Catherine de Lange 

Can a drink really make skin look younger?

Nutricosmetics are dietary powders, pills and drinks designed to reverse signs of skin-ageing. It’s predicted to become a £5bn industry by 2020 – but is it just a spoonful of pseudoscience?
  
  


For the past few weeks my breakfast has taken an unusual twist. Before I crack on with work, I unscrew a small glass vial with a gold lid and down the contents. The bottle has the air of Alice in Wonderland’s “drink me” potion, but the only thing it promises to shrink is my wrinkles.

This would-be youth elixir is called Pure Gold Collagen. It contains fragments of collagen extracted from fish, you can buy it on the high street, and it’s just one of hundreds of new products encouraging us to sip, nibble and gulp our way to healthier-looking skin.

It is estimated that the burgeoning market for these so-called nutricosmetics will be worth $7.4bn (£4.8bn) by 2020, driven by an ageing population and a growing acceptance of functional foods. “Supplements are becoming more popular as users are becoming more aware of their advantage – the nutrients are absorbed into your bloodstream faster than any topical remedy,” says Nicola Kilner, group brands director of Deciem, which produces Fountain, a beauty supplement drink sold in Boots and Net-a-Porter. As of August 2013, the company says it has been selling a bottle of Fountain every 11 seconds.

And drinks are just the start. There are cereal bars and pills, powders and syrups to stir into drinks or sprinkle on food. You can even buy Nescafé and beer with added collagen. All contain active ingredients which, we are told, will keep skin looking younger, make it healthier, boost elasticity and hydration, and improve various elements of skin function.

At face value, the idea of making skin healthier from within makes sense. It’s no secret that a good diet and lots of water are key to a healthy glow. But is there really enough science – if any – to back up the seductive claims of ingestible beauty products? How do they fit into the regulatory systems set up for foods and medicines? Are they just a spoonful of pseudoscience and a dose of empty promises?

To understand many of the claims made around nutricosmetics, it’s necessary to take a closer look at skin. It is made up of several layers, most notably the epidermis – the outer layer – which at the very surface consists of dead cells. Below this is the dermis, which has a blood supply and contains much of the skin’s collagen and elastin fibres, which give it structure and firmness.

The logic goes that by feeding skin from the inside out – with beauty-boosting ingredients absorbed in the gut and delivered via the blood to the dermis – there should be a bigger and longer-lasting effect on appearance than can be achieved by smothering creams and lotions on the dead outer layer. “Creams can hydrate those dead cells and make it superficially look a bit more healthy than it really is,” says Martin Godfrey, head of R&D at Minerva Research Labs, the company behind Gold Collagen. “But it’s always going to be a temporary effect because it isn’t able to get to the guts of where living cells are being produced.”

Beyond this basic principle, the claims vary according to the active ingredients involved. But two blockbuster ingredients are collagen and hyaluronic acid.

Collagen is the protein that makes up around 75% of skin, and is key to its structure and elasticity. But after the age of 20 or so, we lose around 1.5% of our collagen every year. Collagen is also broken down by stressors such as too much sun exposure. That damage should be made up by fibroblasts, the body’s own collagen factories found in all connective tissues, but as we get older these tend to become sluggish. And as the collagen vanishes, so does skin’s youthful appearance.

Collagen is already a staple of many face creams, but the jury is out on how effective these products are. Most moisturising face creams will hydrate the skin and so reduce the appearance of wrinkles, so it’s hard to know whether the effects are truly because it contains collagen. “There isn’t a great deal of data on this but the evidence for topically applied collagen-containing products having any benefit is scant,” says Christopher Griffiths, professor of dermatology at the University of Manchester.

Nutricosmetics, on the other hand, tend to contain small fragments of collagen. This hydrolysed form, says Piers Raper, CEO of skincare drink Skinade, is more easily absorbed, especially when it is already dissolved in a liquid. Once in the body – the theory goes – these collagen fragments trick our own collagen factories into becoming more active. “New collagen seems to switch them on and they produce more,” says Godfrey. And so collagen production reverts back to how it was in the days before you ever worried about wrinkles.

The idea that it is possible to kickstart collagen production is seductive, and has a kind of convincing common sense to it, but is it true? Minerva has carried out placebo-controlled, double-blind studies on hundreds of women taking its Gold Collagen drinks, using objective measures (as opposed to surveys) to assess the effects, and studies have been published in peer-reviewed journals.

It’s clear that Minerva takes research seriously, but for the evidence to be convincing, more and better clinical trials need to be done. One study was conducted on a total of just 18 women. A much larger study showed that 15% of subjects taking Pure Gold Collagen had fewer facial lines and wrinkles after 60 days, but these improvements could have been due to other factors, for example people improving their diet. And while lots of studies have been conducted on animals to demonstrate that collagen supplements could improve the skin, clinical trials in people have been inconsistent in their results and their methodologies. Godfrey says the company is conducting more trials, and trying to work out whether some people respond better to the product than others. “It might be that some people’s fibroblasts are more susceptible, that’s something we need to dig into,” he says.

Not everyone is convinced. “I’m not aware of any really compelling data showing that hydrolysed collagen can restore or repair skin that’s aged either because of the passing of the years or sun damage,” says Griffiths.

One concern is that the collagen will be broken down in the body. “What’s going to stop even fragments of collagen being digested? They are going to be subjected to the acid in the stomach and digestive enzymes,” says Duane Mellor, assistant professor in dietetics at the University of Nottingham.

Collagen has already been used in injectable skin fillers, points out Griffiths, “and there’s no evidence that they stimulate new collagen production, so I just don’t think there’s enough data there to show that this kind of approach is going to restore collagen in the skin.”

Of course, proponents disagree. Godfrey says he too was cynical about collagen absorption when he first started this research, but points to studies using radiolabelling which show that the peptides do get into the blood and to the skin. As for the activity of collagen on fibroblasts, he says Minerva Labs is about to publish new research – albeit not involving humans – proving that hydrolysed collagen has an effect.

The other ingredient added to a lot of these supplements is hyaluronic acid, which plays a role in cushioning connective tissue. It has a unique capacity for retaining water, and helps give skin a plump appearance. Unlike collagen, which decreases more rapidly as an effect of lifestyle, levels of hyaluronic acid, or HA as it’s often called, drop almost equally fast in everyone, says Fountain’s Nicola Kilner. “Nearly half of it will be gone in our 40s,” she says.

HA is often added to face creams and fillers, but the idea that it can penetrate the skin is controversial. But proponents of supplements like Fountain argue, of course, that drinking it is the best way to get it into the body.

More bold claims, but do they stand up? There is peer-reviewed research to show that HA supplements can improve hydration and wrinkles in people with dry skin. But Mellor says that too much HA in the blood could could damage blood vessels and even affect the spread of cancer. “So for it to work it needs to be just enough and targeted to the skin, otherwise it could have other effects,” he says. Fountain disputes the link between HA and cancer. And while there’s some evidence of a connection between high levels of HA and cancer growth, that doesn’t mean that the HA causes it.

Many nutricosmetics are also marketed around the power of antioxidants – molecules that help to delay or prevent some types of cell damage – such as good old vitamin C. But in nutricosmetics, they are being branded as something more sensational.

One drink, called Beauty & Go, for instance, boasts that it contains “macroantioxidants”, which the company says are a newly discovered type of antioxidant that has longer-lasting effects. They even come with their own registered trademark. As well as protecting cells from oxidative stress – this is what the antioxidants in your diet do – the drinks claim a range of other benefits. They might “detoxify your skin after a day of excess”, “stimulate skin regeneration and provide firmness and elasticity”, and keep it “healthy, smooth and radiant for longer”.

The evidence for these claims isn’t strong. The website contains details of a clinical trial that showed that after two months of taking the supplements twice a day, measurements of skin elasticity and firmness had improved significantly. The problem is, the trial included just 30 people, and there is no mention of a control group. Perhaps worryingly, there are also claims such as a “global improvement in gastrointestinal health”.

Antioxidants also feature prominently in Fountain’s range – its Beauty Molecule drink, for instance, contains resveratrol, an antioxidant found in red wine, which is often touted as having anti-ageing effects, as well as helping to protect against cancer and Alzheimer’s disease.

But a review of data on common nutraceutical ingredients concluded that the evidence for resveratrol was mixed. Despite its potential, much of the evidence so far is in animals or lab experiments, and since it is metabolised quickly in the human body, it’s not yet clear how strong these effects would be in real people.

Wouldn’t we just be better off getting antioxidants from a healthy diet of fruit and vegetables? Theresa Callaghan, CEO of Callaghan Consulting International, who advises cosmetics companies on legislation, seems to think so, saying she’d stick to the “eat your vitamins, don’t pee them” motto.

The list of active ingredients in nutricosmetics tends to be long. But while some companies are conducting or commissioning research, (Unilever, for instance, was praised in 2011 for its trial showing that a three-a-day pill acts on genes to improve the appearance of wrinkles and boost collagen), others don’t seem to be as rigorous when it comes to supporting the claims they use to flog their wares. One pill-based supplement, called Youth, contains amino acids that are said to trigger the brain into producing more growth hormones (these also decline as we age) in order to promote younger-looking skin. When I asked Dr Sister, the French doctor behind the pills, whether he was planning to conduct any clinical trials – for instance comparing them with face creams – his answer was straightforward: “No – we have good results with the patients who are taking it and that’s it.”

Because they are marketed as food supplements, it falls to the European Food Safety Authority (EFSA), and the Advertising Standards Authority (ASA) where relevant, to determine whether food supplements and nutricosmetics sold in the UK live up to any health claims they make. The EFSA is the same body that deals with nutraceuticals – products such as Benecol yoghurt drink or Flora proactive margarine, which both claim to help lower cholesterol. Nutraceuticals have added ingredients to provide a health function beyond basic nutrition, falling somewhere between a food and drug, which already makes them tricky to regulate.

Nutricosmetics pose fresh problems. In theory any edible cosmetics should be subjected to the same scrutiny as nutraceuticals. The EU has a list of ingredients and health claims you can make about them - anything not on the list should be submitted for approval. But it’s often ambiguous as to whether the claims they make are truly related to health. This creates a legislative loophole. “Some of the descriptions of healthier-looking skin or younger-looking skin, you could argue are not technically health claims,” says Duane Mellor. “Is beauty health? That’s a great debate really, isn’t it.”

As a result, there have been instances where companies have submitted applications to the EFSA to make a health claim related to a nutricosmetic product, but the claim has been rejected because the regulators do not deem the claimed effect to be related to health. From a marketing perspective, says Mellor, companies can take this kind of rejection to mean “it doesn’t seem to be health related, so we can still say this”.

Earlier this month, the ASA ruled that a TV ad for Pure Gold Collagen can no longer be broadcast in its current form after it received complaints that the advert “misleadingly implied the product directly affected the quality and collagen properties of consumers’ skin”. Minerva, which makes Pure Gold Collagen, said that if it had wanted to make health claims, it could have done so using the approved list of ingredients that are accepted to have a health effect. As for claims about the drink’s effect on appearance, it said it had the data to back them up. But when the ASA did a detailed review of that evidence, it did not find it to be robust enough to support even implied claims.

Last year, the ASA also looked at the science behind another well established nutricosmetic tablet called Imedeen, after an ad claimed it could “work from within to help reduce the appearance of fine lines and wrinkles”. Although they said that this wasn’t a health claim, after assessing all the evidence, the ASA concluded that the science just wasn’t strong enough back up the claims – health or not. Pfizer, which makes the pill, was told it could no longer use the ad. Does more need to be done? “It’s a tough one,” says Mellor. “We are all becoming more scientific as a society, but when you’re talking about something like beauty and the health of the skin, it can be quite subjective. If you are going to regulate that more, it could become quite difficult to enforce.”

Besides, he says, while it’s important to clamp down on misleading claims, “with some of these things, as long as it ticks a box as being safe, and you can afford it, it’s not likely to have a massive effect. But if it makes you feel better about yourself, it’s not doing much harm either.” The real issue here is that people think they can get a quick fix, says Theresa Callaghan. “People like to think everything can just be sorted by popping a pill. It can’t.”

I think I’ll skip the collagen for breakfast. But if the day comes when a drink-me potion can really be proved to turn back the hands of time – I’ll drink to that.

 

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