Beautiful Skin from Within
An Interview with Dr. Mark Tager | Interview by Addie Strickland
With the skin-care industry so saturated in serums, moisturizers, and eyecreams, it becomes difficult to know what to use to create the perfect skin routine. What if we could rule out some of our skin-care steps by looking at our dietary lifestyle? Mark J. Tager, MD, is CEO of San Diego-based ChangeWell Inc., an organization that trains and coaches certified nutritionists, licensed aestheticians, and other health-care practitioners to enhance their craft. In his most recent book, Feed Your Skin Right: Your Personalized Nutrition Plan for Radiant Beauty, Dr. Tager puts science behind the saying, “Beautiful from the inside out,” introducing readers to integrative medicine and regenerative techniques that lead to their personalized skin-care regimen. VIE had the opportunity to interview Dr. Tager about everything from supplements to skin microbiome testing.
VIE: Everyone wants healthy, glowing skin, but each person’s journey depends on their needs, so how do we know what we need individually?
Dr. Tager: In the last decade, a new field of personalized nutrition has evolved. This recognizes the individuality you mention, which I simply express as, “There is no one on the planet with the same skin as yours.” The process begins with dietary and lifestyle assessment, including how you exercise and your stress level. It takes into account age, chronic disease, medications that deplete nutrients, basic labs, gut integrity, nutrigenomics, food sensitivities, and the microbiome. There are many inputs that together provide guidance for the consumer and the practitioner on how to craft a personalized plan.
VIE: Where would you suggest a beginner start on their nutrition journey?
Dr. Tager: The first step is to take stock. Apply a bit of introspection and reflection. What, when, where, and why are you eating? I like to ask people to tell me in exquisite detail everything they’ve eaten in the last twenty-four hours. Make a list and note the approximate time of day and where they were. Food frequency questionnaires can also shed light on typical food patterns. It’s helpful to consider the when and why. The “when” relates to the benefits of consuming all your food in a tighter period and “fasting” for around thirteen hours. The “why” takes into account how emotions shape your patterns.
VIE: What is your advice for the average consumer who is confused about the functions of different supplements and how they affect our skin?
Dr. Tager: This is a more nuanced answer. Confusion comes in many forms. There is confusion about quality and accessibility: Should I purchase my supplements in a discount store, at a specialty retailer, online, or in a clinician’s office? How do I know which ones are good quality? (Hint: Learn to read a supplement label.) What’s so special about “professional-grade” supplements? Set realistic expectations. Supplements are not drugs. They are designed to act as macronutrients (building blocks like calcium), antioxidants, and cofactors of key reactions (think zinc and magnesium). Dietary supplements supplement a healthy diet, which is consuming food that looks like food and is not heavily processed with added sugars, fats, and chemical stabilizers. You can’t out-supplement a crappy diet! I advocate intelligent supplementing—a healthy diet augmented by specific nutrients for which a consumer has a really good (hopefully with some objective data) reason to add.
The process begins with dietary and lifestyle assessment, including how you exercise and your stress level.
VIE: What are some of the most common supplements that would be easy to implement into our daily lives?
Dr. Tager: I recommend a few basic supplements, beginning with a good multivitamin and mineral. Add a fish oil capsule (I like one with curcumin). I am a fan of astaxanthin and CoQ10 as powerful antioxidants; the latter is important for people on statins. There are a handful of well-crafted “beauty from within” skin supplements with good mixes of antioxidants, skin protectants (oral ceramides), and vitamins and minerals. Beyond this, you move into supplements to reduce inflammation (PEA+, which we can discuss), help with sleep, promote cognition, improve digestion (enzymes), and counter dysbiosis in the gut.
VIE: What does it mean to “eat for your genes,” and how can the average person do so?
Dr. Tager: It’s hard to do unless you take a nutritional genomic test. This picks up genetic variants that can signal why you might need more or less of a specific nutrient. The impactful genetic variants affect metabolism. Based on genes, some people have different needs for vitamins and minerals. They also handle glucose differently (tendency to glycate), handle pigment differently, or break down collagen at greater rates. This information can help shape a specific supplement plan, along with a history, a physical, and other labs.
VIE: How does our gut health influence our skin? What are your tips for practicing better gut-health habits?
Dr. Tager: The gut, brain, and skin are all connected, both chemically and through the nervous system. The gut microbiome is disrupted in common skin conditions like acne, psoriasis, atopic dermatitis, and eczema. Spore-based probiotics can help reset the microbiome. I am a big fan of prebiotics—especially sauerkraut and kimchi. The most impactful is fiber from plants. Fiber is the preferred food of the good bacteria in the gut that make the neurotransmitters that affect brain function via stimulation of the vagus nerve. These bacteria create short-chain fatty acids that go into circulation and go to the skin. There, they help with barrier functions. (You don’t want a leaky gut, and you don’t want leaky skin.)
The gut microbiome is disrupted in common skin conditions like acne, psoriasis, atopic dermatitis, and eczema.
VIE: What are refined carbohydrates, and how do they affect our skin and gut health?
Dr. Tager: The average American eats one hundred grams of added sugar daily. The problem with this is that it causes glycation. Glycation is the binding of sugar to the proteins in the body. When sugar binds to the heme in iron, it can be detected as HbA1C in the blood. This is a marker of diabetes. In the skin, sugar will bind to collagen, changing its shape and function and making it more brittle. This can lead to fine lines around the lips and cheeks.
VIE: What is your stance on the skin-care industry, and how has this powerhouse influenced (for better or worse) our skin’s health?
Dr. Tager: I have strong mixed feelings. There are more than one hundred thousand skin-care products on the market. Many come with a good bit of hype. Most products on the market sit on the top of the skin and don’t do much. Yet there is also an incredible dedication by the best companies to develop new molecules and delivery systems and do the appropriate clinical testing to show their products make a difference. So many “biologically active” molecules are making their way into skin-care products. These include growth factors, peptides, exosomes, vitamins and minerals, ceramides, nitric oxide, CBD—the list goes on. All of these come with a science story. The reality is that finding what is best for your skin is a trial-and-error process, which is probably why makeup cabinets around the world are littered with unused, semi-used, or long-forgotten topicals.
Healthy skin comes from within. Thank you, Dr. Tager!
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To learn more about Dr. Tager or to buy a copy of his book, Feed Your Skin Right: Your Personalized Nutrition Plan for Radiant Beauty, visit DrTager.com.