CONTENTS
Cover
About the Book
About the Author
Title Page
Foreword
Introduction
Are You Digest-Ageing?
Chapter 1: Beauty Starts in the Gut
Chapter 2: Eating Beauty
Chapter 3: Inflammation – The Fire Within
Chapter 4: Rejuvenate Your Hormones
Chapter 5: The Beauty Prescription
Chapter 6: Live an Age-Reversing Life
Chapter 7: The Age-Reversing Eating Plan
Afterword
Appendix: Putting it all into Practice – Your 12-week Plan
Sources and References
Index
Acknowledgements
Copyright
This ebook is copyright material and must not be copied, reproduced, transferred, distributed, leased, licensed or publicly performed or used in any way except as specifically permitted in writing by the publishers, as allowed under the terms and conditions under which it was purchased or as strictly permitted by applicable copyright law. Any unauthorized distribution or use of this text may be a direct infringement of the author’s and publisher’s rights and those responsible may be liable in law accordingly.
Epub ISBN: 9781473527782
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Vermilion, an imprint of Ebury Publishing,
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Vermilion is part of the Penguin Random House group of companies whose addresses can be found at global.penguinrandomhouse.com
Copyright © Dr Nigma Talib, ND 2015
Dr Nigma Talib has asserted her right to be identified as the author of this Work in accordance with the Copyright, Designs and Patents Act 1988
First published by Vermilion in 2015
www.eburypublishing.co.uk
A CIP catalogue record for this book is available from the British Library
ISBN 9781785040139
The information in this book has been compiled by way of general guidance in relation to the specific subjects addressed, but is not a substitute and not to be relied on for medical, healthcare, pharmaceutical or other professional advice on specific circumstances and in specific locations. So far as the author is aware the information given is correct and up to date as at November 2015. Practice, laws and regulations all change, and the reader should obtain up-to-date professional advice on any such issues. The author and publishers disclaim, as far as the law allows, any liability arising directly or indirectly from the use, or misuse, of the information contained in this book.
In 2001, whilst driving through the villages of Rajasthan in Western India, I made an observation about the people living in the local villages. They had an abundance of energy, a visible happiness and, of particular interest to me, they had the most fabulous skin. This, despite living in a desert environment with dusty winds, extremes of temperature and no access to cosmetic skincare. I have seen a similar picture in countries all over the world.
In my clinic in central London, I see a multitude of patients complaining of sensitive skin, dry skin, acne prone skin and so on.
Why the paradox? Could it be related to the diets of people in villages around the world being more natural and fresh? Could it be difference in lifestyle, sedentary versus active?
Clearly, there are multiple factors that will ultimately influence our well-being, but we often make the mistake of treating the symptoms and not the cause.
As dermatologists, we know the skin can be a marker for many systemic diseases. Our food today bears little resemblance to the food of our ancestors. Our diet is changing for the worse with ever increasing consumption of processed foods.
For years, skincare has been epitomised by a regime of cleanse, tone and moisturise, quoted like a mantra by generations of department store counter assistants. For the most part, skincare has suffered from over reliance on harsh medicinal products or ineffective cosmetic formulations.
So it is with great pleasure and that I welcome Dr Nigma Talib’s Reverse the Signs of Ageing. Combining her holistic knowledge as a Naturopathic Doctor with her passion for Medical Aesthetics, she offers a blueprint for anyone who wants to invest in improving their health inside and outside.
Many of us are aware of the need to improve our diets while supplementing with appropriate minerals and vitamins, the problem has been lack of guidance. In Reverse the Signs of Ageing, Dr Talib offers us clarity on what to eat and what to avoid. She states she can tell by examining a patient if their diet is too high in sugar, gluten or alcohol and she explains how these groups lead to internal inflammation which has tell-tale signs on the skin.
I have seen first-hand the improvements Dr Talib brings to people, and her patients are her own best advertisement for vitality and graceful ageing.
As life expectancy continues to increase, Baby Boomers, Generation X and all those who follow will live to a much older age than previous generations. These extra years will be all the more cherished if we feel good and look good. Dr Talib is at the cutting edge of a rapidly expanding field and I am confident her book will have a major influence.
I am sure many people can relate to the frustration of trying new creams, lotions, supplements and diets which promise much but deliver little. Einstein has been quoted as saying “insanity is doing the same thing over and over again and expecting a different result.” Well perhaps it’s time to look within and apply the principles of Dr Talib and Reverse the Signs of Ageing.
Dr Tapan Patel MBBS MRCP
Cosmetic Physician
PHI Clinic, London, UK
How many times have you pooped today? Once, twice, not at all … Whatever your answer, I bet it wasn’t the first question you were expecting to be asked when opening a book about reversing ageing. But this is no ordinary beauty book. I don’t believe that tackling ageing or getting perfect skin is related solely to what you put on the outside of your body. It is also about what you put inside your body, as deep down inside the gut is where real ageing begins.
I’m Dr Nigma Talib, Naturopathic Doctor and Medical Esthetician, and I’ve been helping patients with their health and beauty issues for over 14 years in my clinics across the globe. During that time I’ve treated thousands of patients that all have one thing in common: they now look and feel younger (and healthier) than they would have done if they’d never come to see me. And by the end of this book, I’m hoping that’s what’s going to happen to you too.
Our story begins when I started my first practice in Vancouver back in 2001. I am a licensed Naturopathic Doctor (ND). This means I am qualified to treat the root cause of illness using a variety of safe and effective therapies, including acupuncture and Traditional Chinese Medicine, botanical medicine, clinical nutrition, homeopathy, lifestyle counselling and Physical Medicine. Naturopathic Doctors treat a wide variety of chronic health conditions such as allergies, chronic pain, digestive issues, hormonal imbalances, obesity, chronic fatigue and menopause – to name a few.
Naturopathic Doctors are not the same as naturopaths, which are more common in the UK. A licensed Naturopathic Doctor must have an undergraduate degree in pre-medical studies. We receive over 1,200 hours of clinical training and must treat over 225 patients before we even get our qualification. At a correctly accredited school, the Naturopathic Medicine curriculum receives significantly more hours in training in nutrition than graduates of some of the best medical schools in the US, if not the world, and a similar training in the biomedical sciences, which covers subjects such as anatomy, cell biology, physiology, neuroscience and biochemistry.1
This medical background meant that as soon as I opened the doors to my clinic, I started seeing patients with all sorts of health concerns. But as they’d talk about their symptoms, they wouldn’t just talk about their health, but also about their appearance – and time after time they’d start telling me that they were ageing faster than they thought they should. They were complaining of a lack of brightness in their face, their skin texture was getting rougher, fine lines and wrinkles were appearing faster than they expected or they were developing a noticeable increase in pigmentation. Some had got to the point where they felt, ‘Well I am getting older, so I guess I should accept that I feel and look worse than I did when I was in my 20s.’ Others were using fillers and face-freezing jabs to try to disguise the problems they were seeing, believing that this was their only option to try to change what was happening. I disagreed. Yes, there is a pressure on women and men to look younger, but it didn’t make sense to me to be exhausted on the inside, older on the outside and mask both with fillers and paralysing injections.
Seems I was right. As their medical treatment progressed and we addressed the gut problems, hormonal imbalances or inflammation behind pretty much all of their health concerns, my patients also started to notice major skin changes; it was improving in all the ageing areas they had been complaining about before. They were thrilled – and so was I. Not only was I helping my patients achieve optimum wellness, I was also helping them turn back the clock and look better than they had ever done before. Soon they started to tell their friends and family what I was doing, and once their husbands noticed the change I had them coming in as well! No wonder I think of my patients as one big happy family.
At this point, to complement my ND qualification I decided to also train as a Medical Esthetician: a skincare specialist who can use medical-like treatments. I felt that together the two could help me absolutely determine the root causes of why people age before they should.
I saw more and more patients, and as my knowledge grew, I could clearly see the link between their health and why they were ageing. Eventually it got to a point where I realised there was a clear correlation between a change in the health of someone’s gut or their diet and their skin. For example, if someone had been eating more dairy in the weeks before they saw me they’d often appear with dark circles under their eyes; a higher intake of alcohol would leave skin with more fine lines and wrinkles around their mouth, the nasolabial folds (the lines that come down the sides of your nostrils to your mouth) and the eye area; if I took gluten out of a patient’s diet, in no time it would result in a face that was less bloated and puffy.
I used this in combination with traditional Chinese face-mapping to create treatment plans. I quickly realised that following my plan helped my patients’ skin clear up and reversed many of those signs of ageing they were worried about. Patients with rosacea, redness, pigmentation problems, dull, dry or sagging skin, noticed such considerable changes that their friends and family were asking if they’d had some work done! It was so powerful that I couldn’t understand why all dermatologists weren’t using dietary changes to treat the root cause of distressed skin or as an anti-ageing weapon.
I consider myself a biochemical detective, always trying to find the true root cause of my patients’ problems rather than just treating their symptoms with a plaster-like approach. I realised at this point that all of the evidence was pointing to one thing behind the premature ageing – and many of the other health and skin issues my clients were complaining of – and that was poor digestive function.
This might surprise you; after all, how can something that goes on deep inside the body, far, far away from your face reflect how old you look or how healthy your skin appears? But it didn’t surprise me. The gut is the control centre of the body, the place where health and death begins. Whatever happens in the gut will show up in the skin and dictate the health of your entire body. I’ll explain more thoroughly how this can be over the pages that follow, but, very briefly, this is what happens: poor health within the gut starves the skin of the nutrients it needs to thrive; it causes an increase of inflammatory molecules in the body that directly and indirectly attack the skin, which causes faster ageing and aggravates inflammatory skin conditions, such as acne and rosacea. An imbalanced or unhealthy gut can also affect many of the hormones in the body, which again has a knock-on effect on the skin. In a nutshell, poor gut health is behind at least three of the fundamental mechanisms controlling how fast or slow your skin, and your body, will age. I realised that by treating the health of the gut and restoring good digestive function, as I was doing now in all my patients, I was tackling these ageing triggers and creating the amazing effects we both could see.
I didn’t really have a name for what I was seeing until one day I was treating a patient who had digestive problems. She was also concerned about her skin and how she was looking older, and I said, ‘Well you do know that your digestion problems mean you’re ageing faster?’ She replied, ‘You mean I’m digest-ageing.’ All of a sudden I had a name for what I was seeing in so many people. The circle was complete – I knew what was causing it, I knew how to tackle it and now I had a name to explain it to the world.
Since then, I have treated literally thousands of patients for digest-ageing and I am confident that the beauty and health worlds have missed something. I mention health here because of course the skin isn’t the only thing that shows signs of ageing, and the gut can also be the root cause of many of the other issues that plague the body as we get older. Aching joints, weight gain around the middle, thinning hair, poor sleep, lack of energy and the severity of menopausal symptoms can also all be related to gut health. Get your gut healthy and these symptoms can also improve. No wonder that after treatment my patients not only look younger, but say they feel younger too, as everything seems to improve about their health – they regain their energy and get a spring in their step.
So does this mean you should throw away your skin creams and never have another face treatment in your life? No! The best skin comes from treating the inside and the outside. The outside needs topical treatments to strengthen and hydrate the skin, stimulate collagen, fade pigmentation or reduce fine lines and wrinkles, but combining this with healing the body from within creates the perfect marriage of techniques. But with so many lotions, potions, treatments and injections available to us today, all claiming to work miracles, how do you know which are going to give you the best result? Well, later on in this book I’ll explain that too, sharing exactly what I use directly on my patients – many of whom are A-list actresses, actors and models whose faces are their fortune.
What I do believe, though, is that the obviously worked-on face, where someone has overdone the fillers so everything is just a little bit puffy, or where they’ve had so much face-freezing they can no longer make the natural expressions that are our first signs of communication, is the ‘new old’. I’m not alone – more and more of my patients are increasingly rejecting injectables and, instead, are turning to anti-ageing treatments that deliver more natural results; those that result in fresh, radiant skin at the cellular level and still allow the face to have expression.
The way I see it, the ‘new youth’ is to have clear, glowing, bright, dewy, even-toned, firm skin. You want to make healthier what you already have so that when people look at your skin they don’t think you are ‘xx’ years old, but instead think, ‘Wow, that person looks glowing.’ Yes, you might have a few lines showing a life well lived, but you don’t have to have rough skin or excessive sagging to go with them – and you can have amazing skin texture, a brightness to your skin and minimal pigmentation whatever your age. What I’m saying is that while some ageing is natural and unavoidable, as far as I’m concerned if you take control of your health, premature ageing is optional.
This is what I’ve been saying to my patients for years now and I’m thrilled that writing this book allows me to be able to share this knowledge with a much wider audience than I could ever see personally in my clinics. Think of this book as kind of like having me as your personal Naturopathic Doctor in your home wherever you are in the world.
The advice I give over the pages that follow will help you pinpoint the root causes of premature ageing – and then show you how to reverse them. There are plans to tackle four main areas that I now believe absolutely to be behind the symptoms of poor health and premature ageing. The plans work in three stages – Clear, Correct and Protect (CCP), with options to Power Up throughout if you want an added boost.
As you’ll discover, all of these are closely interlinked and for that reason I strongly urge you to read the book as a whole before you start making any changes – and that you follow the plans in turn, rather than attempting to pick and choose the advice you use. At the end of the book, you’ll find a guide to how to put it all into practice stage by stage, week by week.
So what do the plans aim to do? Simply, they fight those primary ageing triggers using a mix of dietary changes, lifestyle changes, evidence-based skincare and some highly targeted supplementation. We start with the health of the gut, as it’s my absolute belief that this is where ageing begins. I’m then going to reveal how what you eat might impact on how fast you age – and, more surprisingly, how some simple changes could eliminate lines, wrinkles and under-eye bags in a matter of weeks.
We’ll talk about inflammation, the silent epidemic ageing so many of our bodies today, and then move on to why all of the above combined with modern life might be throwing your hormones into chaos.
Add to this, my little black book of skincare secrets, advice on lifestyle changes that turn back time and The Age-Reversing Eating Plan packed with delicious recipes, which I guarantee will trigger changes in your skin if you follow it, and the pages that follow really are a complete anti-ageing makeover unlike any other you’ve tried before! In summary:
1 Fine lines and wrinkles
2 Sagging skin
3 Uneven skin tone
4 Dull, lifeless skin
5 Rough skin texture
6 Adult acne
7 Rosacea
8 Under-eye circles and bags
1 Improves the health of your gut, the place where ageing begins
2 Fights inflammation to combat ageing at a deep cellular level
3 Balances the youth-boosting and ageing hormones that modern life disrupts
4 Reveals the ultimate anti-ageing skincare regime
A younger, healthier you
Before we move on to how, let’s give you a clear reason why you should make these changes and reveal quite how much you might be digest-ageing.
The symptoms below are all possible signs that your digestion isn’t working as well as it could. Tick as many that apply and then see what that says about you.
Tick the box if you find yourself suffering the symptom:
Acid reflux
Bloating after meals
Burping
Constipation
Diarrhoea
Flatulence
Heartburn/indigestion
Less than one bowel movement a day
Incomplete evacuation (small pebble-like stools)
Rectal itching
Undigested food in your stool
Tick the box if you’ve noticed the skin signs worsening faster than you might expect, considering your age and skin protection habits – or you think you are experiencing any of the below to a greater extent than peers of the same age:
Acne
Blackheads
Bumpy skin
Dry skin
Dullness
Eczema
Fine lines and wrinkles
Loose, sagging skin, on, for example, the jowls
Open, enlarged pores
Pigmentation
Reddening of the skin
Rosacea
Rough skin texture
Tick the box if you regularly suffer any of the following:
Cracking nails or vertical ridges on the nails
Fatigue
Feeling the cold
Foggy brain
Food intolerances
Frequent minor infections, such as coughs and colds
Fungal infections
Joint pains
Menstrual cramps
Menstrual irregularities
PMS
Sleep problems
Slow weight loss
Sugar cravings
Thinning hair or hair loss
Thrush
Weight gain
White coating on the tongue
The more symptoms that you ticked, the greater the chance that you are digest-ageing – but what’s also important is exactly which of the sections you ticked.
If you have a clear majority of symptoms in checklist 1, you have a low level of digest-ageing. That’s good, kind of … While it does show that your digestion is upset in some way, it means it’s not yet noticeably starting to impact on the rest of your body. If you tackle whatever is causing the digest-ageing now, you’ll probably it find it never will – plus you’ll be free of those uncomfortable, annoying digestive issues you pinpointed.
If you ticked symptoms mostly in the checklists 1 and 2, you have a moderate level of digest-ageing. This means there’s a good chance that the concerns you have regarding your skin are linked to issues causing your gut symptoms too. Using solutions that heal and calm the gut, and tackling skin issues with the right topical treatments, will probably turn things around completely for you.
If you ticked symptoms in all three checklists, you have a high level of digest-ageing. Again, your gut alone could be behind everything you are suffering, but it’s going to be particularly important for you to also follow the specific anti-inflammatory and hormone balancing plans too.
If you ticked symptoms mostly in checklists 2 and 3, you have a low to moderate level of digest-ageing. While you might be unhappy with your skin, it’s possible that your digestion alone might not be behind the problems you have. They may be more related to inflammation or hormonal imbalances, or to not using the right skincare. However, I’d still suggest you follow the Gut-Balancing CCP Plan that you will find in Chapter 1 here. Because we are so used to our bodies and their quirks, many of us don’t realise our gut is imbalanced until we improve its health and suddenly discover how a healthy gut should behave.
If you mostly ticked checklists 1 and 3, you have a moderate level of digest-ageing. You are, however, lucky that it hasn’t yet shown up that much on your skin. This could be because you have extremely good genetics, or perhaps your suncare or skincare regime is mitigating some of the damage you’d normally be seeing. The fact that you are suffering gut symptoms, though, does mean your gut is out of balance, and by improving that, and working on lowering inflammation and rebalancing your hormone levels, you’ll keep your skin looking good.
If you didn’t tick anything, then why are you reading this book?! Go and do something else. Actually don’t – modern life, as you’ll see, is putting our whole body under pressure every single day and while you might have escaped so far, you can still learn how to protect yourself in the future.
So, now let’s get started by looking at exactly why the gut is the foundation of healthy ageing and how, if it’s not healthy, it can play havoc with so much of your body, making you old before your time.
It’s not an exaggeration to say that I look to the gut when it comes to treating every patient I see; it really is the control centre for the entire body. Anything that goes wrong in the gut will cause symptoms all over your body – and it will absolutely show as problems on your face, sooner or later. To beat premature ageing, you have to take care of your gut. Or, as I say to my patients, a problem in your bowels will eventually create jowls.
This might surprise you – after all, most of us think that the job of the gut is merely to digest our food and eliminate waste, but it’s far more complex than that. The digestive system covers a huge area within the body – in 2014, using the most sophisticated techniques so far, experts at Sweden’s Sahlgrenska Academy in Gothenburg measured it to be about 5 m (16½ ft) long and its surface area, if you managed to separate it all out, would cover an area around 30–40 sq m (323–430 sq ft), the size of a small studio apartment.1 Yes, that is all squished up inside your body. Inside, predominantly in the large intestine, live around 100 trillion bacteria. They’re so plentiful they outnumber our body’s cells here 10 to one – meaning, if you think about it, we’re only 10 per cent human and 90 per cent bacteria. If you managed to scoop out all that bacteria and place them in a jar, it would weigh around 1.4 kg (3 lb).
These tiny bacteria are now emerging as one of the major control systems of our entire body. They may be small but they are very powerful. If they are in balance, you are more likely to be in better health – you’ll find it easier to control your weight, and you’ll have healthier, more youthful-looking skin. Why? Because those bacteria have a direct role to play in the health of that skin. For example, they create and help you assimilate nutrients the skin needs to protect itself and repair; they protect the integrity of the gut lining, which helps fight inflammation that ages skin; and they play a role in protecting the skin against damage – both from toxins created within our own body and those created by external factors, such as UV light and pollution. The gut bacteria can also affect acne as the gut, brain and skin produce a neuropeptide called Substance P, which affects sebum production. In one Russian study looking at a group of patients with acne, 54 per cent of them had what the researchers referred to as ‘impaired’ gut bacteria.2 So many skin conditions can be linked right back to this one source.
There’s also an important connection between the gut and the emotions – it’s no coincidence that people say ‘I have a gut feeling about this’, or they suffer loose bowels if they are nervous about something. The brain and the gut communicate thousands of times every single day. Your gut, in fact, is your second brain. It contains an estimated 500 million neurons and releases at least 40 different neurotransmitters; 95 per cent of the body’s serotonin (a hormone associated with improved mood but that also controls gut contraction) is found within the gut and you have more serotonin receptors in your gut than your brain. We also know that while the brain sends signals to the gut, for every one message it sends down, the gut sends nine messages back, covering everything from how full you feel to whether it’s time to go to the bathroom. And just recently, it’s also been discovered the gut can affect emotions. It’s now believed that certain pathogens in the gut produce substances that can trigger symptoms of anxiety and possibly even depression-like symptoms in people who carry them. I always love it when research and clinical practice show the same thing, as for years now I have seen evidence of this. I have often found that my patients who have anxiety and depression-like symptoms also have digestive issues, and once we get to the root cause of those the anxiety and low mood also lift.
Conversely, though, favourable bacteria can help create more positive emotions: French research published in the British Journal of Nutrition,3 for example, found that women supplementing with a product called Probio-Stick containing two specific strains of bacteria (Lactobacillus Rosell-52 and Bifidobacterium Rosell-175) felt less anxious during periods of stress. Why do we care about any of this? Because emotions are also strongly linked to skin health and the speed at which we age. One study on identical twins, for example, found that the twin who had experienced more stress in her life (the doctors chose twins where one was divorced and one was happy in her relationship) looked on average two years older than her less-pressured sister.4 I’ve seen patients that look four, five, even 10 years older than their chronological age because of the stress that they have gone through in their life.
The idea that the gut and ageing were linked was first suggested back in the 19th century when the Russian biologist Dr Ilya Mechnikov realised that the Bulgarian population, a particularly long-living and healthy people at the time, consumed high quantities of yoghurt. He had long suspected that toxins emitted by some of the more negative bacteria in the gut might aggravate the ageing process, but he then started to suspect that the bacteria in the fermented milk so beloved in the Bulgarian diet might counteract this. He took his research into the laboratory and realised that, yes, the bacteria in the yoghurt did seem to prevent the more harmful bacteria in the gut releasing their toxins.
Mechnikov’s work was the foundation of the science of probiotics – something I regularly add to the daily diet of my patients to help tackle digest-ageing. But there’s a lot more to tackling the gut-ageing connection than just adding probiotics. Over the years, studying thousands of patients, I’ve identified four main reasons why the skin might age prematurely if the gut is imbalanced, and you need to counteract them all. Before I go into them in detail, though, there’s something I need to point out …
In this chapter, I’m about to cover each gut problem separately. If only it were that simple. In reality, all the problems are usually linked to each other, and also to the other core ageing triggers – inflammation and hormonal imbalance. If you have one of these problems, you either already have at least one of the others, or they are waiting round the corner if you don’t do something to stop them. To make it simpler, think of your gut as performing like a symphony orchestra, when everything is in time, it makes beautiful synchronised music; if, however, one member of that orchestra goes out of synch, they’ll play out of time on their own for a little while, but eventually they will start to impact on some of the other musicians, who will start to skip beats too. Eventually you’re making a horrible noise rather than beautiful music – until the conductor gets control of things again. That’s also what happens with the gut; for example, if you’re not digesting food properly, the by-products that form as food ferments in the gut damages the gut bacteria and affects the gut lining (causing a problem called leaky gut – see here). If leaky gut occurs, you absorb fewer nutrients and it becomes easier for bad bacteria to adhere to the bowel wall. At this point, the good bacteria start to be crowded out, and this causes even less nutrient absorption and further problems with fermentation. The problems just keep escalating, unless you, the conductor, take control again …
Even if you eat the healthiest diet on the planet, how do you know if you are actually absorbing the nutrients you consume?
The simplest reason that the skin might be affected by gut problems is that they can interfere with the amount of nutrients you can absorb. Virtually every mineral and vitamin we eat aids the skin in some way – for example, vitamins C and E are imperative for collagen formation and repair, while the mineral zinc helps fight problems such as acne. If you’re not absorbing those nutrients, guess what? They can’t do their job and your skin will start to suffer. Protein absorption can also be affected by poor digestion – and protein is the building block of your skin, hair and nails. If you’re not absorbing protein, you’re going to see that reflected back when you look in the mirror. When nutrient absorption is impaired, you could be eating a diet packed with foods that are known to help create beautiful skin, such as berries, avocados and oily fish, but barely any of their vital vitamins, minerals or fatty acids are going to be absorbed.
Your gut bacteria also make nutrients. They make vitamin B7 (also known as biotin), a nutrient essential for cell renewal and healthy skin, hair and nails. They make vitamin B12, which carries oxygenated blood around the body, giving skin a youthful glow that money can’t buy and face freezers, face fillers or even surgery can’t achieve. Finally, bacteria help us make vitamin K, which helps prevent calcium attaching to the elastin fibres of the skin, keeping them springy and firm. If the gut bacteria aren’t doing their job well, you’ll be lacking in sufficient levels of all of those nutrients and your skin will prematurely suffer and sag.
This lack of nutrients also has the potential to reduce hormone levels in the body. I’ll talk further about why good hormone balance is essential for healthy ageing later in Chapter 4, but, for now, know that your body needs nutrients, such as the B vitamins and the minerals selenium and iodine, to help it manufacture hormones, such as oestrogen, progesterone and thyroxine – all of which are vital for healthy, young-looking skin.
There are two main causes of poor nutrient absorption: malabsorption, where a problem in the digestive system stops the body absorbing the nutrients from your food; and maldigestion, where you don’t break down the food well enough to extract all you need from it. The two conditions often go hand in hand – and they are both something I see day in and day out in my practice.
The process of digestion starts as soon as you put something in your mouth. As you chew, saliva is released and this contains the enzyme ptyalin that starts to break down any carbohydrates you’re consuming. When you swallow, the food passes down the oesophagus and into the stomach. Here stomach acids and the enzyme pepsin should be waiting to start breaking down the protein that you’ve eaten. Within a few hours, food moves to the small intestine, where the majority of nutrients get absorbed via enzymes released from the pancreas. Finally, the food moves into the large intestine, where those all-important gut bacteria get to work making nutrients, but also further breaking down any leftover carbohydrates, fibre and even waste products such as dead cells to create vital by-products called short-chain fatty acids. Eventually, when that’s all done and all that is left is waste the body can’t use, the gut sends signals to the brain triggering you to visit the bathroom.
So what can go wrong during this process and why? A lot, is the answer … Let’s take it step by step:
In the mouth: Many of us eat too quickly – we eat on the run, at our desk while fielding phone calls, or we snatch something seconds before we fly out of the door. As such, we tend to bolt our food down without adequately chewing it. This reduces how much saliva comes into contact with food and so carbohydrates, which normally begin to digest here in the mouth, can enter the system without going through the first step that starts their breakdown. This can make them harder to tackle effectively further down the line; and by carbohydrates I don’t just mean foods such as rice, bread or pasta – fruits and vegetables are also carbohydrates. By not chewing well, you run the risk of a sub-optimal digestion of essential skin nutrients, such as vitamin C, betacarotene (which converts into the vitamin A our skin needs) and the antioxidants that counteract the environmental damage from things such as pollutants and UV rays that make our skin age.
In the stomach: Not chewing food also slows things here. As food hits receptors in the cheeks and tongue, the brain starts to analyse exactly which of the macronutrients – protein, carbohydrates or fat – is in the mouthful that you’re consuming. When it detects protein, it signals your stomach to start secreting the acid and pepsin you need to digest it. This is essential when it comes to skin health as protein contains the amino acids that are the building blocks of our skin’s foundations. If protein absorption is impaired, you’ll notice your skin starts to lose its glow as cell turnover slows down. Lines and wrinkles form faster as daily damage is less likely to be repaired. Protein also builds hair and nails – a classic sign I notice in my patients when protein absorption is low is that their hair and nails don’t seem to grow as fast.
Micronutrients, such as zinc, selenium and copper, are also essential for skin health and slowing down ageing – copper, for example, works with zinc to help form collagen, and selenium is an antioxidant that helps fight against oxidation that causes skin damage – and absorption of these micronutrients can also be reduced if levels of acidity in your stomach are lowered.
But less surprising though – ageing can also cause digest-ageing! Production of both stomach acid and the enzymes we need for digestion declines as we age. It’s funny, as we get older we often end up with problems with excess acid, which we treat with medication such as Pepto-Bismol, but your stomach needs to be acidic to digest food.
If you have gas, bloating, burping after meals, a feeling that food just sits in the stomach, heartburn, bad breath, foul-smelling bowel movements and a regularly upset stomach, then it’s possible your stomach acid levels are low. Another way to tell is to drink bicarbonate of soda in water. It’s not a foolproof test, but can give an indication that something is wrong. First thing in the morning before you have anything to eat or drink, add a quarter of a teaspoon of bicarbonate of soda to a glass of water. Drink this down in one go – then see what happens. If you have healthy levels of stomach acid, you should burp within 2–3 minutes as the alkaline soda mixes with your stomach acid and creates carbon dioxide. If you don’t burp, there’s a good chance there’s not enough acid there to cause a reaction.
Now if you’re one of the many people reading this who regularly suffers from heartburn, indigestion or acid reflux, you might think there’s no reason for you to carry out the test – after all, surely you’ve got too much acid? Don’t be so sure. One cause of the conditions we think are ‘acidic’ can actually be low stomach acid, which causes the stomach contents to remain within the stomach longer than they should. If you regularly suffer from these issues you should definitely check your acidity levels, but do note that if you are taking antacids or proton pump inhibitors to keep things under control, these will skew the results slightly. Ask your doctor if it’s okay to stop the medication for a couple of days, and then try the test.
In the small intestine: When food moves to the small intestine, enzymes excreted by the pancreas take over the task of digestion – these are lipase, which acts on fat; amylase, which breaks down carbohydrates; and protease, which breaks down protein. As with stomach acid, enzyme production in the small intestine can also start to decline as we age. In fact, when French researchers checked enzyme levels in the population, they found that production increased until people reached their 30s – then it tapered back off again.5 This lack of enzymes can quite clearly affect the skin in many ways – low levels of protease can cause poor protein digestion, with all those effects I mentioned before. Low amylase means fewer nutrients taken from carbohydrates, and if fat digestion is affected you don’t break the fat down into the glycerols you need to absorb the fat-soluble nutrients vitamins A, D, E and K, and they’ll just pass right out of your system in the stool. All of the fat-soluble nutrients are vital for skin health – vitamin A, for example, helps improve cell turnover, so if levels are low your skin will look and feel rough, even scaly; vitamin E is involved in the synthesis of collagen and helps protect skin against environmental damage; while low levels of vitamin D have been linked to the development of dark circles under the eyes. If you want good skin, you have to digest fat efficiently.
Admittedly your body does try to fight back against poor digestion – if food arrives in the small intestine partially digested, the pancreas tries to combat this by releasing higher levels of those vital enzymes. The problem is, just as you get a bit burned out working too hard day in, day out, so does the pancreas, and eventually a problem called pancreatic insufficiency can develop. Many conventional doctors only treat this when it manifests in its most severe form, associated with problems like alcoholism or Crohn’s disease, but as a Naturopathic Doctor I recognise what’s called sub-clinical versions of many health problems. Conventional medicine doesn’t address these concerns because they aren’t life-threatening – but when an organ stops performing optimally it harms the health and prematurely ages the body. So why wait for it to worsen further before attempting to correct it?
Symptoms of low enzyme levels, which if left uncorrected may then develop into pancreatic insufficiency, include bloating or stomach pain after meals, production of excessive gas via belching or odorous flatulence, watery stools and signs of undigested food in your stools. If you regularly suffer these symptoms, you might want to ask a Naturopathic Doctor or other integrative medical professional for a test that checks your levels of substances called pancreatic elastase or chymotrypsin. These are both enzymes produced by the pancreas and if levels are low you will need to supplement to make up the deficit (see Power Up here).
In the large intestine: Here it’s the gut bacteria that do the majority of the work. I’ve already told you that these produce many of our B vitamins and vitamin K, therefore it’s clear to see that if your bacteria is out of balance, the levels of the nutrients you produce might be lower than optimum. If the gut bacteria are out of balance, the lining of the gut can also be damaged, which in turn impacts on the levels of nutrients you can absorb. But on top of this, the bacteria also produce substances called short-chain fatty acids (SCFAs). These are vital for gut health. They provide the energy your gut runs off and they help protect the colon lining, and dramatically lower the risk of leaky gut syndrome (see here). They are extremely underrated contributors to your body’s health.
But SCFAs are also essential for skin health and reversing ageing. Specifically they help counteract inflammation. Inflammation is such a fundamental cause of ageing and I have dedicated the whole of Chapter 3 to explaining why it’s so important and how to fight it. For now, though, I will just say that if your body cannot fight inflammation you will be ageing faster from within. You’ll also be more prone to skin problems, such as acne, rosacea, eczema and psoriasis.
If you want younger-looking skin, you must look after the bacteria that populate the gut. They are fundamental in determining how fast, and how well, you age.
As I said before, the gut contains around 100 trillion bacteria, a collection also known as the microbiome or microbiota. Which types you have of the 100,000 different strains discovered so far is as individual as your fingerprint, but as a general rule, a healthy microbiome should contain at least 400 different strains of bacteria and 85 per cent of those should be ones that help the body function positively in some way. Studies, however, are showing that this isn’t always the case. A 2013 study from the University of Copenhagen,6 for example, found that almost a quarter of people they studied had 40 per cent fewer bacteria than would normally be expected in a healthy gut – and the bugs they did have were more likely to be ones prone to causing inflammation than the health-promoting bacteria that fight it.
There are many reasons why our microbiome is suffering and they begin as early as birth. Babies in the womb only have a very limited microbiome, but get a huge ‘injection’ of bacteria as they travel through the vaginal canal during birth; however, babies delivered by Caesarean don’t get that exact same boost. Breastfed babies also have a more diverse microbiome than those fed on formula. These early years are so important that scientists now believe that while we can tweak the microbiome in adulthood, its fundamental make-up could be set as early as the age of three.
We also live in a more sterile world now and this reduces the amount of diversity within our gut. Our clean houses and better food hygiene mean we just don’t expose our body to as many types of bacteria as before (in years gone by our food would contain dirt and moulds naturally that exposed us to a greater diversity of bacteria). Then there are our lifestyles – stress, alcohol, commonly used medications, such as non-steroidal anti-inflammatory drugs, and our diets can determine whether our bacteria is mostly formed of healthy bacteria, or the opposite. A recent trial at Harvard University,7 for example, found that adapting the diet to one focused on fruit, vegetables and wholegrains can increase levels of bacteria that dampen inflammation in as little as 24 hours. Conversely, a trial at Ohio State University8 showed that during stress more inflammation-producing bacteria started to thrive – and good bacteria started to disappear.
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