Updated 6th September 2023

Skin aging and acne: What you should do

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As a listener to this show, you’ve probably heard of the gut microbiome. But did you know that your skin has its own microbiome? 

Recent evidence suggests that these microbiomes are vital for our skin health. So, what should we do? Which foods make an impact? 

And if we want our skin to look healthier, how about those collagen supplements that many of you have asked us about? 

In today’s episode, our guest is Dr. Justine Kluk, a consultant dermatologist with a specialist interest in acne. Justine is a member of the British Association of Dermatologists, the Royal Society of Medicine, and the Royal College of Physicians. 

ZOE’s Chief Scientist Dr. Sarah Berry also joins as a cohost to explore these ideas. 

If you want to uncover the right foods for your body, head to joinzoe.com/podcast, and get 10% off your personalized nutrition program.

Justine shares more in-depth skin care and acne information at drjustinekluk.com and as @drjustinekluk on Instagram. 

Follow ZOE on Instagram

Episode transcripts are available here.

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Is there a nutrition topic you’d like us to explore? Email us at podcast@joinzoe.com, and we’ll do our best to cover it.

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Transcript

[00:00:00] Jonathan Wolf: I'm your host, Jonathan Wolf, founder and CEO of ZOE. Today we discuss why your skin has a huge impact on your overall health and learn how to slow skin ageing and reduce acne. We'll give you plenty of practical tips.

You'll learn how what you eat impacts your skin health and whether you really need those collagen supplements that so many of you have asked us about.

Dr. Sarah Berry joins me as cohost today. Sarah is our chief scientist at ZOE and an associate professor at King's College London. Our guest is Dr. Justine Kluk. Justine is a consultant dermatologist with a specialist interest in acne. She's a member of the British Association of Dermatologists, the Royal Society of Medicine, and the Royal College of Physicians.

I'm excited for you to meet Justine, partly because so many of you have sent in questions about your skin health. But also, and also I'm a bit nervous 'cause Justine is my wife. I know Sarah is going to ask a lot of questions I'd probably prefer she didn't.

Wonderful. Well, I'm very excited to do this one, and I have to admit a little nervous. So great to see you.

[00:01:28] Justine Kluk: Great to be here. I'm, I'm even more nervous. So hope that makes you feel better and poor. Sarah stuck in the middle of us.

[00:01:34] Sarah Berry: I’m loving it.  We can gang up on him,

[00:01:37] Justine Kluk: We always do.

[00:01:38] Sarah Berry: I can get him back for like the last year of podcasts.

[00:01:42] Jonathan Wolf: Alright, so I'm not feeling any more relaxed now. I'm gonna try and take a little bit more of a backseat today. And so Sarah is actually gonna start with the quick fire round of questions from our listeners.

[00:01:51] Sarah Berry: Yeah. So Justine, we start all of our podcasts with quick fire questions. The rules are, you can say yes no, or one line only if you have to say one line. Okay. So there's six questions. First one is, can your skin tell you about the health of your whole body?

[00:02:07] Justine Kluk: Yes.

[00:02:08] Sarah Berry: Great. Does what I eat matter for my skin?

[00:02:11] Justine Kluk: Yes.

[00:02:12] Sarah Berry: Wow. That's good news for us, ZOE. Can dairy make acne worse?

[00:02:15] Justine Kluk: Yes. And we’ll talk about why and how much.

[00:02:21] Sarah Berry: Great. Is it possible to reverse skin aging?

[00:02:26] Justine Kluk: We can't reverse it. We can slow it down.

[00:02:30] Sarah Berry: Fabulous. Are collagen supplements a waste of money?

[00:02:35] Justine Kluk: It remains to be determined.

[00:02:37] Sarah Berry: Okay, that's allowed.

[00:02:40] Justine Kluk: I'm, I can simplify possibly. Probably.

[00:02:43] Sarah Berry: now the last question. You are allowed one to two lines, and what I want to know is what's the most unexpected thing you've discovered about skin through working with your patients?

[00:02:54] Justine Kluk: I think the impact, the really huge impact that having a skin condition can have on people's psychological and emotional wellbeing. I think that is something that really drives me to want to share with you guys and with your audience why it's so important that we pay particular attention to our skin health.

[00:03:13] Jonathan Wolf: Amazing. So as I was preparing for today's podcast, I was thinking two things. So firstly, I was thinking I have to be really careful what. I say today or I'm gonna be in trouble for weeks. And the second is actually thought back to Justine and my very first date. And I asked something really stupid, which for those of you who know me, won't be very surprised, like, Justine, why did you decide to specialize in skin rather than all those like much more interesting things you could do as a doctor.

And Justine explained to me that. I was an idiot and that basically skin was the most interesting thing in the world. And so I thought actually that would be a brilliant place to, to start. Could you tell us like what skin does and why it's so important for us all

[00:03:55] Sarah Berry: And while you went on that second date as well, I think

[00:03:58] Justine Kluk: I sometimes, I sometimes ask myself the same question. No. Jonathan was sparkling and witting all the good things even back then. Yeah. So now just exposed to a bigger audience, which is annoying. But, I thought it was just for me, why do I think skin is the most interesting thing? On a personal note, I had acne myself as a teenager, as Jonathan knows, in fact, still do, still take treatment for it.

So for me, it's been a 30 year journey with a skin condition. So I. I think having had that experience and found it really difficult at times, I really want to prevent other people from going through the same. So I think one of the reasons why I think skin is so important is it's visible. Okay. And that can be a good thing.

It also means it's accessible. So if we want to study the skin, we can access it easily. We can take swabs. We can take biopsies. But I think going back to basic principles, why is the skin so interesting and important? I think I can distill it into three points, which is hard for me 'cause I'm quite verbose.

But the first is that there's the skin barrier function, which we'll come and talk about in a, in a moment. But the skin is our outer shield. It's our first point of communication with the environment. And so our skin does provide a sort of some vital functions. For example, regulating heat and water loss, protecting us from uv, from infection, from things we're we're exposed to around us.

The second thing is, and you guys will be interested in this, is it's home to our skin microbiome. And we definitely will be talking about that, I hope. And the third thing, which I think is one of the reasons why I was really interested in becoming a dermatologist, is our skin tells us a lot about what's going on inside our bodies and gives us clues about the health of our internal organ systems.

And so one of the cool things about being a dermatologist is basically we're like, Super detectives and so, you know, there are I think 3000 different dermatological conditions. My colleagues might be listening to this and thinking, no, they're actually 2000. So if I'm over-inflating it, it's 'cause I want to really represent dermatology here today.

But, you know, 2000 different ways of looking at red spots. So you have to be really good as a dermatologist at looking at patterns and looking for clues. And our skin does give us a sort of window into, things that are happening inside. So that's why I think skin is interesting and, why I will say it is the most important part of the body, but of course it's connected to everything, so we can't think of it in isolation.

[00:06:22] Sarah Berry: Yeah. I think it's fascinating that it is like a window, because I must say it's something that I had never thought of before, and there was a study that someone had highlighted to me where they had twins and people were asked to age these twins according to their skin.

Okay. And the twins that they aged as being older, according to their skin, actually went on to die and developed disease a lot sooner than the other twin, just based on them detecting their age based on their skin. That really surprised me.

[00:06:54] Justine Kluk: That is really fascinating and I think maybe when we get into what are the factors that influence aging, you'll see that there may be some common things between what influences skin aging and what influences aging of our other organ systems. And so you can't separate these. Things out, and I think it's something that you guys have talked about on the podcast quite a lot and I've certainly heard Tim say is that we can't think of different parts of our bodies, different compartments separated from each other.

It's something I talk about in my clinic quite a lot. All of this is connected. We haven't always understood how scientists starting to plug gaps, so we understand now about the microbiome. We understand a lot more about hormones, but all of these bits are connected and so you can't just think about trying to address one in isolation.

You have to, of course, therefore will be factors. That influence the health of multiple organ systems. So yeah.

[00:07:42] Sarah Berry: Great. And you talked about the microbiome, which is one of ZOE's real areas of interest. And we talk a lot on our podcast about the gut microbiomes, all of the trillions of bacteria that live inside our gut and impact our health. But I've recently started hearing about the skin microbiome. I know nothing about it.

Jonathan probably does. 'cause he's probably heard you talk about it. But I wonder if you could tell listeners a little bit about what the skin microbiome is in the first place, what functions it has, what we do know, and maybe what we still don't know about it.

[00:08:12] Justine Kluk: So I'll start with the last question, which is we know a lot less about it than we know about the gut microbiome, which might surprise people because I've said that the skin is so much more accessible. So you would think it's the obvious place to start investigations on the microbiome, but that isn't the case.

We know that we have all of these microbes living in our gut. We also have millions of microbes living on the surface of our skin. Something that I think is really fascinating is there's an argument always about what is the largest organ in the body, and it's often said to be the skin, and so dermatologists take a lot of pride in that.

I've actually recently learned that's not exactly true. Okay. Okay. And for anyone who's interested by weight, it's the musculoskeletal system, and by surface area it's actually the lungs and the airways. The sort of gas exchanging surfaces are the largest. But what's really cool about the skin is if you were to kind of roll it out flat, it's two square meters.

[00:09:04] Sarah Berry: That's not that big

[00:09:04] Justine Kluk: Jonathan's gonna say to me, for the Americans, I need to give

[00:09:10] Jonathan Wolf: 10 square feet. 

[00:09:11] Sarah Berry: I don't think she was thinking that way. Yeah, I think we are thinking different metrics

[00:09:15] Justine Kluk: Yeah, I was gonna say math has never been my really strong point, but there are millions of these appendages, so dips and divots in the surface of the skin because of our hair follicles and our sweat glands and our sebaceous glands, which are oil producing glands. And so actually the real surface area of our skin that our microbes can inhabit is 10 times that. 

At least 10 times that. So some, some say sort of 25 square meters. 

[00:09:43] Jonathan Wolf: So it's huge. 

[00:09:43] Justine Kluk:  it's, pretty big. 

[00:09:44] Sarah Berry: A footbal pitch? 

[00:09:43] Justine Kluk:  Don’t ask me

[00:09:47] Sarah Berry: We’ll have someone that's into football getting really cross.

[00:09:49] Jonathan Wolf: but maybe like a tennis court or something

[00:09:51] Justine Kluk: So there are lots of, there are lots of them and there are good and bad ones. Something that's really interesting is a bit like Tim talks about sort of there being these like mini pharmacies that the microbes, he, he compares into mini pharmacies in the gut, sending out signals to the rest of our body. The same is true of the microbes on our skin, and so they interact with our immune system. This is really important, particularly in early life.

We should talk about the hygiene hypothesis, I think, which is the idea that we often think about small children, babies in particular being vulnerable to infection, and they are because their immune system is yet to mature and develop. So the theory in the past was that you should keep everything clean around small children so that you don't expose them to this risk of infection.

And what we've learned is that unfortunately, by not exposing kids to dirt and animals and you know, all of this other stuff, we actually reduce the diversity of the microbes that live on their skin. And therefore, this, affects the development of the immune system and actually increases the risk of people developing allergies and inflammatory skin disorders.

[00:11:06] Jonathan Wolf: And how and how do you do about letting your own children get really dirty in those first few years of life?

[00:11:11] Justine Kluk: I mean, Jonathan knows that this is definitely a sort of do, as I say, not as I do situation. And I, I think it's something actually that I thought quite a lot about since having our daughter, who's now four because. You know, I've trained in a hospital environment where sterility and cleanliness are king, and so that often gets translated into home life.

So, you know, my family, you know, will laugh when they hear this, but like you could eat off the floor in my home. I often say to my daughter, you can eat off the floor here, but nowhere else. Um, But we know that this is not great for kids. And actually there have been some recent studies showing that actually exposing children to the natural environment.

So there was this scheme called Play and Grow where kids, I think there were two to five year olds and they were sent to go and play with leaves and soil outside for a number of weeks. What's amazing is the researchers found that the kids were less stressed and less angry. They had higher gut serotonin levels.

They felt more connected to nature. So by that, they like were more prepared to eat vegetables afterwards and were interested in the environment, and they had greater abundance and variety of microbes on their gut samples at the end of the study.

[00:12:29] Jonathan Wolf: And when you were studying dermatology, and again, were you taught anything about the microbiome at that point?

[00:12:36] Justine Kluk: No, I think the first time I heard the word microbiome was as a dermatology trainee, so I was already pretty advanced in in my career, so,

[00:12:46] Sarah Berry: but it's relatively new, even in nutrition. It's only the last 10 years that we're talking about it. And Justine, something we often talk about is how can we change the microbiome in our gut to make us more healthy? Given the link between the gut microbiome and health, can you change your skin microbiome?

So you talked about there's different bugs that are associated with different skin conditions. Can someone change their microbiome on their skin? Most importantly, does that then alleviate some of the symptoms or conditions that you talked about?

[00:13:14] Justine Kluk: We're only really starting to get into it, Sarah, and I think often people would think that there's more real science here than there is because. I'm gonna be cynical, but there's a commercial opportunity to sell skincare products that say they're gonna balance your microbiome and, and supplements.

[00:13:33] Sarah Berry: Okay. So cream that you can put on that will change your microbiome? So like a probiotic cream?

[00:13:40] Justine Kluk: Yeah, creams containing probiotics and, yeah, so I mean, this is, this is not new. It's been, you know, for the last, I dunno, five plus years there have these products out there. They say they can balance your microbiome, they contain probiotics, et cetera. I. But if you actually, you know, I think people might be surprised because if they are into skincare or beauty and have been into a, a skincare store, looked at the shelves, there are lots of products that have these claims now.

But if you look at the science, actually, it's still in its infancy and it's, it's not nonsense that there are some studies where people have been given oral or topical probiotics and there have been some favorable changes. In reducing some of these pathogenics, some of these bad, microbes that can take over.

But I think the sort of magic bullety type things that say, you know, probiotic cream is gonna balance everything, I'd be a bit skeptical about those things still.

[00:14:34] Sarah Berry: Okay, so I've got a question that I think a lot of listeners might be thinking, or maybe I'm just crazy, but we know that yogurt, for example, is a probiotic and it's gonna be a lot cheaper than any of these creams. What about slathering yogurt on your face? Forget the smell. Has anyone done that?

[00:14:52] Justine Kluk: I'm sure they have. I'm sure they have done, I dunno of any trial where people have put the yogurt on their skin. But I think this goes back to, you know, dermatologists are used to telling people not to put toothpaste on their spots. Like there are things that are designed for a specific purpose.

Yeah. So, you know, eat your yogurt and. In terms of practical things that you could do to potentially support your skin barrier and reduce dysbiosis on the skin, these are things like, for example, using a gentle cleanser on the skin. So I like a cream or a gel cleanser for washing the face morning and evening.

If we over wash our skin, we might disrupt the microbiome on the skin. If we use very harsh soapy cleansing products, we might disrupt the microbiome on the skin.

[00:15:40] Sarah Berry: Does it strip the microbiome if you use quite a tough, like I like what one that really scrubs off everything that's got all grains in it. And will that strip it or does it just reduce

[00:15:52] Justine Kluk: It can do in theory, and I think we've gotta remember that it is quite individual, right? So, you know, some people might say, I use this, you know, exfoliating cleanser and actually that's fine for me. I have no problems with it. If it's fine for, for you and it's not, Disturbing your skin and you have no skin problems, it's probably okay, but the, the microbes on our skin, like certain conditions, so if someone has an inflammatory skin condition and is, is thinking, how can I kind of support the good microbes on my skin?

I would say think about this soap free, gentle, creamy, or gel cleanser if your skin is inflamed. So, In my acne clinic, for example, I tell people not to use those scrubs or exfoliating cleanses because if you think of an inflamed surface and then you're gonna go and scrub something over the top of it, you're going to increase inflammation in the area.

So that wouldn't be a good idea.

[00:16:41] Jonathan Wolf: I'd actually love to take that opportunity to move on to sort of two of the skin topics where we had a huge number of questions from our ZOE listeners, which is acne and skin aging. And I'd actually love to, to start with acne and maybe just start by telling us like, why does acne matter? 

[00:16:59] Justine Kluk: So it's a big problem. Okay. Acne is the, eighth most prevalent disease globally, so not the eighth, most prevalent skin disease, the eighth most prevalent disease, you know, full stop. So big, big problem. 9.4% of the population have acne, so just think like almost one in 10 people. Yeah, it is a lot and it is the most common reason for people to come and see a dermatologist.

It's associated with higher rates of depression and suicide. It's associated with scarring, which can become permanent, in, in more people than you think. So maybe this is a kind of something that stays with people even after the inflammatory phase, has gone. 90% of teenagers will have acne of some severity.

So if they're lucky, that will be very mild. They may just get, have a few, you know, blackheads and a couple of pimples. But for some people it's very much more severe than that and they have, you know, these deeper red swellings and cysts in the skin and they're more likely to get the scars. And I think it's, I always think it's quite cruel that the time at which people are most likely to develop acne is.

Puberty because of the rapid change in the hormones. And this is also where, you know, kids are so vulnerable because they are developing their social identity, they're trying to become more independent. They're navigating personal relationships and they've got exams and all of this pressure that they didn't have when they were younger.

And then they've got a contend with this very visible and painful skin conditions. So I could keep going, Jonathan, but that, those are some of the reasons why I think, it's important.

[00:18:38] Jonathan Wolf: Is it just teenagers cause I know that's actually not most of the people who see you.

[00:18:41] Justine Kluk: No. So for sure it's much more common in the teenage years, and then acne is much more common in males than females in the adolescent years and in the early twenties, but beyond sort of early to mid twenties. It is much more common in females. And so a rough sort of rule of thumb is that half of females in their twenties will have acne, a third of females in their thirties and a quarter of females in their forties.

[00:19:11] Jonathan Wolf: Which is huge isn't it? So half of all women in their twenties, still a third in their thirties.

[00:19:15] Sarah Berry: And what about menopause as well? We hear lots of people talk about getting spots, you know, around menopause. I'm at that perimenopausal phase and I've, I've never had spots. I've been really fortunate, but I've started to notice I've got a few on my spots. I get, on my chest. I get a few here, and you hear anecdotally, a lot of women say during the perimenopause, suddenly acne returns and spots return.

[00:19:38] Justine Kluk: So just to reassure people, if we look at age alone, you are much less likely to develop acne for the first time or to continue having it in your forties or fifties. So the chances of having acne do. Decrease with time. However, at any time of hormonal shifts, you may be more vulnerable to having spots.

So we do see it around the time of, of the menopause. We also see it around pregnancy. Um, and of course the classic time for having acne is, is during puberty.

[00:20:09] Jonathan Wolf: Is it more common than it used to be?

[00:20:10] Justine Kluk: Yeah, it is. And I think we haven't really always understood why acne has been becoming more common over, you know, the last few decades. But I think there are two leading thoughts at the moment.

And the first is the adoption of the Western diet, and the second is increased stress levels.

[00:20:31] Sarah Berry: And could we talk a little bit about the impact that diet might have on acne? 'cause I know lots of of my friends, her parents have children that suffer from acne often will say, oh, Sarah, what should they be eating? And I. I can't tell them what they should be eating, but I know that lots of people will go on elimination diets.

You know, I must avoid all dairy or avoid gluten, et cetera. And you know, when I was growing up, acne was blamed on eating sugar and chocolate

[00:20:57] Justine Kluk: Yeah, I'm, I'm pleased you mentioned elimination diet, so we should come back to that in a moment because it's one of the most worrying things I see in clinic is people coming in and having read that various foods can contribute to acne and have taken that further and started. Excluding all sorts of things from their diet and are frankly malnourished when they turn up in clinic.

And also have developed, I think, disordered eating, as a result of I think, misinterpreting information about food and acne.

[00:21:30] Sarah Berry: And especially for adolescents, that's such an important time to make sure that you are eating, you know, wide variety of nutrients. You know, the, the prevalence of iron deficiency anemia in adolescence is huge. And so if people are avoiding certain foods, that's a real problem.

[00:21:46] Justine Kluk: And I think of, you know, my stepson, so we have a 15 year old at home, he'll be. Absolutely dying that he gets mentioned today, but, dying of embarrassment that it's not excited, excitedness. But you know, you, they, they have to sleep so much right in their teenage years because they need all this, you know, conserving energy for growing.

So actually we do need to think about fueling ourselves properly and not restricting things, particularly when there isn't sufficient evidence to, to suggest it would be helpful. So, you know, what, what do we know? We know that diets with high glycemic content are associated with increased severity of acne.

[00:22:23] Sarah Berry: Can I just tell people what we mean?

[00:22:24] Justine Kluk: please do. And, and I, and actually I'm not a nutritionist, so I would rather you explain what it means.

[00:22:31] Sarah Berry: Well, we haven't podcasts talking about it, but when we talk about high-glycemic foods, we mean foods are typically high in really refined carbohydrates. So white bread, white pasta, potatoes, that kind of thing, that cause a really rapid increase in blood sugar.

So you eat these kind of foods about 15, 20 minutes later, you've got this big peak in blood sugar, and it also stimulates lots of hormones like insulin.

[00:22:52] Justine Kluk: and insulin-like growth factor. And so a little bit about acne so people understand how the sort of pathway is connected. Is that what basically underlies acne is an increase in oil production in the skin? Mm-hmm. Blockage of. The pause where the oil is supposed to come out onto the surface of the skin by dead skin cells.

And then this creates a delicious feast for this particular bacteria, C acnes that feeds on this. And this triggers inflammation and underlying, this is a particular group of hormones called androgens. Testosterone is the classic one, which increases the oil production and the pore clogging. And we can connect foods to this because these sugary foods and these very refined carbs, your blood sugar rises, then your insulin rises and insulin like growth factor rises, IGF one.

And this increases these androgen hormones. So it kind of, we can connect all the different dots along the the pathway.

[00:23:49] Sarah Berry: Okay. You also talked about inflammation, which is something Jonathan particularly loves talking about, and I. I quite like talking about it with him. We know as well from our own ZOE PREDICT research that the food that we eat is associated with our gut microbiome. It's also associated with lots of inflammatory factors.

We also know if we consume really high glycemic index food, it actually initiates an inflammatory response. Now, this is inside our blood. This is inside our gut. Would any of that be related to the kind of inflammation you're talking about that's going on at the level of the skin?

[00:24:22] Justine Kluk: The answer is yes, because there is a connection between our gut health and our skin health. We call this the gut skin axis, and so for sure the same sort of principles will apply that you know, sugar is. The most important one, dairy is one of them. People often will see an association with eating dairy and their skin getting worse, or certainly will have read about it from an acne perspective.

And there is some evidence now, mainly, there aren't any RCTs as far as, and whereas mainly observational studies showing that. In Western populations, dairy can aggravate acne, particularly milk because this seems to have a greater impact on insulin than other things like cheese, potentially because of the whe content.

So whey supplements can be problematic for acne sufferers as well. So the two areas of nutrition where there's been most research and evidence of their impact is, is dairy and, and the sugary stuff.

[00:25:17] Jonathan Wolf: So Justine, what would your practical advice be to help people with acne? 'cause there can be a lot of people listening to this who would love to know, okay, what can I do for myself or. Or maybe they're thinking, you know, about their teenage children, what would you say?

[00:25:29] Justine Kluk: I'd say the first thing is do go and get expert help if it's something that you are not. Able to manage yourself at home. I'm gonna start with that because I think there is a big spectrum of severity with acne. There's very mild acne, which can be self-managed at home as some of the tips I'll give you in a second.

But there are people who have much more severe acne. It may be affecting their mental health, it may be causing scarring. And I think in that circumstance, please go get some support from your family physician, your gp, or a dermatologist, and do these other things on top of that. But, I wouldn't want to delay people getting, appropriate treatment.

I think there are some skincare tips I would give thinking about supporting the skin barrier and also, you know, in inverter comm is helping to balance the skin microbiome, but you know, to create a healthy environment for the skin microbes that are beneficial to us. Moisturizing the skin is important.

So moisturizing the skin reinforces skin barrier function and it makes the skin, a happier, healthier place if you have acne. People often avoid using moisturizer 'cause they're worried about clogging their paws up more. Look for the words non-comedogenic on a. Package that means non pore blocking.

And that is, something that you might find helpful. Vitamin A, retinol retinoids. This group, in topical form is really good for reducing PO clogging in the skin and can also reduce inflammation to a degree, more so for the prescription forms in the over the counter forms. But I think what is really important is choose one.

And incorporate in your skin routine. So I would say cleanse your skin or tell your teenager if this, if you're gonna be relaying the, the information, cleanse your skin with a non stripping product twice a day. Moisturize the skin with a non-comedogenic, product twice a day. Put a non-comedogenic sunscreen on in the morning and choose one active ingredient or one product with these active ingredients in to incorporate into your routine and introduce it slowly, because again, you can sometimes do more harm than.

Good. If you are too aggressive and overzealous with these active ingredients, try to combine too many of them together. Try to use too much too soon. I mean, I remember as a teenager being given a cream for acne and thinking this is the answer to all my problems. And like squirting half the tube out and putting it on overnight.

And of course nothing happens immediately. And you think my acne's gonna be gone tomorrow. And then you wake up the next morning and you're like, you can't smile 'cause your face is red and it's gonna crack and it's really sore. And so, you know, I always say to my patients, You know, I'm glad you're excited about using this, but you know, you do need to, you know, you do need to incorporate it gradually into the routine because you can actually end up doing more harm than good if you are, you know, not slow and steady.

[00:28:12] Sarah Berry: So Justine, you've talked us through top tips of what you can apply to your skin and your understanding of nutrition and acne. So if I could just summarize back from a practical perspective, based on what you've said about nutrition, you are suggesting that foods are high glycemic index are gonna be a problem.

So this is where this perception that, for example, sweets chocolate might be bad, but also therefore, perhaps people should be reducing the amount of these refined carbohydrates. So, For example, the white bread, the white rice, the pasta, the potatoes, and any other kind of rapid carbohydrates that increase blood sugar.

And would you say that that would be a good diet tip that we could also give people.

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[00:28:53] Justine Kluk: Yes, and I think one of the things you said in this podcast before that I think is like really helpful. And practical is even if you do nothing else, you can just switch. Having your white bread, white rice, or white pasta with whole meal versions of that. You don't have to change your lifestyle or any of the other things that you do. That's a sort of simple switch that you could make as a starter for 10.

[00:29:13] Sarah Berry: Or add protein, healthy proteins or healthy fibers. Not all fibers healthy. You can add healthy proteins, fiber, or some healthy fats as well, which will kind of reduce that blood sugar

[00:29:24] Justine Kluk: Yeah, exactly. And I would also say just life is about balance and it is okay to have treats, and I wouldn't want the take home message for anyone, you know, to be that. You know, if they're at a restaurant on their birthday, they can't have the pasta as it's served, or they can't have a pudding that night.

Like I. It's okay to do that as long as that's, you know, that is the treat and not the norm I would say.

[00:29:44] Sarah Berry: Okay, so while we're talking about food, I'd quite like to quiz you a little bit about Jonathan now that I've got you here. Um, so Jonathan is obviously incredibly well behaved in everything he does. So my perception is, is that Jonathan follows the ZOE recommendations.

To a T. So I'm not even convinced that he would go and have his, birthday cake at a restaurant if it didn't score high on the ZOE score. Have you noticed his diet changed since he started the whole ZOE program? And also I'd be curious to know how yours has changed.

[00:30:17] Justine Kluk: So I'd say Jonathan's diet changed before the ZOE program a little bit, and I'm sure this is why he, you know, went on to, to. Form ZOE. Jonathan's talked a bit about, you know, having had, issues with his gut in the past, et cetera. I hope you don't mind me saying that Jonathan and so had already started making some ja some changes to the way he ate before we even met.

But, you know, he does live it at home. And, I think actually after, you know, a couple of years of being told, you know, the…

[00:30:48] Jonathan Wolf: What was our life like after I did ZOE and before you did ZOE?

[00:30:49] Justine Kluk: So to be really careful about how I say this. Yeah, I was gonna say, we actually, we have pretty,

[00:30:56] Sarah Berry: oh, now I want to know what Justine was gonna say. The fact that she's thinking twice about how to say it.

[00:31:00] Justine Kluk: I was gonna say, you know, it's sort of minefield here. I think we have a sort of, you know, there are lots of jobs we share in the house. We both work, we both have young children and the sort of split is normally I prepare the food during the week and Jonathan does it on the weekends. That's how we do it.

[00:31:16] Sarah Berry: I have seen on your Instagram account the pictures you've been posting of your meals. They look incredibly healthy. They all look like they will, would score above eight at ZOE, but most importantly, they look really tasty.

[00:31:27] Justine Kluk: So this is, is sort of part of, thank you Sarah. This is kind of part of the evolution. So Jonathan was kind of the early adopter and he was. You know, doing ZOE and I would be preparing the food during the week. And I think it would be fair to say we were having the same thing on repeat every week because I'm time poor.

I've never had very much confidence in my ability to cook. My mum is an amazing cook and somehow I think I always felt overwhelmed. It seemed like quite a lot to do and didn't get into it. So after a couple of years of having the same foods on repeat every single week, the same five things on rotation, and Jonathan saying it'd be really nice if we could have, you know, a bit more.

A few more plants or what have you. I then did ZOE myself last year and I was really excited about it. I, you know, I'm a science geek and I love the idea of, you know, putting on the CG m, seeing what was happening to my blood sugar in real time. I had some shockers things that I was eating that I thought were really good for me, caused massive blood sugar spikes.

I love doing this sort of at-home poop test and all of that, this sort of science experiment at home bit, but, Having then, you know, these results that arrived that were personalized to me, I was then much more invested in actually making some changes. So it felt less like Jonathan nagging me to do things because, you know, it was good for him, or he thought it was healthy for us as a family.

[00:32:43] Sarah Berry: Jonathan nag? Never

[00:32:45] Jonathan Wolf:I dunno who you would be talking about. It sounds so implausible.

[00:32:49] Justine Kluk: So, you know, I kind of felt like, you know, this was something that, that I could get on board with as well. And then I think the, the, the biggest surprise to me was actually getting into cooking because this was something I was like, I can't cook, won't cook person and.

I've worked out for myself that there are a lot of things I can do even without the app now. So I know that if I just have a load of beans, tin, you know, canned beans, red kidney beans, pinto beans, canal beans, or what have you in the cupboard, I have some chopped tomatoes and I have an onion, you know, in the, in the fridge somewhere.

If I have these staples, I can basically do a bunch of stuff that, you know, I can always feed us.

[00:33:29] Jonathan Wolf: And how much have you changed your diet?

[00:33:32] Justine Kluk: Quite a lot actually.

[00:33:33] Jonathan Wolf: I would say lots.

[00:33:34] Justine Kluk: Yeah, quite a lot actually. I think that the.

[00:33:37] Jonathan Wolf: what I love by the way is that I said all of this stuff for the previous couple of years, having obviously taken part in the early studies and getting my results and Justin's like, whatever, just gonna ignore you.

'cause obviously I say all sorts of stuff all the time, that might not always be right and um, it was only when you actually did ZOE yourself and got your own results and guidance right. That that made the shift. It was really interesting that then it was like for you, it wasn't just your husband nagging at you.

And actually I wasn't expecting Justine to change very much. I think you had a very clear view that you knew what was good for you and what was healthy. And

[00:34:10] Sarah Berry: But it's having that proof

[00:34:11] Jonathan Wolf: has really changed her diet, which is great for me 'cause it means the whole family's diet has shifted dramatically as a result.

[00:34:17] Justine Kluk: there's something very convincing about seeing your own data. Absolutely. I think that's, that's really what it boils down to. That, and for me also that I, the fact that preparing food doesn't have to be as difficult as, as you think it is and, and incorporating, you know, if you have, as I say, a few of the staples in your cupboard at home, you can do this with very little effort and time.

And I know because I have a four year old and I run a clinic and I have a very demanding husband.

[00:34:44] Sarah Berry: Jonathan demanding? No way.

[00:34:47] Jonathan Wolf: And my only frustration now is that Justine has to take a photo

[00:34:49] Sarah Berry: He’s changing the topic because we’re talking about how demanding Jonathan is.

[00:34:52] Jonathan Wolf: So I was gonna say, my only frustration now is, 'cause Justine does most of the cooking now, so she's just much more than she did before. 'cause she's, she's really got into it, outta this, which again, was not an at all, like an expected byproduct.

We've learn to eat a lot of things I think like. You know, we would never eat any sort of bean ever, right? Like that's sort of like you eat baked beans when you're a child. And I think there's no doubt there's been a sort of shift. And what's interesting, I think I'm fascinated by is, I. You eat some of these things the first time you're like, I don't even, I don't like this very much.

I'm eating this. 'cause it tells me that it's healthy. And what is really interesting is, you know, if you can stick with that for a month, it's like your whole taste buds change. Don't you find, and suddenly you start to think, actually this is really nice. And it's almost like you're somehow shrugging off a lot of whatever you are, you've been learning from this ultra processed food and maybe your microwaves are changing a bit with it.

[00:35:43] Sarah Berry: But your taste buds change. So like with salt, salt for example, which we're over consuming in the uk and it's a big problem how much we're consuming, but you become desensitized to it. And so they say that you've got to gradually. Wean yourself off it and your taste buds will then start to appreciate it more.

I'm really conscious of time and I think it would be great to talk about a topic that I'm really interested in, which is, as a 46 year old woman, I, myself and all my friends are interested in skin aging and so you said in a quick five questions, we can't reverse signs of aging, but we might be able to slow it down.

[00:36:19] Justine Kluk: There may be some people listening to this, scientists who say we can reverse aging. But I think let's talk about some of the practical things that we, we know for sure at this point. Can, can slow things down

[00:36:28] Sarah Berry: we could start by talking about what actually causes skin aging, so we know what potentially we can avoid, and then some great tips from you on how we can actually slow it down as well.

[00:36:38] Justine Kluk: Okay, sure. So I think when we think about skin aging, we divide it into sort of two categories. There's intrinsic aging, so this is the passing of time, so chronological aging and genetics. And I think a lot of people would expect that those have the greatest influence on how our skin ages.

[00:36:58] Sarah Berry: So you mean, for example, if your mom's or or father skin aged? Well, you might think, well that's fine. I'm gonna have great skin as well.

[00:37:05] Justine Kluk: So, yes, correct. And also that you might expect that someone who is 70 looks older than someone who is 60. Okay. So there's also this sort of chronological age. Then we have the second category, which are, extrinsic influences on aging.

[00:37:22] Jonathan Wolf: meaning

[00:37:23] Justine Kluk: So meaning things that impact our skin from the environments, environmental exposures.

And actually the most influential of these is sun exposure, and we call that photo aging. And people will probably be amazed to hear that 80% of visible skin aging is attributable to sun exposure.

[00:37:45] Sarah Berry: So if I had, which I didn't unfortunately stayed out of the sun, put sun cream on really? Up until now, and I've only just started wearing sun cream since I've been watching you on Instagram, talk about how important it was if I'd have slathered myself in sun cream up until now. Could my skin look...

[00:38:04] Justine Kluk: Could you look even more youthful than you do already?

[00:38:06] Sarah Berry: Could I look like my 20 year old self?

[00:38:08] Justine Kluk: Possibly. So the, you know, the evidence is that sun protective behaviors and. Part of that is sunscreen. Part of it is also, you know, staying out of the sun between 12 and two, when you know the sun is directly overhead wearing a hat, you know, covering up in the sun.

So it's not, you know, sunscreen is part of the armamentarium, but it's not everything. But yes, the answer is that protecting your skin in the sun can for sure slow signs of aging. And I think this is quite empowering because we can all do this. It's, its not, it's control. Exactly. It's not very difficult.

[00:38:43] Jonathan Wolf: I remember Justine and I went on this amazing holiday to Japan early in our relationship. I was trying to convince her to like stay with me and we saw all these women there, right of all ages basically with umbrellas and it's not raining. It's like a sunny day. Yeah. And so you see like this huge focus there on managing skin exposure.

And Justine was like, this is part of why they all look so incredibly young. Isn't that what what you

[00:39:06] Justine Kluk: and actually that reminds me of something, you know, that's also very interesting is that how we age. So, you know, the manifestations of aging may be slightly different actually in different populations as well, so, In more sort of European populations, wrinkling may be the predominant thing. And in Asia, so you were talking about Japan, brown marks or brown spots, dark spots, whatever you want to call them.

These pigment changes may be the predominant hallmark of aging. But you know, some, sometimes people wonder what we mean when we say skin aging. What are we talking about? And we are basically talking about. The skin becoming drier over time. We lose more moisture through our skin. We lose collagen. This sort of protein in our skin that makes it firm.

And reduction in collagen causes the skin to wrinkle more and to sag more. And then the other thing that we get is these darker brown spots on the skin.

[00:39:55] Sarah Berry: And so lots of people I know are taking collagen supplements on the belief that they will enable their skin to stay younger, look more youthful. Do they work?

[00:40:07] Justine Kluk: The, the jury really is still out. Sarah, I mean, am I recommending these in my clinic? No. Is the answer Are there other doctors recommending them? Yes, people might wanna know what we're talking about when we say collagen supplements. These, this is sort of collagen that people take in, I guess, capsule form.

Um, they're broken down into peptides, absorbed in the intestine. It has been proven that they do find their way into the bloodstream about an hour after they've been eaten, and then they accumulate in the skin. And the idea is that they trigger increased collagen production in, in the skin, which makes the skin firmer.

That they may trigger elastin in the skin, which is this other protein that makes the skin more springy, and also improve hydration, in the skin. And there have been some studies that show favorable effects when people have taken collagen supplements. There's others that show, less of a benefit.

The difficulty with interpreting the data is that a lot of the studies are sponsored by companies who make supplements so they have an interest in presenting the data in a way that would show, you know, that there's a favorable effect. And a question I always have is, we know that we tend to absorb these nutrients better when we get them in food.

So do we really need to take a collagen supplement? Couldn't we be thinking more about, you know, the Mediterranean diet and, and getting these nutrients in our food? So before going and shelling out a lot of money on collagen supplements, 'cause that's the other thing, the studies have shown that the effects don't last when you stop taking the collagen supplements.

So, this is something that if you were deciding that you were going to take on board, you'd have to keep on doing that could end up being awfully expensive. So why don't we think about the. The inexpensive, easily accessible things that we can do that have lots more evidence behind them. And that's the sunscreen, retinol.

Retinol comes from vitamin A and it's available in topical form for improving signs of skin aging. Something you put on your skin in the evenings usually 'cause it can make the skin a bit more sensitive to, to the sun. And that can. Boost collagen production in the skin, making the skin, firm, and can also help with reducing the appearance of some of these brown marks that appear on the skin as well.

So that would be something that.

[00:42:25] Jonathan Wolf: Is this real? Is it? Because I remember when I first met you, I'm like, this is all potions isn't it? Isn't everything that you put on your skin is all

[00:42:32] Justine Kluk: No, no, that's real. I often say there are three things if you want to think about skin aging that you can incorporate into your daily routine. And sunscreen is number one. Number two is using retinol at night. And for anyone who's listening to this who may be pregnant or trying to get pregnant, I.

That's not the time to use retinol. It shouldn't be used at, at that point in life. And the third thing is thinking about antioxidants that you can apply to the skin. And vitamin C is the most studied one. Um, so we know that if you apply vitamin C to your skin in topical form, that this increases collagen synthesis, so helps to boost your own collagen production.

It helps to reduce dark marks on the skin. So we make, make fewer of these, and it also protects us from inflammation in the skin as well. So, so vitamin C, topical vitamin C is important. And there are other antioxidants, so things like resveratrol, co-enzyme, Q 10. So, you know, there are other antioxidants that are important, but, but basically these three groups, antioxidants, sunscreen, and retinal are the, the key things.

[00:43:32] Sarah Berry: And I wonder if I could ask you two top nutrition skin mix. Myths that I have seen doing the rounds on social media. They might not be myths. So you are the person to ask. One is that polyphenols are our own natural sunscreen. Is that correct? Because I, I've seen this as headlines, just eat loads of polyphenols and you don't need to apply sunscreen.

[00:43:54] Justine Kluk: I would say, why don't you do both? Okay. So I think we are not yet at a posi in a position where we can say that there is something that you eat that is going to protect your skin well enough so that you don't need to rely on sensible sun protection behaviors. Staying in the shade, wearing a hat, covering up.

If you are someone who doesn't like using sunscreen, there are other things that you can do. I personally am very comfortable putting sunscreen on exposed sites and um, and I wouldn't rely on on these oral polyphenols, but it's not total, it's not total nonsense in that there is theory there. So for example, you think about a carotenoid like lycopene may have some photoprotective effects, omega three might have some photoprotective effects, but I definitely am not swapping my sunscreen for those.

[00:44:41] Sarah Berry: Okay, great. The other thing that I've seen in lots of headlines is intravenous antioxidant, vitamin drips. It will make you look 10 years and feel, but make you look 10 years younger. And this is a growing craze, I think amongst a a, a niche community.

[00:44:57] Jonathan Wolf: And for those of you listening, Justine is shaking her head ever more vehemently, as Sarah is saying this

[00:45:03] Justine Kluk: I'm just not even going to talk about. Yeah, no, I, I don't believe in those.

[00:45:06] Sarah Berry: Okay, so I often use the word bollocks to talk about nonsense when it comes to nutrition, and what you are saying is intravenous antioxidant drips. To make your skin 10 years younger is BOLs, but polyphenols in acid potential sunscreen isn't advisable, but there is some science behind why it might be

[00:45:27] Justine Kluk: I think, yeah, I may, I may have even sounded much more strong on the polyphenols or sun protection than I intended to. What I'm saying is I wouldn't dismiss it like ke, you know, keep an eye on the space. But for sure, we're not at a position yet where I would say swap your sunscreen for that and the antioxidant drips.

I'm always like in, you know, when you work in science or medicine, you have to keep an open mind because things change. I'm prepared to be convinced that tho those are a good idea, but I'm not at the moment.

[00:45:52] Jonathan Wolf: I have to ask a follow up question 'cause it like impacts my life. So how important is it in fact that you apply sun protection?

[00:45:58] Justine Kluk: It is important. Okay. And I think we've talked about skin aging here, but you know, there are other things, right? Like your risk of skin cancer increases with age and with cumulative UV exposure, with sunburns, that increases your risk of skin cancer to not to, you know, you know, not least because also they're uncomfortable at the time.

So protecting your skin and the sun is more than. Preventing your skin looking older earlier. It's also about reducing risk of things like skin cancer.

[00:46:26] Jonathan Wolf: So just before we run outta time, I mean we've talked a lot about food. We talked a lot about skincare routines. Is there anything else that a listener can do that can really affect the health of their skin?

[00:46:37] Justine Kluk: Yeah. So absolutely. Stress is, is. Mega and, and sleep. And so actually in the clinic when I counsel people about how we're gonna manage their skin condition, I always start with genes and hormones. And then we talk about skincare habits. We talk about the food we eat, we talk about stress and sleep. These are the sort of the key things we touch on.

Something that I think people might be really interested to know is I, I mentioned earlier about people with acne having high rates of depression and suicide. Did you know. That, some of our stress hormones, so thinking about this brain and skin connection, some of our stress hormones actually get released in the sebum, the oil from our oil producing glands in the skin and literally bathe the surface of our skin.

[00:47:22] Jonathan Wolf: So we are like bathed physically in stress.

[00:47:25] Justine Kluk: correct. So, so it is, there is definitely a really strong connection between the brain and the skin, in ways that people might not expect.

[00:47:35] Sarah Berry: Yeah, it's really interesting 'cause I've always thought of the skin as just this inert outer layer. Like we started, you know, when we started talking. But talking to you now, and obviously, you know, having listened to lots of your Instagram posts, It is, it's fascinating how it is a living part of us.

[00:47:53] Justine Kluk: Yeah. Yeah, absolutely. And uh, it's got, you know, we've got this, this community of all these bugs living on us as well. So, it is very much a sort of reactive, dynamic organ and there's so much more we're still going to learn about it, but, you know, I hope I've convinced you absolutely. That looking.

Absolutely. You know, people often think about, you know, going back to Jonathan's original point about how when he met me, he wondered why I wasn't. You know, a kidney physician or something like this. And, you know, skin is absolutely, it is absolutely fascinating. And there's, as I said, so much more. We're learning about it.

So I hope I've convinced everyone else of the same.

[00:48:31] Jonathan Wolf: I wouldn't be allowed home if I didn't say so.

[00:48:35] Justine Kluk: you're not allowed to answer any other way.

[00:48:36] Jonathan Wolf: Amazing. Thank you very much, Justine. I'm gonna try and do a little summary and I'm, I really have to get this one right.

[00:48:44] Sarah Berry: Yeah. So Jonathan, before you do

[00:48:46] Jonathan Wolf: Sarah, you're gonna do the summary.

[00:48:47] Sarah Berry: I'm not going to do the summary, but before you do your summary, I have been subjected to a year of quickfire questions from you. Justine has been subjected to about six years of quickfire questions.

So we have some quickfire questions for you. We have five questions.

[00:49:02] Jonathan Wolf: Oh no, I wasn't prepped for this at all. That's very unfair. Okay, go on

[00:49:05] Sarah Berry: Five questions each. Okay.  The fifth question is gonna be tough or each of our fifth questions tough. So you get two points, alright? So you can get a maximum of 12 points.

[00:49:14] Jonathan Wolf: Well, I'm very competitive, so I'm heading for the

[00:49:17] Sarah Berry: If you don't get 10 out of 12, there is gonna be a forfeit.

So the forfeit is, if you don't get 10 out of 12, you will either have to drink a Diet Coke or you'll have to eat at McDonald's. And we are going to let your son Zach decide which of those you're gonna have to do.

[00:49:32] Jonathan Wolf:  I can't do either of those, so I better score. 10. Okay.

[00:49:36] Sarah Berry: Pressure is on. So I'm gonna go first. Alright. Now my questions are going to test just how much you listened to me. Okay. Um, and how much you've listened to the podcast. Okay. Okay. Wow. Ready? Yes. Okay. Are, this is a controversial one. I'm gonna start with, are all ultra processed foods bad for you?

[00:49:54] Jonathan Wolf: No if you use the Nova classification.

[00:49:57] Sarah Berry: Well done. Should we all be taking Omega three supplements?

[00:50:04] Jonathan Wolf: No, because you can also get it through diet.

[00:50:07] Sarah Berry: Okay, great. Does diet improve menopause symptoms? Yes. Okay. Who do you prefer doing podcasts with? Tim or me?

[00:50:21] Jonathan Wolf: That's like choosing between your parents. I love them both equally.

[00:50:24] Sarah Berry: Oh, Jonathan. Damn, I think I, I should take a point away for that.

[00:50:28] Jonathan Wolf: Tim's not here. I prefer you, Sarah. I want to get, just in case I only get nine points, I really don't wanna have to eat at McDonald's.

[00:50:33] Sarah Berry: Um, yeah, I would've deducted a point for that.

Now this is the challenge. This is the two point question. Okay? All right. Now it's quite tough, but I've talked about this so often on our podcast. Okay, so what percentage of energy is not absorbed when you eat nuts?

[00:50:54] Jonathan Wolf: Ooh,

[00:50:55] Sarah Berry: So this is, so this is for people listening. This means by what percentage? Back of pack labeling overestimating the energy content. I'll let you go.

[00:51:05] Jonathan Wolf: I think it's about a third.

[00:51:06] Justine Kluk: Oh my goodness.

[00:51:07] Sarah Berry: Well done. That's six outta six.

[00:51:10] Jonathan Wolf: you see I always, I always listen to you,

[00:51:11] Sarah Berry: Pressure. Now we're over to Justy.

[00:51:14] Jonathan Wolf: All right. I'm more scared about this one.

[00:51:15] Justine Kluk: So you don't have to be scared. And actually I'm testing your truthfulness here 'cause I know the answer to some of these questions. So, it'd be interesting by other people. They'll have to have to help me keep counting here, Sarah. So number one is going to be, is acne more common in males or females?

[00:51:34] Jonathan Wolf: I know at least for adults it's more common with women.

[00:51:38] Justine Kluk: Okay. Yeah, that's correct.

[00:51:39] Sarah Berry: But you said for adolescents it's more common in men

[00:51:42] Justine Kluk: so Exactly. So, so over the age of 25 more common in females and in adolescents, in males. Well done. What is, I can't tell

[00:51:51] Jonathan Wolf: by the way, you don’t know how nervous I am right now,

[00:51:55] Sarah Berry: I've had years of your quick fire questions.

[00:51:57] Jonathan Wolf: I realize it's a lot easier to ask them than to have to answer them. I have more sympathy now with all my guests.

[00:52:02] Justine Kluk: Okay, so question two is, what is the minimum SPF I would consider, buying for a sunscreen product that we keep at home?

[00:52:12] Jonathan Wolf: 500. No, that was a joke. 50.

[00:52:14] Justine Kluk: So I would say 30 or higher. Okay.

[00:52:17] Sarah Berry: should we let him have that point?

[00:52:18] Jonathan Wolf: the reality is she says that, but we never buy one that doesn't say 50 on it.

[00:52:23] Sarah Berry: hold on. It's yes or no. You are now, explaining your answer.

[00:52:27] Justine Kluk: I think we can accept 50. I think we can accept 50. the answer is 30 though. and the next question is, which meal or food do you most associate with happy times? And I know the answer.

[00:52:43] Jonathan Wolf: Oh, gelato ice cream.

[00:52:45] Justine Kluk: i thought that was what he was going to say. So for context, for people who, you know, who don't know Jonathan family have been going to a particular place in Italy in the summers for, I'll say, I was gonna say centuries. See, Jonathan, he's been following my advice. Skincare. 

And I know that Jonathan, one of Jonathan's big passions in life is gelato. And this is something that Tim might say, it's a heritable trait. this is something that, that my stepson has definitely, inherited. My next question was, what is the ZOE inspired meal that I've made that you've most enjoyed?

[00:53:23] Sarah Berry: This is question four.

[00:53:24] Jonathan Wolf: I think that the one I have most enjoyed is when we actually had Will Bulsiewicz, who many people on the podcast know, and Sharon, who's our head of marketing round for dinner, and they're both vegan and you made this sort of bean stew, which was absolutely fantastic. And if you had said to me 10 years ago that I would've eaten like a vegan be stew and said that it was amazing, I'd have been like, what? But like, where's the steak?

[00:53:53] Justine Kluk: And the only person who didn't enjoy that meal was my stepson. Who was like, where is the meat? Yeah, exactly. Okay., so I've got one more question.

[00:54:02] Sarah Berry: one more question. This can be the one that is the bonus question, but he's doing fine, so he's not gonna get a forfeit, unfortunately. Dammit.

[00:54:09] Justine Kluk: Okay. I was gonna say Star Wars or Princess Bride.

[00:54:13] Jonathan Wolf: Oh, well that is so tricky. Well, I'm gonna really divide the audience to see, I feel like that's really like being a asked to choose your favorite child.

[00:54:22] Justine Kluk: So this was one that we, when Sarah said, we're gonna do some quickfire questions, and by the way, you can see I'm obviously not used to the quickfire question because they've taken a bit longer to answer. However, we had to have a consultation at the dinner table last night. So Jonathan, was out last night.

So the family sat around the table and this was the question that we chose together.

[00:54:41] Jonathan Wolf: I think I'm ultimately gonna go Star Wars, but I mean, I, I could, I'm gonna go Star Wars. Okay. Will Zach still talk to me?

[00:54:50] Justine Kluk: I mean, I don't know.

[00:54:53] Sarah Berry: Well done, Jonathan. You've scored 12 out of 12. You do not have to eat McDonald's and you do not have to have a diet cake.

[00:54:58] Jonathan Wolf: Wonderful, which will keep my skin looking healthy for longer. Let me do a quick summary of today's session where we covered a lot of stuff. I think first thing we said is that skin is really important. You know, it's not just this impermeable barrier. We now know it has its own microbiome of these millions of bacteria and the interestingly, lots of skin conditions that we have actually linked to sort of individual sort of bad bugs in that context.

We talked about acne, which is one of the big topics that our members wanted to talk about. Apparently half of women in their twenties and still a third of women in their thirties have acne. So it's not just something that you go through as, as a teenager that it can have really life-changing impact.

You talk about people even, you know, committing suicide, which is really terrible. interestingly, there is some evidence that food can have an influence and specifically dairy and sort of food causing these. Big high blood sugar spikes can be an issue, but there's also danger of people going to this like cutting all their diet out and that's even worse.

So to sort of be cautious as one approaches that, that we had some great sort of practical tips. So gentle cleanser, don't strip your skin moisturizer you can do if you have acne and none of these devices that are sort of scraping at your face. And Justine described, you know, using her fingertips, which I can tell you is.

Is indeed how she does this. Then we talked about anti-aging. So, Sarah wants to know how to continue to look 30 forever, which I think is definitely achievable.

[00:56:18] Sarah Berry: This is why I keep coming on the podcast 'cause you keep saying nice things.

[00:56:21] Jonathan Wolf: and what Justine said is actually sun exposure is 80% of your skin aging. So really it isn't about your genes, it's about things that are under your control.

So that means sunscreen and just not being in the sun, you know, like all the time is, is really important. But there are some. Real things that you can do. And you mentioned retinol and an antioxidant like vitamin C, both of which I refuse to do 'cause it's too much effort, but I know that Justine does religiously.

And then finally we talked about sort of what else can you do. So firstly, bin those collagen supplements, bin, all these other supplements, like in terms of the amount of money this is isn't worth it. And a lot of it, I think there's very little evidence. On the other hand, interestingly, stress can have this huge impact.

So if there's things you can do that reduce stress, it really can affect your skin. And amazingly, apparently, if you are really stressed, you're actually bathing your skin in it, which I'd never heard before is slightly terrifying. 'cause I get stressed quite often in this idea that you're sort of. Soaked

[00:57:14] Justine Kluk: Marinating in it.

[00:57:16] Jonathan Wolf: Marinating in it, is amazing, but also sleep and even just going into nature might be able to do something. For all of you who are listening to this, working from home, therefore is sort of like, keep listening to the podcast, but walk out into nature and improve your skin. Sarah and Justine, thank you so much.

[00:57:30] Justine Kluk: Thank you.

[00:57:31] Sarah Berry: That was fun. Enjoyed it.

[00:57:33] Justine Kluk: Me too. Thanks for having me.

[00:57:34] Jonathan Wolf: Oh, it was a real pleasure, and I've got through it without anything too disastrous, so I'm pretty happy. Sarah, you obviously didn't know the right questions to ask. Thank you all. Bye-bye. 

Thank you, Justine and Sarah, for joining me on ZOE Science & Nutrition today. If you want to understand how to support your body with the best foods for your skin and your gut health, then you may want to try ZOE's personalized nutrition program. You can learn more and get 10% off by going to joinZOE.com/podcast

As always, I'm your host, Jonathan Wolf. ZOE Science & Nutrition is produced by Yella Hewings-Martin, Richard Willan, and Alex Jones. See you next time.

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