We Are Such Stuff As Fish Are Made Of
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Research Review: Collagen
For something that’s a very popular supplement, not many people understand what collagen is, where it comes from, or what it does.
In a nutshell:
Collagen is a kind of protein. Our bodies make it naturally, and we can also get more in our diet and/or take extra as a supplement.
Our bodies use collagen in connective tissue, skin, tendon, bone, and cartilage. It has many functions, but a broad description would be “holding things together”.
As we get older, our bodies produce less collagen. Signs of this include wrinkles, loss of skin hydration, and joint pain.
Quick test: pinch the skin on the middle of the back of one of your hands, and then watch what happens when you get low. How quickly and easily did your skin returns to its original shape?
If it was pretty much instantanous and flawless, congratulations, you have plenty of collagen (and also elastin). If you didn’t, you are probably low on both!
(they are quite similar proteins and are made from the same base “stuff”, so if you’re low on one, you’ll usually be low on both)
Quick note: A lot of research out there has been funded by beauty companies, so we had our work cut out for us today, and have highlighted where any research may be biased.
More than skin deep
While marketing for collagen is almost exclusively aimed at “reduce wrinkles and other signs of aging”, it does a lot more than that.
You remember we mentioned that many things from the bones outward are held together by collagen? We weren’t kidding…
Read: Osteoporosis, like skin ageing, is caused by collagen loss which is reversible
Taking extra collagen isn’t the only way
We can’t (yet!) completely halt the age-related loss of collagen, but we can slow it, with our lifestyle choices:
- Don’t smoke tobacco
- Drink only in moderation (or not at all)
- Avoid foods with added sugar, and high-processed foods in general
- Wear sunscreen when appropriate
Can I get collagen from food?
Yep! Just as collagen holds our bodies together, it holds the bodies of other animals together. And, just like collagen is found in most parts of our body but most plentifully in our skin and bones, that’s what to eat to get collagen from other animals, e.g:
- Chicken skin
- Fish skin
- Bone broth ← health benefits and recipes at this link!
What about vegans?
Yes, vegans are also held together by collagen! We do not, however, recommend eating their skin or boiling their bones into broth. Ethical considerations aside, cannibalism can give you CJD!
More seriously, if you’re vegan, you can’t get collagen from a plant-based diet, but you can get the stuff your body uses to make collagen. Basically, you want to make sure you get plenty of:
- Protein (beans, pulses, nuts, etc are all fine; it’s hard to go wrong with this)
- Vitamin C
- Vitamin D
- and Zinc
Just be sure to continue to remember to avoid highly-processed foods. So:
- Soy mince/chunks whose ingredients list reads: “soya”? Yes!
- The Incredible Burger or Linda McCartney’s Sausages? Sadly less healthy
Read: Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet
Meat-eaters might want to read that one too. By far the worst offenders for AGEs (Advanced Glycation End Products, which can not only cause collagen to stiffen, but also inactivate proteins responsible for collagen repair, along with doing much more serious damage to your body’s natural functions) include:
- Hot dogs
- Bacon
- Fried/roasted/grilled meats
Is it worth it as a supplement?
That depends on you, your age, and your lifestyle, but it’s generally considered safe*
*if you have a seafood allergy, be careful though, as many supplements are from fish or shellfish—you will need to find one that’s free from your allergen
Also, all collagen is animal-derived. So if you’re a vegan, decide for yourself whether this constitutes medicine and if so, whether that makes it ethically permissible to you.
With that out of the way:
What the science says on collagen supplementation
Collagen for skin
Read: Effects of collagen supplementation on skin aging (systematic review and meta-analysis)
The short version is that they selected 19 studies with over a thousand participants in total, and they found:
In the meta-analysis, a grouped analysis of studies showed favorable results of hydrolyzed collagen supplementation compared with placebo in terms of skin hydration, elasticity, and wrinkles.
The findings of improved hydration and elasticity were also confirmed in the subgroup meta-analysis.
Based on results, ingestion of hydrolyzed collagen for 90 days is effective in reducing skin aging, as it reduces wrinkles and improves skin elasticity and hydration.
Caveat: while that systematic review had no conflicts of interests, at least some of the 19 studies will have been funded by beauty companies. Here are two, so that you know what that looks like:
Funded by Quiris to investigate their own supplement, Elasten®:
A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density
Funded by BioCell to investigate their own supplement, BioCell Collagen:
The Effects of Skin Aging Associated with the Use of BioCell Collagen
A note on funding bias: to be clear, the issue is not that the researchers might be corrupt (though that could happen).
The issue is more that sometimes companies will hire ten labs to do ten research studies… and then pull funding from ones whose results aren’t going the way they’d like.
So the “best” (for them) study is the one that gets published.
Here’s another systematic review—like the one at the top of this section—that found the same, with doses ranging from 2.5g–15g per day for 8 weeks or longer:
Read: Oral Collagen Supplementation: A Systematic Review of Dermatological Applications
Again, some of those studies will have been funded by beauty companies. The general weight of evidence does seem clear and favorable, though.
Collagen for bones
Here, we encountered a lot less in the way of potential bias, because this is simply marketed a lot less. Despite being arguably far more important!
We found a high quality multi-vector randomized controlled study with a sample size of 131 postmenopausal women. They had these women take 5g collagen supplement (or placebo), and studied the results over the course of a year.
They found:
- The intake of the supplement increased bone mineral density (BMD)
- Supplementation was also associated with a favorable shift in bone markers, indicating:
- increased bone formation
- reduced bone degradation
Read: Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Wome
A follow-up study with 31 of these women found that taking 5 grams of collagen daily for a total of 4 years was associated with a progressive increase in BMD.
You might be wondering if collagen also helps against osteoarthritis.
The answer is: yes, it does (at least, it significantly reduces the symptoms)
Read: Effect of collagen supplementation on osteoarthritis symptoms
In summary:
- You need collagen for health skin, bones, joints, and more
- Your body makes collagen from your food
- You can help it by getting plenty of protein, vitamins, and minerals
- You can also help it by not doing the usual Bad Things™ (smoking, drinking, eating processed foods, especially processed meats)
- You can also eat collagen directly in the form of other animals’ skin and bones
- You can also buy collagen supplements (but watch out for allergens)
Want to try collagen supplementation?
We don’t sell it (or anything else), but for your convenience…
Check it out: Hydrolyzed Collagen Peptides (the same as in most of the above studies), 90 days supply at 5g/day
We selected this one because it’s the same kind used in many of the studies, and it doesn’t contain any known allergens.
It’s bovine collagen, meaning it’s from cows, so it’s not vegan, and also some subscribers may want to abstain for religious reasons. We respect that, and/but make our recommendations based solely on the science of health and productivity.
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Chromium Picolinate For Blood Sugar Control & Weight Loss
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First, a quick disambiguation:
- chromium found in food, trivalent chromium of various kinds, is safe (in the quantities usually consumed) and is sometimes considered an essential mineral, sometimes considered unnecessary but beneficial. It’s hard to know for sure, since it’s in a lot of foods (naturally, like many trace elements)
- chromium found in pollution, hexavalent chromium (so: twice as many cationic bonds, if this writer’s chemistry serves her correctly) is poisonous.
We’re going to be writing about the food kind, which is also possible to take as a supplement.
In this case, supplementing vs getting from food is quite a big difference, by the way, since (unlike for a lot of things, which are often the other way around) the bioavailability of chromium from food is very low (around 2.5%), whereas chromium picolinate, one of the most commonly-used supplement forms, boasts higher bioavailability.
Does it work for blood sugars?
Yes, it does! At least, it does in the case of people with type 2 diabetes. Rather than bombard you with many individual studies, here’s a systematic review and meta-analysis of 22 criteria-meeting randomized clinical trials that found:
❝The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes.
Chromium monosupplement may additionally improve triglycerides and HDL-C levels.❞
Type 1 diabetes does not have anything like the same weight of evidence, and indeed,
we couldn’t find a single human study. It was beneficial for mice with artificially-induced T1D, thoughwait no, we have an update! We found literally a single human study:Chromium picolinate supplementation for diabetes mellitus
Literally, as in: it’s a case study of one person, and the results were a modest reduction in Hb A1c levels after 3 months of 600μg daily; the researchers concluded that ❝chromium picolinate continues to fall squarely within the scope of “alternative medicine,” with both unproven benefits and unknown risks❞.
As for people without diabetes, it may reduce the risk of diabetes:
Risk of Type 2 Diabetes Is Lower in US Adults Taking Chromium-Containing Supplements
However! This was an observational study, and correlation ≠ causation.
Furthermore, they said:
❝Over one-half the adult US population consumes nutritional supplements, and over one-quarter consumes supplemental chromium. The odds of having T2D were lower in those who, in the previous 30 d, had consumed supplements containing chromium❞
That “over one-quarter consumes supplemental chromium” brought our attention to the fact that this is not talking about specifically chromium “monosupplements” (definitely not quarter of the adult population take those), but rather, “multivitamin and mineral” supplements that also contain a tiny amount (often under 50μg) of chromium.
In other words, this ruins the data and honestly the benefit could have been from anything in the “multivitamin and mineral” supplement, or indeed, could just be “the kind of person who takes supplements is the kind of person who lives a lifestyle that is less conducive to becoming diabetic”.
Does it work for weight loss?
We’re running out of space here, so we’ll be brief:
No.
There are many papers that have concluded this, but here are two:
Chromium picolinate supplementation for overweight or obese adults
and
Is it safe?
Science’s current best answer is “we don’t know; it hasn’t been tested enough; we haven’t even established the tolerable upper limit, which is usually step 1 of establishing safety”.
Nor is there an estimated average requirement (if indeed there even is a requirement, which question is also not as yet answered conclusively by science), and science falls back to “here’s an average of what people consume in their diet, so that’s probably safe, we guess”.
(that average was reckoned as 25μg/day for young women and 25μg/day for young men, by the way; older ages not as yet reckoned)
You can read about this sorry state of affairs here.
Want to try some?
Notwithstanding the above lack of data for safety, it does have benefits for blood sugars, so if that’s a gamble you’re willing to make, then here’s an example product on Amazon.
Note: the dosage per capsule there (800μg) is half of the low end of the dose that was implicated in the serious kidney condition caused in this case study (1200–2400μg), so if you are going to try it, we strongly recommend not taking more than one per day.
Take care!
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Tech Bliss – by Clo S., MSc.
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The popular idea of a “digital detox” is simple enough, “just unplug!”, they say.
But here in the real world, not only is that often not practical for many of us, it may not always even be entirely desirable. The Internet (and our devices with all their bells and whistles) can be a source of education, joy, and connection!
So, how to find out what’s good for us and what’s not, in our daily digital practices? Clo. S. has answers… Or rather, experiments for us to do and find out for ourselves.
These experiments range from the purely practical “try this to streamline your experience” to the more personal “how does this thing make you feel?”. A lot of the experiments will be performed via your digital devices—some, without! Others are about online interpersonal dynamics, be they one-on-one or navigating a world in which it seems everyone is out to get us, our outrage, and/or our money. Still yet others are about optimizing what you do get from the parts of your digital experience that are enriching for you.
As the title suggests, there are 30 experiments, and it’s not a stretch to do them one per day for a month. But, as the author notes, it’s by no means necessary to do them like that; it’s a workbook and reference guide, not a to-do list!
(On the topic of it being a reference guide…There’s also an extensive tools directory towards the end!)
In short: this is a great book for optimizing your online experience—whatever that might mean for you personally; you can decide for yourself along the way!
Click here to get a copy of Tech Bliss: 30 Experiments For Your Digital Wellness today!
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7 Ways To Boost Mitochondrial Health To Fight Disease
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Fatigue and a general lack of energy can be symptoms of many things, and for most of them, looking after our mitochondrial health can at least help, if not outright fix the issue.
The Seven Ways
Dr. Jonas Kuene suggests that we…
- Enjoy a good diet: especially, limiting simple sugars, reducing overall carbohydrate intake, and swapping seed oils for healthier oils like avocado oil and olive oil.
- Take supplements: including coenzyme Q10, alpha-lipoic acid, and vitamins
- Decrease exposure to toxins: limit alcohol consumption (10almonds tip: limit it to zero if you can), avoid foods that are likely high in heavy metals or pesticides, and check you’re not being overmedicated (there can be a bit of a “meds creep” over time if left unchecked, so it’s good to periodically do a meds review in case something is no longer needed)
- Practice intermittent fasting: Dr. Kuene suggests a modest 16–18 hours fast per week; doing so daily is generally considered good advice, for those for whom this is a reasonable option
- Build muscle: exercise in general is good for mitochondria, but body composition itself counts for a lot too
- Sleep: aiming for 7–9 hours, and if that’s not possible at night, add a nap during the day to make up the lost time
- Get near-infrared radiation: from the sun, and/or made-for-purpose IR health devices.
For more info on these (including the referenced science), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Coenzyme Q10 From Foods & Supplements
- How To Reduce Or Quit Alcohol
- Intermittent Fasting: What’s the truth?
- Build Muscle (Healthily!)
- Red Light, Go!
Take care!
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Beat Sugar Addiction Now! – by Dr. Jacob Teitelbaum & Chrystle Fiedler
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Sugar isn’t often thought of as an addiction in the same category as alcohol or nicotine, but it’s actually very similar in some ways…
A bold claim, but: in each case, it has to do with dopamine responses to something that has:
- an adverse effect on our health,
- a quickly developed tolerance to same,
- and unpleasant withdrawal symptoms when quitting.
However, not all sugar addictions are created equal, and Dr. Teitelbaum lays four different types of sugar addiction out for us:
- Most related to “I need to perform and I need to perform now”
- Most related to “I just need something to get me through one more stressful day, again, just like every day before it”
- Most related to “ate too much sugar because of the above, and now a gut overgrowth of C. albicans is at the wheel”
- Most related to “ate too much sugar because of the above, and now insulin resistance is a problem that perpetuates itself too”
Of course, these may overlap, and indeed, they tend to stack cumulatively as time goes by.
However, Dr. Teitelbaum notes that as readers we may recognize ourselves as being at a particular point in the above, and there are different advices for each of them.
You thought it was just going to be about going cold turkey? Nope!
Instead, a multi-vector approach is recommended, including adjustments to sleep, nutrition, immune health, hormonal health, and more.
In short: if you’ve been trying to to kick the “White Death” habit as Gloria Swanson called it (sugar, that is, not the WW2 Finnish sniper of the same name—we can’t help you with that one), then this book is really much more helpful than others that take the “well, just don’t eat it, then” approach!
Pick up your copy of Beat Sugar Addiction Now from Amazon, and start your journey!
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Pasteurization: What It Does And Doesn’t Do
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Pasteurization’s Effect On Risks & Nutrients
In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:
- About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
- About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
- About 14% said “both raw milk and pasteurized milk are equally unhealthy”
- About 9% said “both raw milk and pasteurized milk are equally healthy”
Quite polarizing! So, what does the science say?
“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”
True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):
Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds
As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.
This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.
Source for both of the above claims:
(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)
Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?
False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.
Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).
Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:
FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption
this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!
Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.
In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.
Milk generally is good/bad for the health: True or False?
True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:
- Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
- Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation
You may be wondering…
…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, so:
Take care!
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What will aged care look like for the next generation? More of the same but higher out-of-pocket costs
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Aged care financing is a vexed problem for the Australian government. It is already underfunded for the quality the community expects, and costs will increase dramatically. There are also significant concerns about the complexity of the system.
In 2021–22 the federal government spent A$25 billion on aged services for around 1.2 million people aged 65 and over. Around 60% went to residential care (190,000 people) and one-third to home care (one million people).
The final report from the government’s Aged Care Taskforce, which has been reviewing funding options, estimates the number of people who will need services is likely to grow to more than two million over the next 20 years. Costs are therefore likely to more than double.
The taskforce has considered what aged care services are reasonable and necessary and made recommendations to the government about how they can be paid for. This includes getting aged care users to pay for more of their care.
But rather than recommending an alternative financing arrangement that will safeguard Australians’ aged care services into the future, the taskforce largely recommends tidying up existing arrangements and keeping the status quo.
No Medicare-style levy
The taskforce rejected the aged care royal commission’s recommendation to introduce a levy to meet aged care cost increases. A 1% levy, similar to the Medicare levy, could have raised around $8 billion a year.
The taskforce failed to consider the mix of taxation, personal contributions and social insurance which are commonly used to fund aged care systems internationally. The Japanese system, for example, is financed by long-term insurance paid by those aged 40 and over, plus general taxation and a small copayment.
Instead, the taskforce puts forward a simple, pragmatic argument that older people are becoming wealthier through superannuation, there is a cost of living crisis for younger people and therefore older people should be required to pay more of their aged care costs.
Separating care from other services
In deciding what older people should pay more for, the taskforce divided services into care, everyday living and accommodation.
The taskforce thought the most important services were clinical services (including nursing and allied health) and these should be the main responsibility of government funding. Personal care, including showering and dressing were seen as a middle tier that is likely to attract some co-payment, despite these services often being necessary to maintain independence.
The task force recommended the costs for everyday living (such as food and utilities) and accommodation expenses (such as rent) should increasingly be a personal responsibility.
Aged care users will pay more of their share for cooking and cleaning.
Lizelle Lotter/ShutterstockMaking the system fairer
The taskforce thought it was unfair people in residential care were making substantial contributions for their everyday living expenses (about 25%) and those receiving home care weren’t (about 5%). This is, in part, because home care has always had a muddled set of rules about user co-payments.
But the taskforce provided no analysis of accommodation costs (such as utilities and maintenance) people meet at home compared with residential care.
To address the inefficiencies of upfront daily fees for packages, the taskforce recommends means testing co-payments for home care packages and basing them on the actual level of service users receive for everyday support (for food, cleaning, and so on) and to a lesser extent for support to maintain independence.
It is unclear whether clinical and personal care costs and user contributions will be treated the same for residential and home care.
Making residential aged care sustainable
The taskforce was concerned residential care operators were losing $4 per resident day on “hotel” (accommodation services) and everyday living costs.
The taskforce recommends means tested user contributions for room services and everyday living costs be increased.
It also recommends that wealthier older people be given more choice by allowing them to pay more (per resident day) for better amenities. This would allow providers to fully meet the cost of these services.
Effectively, this means daily living charges for residents are too low and inflexible and that fees would go up, although the taskforce was clear that low-income residents should be protected.
Moving from buying to renting rooms
Currently older people who need residential care have a choice of making a refundable up-front payment for their room or to pay rent to offset the loans providers take out to build facilities. Providers raise capital to build aged care facilities through equity or loan financing.
However, the taskforce did not consider the overall efficiency of the private capital market for financing aged care or alternative solutions.
Instead, it recommended capital contributions be streamlined and simplified by phasing out up-front payments and focusing on rental contributions. This echoes the royal commission, which found rent to be a more efficient and less risky method of financing capital for aged care in private capital markets.
It’s likely that in a decade or so, once the new home care arrangements are in place, there will be proportionally fewer older people in residential aged care. Those who do go are likely to be more disabled and have greater care needs. And those with more money will pay more for their accommodation and everyday living arrangements. But they may have more choice too.
Although the federal government has ruled out an aged care levy and changes to assets test on the family home, it has yet to respond to the majority of the recommendations. But given the aged care minister chaired the taskforce, it’s likely to provide a good indication of current thinking.
Hal Swerissen, Emeritus Professor, La Trobe University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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