Skincare Supplements & How Diet Affects Beauty with Dr. Rajani Katta

Summary

Fat Mascara Podcast Episode Summary

Episode Title: Skincare Supplements & How Diet Affects Beauty with Dr. Rajani Katta
Release Date: January 17, 2025
Hosts: Jennifer Sullivan & Jessica Matlin

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Introduction to Dr. Rajani Katta and Preventative Dermatology

[03:28]
Jennifer Sullivan welcomes Dr. Rajani Katta, a renowned dermatologist from Houston, Texas, to discuss the intersection of diet, supplements, and skincare. Dr. Katta introduces herself as a preventative dermatologist, a term she elaborates on to encompass a holistic approach to skin health. Unlike traditional cosmetic dermatologists who focus primarily on aesthetic enhancements, preventative dermatologists aim to avert skin issues before they arise. Dr. Katta emphasizes that her role extends beyond sunscreen application and includes selecting appropriate skincare products for sensitive skin and eczema patients, as well as exploring links between dermatology and systemic diseases like diabetes.

The Impact of Diet on Skin Health

[04:24] - [07:31]
Jessica Matlin steers the conversation toward the role of diet in skin health, highlighting anecdotal reports where eliminating dairy or gluten significantly improved individuals' skin conditions. Dr. Katta confirms that there is tangible evidence supporting the connection between diet and skin health.

Evidence from Research:

• Acne and Sugar Intake: Dr. Katta references a comprehensive study where participants with higher sugar consumption reported increased instances of adult acne ([05:03]). Additionally, a decade-old study involving young men in Australia demonstrated that those adhering to a low glycemic diet experienced reduced acne severity after 12 weeks ([05:52]).
• Biological Mechanisms: Further research indicates that such diets can lead to smaller oil glands and lower hormone levels linked to acne development ([06:55]).

Understanding Glycemic Load:
Clarifying the term, Dr. Katta explains that glycemic load pertains to how quickly foods raise blood sugar levels. She prefers to discuss it in terms of "sugar spikes," making it more relatable for her patients. For instance, consuming a high-sugar beverage like a Starbucks mocha Frappuccino can cause a rapid increase in blood glucose, negatively impacting skin health ([07:04]).

Nutrient-Rich Foods for Optimal Skin

[08:05] - [09:43]
Dr. Katta advocates for a diet rich in antioxidants to combat free radicals generated by UV radiation, pollution, and stress, which can damage collagen and lead to premature aging. She recommends incorporating:

• Fruits and Vegetables
• Leafy Greens
• Herbs and Spices with high antioxidant properties

Conversely, she advises limiting intake of sugary and processed carbohydrates to prevent "sugar sag," where excessive sugar consumption damages collagen, reducing skin elasticity and increasing wrinkle formation ([09:43]). A study involving elderly individuals in the Netherlands supports this, showing a correlation between high snack consumption and increased wrinkles ([09:43]).

The Rise of Beauty Supplements

[10:25] - [15:56]
Jennifer shifts the discussion to the burgeoning market of beauty supplements, questioning their efficacy and regulation. Dr. Katta provides a historical perspective, suggesting that the popularity of supplements like biotin began with addressing specific deficiencies causing visible issues such as hair loss. However, she cautions that beyond deficiency states, additional supplementation may offer no benefits.

Regulatory Landscape:
Dr. Katta expresses concern over the lack of regulation in the supplement industry:

• Dietary Supplement Act of 1994: Allows supplements to be marketed without FDA approval, provided labeling regulations are met ([12:28]).
• Safety and Efficacy: Supplements aren't required to prove safety or effectiveness before hitting the market. This loophole means anyone could potentially produce and sell supplements without rigorous testing ([12:34]).
• Quality Control Issues: Only a fraction of manufacturing facilities are inspected, leading to high rates of non-compliance ([12:53]).

Health Risks:
Dr. Katta highlights specific dangers:

• Biotin Interference: High doses can disrupt blood tests for thyroid function and heart attacks, posing significant health risks if undetected ([14:57]).
• Hormonal Supplements: Products containing saw palmetto can have anti-androgen effects, potentially causing birth defects ([21:04]).

Ensuring Safe Supplement Use:
To navigate the unregulated market, Dr. Katta advises:

• Third-Party Seals: Look for certifications from organizations like USP (United States Pharmacopeia), ConsumerLab, or NSF International to ensure product safety and label accuracy ([24:35]).
• Transparency from Manufacturers: Prefer brands that disclose the source of their ingredients and provide clear information about their products ([31:20]).

Efficacy of Common Beauty Supplements

Collagen Supplements:
Jessica inquires about the effectiveness of collagen supplements, noting the overwhelming market presence and varying claims by different brands. Dr. Katta responds cautiously, stating that current research is limited:

• Limited Studies: Only 11 small-scale studies (around 500 participants) exist, with inconsistent results regarding wrinkle reduction ([28:30]).
• Diverse Formulations: Variations in collagen types (hydrolyzed vs. peptides) and dosages make it difficult to assess overall efficacy ([30:12]).
• Contamination Risks: Some products may contain harmful levels of heavy metals like cadmium ([33:33]).

Biotin and Hair Health:
While biotin supplements can aid hair growth in individuals with deficiencies, there is no evidence supporting benefits for those with normal biotin levels ([11:45] - [12:11]).

Personal Practices for Skin Health

Dr. Katta shares her own approach to maintaining skin health without relying heavily on supplements:

• Dietary Focus: Emphasizes probiotic-rich foods (e.g., kombucha) and antioxidant-dense foods like almonds, which have been shown to improve skin smoothness and reduce wrinkles ([34:19] - [35:25]).
• Testing Before Supplementation: Advocates for testing nutritional levels before recommending or taking supplements to address specific deficiencies ([25:56]).

Fun Segment: Five Quick Questions

To conclude the episode, Dr. Katta participates in a light-hearted five-question segment:

1. First Beauty Product Loved: Red lipstick ([36:41] - [36:56]).
2. Celebrity Best Friend: Padma Lakshmi, appreciating her new cooking show ([37:00] - [37:10]).
3. Favorite Indulgent Snack: Super gooey oatmeal chocolate chip cookies ([37:22] - [37:46]).
4. Pump-Up Song: "Dancing Queen" by ABBA ([38:02] - [38:13]).
5. Current Obsession: Instant Pot, recently learned to use it for quick meals like black beans and rice ([38:24] - [38:53]).

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Key Takeaways

• Diet Plays a Crucial Role in Skin Health: High-sugar diets can exacerbate conditions like acne, while nutrient-rich foods support skin resilience and longevity.
• Supplements Require Caution: The lack of stringent regulation necessitates vigilance. Always seek third-party certifications and consult healthcare professionals before starting new supplements.
• Personalized Approach to Skincare: Individual nutritional statuses and skin types vary, making personalized assessments essential for effective skincare strategies.
• Evidence-Based Practices: Prioritize treatments and supplements backed by robust scientific research over anecdotal claims.

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Notable Quotes

• Preventative Dermatology Defined:
  Dr. Rajni Katta [04:28]: "I really think of it as sort of a holistic approach to skincare."

• Impact of Sugar on Collagen:
  Dr. Rajni Katta [09:43]: "Sugar starts to damage your collagen. It actually makes it more brittle and you lose elasticity."

• Lack of Supplement Regulation:
  Dr. Rajni Katta [12:34]: "You don't have to prove safety. So that's a big barrier right there."

• Efficacy of Collagen Supplements:
  Dr. Rajni Katta [28:30]: "Does it work? So this is... your guess is kind of as good as mine because we hardly have any research studies."

• Third-Party Seals Importance:
  Dr. Rajni Katta [24:35]: "These seals just indicate that a third party lab has checked it out and make sure it's not contaminated."

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This episode provides a comprehensive look into how dietary choices and supplements can influence skin health, emphasizing the importance of evidence-based practices and regulatory awareness in the beauty supplement market.

Transcript

[Jen Sullivan]

Hello.

[Jessica Matlin]

Hello.

[Jen Sullivan]

Welcome to Fat Mascara. It's a podcast about beauty culture hosted by me, Jen Sullivan. Hi everyone. And her, Jessica Matlin. She's not here just yet. She'll be back momentarily for the interview we have today. Before we get into that, if you're a new listener, we love you. Welcome. Maybe you didn't know, but the price of entry for Fat Mascara is to hop over to itunes and give us a review. I mean, not necessary, but we love a review, so please do that and that helps us grow our family. You know what else does on Spotify? This feature we love. You can scroll down after you listen and leave a comment on each episode directly. So at the beginning of the show, you know, I've been loving sharing some of these. I have two I pulled from our interview last week with journalist Jenny Jin where she was giving me the lowdown on what's going on in South Korea and beauty culture there. The products that are hot. So I just wanted to share these from our listeners. This one's from Suzanne, 29. Such a fun, well rounded episode that covered culture, beauty and self care. It would be great to have a six month or more check in with Jennie and if she feels the pressures about improving her outward appearance. End of that one. That's interesting. Actually, I forgot to ask Jennie how long she's going to be in South Korea. And I know she's already partaken in the skin Botox as we heard in the episode, but I will. I'm going to check in with her about that and give that a think. Okay. And then we have Merv Hughes. Hi, Merv. The comment is Ari, the toilet seat covers. Oh, we were talking about how they're not available regularly in South Korea, but some people carry around their own disposable ones that they use. So Merv says re the toilet seat covers. People who hover are the problem. Oh my God. I'm the one who said hover. Anyway, not sure how it is in Korea, but Americans are so disgusting for doing this and leaving their urine there for me to sit in. Never experienced it before moving to the US So rude. Okay, good point. I'm a hoverer, but I also be neat and wipe the seat. You know that old rule, please be neat, wipe the seat. So I love these comments. Some of them are so specific. You can also just, you know, review the podcast on Spotify or itunes. Oh my God, the hovering. I'm sure Dr. Rajnikata is going to love that. She's a doctor. She'll be fine with it. And she is our guest today. So. All right, let's get into it. We have Dr. Rajni Katsa. She's here to talk about how diet efficiency affects your skin, but more importantly, beauty supplements. So Dr. Kata is a dermatologist in Houston, Texas. She currently serves on faculty for both the Baylor College of medicine and the McGovern Medical School. She's written nine books, over 100 medical journal articles on diet and dermatology and allergic reactions to the skin. She's honestly one of my favorite people ever to interview, especially when it comes to the topics we're talking about, which is diet and supplements. So this interview was originally conducted in 2020. We re edited it and are bringing it to you now because it's January, and I think that's when people are generally more careful about everything they're putting in their body. I've been getting questions about supplements, also diet. So it feels very topical right now. And with that, let's get into it and hang out with Dr. Kata. Here she is. Okay. So, Rajani, now that we're all set up, thanks for coming on Fat mascara.

[Dr. Rajni Katsa]

Oh, thank you so much for having me. This is so exciting.

[Jen Sullivan]

Is this your first podcast?

[Dr. Rajni Katsa]

No, I've done other podcasts before, but I've been listening to yours recently, and I'm really excited to be part of this.

[Jen Sullivan]

Okay. She's a pro. That's good. So my first question is, on your website, you describe yourself as a preventative dermatologist. I've seen cosmetic dermatologists, medical dermatologist. What is preventative dermatology?

[Dr. Rajni Katsa]

Well, I'm really glad you asked that, because I think when people think about preventive dermatology, they really think about sunscreen and skin cancer prevention. But there's really so much more to it than that. I mean, if you think about choosing the right skincare products, I'm really focused on people with sensitive skin and eczema. So a lot of it is preventing allergic skin reactions. But I'm also really interested in how do we prevent systemic diseases. You know, even though I'm in dermatology, I'm really interested in diabetes prevention. And we have a lot of links to that that sort of extend out from dermatology.

[Jen Sullivan]

Okay, so this is like whole body health.

[Dr. Rajni Katsa]

Yes. I really think of it as sort of a holistic approach to skincare.

[Jessica Matlin]

So talking about whole body health, you know, we have to talk about diet, and a lot of people have these anecdotal stories about when they change their diet. It made the biggest difference with their skin. We Get a lot of people, you know, telling us about how, you know, if they gave up dairy, it made a huge difference in their skin. If they gave up gluten, made a huge difference in their skin. Do we have any proof that different types of diet changes can make skin conditions worse? Or if they make this huge diet switch, it can actually improve their skin? Is there real evidence?

[Dr. Rajni Katsa]

There actually is. I'm really glad you asked that because I've sort of been in this area really looking at the research studies for almost the past decade. And if you put it all together, we have evidence from lots of different, from lots of different studies. So some of these studies are, if you look at big populations and others are more case reports, you know, individual patients reporting things. But I'll give you the example of acne because that's the one I get asked about a lot. So we just had a really good study that just came out that tracked people and they would take food frequency questionnaires and then they would report on how much adult acne they had. And people who reported having a higher intake of sugary foods especially reported having more acne. So that's one way of looking at that question. But we've actually.

[Jessica Matlin]

That's just self reported, right, though that's self.

[Dr. Rajni Katsa]

Yeah, that's self reported, which is a really important point. But there's a different kind of way to approach that question from a research standpoint. And I really like this study because this came out over 10 years ago. But they took two groups of young men in Australia and they had one just eat their normal diet and the other one they put on a low glycemic load diet. And so these were young men with pretty moderate to severe acne and they had them follow their diets for 12 weeks. And at the end of the 12 weeks, they compared the two groups and the one that was following this low glycemic, low diet, they actually had less acne. So less acne that you could count. And they've done later studies of that same kind of approach and they've even done skin biopsies of patients who've undergone this dietary approach. And they've actually found smaller oil glands and lower levels of certain hormones that we know are linked to acne. So acne is an example of a, you know, a nice area where we've shown that high glycemic load diets can worsen acne. But, you know, we're starting to find evidence from lots of different skin conditions.

[Jessica Matlin]

And when, when you say glycemic you're saying, I realize I'm making this sound very simplistic, but glycemic is sugar, right?

[Dr. Rajni Katsa]

Yes.

[Jessica Matlin]

Okay.

[Dr. Rajni Katsa]

So no, no. And I should back up because I use the word sugar spikes. I typically, if I'm talking to patients, I don't use the words low glycemic. I think about it as sugar spikes. So if you drink like a Starbucks mocha Frappuccino and you're like downing 16 teaspoons of sugar, well, what that does is your blood sugar levels are going to spike really high and really quick. And so that's an example of a high glycemic food.

[Jessica Matlin]

Right? Okay. So there, there is a connection or there may be a connection is what you're saying, right?

[Dr. Rajni Katsa]

Yeah, I think there's a strong connection for certain conditions. And there's not as much of a condition for. There's not as much of a connection for other conditions. But it's interesting, as we have more research, we're starting to see this connection a little bit better.

[Jessica Matlin]

So if someone just wants to have better skin, but they maybe don't have a specific concern like acne, what foods do you suggest they might want to add to their diet? Or are there any foods that they might want to avoid? Let's say they just want great skin.

[Dr. Rajni Katsa]

So, you know, I like to talk about eating power. So you really have to focus on foods that have powerful nutrients. And so the big ones are things that we all have learned about and thought about. You know, fruits and vegetables and leafy greens. But there's actually a lot of evidence too, about the ingredients that are found in spices and herbs. So that's another one that I'm a big fan of. And part of the reason is because those foods are all high in antioxidants. And so what that does is it battles. You know, if you think about UV radiation hitting your skin all day and also pollution and stress, you get an increased production of free radicals, right? And those free radicals, right, they start to ping pong around your skin and into your collagen and they start to cause damage and they start to cause dark marks and they lead to increased wrinkling.

[Jessica Matlin]

I mean, this is happening all day. I'm thinking like UV radiation technology, radiation, stress, like this is a constant assault all day. So yes, this is happening.

[Dr. Rajni Katsa]

It absolutely is. And you know, your skin's got these beautiful built in mechanisms to fight that, but throughout the course of the day, that's constantly being used up, those antioxidants. So you've got to replace them. With diet. So fruits, vegetables, herbs, spices. Those are kind of the big four. There's certainly other ones, but you mentioned foods to avoid. I've got to say the big one is sugar. Well, sugar and processed carbohydrates. Because we've actually had really good research studies showing that sugar starts to damage your collagen. It actually makes it more brittle and you lose elasticity. So there's something called sugar sag, where if you eat a lot of added sugar, it can start to damage your collagen and really make you more prone to early wrinkling.

[Jessica Matlin]

Oh, wow.

[Jen Sullivan]

Can you see that in a patient? Like, have you ever had someone walk in and be like, oh, wow, they eat a lot of sugar?

[Dr. Rajni Katsa]

So I have not seen that, but I'm glad you asked that, because there was this really interesting study that just came out a couple years ago, and they looked at elderly people in the Netherlands, and so they had people just grade their skin, like, how many wrinkles do these elderly people have? And then when they went back and compared their overall dietary pattern, the people who reported eating a lot of snacks and processed foods were graded as having more wrinkles than the other group who were eating more fruits and vegetables. So in an individual patient, it's really hard to see that. But I think you take it as a population and you can start to see these effects.

[Jen Sullivan]

And you mentioned herbs and spices. A lot of people talk about leafy greens. We've heard that. I'm glad you brought up herbs and spices, because we want to talk about supplements, because we've seen so many new supplements in the beauty market. And a lot of them are like, Jess and I, like, every month, it's like, okay, now we need this mushroom. Now we need turmeric. Now we need this spice. And we put it in a powder for you. Now it's in a pill for you. So before we talk about that, can we just ask you in general, like, when did the whole idea of taking a vitamin or taking a supplement even start? And why do people start doing that? It feels like they're everywhere now, but it wasn't always that way. Right.

[Dr. Rajni Katsa]

It really does feel like it's everywhere. And I can't pinpoint when the whole beauty supplement market took off. But my theory is that, you know, we started to have more and more cases of people with vitamin and nutritional deficiencies who are having skin problems. So one of the big ones is biotin, if you have a biotin deficiency, which, by the way, is really uncommon. But there are people who are born with Congenital enzyme deficiencies, and they don't have enough biotin and they start to get hair loss. And so if you give those people biotin, their hair grows back. So I think it started from cases like that where you hear about people who are deficient, and then all of a sudden people are just expanding that to, well, okay, if a little bit is good, you know, a lot must be really good. Right? So I think that's where it started is that whole deficiency state.

[Jen Sullivan]

Wait, so are you saying someone who isn't deficient who won't get a benefit from added biotin as far as hair?

[Dr. Rajni Katsa]

So we have looked, and we've had some good researchers look at all of the studies that have been put out there about giving biotin, and there are definitely reports. If you are deficient in biotin, then taking a supplement helps. But if you are not deficient, if you've got normal levels to start with, we have no evidence that taking extra helps your hair.

[Jen Sullivan]

Wow. I do think a lot of people think that.

[Jessica Matlin]

So before we even get into if these supplements actually work, how are these things regulated?

[Dr. Rajni Katsa]

Well, like, not much. The whole.

[Jessica Matlin]

How is this legal?

[Jen Sullivan]

You should see her face right now, by the way, everyone. Her face just fell.

[Dr. Rajni Katsa]

No, I really am astounded by the lack of regulation. I mean, it all goes back to 1994. They did put out a Dietary Supplement Act. And basically what it said is, if you're a dietary supplement, you do not need any approval by the FDA or really anybody before you take a supplement to market.

[Jessica Matlin]

So Jen and I could, like, cook one up tonight and, like, basically by next week have it on the market if we really put our minds to it.

[Dr. Rajni Katsa]

If you really put your minds to it, yes. I mean, you don't have to prove safety. So that's a big barrier right there. You don't have to prove that it's safe. You don't have to prove that it's effective. You do have to be very careful with what you say on the label. There are labeling regulations.

[Jessica Matlin]

Right, right, right.

[Dr. Rajni Katsa]

And then you probably don't want to just manufacture it in your kitchen, but you don't have to prove that. You have to do what's known as. You have to adhere to what's known as good manufacturing practices, but you don't have to prove that. And just as an aside, there's an investigative laboratory that sort of reports on these issues. The FDA last year was only able to investigate about 500 factories across the world, and they gave citations to over 50% of those factories that they.

[Jessica Matlin]

And that's just because of, like, bandwidth. Like, they just don't have the time and the resource to.

[Dr. Rajni Katsa]

Yeah. They don't have the personnel, they don't have the budget.

[Jen Sullivan]

This scares me.

[Jessica Matlin]

That's crazy. Yeah.

[Dr. Rajni Katsa]

Oh, it scares me, too. And that's just talking about good manufacturing. I mean, once you start to get into the fact, I mean, even what you just said about biotin.

[Jessica Matlin]

Right.

[Dr. Rajni Katsa]

A lot of people don't realize that we don't actually have proof of efficacy. But the other part of that, where we don't have proof of safety, I mean, it was only two years ago that the FDA put out a warning of biotin. And the warning that a lot of people. I don't know if a lot of people have heard about it, but some people have heard about it. It's a big FDA warning because if you take high doses of biotin and then you go to get a blood test, it interferes with a lot of blood tests. So it interferes with tests of thyroid function, but it also interferes with tests for heart attacks. So if. Right. If you're taking a hair supplement and you go into the emergency room and they test you for a heart attack, your test has a high chance of not being accurate because that biotin has interfered with it.

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[Jessica Matlin]

What are some other problems? Like I don't want people to think that because this is, this is not my impression. I don't believe that people who are creating these supplements are knowingly like trying to do harm to their consumers. What are some other dangers that could happen from supplements? What are some other like, negative effects? Because if I'm taking these supplements, I don't want our listeners to think, I don't want our listeners who are taking supplements to think like necessary that they're going to go into gnc, take a product and then like, you know, drop dead in 10 minutes. Like, I don't, I don't necessarily think that's the problem here, but like, what are the problems?

[Dr. Rajni Katsa]

No, I'm glad you said that because I think what you said, one point that you said, I don't want to.

[Jessica Matlin]

Scare the hell out of our listeners is what I'm saying.

[Dr. Rajni Katsa]

Right, right. And I think one point that you said is really important, which is that I don't think anybody's going in creating these with the intention of, you know, doing harm. I think the biggest issue is that we just don't know. And I'll give you this example. This was over a decade ago where researchers, they spent millions of dollars to look at beta carotene supplements and they gave them to smokers because they thought it would reduce the risk of lung cancer. And so these are researchers and they really had good laboratory, but they had to stop this research trial early because the smokers actually who took the beta carotene supplements had higher rates of lung cancer. And we've even seen that with certain skin cancer supplements. So there's a lot that we just don't know. And so that's kind of the big thing to be aware of that even if it's a vitamin or mineral, if it hasn't been studied at these really high doses for Seven years at a time. There's kind of risks that we don't know. But in the short term, I'll tell you about a few. To be careful. So there are beauty supplements that are out there that have melatonin and, you know, melatonin helping with sleep, but that can cause drowsiness and impairment. That's one to be careful of. The other one I'd really tell people to be careful of that we're seeing now is some of our young patients are looking at acne supplements that are sold online. Some of them have really high doses of vitamin A. And if you take really high doses of vitamin A, that can actually cause birth defects.

[Jessica Matlin]

Yes, I do know that. Yeah. Yeah.

[Dr. Rajni Katsa]

So that's one to be careful of.

[Jessica Matlin]

That's very serious.

[Dr. Rajni Katsa]

Yeah, it's really concerning. And the labeling laws on supplements. There are labeling laws, but they don't have to require like a pregnancy category X warning. So they don't have to tell you if there's a known risk of birth defects. And there's a hair loss supplement that's out there that uses saw palmetto and Saw. Yeah, it uses saw palmetto because that's supposed to have hormone, like sort of anti hormone benefits. But if that was a prescription medication, it would be a category X because when you start messing with hormone levels like that, your unborn fetus can start to have abnormal genitals. So that's just an example.

[Jessica Matlin]

Oh, Lord.

[Jen Sullivan]

Does it have like an estrogenic effect? Is that what it is? The saw palmetto?

[Dr. Rajni Katsa]

Oh, yeah. Well, very close. It has an anti androgen effect.

[Jen Sullivan]

Okay. So beware of that.

[Jessica Matlin]

Thank you for that. That's very valuable information, I would say. Not that every gynecologist, obstetrician is, you know, a genius with looking at labels, but I always brought anything that when I was pregnant, I brought anything I was about to take, any kind of supplement, you know, gummy, anything. I brought it to the office and showed it to my ob. So I really would recommend that because some of them, they're not all created equal. Is there anything else to look to look for to ensure you're buying a safe product? Any other keywords, buzzwords? I've always thought too, like, if it's too cheap, should we be wary?

[Jen Sullivan]

Like maybe this one's like a little shady.

[Jessica Matlin]

Yeah. I said don't be scared. I told our listeners not to be scared. I have to tell you, I'm getting a little, little nervous, a little sweaty here.

[Dr. Rajni Katsa]

I'm sorry. No, I have to say. So if it were me, I'll tell.

[Jessica Matlin]

You, that palmetto thing freaked me out.

[Dr. Rajni Katsa]

I know, right? It is scary.

[Jen Sullivan]

Yeah. What would you do?

[Dr. Rajni Katsa]

So if it were me and I had to, like, I had a vitamin D deficiency for a while. So if you go to the Office of dietary Supplements from the nih, one of the things they really recommend is that you look for a seal of approval from a third party independent laboratory. And so these seals just indicate that a third party lab has checked it out and make sure it's not contaminated, that it's not, you know, that it has the dose that's on the package. Because there have been lots of issues with contamination with like heavy metals or even microbes, you know, or even prescription medications. There have been a lot of reports like that. So you've got to look for that seal. And there are several. One is ua, one is consumer lab, one is nsf. So those are examples of seals that I would look for before I picked up one. So we did a survey, we sort of just went to the store and we looked at a bunch of the beauty supplements that are out there. And what we found, we found six that were retailing for over $100, and none of them had that seal of approval. But then we found one that was $3 and it did have a seal. And so one of the things I'm really advocating is, you know, if you have any supplement manufacturers that are out there, I'm really advocating that they really put on their package those seals just, you know, spend the extra money and have a third party lab test your product so that as a consumer I can feel comfortable with your product.

[Jen Sullivan]

I have to ask, at this point, we've been speaking mostly about the USA here, obviously, do you know around the world, because we have listeners in other countries. Is it different in every country or should people be wary of the supplement market all over the world in the way that you just said?

[Dr. Rajni Katsa]

You know, I'm glad you asked that because I have really focused on the United States labeling laws. I don't actually know all of the specifics around the world.

[Jen Sullivan]

That's why I just wanted to check, just so people listening in other countries are aware. You mentioned the six beauty supplements that you guys were looking at. You and your colleagues. Have you ever seen any of them actually work for the purpose that they are labeled and intended? Like you had a patient come in with hair loss and they were taking something and it worked for them, or, you know, I'm just wondering if there's anything that works out there.

[Dr. Rajni Katsa]

I have to Say, I mean, I have seen, and it's all anecdotal. I mean, I have seen patients with deficiencies, you know, like a vitamin D deficiency. Like, I'll give you an example. One of my eczema patients who we recommended that she get tested for vitamin D deficiency and she was deficient and she did take vitamin D and then she got better. So that's an example of a deficiency. I have to say I'm far more likely to recommend testing than I am to just recommend a supplement. You know, I'm a big believer in testing first. But then your other question was about, you know, and most of the supplements, they're not very. They don't. They're not allowed to make very specific claims about diseases. But if they say something like beauty or they might say, you know, fuller hair growth or something like that. I've had patients who believe, you know, that it helps. It's really hard for me to know, speaking to them, because there's also a condition that a lot of women develop after pregnancy called telogen effluvium, where you're talking about that.

[Jessica Matlin]

The other week, did you.

[Dr. Rajni Katsa]

Yeah.

[Jen Sullivan]

Jen had a baby four months ago. Yeah, I saw.

[Jessica Matlin]

No, that was happening. Yeah.

[Dr. Rajni Katsa]

And you're experiencing it? Yeah, well, you know, and I had it after I had one of my children. And, you know, your hair just falls out by its roots. So if you're really desperate and you're experiencing that, you might choose to take a hair loss supplement. But the thing is, that condition tends to reverse on its own if you give it six to 12 months. So sometimes it's hard to. Yeah, six to 12 months. Hang in there. It worked for me. It definitely turned around. So sometimes it's hard to tell, you know, with these supplements, are you really seeing an effect or is it just something that, you know is unrelated?

[Jen Sullivan]

And also, if you are seeing an effect, because lots of people have anecdotal evidence, it wouldn't be overnight. Right. Like, if you change your diet and. Or start taking a supplement or level out something that you were low in a particular vitamin or mineral, how long before you would see that effect in your skin and. Or your hair or nails or whatever.

[Dr. Rajni Katsa]

Oh, yeah, no, you're absolutely right. It would not be overnight. I mean, typically it takes your skin cells about 28 days to turn over. So, you know, for that purpose, you're probably going to, you know, I would say you'd have to wait at least one to two months to see results if you're going to see any results. And for certain conditions, it would probably be longer than that.

[Jen Sullivan]

Right. And then again, just because some people. I think we talked about this when I interviewed you before, you said, like, I. People do say they see results, and then they put them on Instagram or the Internet, and then people just get this, like, halo effect of, like, if worked for them, it'll work for me. Is it possible that these people aren't lying, per se? It did work for them, and then it just might not work for the person who is taking it.

[Dr. Rajni Katsa]

Oh, yeah, exactly. I mean, that's the first rule of medicine, right? Everybody's different. You know, what's your baseline nutritional status? What are you lacking? What are you deficient? And also, everybody's just, you know, everybody's skin is so different. Some people are prone to acne. Some people are prone to dry skin. And so, you know, where are you starting at, too? So absolutely. Everybody's so different. It's really hard to compare some of these anecdotal reports because of that reason.

[Jessica Matlin]

I'm very excited for this portion of the show because we get about, I would say, a handful of questions every single week about collagen supplements because they're just so popular, whether it's in chewy gummies or if it's in a drinkable form. Do you think that these things actually work? Oh, and P. S Every different brand that makes it swears that, like, theirs is the one that really works.

[Dr. Rajni Katsa]

Well, you just went right to it. Does it work? So this is. And I gotta say, you know, in some ways, your guess is kind of as good as mine because we hardly have any research studies, so the collagen industry is billions of dollars now, and it is just climbing.

[Jessica Matlin]

Yeah, it's tremendous. And it's in, like, you know, it's in Whole Foods. It's in really legitimate retailers. And when I talk to the. When I talk to the brands, I'm, you know, I'm always. I always leave feeling like I met the one that really works. Like, the science is real. Like, they have really smart, very, you know, like a highly trained scientist working for these brands. It's very. Like, this is a legitimate operation. But then I'm so confused, like, an hour later.

[Dr. Rajni Katsa]

I know, I know, right? Okay, so I'm gonna give you my opinion. And this is an opinion. They had a study that. They had a review article that just came out, I think, last year, and they looked far and wide for any of these randomized controlled trials where they actually gave collagen to people. And if you look at These, they were only able to find 11 studies, and those 11 studies were about 500 patients. So this is a really small population on which to base these big claims. But beyond that, this is the part that I'm a little worried about. I think patients or I think consumers are sort of assuming that they're going to take collagen and their skin and maybe their wrinkles are going to be better. But if you looked at these 11 studies, there was really only one that had good wrinkle outcomes. Most of them are looking at things like transepidermal water loss, measures of barrier function.

[Jessica Matlin]

And these are issues could be solved with a great moisturizer. Right?

[Dr. Rajni Katsa]

Yes, I know. Right. But also, even beyond that, a lot of these also, like, you can have dietary influences that improve transepidermal water loss. So my personal approach is that I really like to see a product, you know, just being used in a lot of people for the outcome that I'm interested in. So if I'm interested in wrinkling, like, that's what I want to see. But they're not necessarily measuring wrinkle, wrinkling. And again, it's 11 studies, and unfortunately, the doses were all over the place. You know, they used all these different types of doses. And then the other part to speak to what you were just saying is that they were looking at different types of collagen. So some of these are hydrolyzed and some of them are peptides. I mean, they're. They're kind of. I don't know that they're really comparing the same thing. And then, you know, and I'm just going to throw in one more thing just to make it more complicated. So again, just to make it more complicated, we went to the store and we pulled out 59 different collagen products, and we looked at them, and over half of them did not tell us where the collagen came from. So, like, I want to know.

[Jessica Matlin]

What does that mean? What does that mean? Like, what are you inferring?

[Dr. Rajni Katsa]

Yeah, like, I want to know where your collagen's coming from. Is it coming from a cow? Is it coming from a fish? Is it coming from a pig? And most of them just didn't tell you.

[Jen Sullivan]

Are there any vegetarian collagens?

[Jessica Matlin]

Yeah, I don't like this.

[Dr. Rajni Katsa]

There are some collagens that are on the market that call themselves vegetarian collagen, but I'm not really sure what that means. I'm not really sure if vegetarian collagen is a real thing.

[Jen Sullivan]

Yeah.

[Jessica Matlin]

Can I ask you now? Okay. Now I'm really getting like, like activated. Okay, where are they getting this collagen? Is this come from, like a byproduct? Like, factory? Like, salesman? Like, who is. Where are they getting this collagen? Like, who is the middleman that is selling them the collagen?

[Dr. Rajni Katsa]

So I actually think that's the next step in this process. Like, I've just gone to the, you know, to the stores and looked at what the label said. So you've really hit it. I really want to talk to the manufacturers and find out. Because if you think about collagen, you're thinking about fish skin, you're talking about cow skin, cow hoofs. I mean, that's really where you're supposed to get collagen from. So is it a byproduct? I don't know. And I'd really be careful about cow collagen, because how did they get it? Am I 100% sure that there's no brain material in there, that there's no nervous. Nervous system material in there? You know, not that there's ever been reported mad cow disease and, you know, but those are the sort of things I think about that, you know, I.

[Jessica Matlin]

Just don't want to be. I just don't want to be a part of this system. I don't want to be a part of this system.

[Dr. Rajni Katsa]

Well, I think it's just a matter of learning more. That's why I think, you know, that's why I think if I was a manufacturer, I'd be really transparent about sourcing and safety. And just as another aside, one of those third party investigative laboratories that I mentioned is called consumer lab, and they do great research studies. So they surveyed 16 collagen powders and they tested them for things like lead and mercury and cadmium. And out of their 16, they found that one did have high levels of cadmium, and so they did not recommend it. And cadmium is a. Yeah.

[Jessica Matlin]

What is cadmium?

[Dr. Rajni Katsa]

It's a heavy metal. So if you think about lead, mercury, and cadmium, those are all heavy metals. And if you ingest that on a regular basis over a period of time, you can start to have, like, lead toxicity, lead poisoning.

[Jessica Matlin]

Okay.

[Dr. Rajni Katsa]

So cadmium would be the same sort of thing that you'd have to be careful of. So that's that whole, you know, quality thing.

[Jessica Matlin]

So you have some reservations or some curiosity about where the collagen in this collagen industry is being sourced?

[Dr. Rajni Katsa]

I do, yeah.

[Jessica Matlin]

Okay, that's really interesting. I have not. I've not heard about this before, so. And we've not raised this on the show before, so thank you.

[Jen Sullivan]

Yeah. Well, now I'm wondering, I'm guessing you don't take any beauty supplements from this conversation, but I want to know what you do to keep your skin looking good.

[Jessica Matlin]

Yeah, you're looking great.

[Dr. Rajni Katsa]

Oh, bless you. Thank you both. I have to say that, you know, when I was vitamin D deficient, I did take vitamin D, you know, to bring my levels up. And there was a time when I was taking probiotics. You know, probiotics are kind of an interesting area, and that's kind of a whole long digression, but that's kind of an interesting area. I don't take probiotics right now, but I have to say, I do eat a lot of probiotic foods. And I was reading somewhere there was a magazine article and I love this line. Kombucha is the new champagne. I love that line. So I do eat a lot of probiotic foods, and then I'm really big into antioxidant rich foods, you know, And I mentioned about the collagen, how out of those 11 studies, there was just one that really looked at eye wrinkle volume. Well, there was a nice study that came out last year that looked at almonds. So they had. And it's just these are all small studies. Even the collagen studies are small. But in this study, they had them take 2 ounces of almonds every day for a couple of months, and they were actually able to show a benefit in the volume of eye wrinkles. So I thought that was really interesting. And I've loved nuts for years.

[Jen Sullivan]

But not for Jess. Jess would be dead if she did that.

[Jessica Matlin]

I'm very allergic. But you enjoy almonds with almond allergy.

[Jen Sullivan]

So, Jess, you're gonna have wrinkly eyes and my eyes are gonna look great.

[Jessica Matlin]

Yeah, I'll, I'll, I'll take. You know, can't win it over.

[Jen Sullivan]

You have other things.

[Jessica Matlin]

Can I ask, you mentioned you take vitamin D. Is there a brand of vitamins that you love? You know, when you. Let's say our listeners are going to hit up the CVS after this, and there's so many brands. Is there one that they should gravitate to?

[Dr. Rajni Katsa]

Oh, yeah. I don't have a particular brand that I gravitate to. I really look for one that has that seal of approval.

[Jessica Matlin]

Okay.

[Dr. Rajni Katsa]

So I really focus on that.

[Jen Sullivan]

I'm going to do a little research, too, about the seals in other countries, so we could put that on our blog afterwards. Because I'm sure. Right. I'm sure there's in other countries, bodies like that that do the same kind of third party testing. There must be, which is a good tip. This has been great. Very enlightening. So now we get to have fun. Take off your doctor hat. What's a doctor hat? There's no such thing. Your surgical mask. We have the fat mascara. Five questions. Jess is going to ask you just quick questions. Speed round. First thing that comes to your mind. Jess, take it away.

[Jessica Matlin]

This is all very light. This is all very light. What was the first beauty product that you ever fell in love with?

[Dr. Rajni Katsa]

I have to say in college, red lipstick.

[Jessica Matlin]

Did you have a brand?

[Dr. Rajni Katsa]

I don't even remember what I bought back in the day. I'm sure it was a drugstore brand. I loved it.

[Jessica Matlin]

As long as it was red.

[Dr. Rajni Katsa]

Yeah, as long as it was red, exactly.

[Jessica Matlin]

Is there a celebrity who you just know you would be best friends with?

[Dr. Rajni Katsa]

You know, I have to say, I really like Padma Lakshmi. She's got this new cooking show on and she's cool.

[Jen Sullivan]

I want to watch this.

[Dr. Rajni Katsa]

I'd love to be back.

[Jessica Matlin]

I just read about that show today.

[Dr. Rajni Katsa]

Right?

[Jessica Matlin]

It's like Cooking America or something like that. She's like going across the country. She's doing something. Yeah, she's great. What is your favorite most indulgent snack? And please be specific.

[Dr. Rajni Katsa]

Okay, well, it's gotta be super, super gooey. Oatmeal chocolate chip cookies. I'm a cookie monster, so no raisins. Oh, no raisins.

[Jessica Matlin]

No oatmeal Cookie question.

[Jen Sullivan]

Always chocolate chips or raisins? I like the raisins. I don't know.

[Dr. Rajni Katsa]

Do you really? Oh, I hardly ever make them.

[Jen Sullivan]

They're healthier. Rajni. They're giving me antioxidants.

[Dr. Rajni Katsa]

You know what? You've got me on that one. Absolutely, you're right on that. Okay, there you go.

[Jessica Matlin]

I like that you took an oatmeal cookie, though, and you added the chocolate chips. Like, I thought that was interesting. The oatmeal and the chocolate chip.

[Dr. Rajni Katsa]

Oh, yeah. It's just such a good balance. You gotta have the chocolate chips in there. I'm sorry.

[Jessica Matlin]

No, I like it. What's the song that pumps you up?

[Dr. Rajni Katsa]

Oh, I mean, I've gotta love, you know, just About Anything by Abba, but I'm gonna go with Dancing Queen.

[Jessica Matlin]

And then what would you like to raise a wand to? So on Fat mascara. We raise a wand to like a beauty product, a TV show, anything that we're just obsessed with at the. At the end of the show.

[Dr. Rajni Katsa]

Oh, you know, right now, since we've been quarantining, I have to say, it's my. I finally got my instant pot out of my pantry, and I finally learned how to use it, so I did it. I'm gonna raise a wine to the instant pot. It's really. It's pretty fantastic.

[Jessica Matlin]

What are you making?

[Dr. Rajni Katsa]

Well, I just made black beans and rice, and it was so fast. Yeah, really tasty.

[Jessica Matlin]

Nice. Get that fiber, those antioxidants.

[Dr. Rajni Katsa]

You know it. You know it.

[Jessica Matlin]

Love it. Oh, my gosh.

[Jen Sullivan]

Thank you so much.

[Jessica Matlin]

You're great. We learned so much. This was a great episode.

[Dr. Rajni Katsa]

Okay. Thank you guys so much for inviting me on.

[Jen Sullivan]

This is fun.

[Jessica Matlin]

Thank you. This is great. We hope you enjoyed the show.

[Jen Sullivan]

It's your reviews and feedback that help us make the podcast even better. Head over to itunes to rate and review us or email your thoughts to infoatmascara.com we also want to answer your.

[Jessica Matlin]

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[Jen Sullivan]

If you send it as a voice memo file, we can even share your voice on the podcast. You can also do that by leaving us a voice message. Our phone number in the United States is 646-481-8182.

[Jessica Matlin]

Thanks so much for listening.