nutrition, 57(8): 1631-1637.

Sharma, M., Schoop, R., Suter, A., and Hudson, J.B. (April 2011) “The potential use of Echinacea in acne: control of Propionibacterium acnes growth and inflammation.” Phytotherapy Research, 25(4): 517-521.

The root cause of acne, also known as acne vulgaris, is the bacterium known as Propionibacterium acnes. Those with acne have been found to have higher levels of this bacterium versus those without acne. Everyone has levels of P. acnes to some degree in the skin. However, it is when the bacterium colonizes the duct of the sebaceous gland that an immune response is triggered. When this happens, an inflamed acne pustule is formed.

Inflammation not only occurs in such late stages of acne development, but also in the early stages too. And recent research shows that acne may also develop in the lack of presence of P. acnes. Other possible causes of acne vulgaris, in their early stages of research include the pro-inflammatory cytokines interleukin-1 beta, 8, 12, and 19.

Some people may struggle with acne more than others due to a variety of factors that may differ from person to person. Some risk factors of acne include:

• Excess oil production
• Hair follicles clogged by oil and dead skin cells
• Excess activity of hormones such as in puberty; or taking medications that contain hormones such as androgens, corticosteroids, or lithium.
• Family history; especially if both parents had acne.
• Exposure to greasy skin care products or grease in the workplace.
• Friction or pressure on the skin such as holding a phone against your face a lot or wearing a helmet frequently.

Stress is not a direct cause of acne but can make any acne that you have worse. In terms of the brain-gut-skin axis, any anxiety you feel may start to imbalance your gut microbiome, and in turn cause inflammation in the skin. Therefore, relaxation breathing, meditation, yoga, or talk therapy may be helpful in managing stress and lowering your risk of acne.

Research is also starting to reveal a possible link between diet and inflammation. Carbohydrate-rich foods, dairy products, and sugary foods may increase risk of acne lesions. Therefore, stick to anti-inflammatory foods such as antioxidant rich fruits and vegetables as well as omega-3 rich foods like avocado, nuts, seeds, and olives.

References:

Arck, P., et al. (2010). “Is there a ‘gut–brain–skin axis’?” Experimental Dermatology, 2010; 19: 401–405. 

Askari, PhD, N., et al. (February 2017) “Association between Acne and Serum Pro-inflammatory Cytokines (IL-1α, IL-1ß, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) in Mustard Gas-Exposed Patients: Sardasht-Iran Cohort Study.” Archives of Iranian Medicine, 20(2): 86-91.

Mayo Clinic (accessed July 3, 2018) “Acne.” Mayo Clinic Online.

Mochtar, M., et al. (2018) “The Difference in Interleukin-19 Serum on Degrees of Acne Vulgaris Severity.” International Journal of Inflammation, Volume 2018, Article ID 4141579, 4 pages.

Tanghetti, MD, E.A. (September 2013) “The Role of Inflammation in the Pathology of Acne.” 6(9).

Everything that happens inside the body can impact the skin. You could say that our skin signals us to any unhealthy processes or imbalances that may be going on in our body. For example, the skin condition psoriasis usually presents itself as plaques of itchy and inflamed skin on various parts of the body. Recent research has found that this inflammation is signaling an imbalance of good bacteria in the body. And when such good bacteria as Bifidobacterium infantis is introduced back into the body, psoriasis plaques and inflammation symptoms start to improve.

This impact of bacterium in the body on the skin is associated with the gut-brain-skin axis theory. This theory states that when a person gets stressed or is exposed to a stressful situation either mentally, such as anxiety or depression, or physically such as UVB exposure or smoking exposure, the gut is impacted. These stressors can cause a rise in “bad” bacteria that can cause oxidative stress and in turn, damage to cells in the body. This damage can extend to the skin cells, which can cause inflammatory skin conditions such as acne, rosacea, and psoriasis.

When you eat a highly processed food item that is low in nutrient value and high in additives and preservatives, this can cause such oxidative stress in the body’s cells. Preliminary research shows that some food additives used to preserve, flavor, or color food may cause such stress. Foods high in carbohydrates like sugar and flour may also increase the risk of inflammation in the body and skin.

Therefore, it is recommended to consume mostly anti-inflammatory foods that are rich in antioxidants. Examples of such foods include healthy fats like those found in fatty fish like salmon, nuts, seeds, and avocado, as well as antioxidant-rich fruits and vegetables like berries, carrots, peppers, leafy greens, and grapes, to name a few.

References:

Arck, P., et al. (2010). “Is there a ‘gut–brain–skin axis’?” Experimental Dermatology, 2010; 19: 401–405. 

Dorier, M., et al. (2017) “Continuous in vitro exposure of intestinal epithelial cells to E171 food additive causes oxidative stress, inducing oxidation of DNA bases but no endoplasmic reticulum stress.” Nanotoxicology, Taylor & Francis, 2017. 

Groeger, D., et al. (2013). “Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut.” Gut Microbes, 4(4), 325–339. http://doi.org/10.4161/gmic.25487

Paula Neto, H.A., et al. (November 2017) “Effects of Food Additives on Immune Cells As Contributors to Body Weight Gain and Immune-Mediated Metabolic Dysregulation.” Frontiers in Immunology, https://doi.org/10.3389/fimmu.2017.01478.

Vijayashankar, M. and Raghunath, N. (2012) “Pustular Psoriasis Responding to Probiotics- A New Insight.” Our Dermatology Online, 3(4): 326-328.

Acne is an inflammatory skin condition. Therefore, any foods that trigger inflammation may increase your risk of developing acne. This means that any highly processed foods with a long list of additives, preservatives, and artificial ingredients should be limited or avoided. Examples of these types of foods include processed candies, salty snacks, and canned or prepackaged convenience foods. Further studies need to be done, but preliminary research suggests that processed food consumption may be linked to oxidative stress in the body, which can lead to increased risk of chronic disease and skin health conditions.

A study of young adults looked at the impact of diet on acne severity. The research shows that those who reported a diet higher in added sugar, total sugar, milk servings, saturated fat, and trans-fat had a greater likelihood of having moderate to severe acne. Another similar study of adults found that those who had moderate and severe acne consumed greater amounts of carbohydrate-laden foods and high glycemic load foods. The glycemic load reveals how much the food impacts blood glucose levels, so those foods with higher glycemic loads such as white-wheat flour bread, baked goods, and candy are more likely to cause skin health issues.

You may wonder how certain foods can cause a skin condition such as acne. It is suggested that AGEs, or advanced glycation end-products may be the link between diet and inflammatory skin conditions like acne. AGEs are found in cooked meat, oils, and cheese can trigger an inflammatory response. Foods that contain sugars can bind to bacterial protein products to produce AGEs. On the other hand, consuming a diet high in healthy fats and whole foods, such as in traditional Mediterranean and Asian cooking methods, may help reduce formation of AGEs and in turn improve skin health, upon further study.

References:

Burris, MS, RD, CSSD, J., Rietkerk, MD, MBA, W., and Woolf, PhD, RD, FACSM, K. (March 2014) “Relationships of Self-Reported Dietary Factors and Perceived Acne Severity in a Cohort of New York Young Adults.” Journal of the Academy of Nutrition and Dietetics, 114(3): 384-392.

Burris, PhD, RD, CSSD, CSG, J., Rietkerk, MD, MBA, W., Shikany, DrPh, PA-C, J.M., and Woolf, PhD, RD, FACSM, K. (September 2017) “Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne.” Journal of the Academy of Nutrition and Dietetics, 117(9): 1375-1383.

Higdon, PhD, J. (2003; updated in March 2016 by Delage, PhD, B.) “Glycemic Index and Glycemic Load.” Linus Pauling-Oregon State University. http://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load

Smith, BMedSci, MBbS, FRACP, PhD, P.K., Masilamani, PhD, M., Li, MD, X-M., Sampson, MD, H.A. (February 2017) “The false alarm hypothesis: Food allergy is associated with high dietary advanced glycation end-products and proglycating dietary sugars that mimic alarmins.” The Journal of Allergy and Clinical Immunology, 139(2): 429-437.