Episode 21: Sugar Sag and Collagen Supplements

Our diet is a key component that can add to our aging.
Did you know that sugar can cause "Skin Sugar Sag"?

In this episode, Dr. Saluja and Kane explore how sugar consumption can significantly impact skin health through a process known as glycation. This occurs when excess sugar molecules attach themselves to collagen and elastin, the proteins that keep skin firm and elastic. Over time, this reaction forms harmful new molecules known as Advanced Glycation End-products (AGEs). AGEs accumulate, leading to the breakdown of collagen and elastin, resulting in skin that appears less firm and more wrinkled—a phenomenon often referred to as "sugar sag." Reducing sugar intake can help mitigate this process, preserving skin's youthful appearance and maintaining its structural integrity

Thank you for your listenership!

Transcript

Dr. Minni Saluja 0:10

Hi, everyone. I hope you're well, and thank you for returning to another episode of Just Laser It and all things cosmetic. Cain, how are you

Kane Rogers 0:17

doing? I'm doing really well. We've, we're doing another one rather quickly.

Dr. Minni Saluja 0:21

Rather quickly with inside of a month,

Kane Rogers 0:23

pretty good.

Dr. Minni Saluja 0:24

that's pretty good, isn't

Kane Rogers 0:25

week, isn't it?

Dr. Minni Saluja 0:27

Two weeks, two weeks. Yeah, it's been a couple of weeks. Well, we're going to do something different today, Cain. So we always talk about different energy based devices and different type of products, et cetera, that we can utilize for aesthetic purposes. But today we're going to focus more on. external factors in how to improve the procedures that we are doing in the office.

Kane Rogers 0:49

Okay,

Dr. Minni Saluja 0:49

So, you know, what's interesting is, and you've seen this, I've shown you different before and after photos, but I can identify appropriate patients for procedures, right? And I could do similar settings with a similar device on these patients. And yet I can have different outcomes for these patients. I can get some patients with off the chart results and other patients with, yeah, yeah, I can kind of see something type of a result. And it always makes me scratch my head and say, what can be done differently? What is, the factor, the X factor that's making the difference here? And. Do you know some of the different things that perhaps can make a difference? Like, what do you think of when you think of why some patients might interact well with a procedure and really show a visible difference and others may not?

Kane Rogers 1:39

I think of sun damage. I think of smoking. I think of just kind of overall dermal health.

Dr. Minni Saluja 1:46

Sure. I mean,

Kane Rogers 1:46

but that's, yeah, that's probably about it. I mean, I imagine that's one of the more challenges for you. I mean, you have a ton of expertise and experience in this, but yeah, how do you, how do you predict how somebody is going to respond?

Dr. Minni Saluja 2:00

well you bring up good points? So certainly a part of this is genetics, right? But a lot of it is epigenetics. In fact, the majority of it is epigenetics. Different exposures that we have extrinsic to ourselves. So you brought up sun damage and. We know sun damage can do a lot of things, but one thing it does do on a molecular level down to our DNA is it creates these thymine dimers. And if you think of the DNA as a double helix and it has to be unzipped to be copied, these thymine dimers almost make it so you have a zipper that doesn't unzip and it creates kinks in the, in the DNA. So it could relate to that. and skin cancers and all sorts of other things. So certainly that's something, and we know that smoking can cause oxidative damage for sure, amongst other things, and can lead to poor production of collagen elastin, but Kane, one of the other things is. is our diet. Again, back to our diet. We, we talked a little bit about fiber, et cetera, but, but our diet and eating too much simple sugar can make a difference.

Kane Rogers 3:06

Yeah, it makes me think back on when we were kids. You are what you eat.

Dr. Minni Saluja 3:09

Oh, very, very true. And I mean, Hippocrates, let food be thy medicine is such a true statement that it can really relate to our health. And I, and I often just as a side note, I think of my parents who were in their eighties. And my mom who makes three meals a day doesn't use canned foods and what she can do and I'm not just talking from an aesthetic perspective, I'm just talking from a functional perspective yoga and walking, like it, it does make a significant difference. And so sugar specifically can cause something, too much sugar can cause something called sugar sag. And there's, so there's an actual terminology that's, that's associated with sugar,

Kane Rogers 3:47

also cause belly.

Dr. Minni Saluja 3:49

belly sag and, and skin

Kane Rogers 3:51

know that too well right now.

Dr. Minni Saluja 3:53

And skin sack, but what it does is it creates these advanced glycation end products. And so what it's doing is it's interacting with our the fats, the lipids in our, in our body. It's interacting with all sorts of bio molecular structures and it's creating these A G E's, these advanced glycation end products. And these advanced glycation end products can actually begin to interact with our collagen and our elastin. It can make our elastin very stiff and it can, it can break down our collagen fibrils as well. So we get poor quality or as you were saying to earlier, poor dermal health from too much sugar. So Thank you.

Kane Rogers 4:35

much sugar. It's interesting. I've never thought of sugar contributing to dermal health or kind of how you initially started this as, you know, how you can potentially respond to a treatment. I mean, I think of sugar and we, we know all the, the health impacts. Overall, you know, obesity, diabetes. So on, but I never really thought of it in terms of how it's contributing to my skin.

Dr. Minni Saluja 4:58

Yeah, absolutely. And so the other thing too is these A. G. E. S. can also interact independently, independently with molecular oxygen. And what it does is it creates oxidative damage, oxidative free radicals. And we all know about antioxidants and all that. So that's what antioxidants are about. They're helping to minimize these oxidative free radicals in our body. And so if we're creating A. G. E. S. that create oxidative damage. We're really kind of hitting our skin from multiple different biomolecular aspects. So it is important. It is

Kane Rogers 5:35

So what can you do about it? I mean, are, are there products? I mean, I know we can talk about diet, obviously, to, to minimize your processed sugar intake, your

Dr. Minni Saluja 5:43

Well, I think that's number one, Kane. I think that yes, there's products, there's devices, but let's start with our diet. And that's where I really want to empower patients because I think there's so much that we can do on our own between treatments to maximize treatments and also just in general health purposes. So yes, whole foods diets are so important. And you know, when you think about, When you think about all the benefits that are in fruits, it's, you know, the phenols, the polyphenols that are in there. All these things are so important to help with free radical damage. And it's not juicing. You know, juicing, juicing takes out the fiber and you're just getting the juice. And that in and of itself is not great either. You need that whole fruit. That's what's important.

Kane Rogers 6:32

Well, I mean, okay. And I'll

Dr. Minni Saluja 6:33

Because, and I'll tell you why.

Kane Rogers 6:35

mean, it's not a bad, I mean, it's better than an alternative of eating a cookie.

Dr. Minni Saluja 6:39

it is, but it spikes your sugar too much. When you're, when you take out that fiber, the fiber is what slowly releases the sugar. And so when you're taking that fiber component out, you're basically getting sugar spikes, which is increasing insulin. And that brings up another point is that insulin can turn on all sorts of inflammatory biomarkers in our body. And you've heard of inflammaging. When our inflammation is increased, we age more. So, so it's really important to

Kane Rogers 7:07

Well, I think you bring up a good point where it's empowering the patient to have this type of knowledge that yeah, your sugar intake is going to impact potentially the results that you get from these treatments that you're investing in. And it's, it's a sizable investment. A lot of times when people come in and have something done and to know that, Hey, there are other things that you can do to help. Yeah. with your results. And one of those things is your diet.

Dr. Minni Saluja 7:38

Absolutely. So that's one thing that you could do. Minimize your sugar intake. The other thing is let's talk about antioxidants. I think that's, we talked about eating a whole foods diet, but also it's not a bad idea to take some vitamin C and certainly to apply vitamin C topically to the skin. And there's multiple different products that are out there. Just whenever you're selecting a vitamin C topical product, really make sure it's L ascorbic acid. Make sure it's an amber colored bottle, so it doesn't oxidize, doesn't break down. I personally like the SkinCeuticals Vitamin C E Ferulic Acid. It's, it's at a pH content that actually penetrates into the stratum corneum, but there are other good products as well, but just make sure you're not getting a product that's, that you think you're getting from the. From the dollar store that might work and it might be the totally wrong. It's might not even be L ascorbic acid. So just kind of keep that in mind as well.

Kane Rogers 8:34

well. Yeah, it's, I mean, I guess it's just, it's literally a billion dollar industry, these, these products that are out there. So yeah, do your homework.

Dr. Minni Saluja 8:42

Do your homework for sure. And you just don't know what other cross contaminants are in there as well. So, so get it from a reputable source.

Kane Rogers 8:49

topically, so we're talking about diet, number one,

Dr. Minni Saluja 8:53

Oral vitamin C through the diet, or you could even with supplementation and topical. I use vitamin C serum in the morning time. That's when I wake up, that's the first thing that I do. You now I have you on it too. So that's important as well. And then of course we want to sun protect our skin as well, but there's also, there's some evidence and you know, I'll tell you,

Kane Rogers 9:14

tell you,

Dr. Minni Saluja 9:15

I've poo pooed this a long time, but patients always ask me about oral collagen, right? And. What I try to describe to them is that the collagen that you're taking orally is not going to intercalate with your skin and all of a sudden become, become new

Kane Rogers 9:34

You're using big words again. Articulate. What did

Dr. Minni Saluja 9:36

it's not going to hone in on your skin and all of a sudden become, but there is some evidence. So I stand corrected here. There is some evidence that hydrolyzed collagen. Can actually create a little bit more improvement as far as skin elasticity and hydration and also the dermal density. And when you think about dermal density, it's because of collagen. So I guess they're saying in a roundabout way, it does improve a little bit of

Kane Rogers 10:04

So there is some evidence that ingesting collagen,

Dr. Minni Saluja 10:08

There is, and I used to say, nope, nope, nope, it's not going to do much, but there are some studies and there's this one study that's over a thousand patients and there's no conflicts of interest. I always like to see who sponsored the study as well, that there are some benefits with this, with this hydrolyzed collagen. And again, the only reason why I get so About it is, is it's not regulated, so I don't know. Again, the cross contaminants that are within these different products as well, that's hard to, that's hard to determine. But once again, reputable brands, et cetera. And I don't have any good brands to share with you because I just haven't embraced the whole notion, but I'll certainly do more research on it as well

Kane Rogers 10:48

Yeah, that's what I was going to ask you. I have a hard time understanding how ingesting a collagen tablet can actually help you. You know, it just seems to me like it would go through your digestive system. But, but, you're saying that there's evidence that it does have an impact. So question number one, is it a significant impact? Is it something that anybody would actually notice? And number two, is there a quality associated with the collagen supplement that you're taking? Sure.

Dr. Minni Saluja 11:17

I mean, yes, I think all those things, what's the potency of it, et cetera, et cetera, are very important, but there is, what they're finding is that when you ingest these hydrolyzed collagen that it, they are finding it in the bloodstream and they are finding that it's going to the sites and improving the quality. So certainly there's improvement in the ligaments, so in and in hair, nails and all of that, but they are finding that they did biopsies and they did indeed show. improved evidence of the elasticity, the hydration and the dermal density, as I was saying as well. So I don't know. I think they just need larger randomized trials and to look at this a little bit more and see indeed, but, but it was nice to see this, this. larger study that, that was basically evaluating this.

Kane Rogers 12:04

So there is some

Dr. Minni Saluja 12:05

there is some, I'm going to keep my eyes open to it. I mean, will I rush out and buy a ton of collagen? No. Do I have some in the cabinet? Yes. You know, the powder that I haven't had in a while in my shakes, but so I put it this way. If it's not hurting you, it's not a bad thing, but there is evidence that potentially it may be beneficial.

Kane Rogers 12:25

I think you'd want, to me, the quality would be really imperative in making a selection. You can go to Walmart and probably buy something pretty cheap, and you're going to get what you pay

Dr. Minni Saluja 12:35

Right, right. And I, and I don't have a, I just haven't done my deep dive into this. So it's hard for me to recommend things that I'm just uncertain about right now. But, but there are, you know, again, some studies that are showing, showing that some, some getting a little bit larger with the, with the subject counts, which is important too. I don't want to see it. 45 patients. I want to see a study with thousands of

Kane Rogers 12:57

think it's an interesting follow up to look at mechanism of action and, and how it's actually working.

Dr. Minni Saluja 13:02

Sure. Absolutely. All those things are important. But, so, that was just the importance of this component, is that we really do have to look at our diet when we think about these things, and we have to look at our, our protocols for our own home care, meaning that washing your face with gentle cleansers, making sure that we're moisturizing, making sure, sure, that we have an antioxidant, then moisturize,

Kane Rogers 13:24

then certainly using

Dr. Minni Saluja 13:26

Using our SPF and whatnot, and then some type of retinoic acid or, or even if it that's too harsh, a glycolic or something to increase cell turnover at night as well. I think that's, you don't have to go crazy buying thousand or thousands of products, but just some of the pillars of good skincare,

Kane Rogers 13:42

I guess my takeaway is going back to what I said earlier. It's as we used to always say, as kids, you are what you eat. And this should empower us to be able to help generate the results that we want from the investments that we make. And also just to help lead a healthier, happier life.

Dr. Minni Saluja 14:00

That's right. So that's it. That's all I got today. A little, little shorter of

Kane Rogers 14:04

Quick and dirty.

Dr. Minni Saluja 14:05

quick and clean, clean eating.

Kane Rogers 14:07

So,

Dr. Minni Saluja 14:08

All right. So I hope everyone has a wonderful evening and we'll try to do a future one. Maybe within a month.

Kane Rogers 14:16

Thanks for listening everybody.

Dr. Minni Saluja 14:17

Bye bye.

Kane Rogers 14:18

Bye.