 Hey everybody, Dr. O here. Welcome to part three in the real talk about loose skin series. I'm super happy that you're here. I've actually been really excited about the feedback that I've received from this series so far, but I'm most excited about the number of people who have seen results by using the strategies that I'm outlining in this series. I've heard from no fewer than 20 people who have lost large amounts of weight with zero loose skin. It is super exciting to hear. It is possible. Back in part one we looked at the causes of loose skin and the risk factors that will make it worse. We also covered the major lifestyle factors that will make dealing with loose skin hard if not impossible. Then in part two we covered fasting and other ways to improve skin health by boosting autophagy. So here in part three though we're going to cover the importance of feeding your skin the nutrients that it needs to tighten up and heal. So in this video we will cover my four favorite skin nutrients. As you can see them here collagen peptides, vitamin C, hyaluronin or hyaluronic acid which is what I'll call it, and the omega-3 fatty acids EPA and DHA. I'll do another video in the future about other nutrients that can improve skin health just later on in the series. These are the ones though that I personally had success with and where I see the most support in the research. Reach out if you have questions about other nutrients. I will definitely add them to the list and add them to the series. But first why do we need to nourish our loose skin and why do these specific nutrients matter? The best way to improve your skin health is from the inside out. Each of these nutrients tackle one or more of the key issues that lead to loose skin in the first place. I covered the issues in detail in part one but let's take a quick look at a bit of the research here as well. So what does the science have to say? Skin changes due to massive weight loss, histological means tissue level, histological changes and the cause of the limited results of contouring surgeries. So they compared skin fragments of 20 patients who had massive weight loss because or due to bariatric surgery and then 20 patients living with morbid obesity. Here's a quote, structural dermis alterations in the massive weight loss group demonstrated collagenous remodeling with consequent reduction of thick organized structured and directed fibers in favor of thin misaligned and loosely arranged fibers. So we know that massive weight loss leaves damaged collagen behind. This is why it is crucial that we improve the health of our collagen every way that we can. Next one, image analyzer study of the skin and patients with morbid obesity and massive weight loss. This time they biopsied 30 patients and here's a quote, collagen was significantly less dense in the reticular dermis with damage to the elastic fiber network. That's the key here. So now we also know that we need to address skin elasticity if we want to prevent minimize or eliminate loose skin. Last one, skin protein profile after major weight loss and its role in body contouring surgery. This study showed that there's a persistent increase in inflammatory markers in skin after rapid weight loss. So anything that can help control inflammation at the level of the skin will also be a part of the solution. So now we have our targets. So let's go ahead and dive in. So skin nutrient number one is collagen peptides. You need a steady supply of collagen to improve skin elasticity and overall skin health. All the collagen that's actually made in your body begins as something called pro collagen. You're going to hear that word a few times today to make pro collagen, your body uses two amino acids, glycine and proline. So a protein rich diet that's high in these amino acids will definitely help boost collagen production. But I'm going to show you soon why I think consuming hydrolyzed collagen peptides is actually ideal. So what are hydrolyzed collagen peptides? And I'll just usually call them collagen peptides. They're very similar to gelatin. It's a processed form of the collagen that's found in the connective tissue of animals. When gelatin is processed into smaller little peptide chains, it's called collagen peptides. So let's look at the study first. What does the science say? Oral collagen supplementation, a systematic review of dermatological applications. So this review looked at 11 studies with a total of 805 patients. It concluded, like I do, that oral collagen supplements increased skin elasticity, hydration and dermal collagen density, all things we need if we want to improve or eliminate loose skin. Right? So we're fighting against loose skin. We've already talked about the things we have to deal with. And collagen checks quite a few of those boxes. But two of the studies in this review really caught my eye because they found that a relatively large percent of the collagen peptides are actually absorbed intact rather than being broken down in the digestive tract first. So the first one was Yazaki. Yazaki found that taking collagen peptides led to a 13.6% increase in collagen tripeptides in the blood. And then Ohara et al. found that 30% of the amino acid hydroxyproline from collagen peptides was absorbed as part of a peptide rather than in its free form. So what does this mean? This means that collagen isn't completely broken down in your gut before it's absorbed. People often say there's no need to take collagen supplements because your body will just digest them and break them down into individual amino acids and absorb them just like every other protein. But that doesn't appear to be true. Some of these collagen peptides are making it into our body intact. So this is why I recommend taking collagen peptides rather than just eating a high protein diet and hoping your body will maximize collagen production. So don't get me wrong, right? You know from my fat loss series, I love protein. And you know from my sleep videos that I love the amino acid glycine and I love bone broth. But there appears to be something special about the collagen peptide specifically when it comes to skin health. Another study. A collagen supplement improves skin hydration, elasticity, roughness and density, results of a randomized placebo controlled blind study. So there were 72 healthy women aged 35 years or older in this study. They received either two and a half grams of collagen peptides or a placebo for 12 weeks. And here's what happened. You can see here in this image that the test product that they used with the two and a half grams of collagen peptides significantly improved skin hydration, skin elasticity, skin roughness and skin density. As you can see from the chart here, the improvements were sizable as well. Basically, the improvements ranged from 18 to 25% after 12 weeks of only taking two and a half grams of collagen peptides per day. I'll take that for sure. Another one, effects of hydrolyzed collagen supplementation on skin aging, a systematic review and meta analysis. So this review looked at 19 studies with a total of 1125 participants aged between 20 and 70 years. They did a grouped analysis of these studies that showed favorable results of hydrolyzed collagen supplementation compared with placebo in terms of skin hydration, elasticity and wrinkles, right? That we keep coming back to these same things and collagen peptides appear to improve them. Another one, dietary supplementation with specific collagen peptides has a body mass index dependent benefit beneficial effect on cellulite morphology. So this one's talking about cellulite, but I thought you've interested in that as well. 105 women aged 24 to 50 with moderate cellulite. They received two and a half grams of collagen peptides or a placebo per day for six months. The collagen peptide treatment led to a statistically significant decrease in the degree of cellulite and a reduced skin waviness on the thighs in normal weight women who had reached their goal weight. That's why they talk about body mass index dependent. It worked better as people approach their goal weight. It didn't work as well with people that still had a lot of weight to lose. All right. So I typically recommend aiming for 10 to 12 grams of collagen peptides per day, even though some of these studies were only using two and a half grams per day. I'd rather take a little too much than take a little too little, but you can decide for yourself. Here is my current favorite collagen peptide product. It's Anthony's collagen peptide powder. I just buy it on Amazon. It has 12 grams of collagen peptides per serving. I like the source. I'm amazed at how easy it mixes in water, right? I just stir it with a spoon and it's ready to drink. That's what that's one thing I really love about it. But I've also used Great Lakes collagen peptides in the past. It also has 12 grams of collagen peptides per serving. So maybe you'd like to try that one too. A couple more things before move before we move on though. Number one, I'm a big fan of collagen peptides for the skin. And I think the research is supportive of it. But the research on collagen for muscle and joint health isn't usually near as positive. But take it for skin health. And if you get lucky, you'll be pleasantly surprised by some joint health improvements as well. I personally feel that it has helped my knees. But my knees are so much better than they used to be. But I've made so many changes to my diet and lifestyle that it's often hard to tell what's making me feel better. So take that for what it's worth. And then number two, there's a question about this. You can take collagen with or without food, but I typically recommend taking it with food. And here's why. Collagen is not a complete protein source. That means it doesn't have all of the essential amino acids that we need to build a human body. It doesn't have the amino acid tryptophan. So add it to a meal that has other protein sources, if you want to get the most out of it. But there's nothing wrong with taking it without food, if that's what works better for you. I know some people like to put it in their morning coffee and things like that. But if you do that, I wouldn't count the collagen protein towards your total protein target for the day, since it won't stimulate muscle protein synthesis on its own. So just something to keep in your back pocket. All right, moving on. Skin nutrient number two is vitamin C. Vitamin C stimulates collagen and elastin synthesis in the skin. It also helps protect the skin from the damage caused by the sun's UV rays. We take a drink here quick. This is really cool. So what's the science say here? Effects of different vitamin C enriched collagen derivatives on collagen synthesis. This is a very interesting story in my opinion. This is one of several studies by Dr. Keith Barr that showed that collagen had no effect unless some vitamin C is present. They compared vitamin C enriched gelatin to vitamin C enriched collagen peptides to a gummy containing equal parts of both, some gelatin and some collagen peptides. But here's the key before we move on. All the treatments had collagen in them. But the process of making the gummies involved boiling the solution. Vitamin C is heat sensitive. The boiling destroyed the vitamin C in the gummies. And this is what led to the odd results. So back to the study. All three of the supplements increased amino acids in the circulation. So the amino acids that make collagen increased in the blood whether vitamin C was present or not. But here's the key. N-terminal peptide of pro collagen levels increased around 20% from baseline in both the gelatin and the collagen peptide groups but not the gummy. So why does that matter? N-terminal peptide of pro collagen is a mouthful but it's also a marker of collagen synthesis. So you need collagen peptides and vitamin C if you want to produce collagen. This was a super cool finding in my opinion. Here's a quote. These results suggest that vitamin C enriched gelatin and hydrolyzed collagen supplementation may improve collagen synthesis when taken one hour prior to exercise. So this wasn't specific to skin. So what about skin health in general? What's the science say here? The roles of vitamin C and skin health. So these were healthy males and females. Between 40 and 65 all of them had visible signs of skin aging. So they took 50 milligrams of vitamin C for 90 days and that led to improved skin elasticity and skin moisture. It also improved the the skin surface appearance and evenness. So vitamin C appears to improve skin health on its own but its real power is making your collagen peptides more effective at building new collagen. That's what the science has to say. Here's my favorite brand of the essential C complex from Paleo Valley. It has 450 milligrams of natural vitamin C from from a superfood blend from whole food sources. But you don't need this much vitamin C to make an impact. It appears that 50 milligrams near the time you consume your collagen seems to be enough. Alright skin nutrient 3 is a really cool one too. Hyaluronic acid. This is the one that you may have never heard of. Hyaluronic acid is a major component of the extracellular matrix of your skin. About 50% of your body's hyaluronic acid is actually found right in the skin. Its primary job is to attract and retain moisture like a sponge. Just one molecule of hyaluronic acid can hold up to a thousand times or even more of its own weight in water. So pretty cool. Really important for skin hydration. Hyaluronic acid though also plays a role in the health and function of the dermis of your skin. If you go back to part one the epidermis is the part of the skin you can see. The dermis is the part below that where all the collagen and elastin and all the important stuff is. Fibroblasts are the cells in the dermis of your skin that make collagen. They make elastic fibers and they also make hyaluronic acid. But what's cool is supplementing with hyaluronic acid leads to an increased number of these fibroblasts in your skin and that also promotes an increased production in these fibroblasts. So they make more collagen. They make more elastic fibers, elastin, and they make more hyaluronic acid. So this is really good news. But what's the bad news? Well that's going to be right here. As we age our bodies produce less and less of it. This chart shows the skin concentration of hyaluronic acid in females of different ages. So as you can see here it's called hyaluron and that's the other name for it. Between nineteen and forty seven years of age the skin concentration is 0.330 percent. At 60 years of age it's plummeted down to 0.015 percent and by 70 years of age we're down to 0.007 percent. So this loss of hyaluronic acid in the skin contributes to the loss of elasticity that we see in our skin as we age. But thankfully we can fight back with supplementation. So what's the science have to say? Oral intake of a new full spectrum hyaluronin improves skin profilometry and aging. A randomized double-blind placebo controlled clinical trial. There were 60 subjects. They received 200 milligrams per day of hyaluronic acid or a placebo for 28 days. After those 28 days there was a 5.1 percent increase in skin elasticity, a 10.6 percent increase in skin hydration, an 18.8 percent decrease in wrinkle depth, and a 17.6 percent decrease in wrinkle volume. All cool stuff. Another one. Ingestion of an oral hyaluronin solution improves skin hydration, wrinkle reduction, elasticity, and skin roughness results of a clinical study. This one had 20 females between the ages of 45 and 60. They supplemented with hyaluronic acid once daily for 40 days. And here's what we see. This is looking at change in skin elasticity. I don't speak German, but Vorherr means previously. This is the baseline data. And then Togger Tegg in German, I don't know how to say it, sorry, is days. So after 20 days they saw an 8.58 percent increase in skin elasticity. And after 40 days there was a 13.25 percent increase in skin elasticity. So pretty awesome numbers. The maximum gain of elasticity in any of the subjects was 26.16 percent in only 40 days. So pretty exciting. They also looked at skin hydration. So skin hydration increased by 21.63 percent after 20 days by 24.43 percent after 40 days. And the maximum increase in skin hydration in any of the subjects during the study was 37.18 percent in 40 days. They also did show a 16.9 percent reduction in skin roughness and a 26.36 percent decrease in wrinkled depth. So if you're looking for those things as well. All right, so what's here's a quote from it. Intake of the hyaluronic acid solution led to a significant increase in skin elasticity, skin hydration, and to a significant decrease in skin roughness and wrinkle depths. So here's my favorite, the hyaluronic acid powder from bulk supplements dot com. I try to get a lot of things from them. They're just no must no fuss. I love the price and the value. 200 milligrams per day seems like a good dose based on these studies that we just saw as well. All right, the last one, skin nutrient number four is the omega three fatty acids. The omega three fatty acids found in fatty fish may help increase skin elasticity and have anti aging effects. Omega three fats are anti inflammatory. Remember earlier we talked about how inflammation damages your skin. So here's just the one study we'll look at here. So what's the science have to say here? Supplementation with Eskimo skincare improves skin elasticity in women, a pilot study. So Eskimo skin care is just an official supplement full of the omega three fats EPA and DHA. Excuse me. Sorry. So there were 24 healthy subjects between the ages of 40 and 60. They were all they were all women. Skin elasticity was measured by using a cutometer like like with most of the studies. But after three months, they saw a 10% increase in skin elasticity in the group that was treated with the EPA and DHA the fish oil supplement. So pretty cool. All right, here's the product that I use. I just buy it on Amazon. So it's super omega three plus from life extension. I just trust the company and the product. I take it for lots of reasons. Skin health is just a nice bonus. So remember after I've gone to these four supplements, right, that this is not medical advice. Talk to your doctor or your pharmacist to decide whether or not these supplements are a good idea based on your medical history. This is actually especially true with the omega three fats. I'm a big fan of them, but they can impact blood clotting as well as atrial fibrillation risk. So always better safe than sorry. Okay, so there you have it. These are my four favorite nutrients to improve loose skin. Each of them seem to work on their own, but I personally feel like they work together better, right? They have a synergistic effect where they because if you're getting increased collagen production from a several of them increase elasticity from several of them decreased inflammation. And we know that especially the vitamin C and collagen work well together. So I think this combo will work the best is better than the sum of its parts basically. All right. So that's part three. Part four of this series will will be about other therapies you can try to improve loose skin as well. My main focus is going to be on red light therapy and low level laser therapy, but I'll address other topics too. I'm super excited about this one because I used to use a lot of low level laser therapy in my practice many, many years ago. So reach out if you have any questions or topics that you want me to cover, right? I can I will add them to the series as I go on. A good example is that several people like I lost track of counting have reached out and asked me to look into the science behind derma rolling. So you asked and I will deliver. I'll see you then. Have a wonderful day. Be blessed.