Nutrition for Healthy Skin (eBook)

Jean Krutmann is Professor of Dermatology and Environmental Medicine and Director of the Institut für Umweltmedizinische Forschung (Institute for Environmental Medical Research) at the Heinrich Heine University, Düsseldorf. His field of research is dermatotoxicology and immunodermatology, with special emphasis on environmentally induced skin diseases. He is author or co-author of more than 200 papers and the recipient of various awards. Professor Philippe Humbert is Head of the Dermatology Department at Besançon University Hospital Center and manager of the center’s Skin Engineering and Biology Laboratory. He is also Vice President of the French Society of Dermatology and Chairman of the International Society for Biophysics and Imaging of the Skin. Professor Humbert has an impressive publication record on a range of topics in dermatology.

Foreword 5
Preface 6
Contents 7
Part I Nutrition and Skin: The Scientific Basis 9
1: Cutaneous Changes in Nutritional Diseases 10
1.1 Nutritional Deficiencies 10
1.1.1 Marasmus and Kwashiorkor 10
1.1.2 Essential Fatty Acid Deficiency 12
1.1.3 Vitamin Deficiencies 12
1.1.4 Trace Element Deficiencies 15
1.2 Excess Nutrition 17
1.2.1 Obesity 17
1.2.2 Hypervitaminoses 17
1.2.3 Trace Element Deposition 18
1.3 Abnormalities of Amino Acid Metabolism 18
1.4 Nutrition, Skin Physiology, and Skin Pathology 19
References 19
2: Skin Aging 21
Core Messages 21
2.1 Introduction 21
2.2 Mechanisms of UV-Induced Photoaging 23
2.3 Mitochondrial DNA Mutations and Photoaging 23
2.4 Connective-Tissue Alterations in Photoaging: The Role of Matrix Metalloproteinases and Collagen Synthesis 25
2.5 UV-Induced Modulation of Vascularization 26
2.6 Photoaging as a Chronic Inflammatory Process 27
2.7 Protein Oxidation and Photoaging 27
2.8 Infrared a Radiation-Induced Retrograde Signaling 27
2.9 Concluding Remarks: The Defective Powerhouse Model of Photoaging of Human Skin 28
References 29
3: Non-melanoma Skin Cancer 31
Core Messages 31
3.1 General Overview 31
3.1.1 Skin Carcinogenesis 31
3.1.2 Protective Mechanisms of Carcinogenesis 32
3.1.3 Carcinogens of the Skin 32
3.2 Different Types of Non-melanoma Skin Cancer 33
3.2.1 Seborrheic Keratosis 33
3.2.2 Clear Cell Acanthoma 34
3.2.3 Dyskeratoma (Syn. “Warty Dyskeratoma”) 34
3.2.4 Actinic Keratoses 34
3.2.5 Bowen’s Disease [6] 34
3.2.6 Bowenoid Papulosis 34
3.2.7 Erythroplasia 35
3.2.8 Squamous Cell Cancer 35
3.2.9 Keratoacanthoma 35
3.2.10 Basal Cell Carcinoma 36
3.2.10.1 Clinical Subtypes 37
3.2.11 Prevention of UV-Induced Skin Cancer 37
3.2.12 Treatment of Non-melanoma Skin Cancer [11, 18, 21] 37
3.2.12.1 Surgical Methods 38
Take Home Pearls 38
References 38
4: Skin Barrier Function 40
Core Messages 40
4.1 Overview of Barrier Function in Normal Skin 41
4.1.1 Cutaneous Barrier Function 41
4.1.2 Co-regulation and Interdependence of Permeability Barrier and Antimicrobial Defense 42
4.1.3 Stratum Corneum as a Dynamic Sensory Interface 43
4.1.4 External Stressors Alter Permeability Barrier Function 43
4.1.5 Sources, Function, and Pathophysiology of Stratum Corneum Acidification 44
4.1.5.1 Endogenous Sources of Stratum Corneum Acidification 44
4.1.5.2 Role of pH in Regulating Function 44
4.1.5.3 Pathophysiology of an Elevated Stratum Corneum pH 45
4.1.6 Permeability Barrier Function in Relation to Pigmentation 45
4.1.6.1 Enhanced Barrier Function in Darkly Pigmented Skin 45
4.1.6.2 Enhanced Epidermal Function of Darkly Pigmented Skin Correlates with a Lower SC pH 46
4.1.6.3 Lower pH of Melanocyte Dendrites Could Account for Lower pH of Pigmented Skin 46
4.2 Barrier Failure in Atopic Dermatitis 47
4.3 Basis for Abnormal Barrier Function in Atopic Dermatitis 48
4.3.1 Inherited Abnormalities 48
4.3.2 Acquired Stressors Could Further Aggravate Barrier Function in AD 49
4.4 “Outside–Inside,” Then Back to “Outside” Pathogenic Mechanism in AD 49
4.5 A Potential New Therapeutic Paradigm for AD 50
References 51
Part II Functional Food for Skin Works: Intervention Studies in Humans and Animal Models 54
5: Botanical Antioxidants for Skin Protection: An Overview 55
Core Messages 55
5.1 Introduction 55
5.2 Green Tea/EGCG 56
5.3 Pomegranate 58
5.4 Resveratrol 59
5.5 Silymarin 60
5.6 Genistein 61
5.7 Curcumin 61
5.8 Sulforaphane 62
5.9 Lycopene 62
5.10 Lutein/Zeaxanthin 62
5.11 Conclusion 63
References 63
6: Systemic Photoprotection by Carotenoids 68
6.1 Introduction 68
6.2 Carotenoids: Properties 68
6.3 Carotenoids: Skin Effects 70
6.4 Carotenoids: New Developments 71
6.5 Conclusion 72
References 72
7: Systemic and Topical Use of Green Tea Polyphenols for Healthy Skin 74
Core Messages 74
7.1 Introduction 74
7.2 Systemic Versus Topical Administration of Green Tea 75
7.3 Evidence from Animal Models 76
7.4 Evidence from Human Studies 76
7.5 The Role of Green Tea in Photocarcinogenesis 77
7.6 The Role of Green Tea in Photoaging 77
7.7 The Role of Green Tea in the Sunburn Response 77
7.8 The Role of Green Tea in Photoimmunosuppression 78
7.9 The Role of Green Tea in Other Skin Disorders 78
7.10 Cellular Effects 78
7.10.1 Modulation of Keratinocyte Apoptosis 78
7.10.2 Keratinocyte Proliferation 79
7.10.3 Inflammatory Cell Infiltration 79
7.11 Biochemical Effects 79
7.11.1 Cytokine Modulation, Angiogenesis, and Inflammation 79
7.12 Molecular Effects 80
7.12.1 DNA Damage 80
7.12.2 Reactive Oxygen Intermediates 80
7.13 Signal Transduction Pathways 81
7.13.1 Apoptosis, p53, and Cell Cycle Regulatory Pathways 81
7.13.2 Mitogen-Activated Protein Kinases (MAPK) 81
7.13.3 Nuclear Factor-kB 81
7.13.4 AP-1 82
7.13.5 Phosphatidylinositol 3-Kinase/Akt and p70 S6-K 82
7.13.6 Proteasome Activation 82
7.13.7 Signal Transducer and Activator of Transcription (STAT)-3 Signaling 82
7.14 Conclusion 82
Take Home Pearls 82
References 83
8: Flavonoid-Rich Nutrients for the Skin 87
8.1 Introduction 87
8.2 Flavonoids: Structure and Occurrence 87
8.3 Flavonoids: Biochemical Properties 88
8.4 Flavonoids in Photoprotection 89
8.5 Conclusion 91
References 91
9: Omega-3 Fatty Acids and Skin 93
9.1 Introduction 93
9.2 Classification and Nomenclature 94
9.3 Sources 94
9.3.1 Short Chain n-3 PUFAs 94
9.3.1.1 ALA 94
9.3.1.2 STA 95
9.3.2 Long-Chain n-3 PUFAs: EPA and DHA 95
9.4 Recommended Dietary Intakes 95
9.5 Omega-3 PUFA in the Skin 96
9.5.1 Omega-3 Content of Skin 96
9.5.2 Omega-3 Delivery to the Skin 96
9.5.3 Metabolism of n-3 PUFAs 97
9.5.3.1 Synthesis of Long-Chain n-3 PUFAs 97
9.5.3.2 Metabolism of PUFAs to Eicosanoids 97
9.6 Activities of Omega-3 PUFAs 98
9.6.1 Modulation of Cell Signalling 98
9.6.2 Modulation of Gene Expression 98
9.6.3 Modulation of Pro-inflammatory Mediators 99
9.6.4 Modulation of Immune Function 99
9.6.5 Modulation of Oxidative Stress 100
9.6.6 Modulation of Apoptosis 100
9.7 Beneficial Effects of Omega-3 PUFAs in the Skin 100
9.7.1 Photoprotection 100
9.7.1.1 Acute UVR Damage 100
9.7.1.2 Chronic UVR Damage 101
9.7.2 Psoriasis 101
9.7.3 Atopic Dermatitis 102
9.7.4 Acne Vulgaris 102
9.7.5 Wound Healing 102
References 103
10: Potential Benefits of Soy for Skin, Hair, and Nails 110
Core Messages 110
10.1 Introduction 110
10.2 Biology of Soy 110
10.2.1 Soy Isoflavones 110
10.2.2 Mechanisms of Action 111
10.2.2.1 Estrogen Receptor Binding 111
10.2.2.2 Non–ER Binding Activities 111
10.3 Soy for Skin Care 112
10.3.1 In Vitro Studies 112
10.3.2 Topical Application 113
10.3.3 Dietary Consumption 114
10.4 Soy for Hair Care 115
10.5 Soy for Nail Health 116
10.6 Summary and Conclusion 116
Take-Home Pearls 116
References 117
11: Photoprotection by Nicotinamide 119
Core Messages 119
11.1 Nicotinamide Plays a Key Role in Cellular Energy Metabolism 119
11.2 Sources of Nicotinamide 120
11.2.1 Nicotinamide Deficiency 120
11.3 Pharmacology 121
11.3.1 Pharmacokinetics 121
11.3.2 Adverse Effects 121
11.4 Nicotinamide in Dermatology 121
11.5 The Induction of Skin Immunity Is a Dynamic Process 121
11.5.1 Considerable Cellular Energy is Required to Combat Ultraviolet Radiation-Induced Cutaneous Stress 122
11.6 Nicotinamide and Photocarcinogenesis 123
11.7 Nicotinamide and Photoimmunosuppression 123
11.7.1 Ultraviolet Radiation-Induced Immunosuppression 123
11.7.2 Topical Nicotinamide Protects Against UV-Induced Immunosuppression in Humans 124
11.7.3 Oral Nicotinamide Protects Against UV-Induced Immunosuppression in Humans 125
11.8 Nicotinamide and Photoageing 125
11.9 Mechanisms of Photoprotection 125
11.10 Conclusions 125
Take Home Pearls 126
References 126
12: Probiotics and Regulation of Immune Responses 129
Core Message 129
12.1 Introduction 129
12.2 Mammals Depend on Intestinal Microflora to Promote the Development of Efficient Immune System 129
12.3 The Immune System: Innate and Acquired Immunity 130
12.4 The Interaction of Commensal Bacteria with the Host Leads to a State of Tolerance 131
12.5 Probiotics: A Large Field of Application but yet Misunderstood Mechanisms 131
12.6 Regulating Activity of Probiotics in Atopic Dermatitis 132
12.7 Oral Probiotic Bacteria Can Reduce Contact Hypersensitivity in the Mouse 133
12.8 Oral Probiotic Bacteria Facilitate the Recovery of Cutaneous Immune Homeostasis After UV Exposure 133
12.9 Conclusions 133
References 135
13: Prebiotic Cosmetics 136
Core Messages 136
13.1 Introduction: Human Microflora Is a Constituent of Healthy Skin 136
13.1.1 Skin Microflora 136
13.1.2 Oral Microflora 137
13.1.3 The Skin’s Innate Defense System 138
13.2 Application of Nutrients/Actives to Balance the Skin Microflora 139
13.3 Microbial Products 140
13.4 Probiotic Oral Care Compounds 141
13.5 Stimulating Skins Own Defense 142
13.6 Conclusions 143
References 143
14: Micronutrients for Hair and Nails 147
Core message 147
14.1 Hair and Nails: Anatomy and Physiology (Figs. 14.1 and 14.2) 147
14.2 Nutrition in General 149
14.3 Diets 150
14.4 Vitamins 150
14.4.1 Vitamin A 150
14.4.2 Vitamin B1: Thiamine 150
14.4.3 Vitamin B3: Niacinamide 151
14.4.4 Vitamin B5: Pantothenic Acid 151
14.4.5 Vitamin B6: Pyridoxal Phosphate 151
14.4.6 Vitamin B12: Cyanocobalamin 151
14.4.7 Vitamins B Plus Amino Acids 151
14.4.8 Vitamin C: Ascorbic Acid 152
14.4.9 Vitamin D 152
14.4.10 Vitamin E: a-Tocopherol 152
14.4.11 Vitamin H: Biotin 152
14.5 Miscellaneous 153
14.5.1 Essential Fatty Acids 153
14.5.2 Starflower Seed Oil 153
14.5.3 Melatonin 154
14.5.4 Cysteine and Cystine 154
14.5.5 Taurine 154
14.5.6 Gelatin 154
14.5.7 Iron 155
14.5.8 Silicon 155
14.5.9 Rhodanide 155
14.5.10 Fluor and Fluorides 156
14.5.11 Calcium 156
14.5.12 Zinc 156
14.5.13 Selenium 156
14.5.14 Thyroid Hormones 156
14.5.15 Honey and Gelée Royale 156
14.6 Herbal Medicine 156
14.6.1 Soy 157
14.6.2 Mulberry 157
14.6.3 Gingko biloba 157
14.6.4 Green Tea (Camellia sinensis) 157
14.6.5 He Shou Wu or Fo-Ti (Polygonum multiflorum) 157
14.6.6 Pygeum (Pygeum africanum) 158
14.6.7 Saw Palmetto (Serenoa repens) 158
14.6.8 Stinging Nettle (Urtica diocia) 158
14.6.9 Dong Quai (Chinese angelica) 158
14.6.10 Panax ginseng 158
14.6.11 Eleuthero Root 158
14.6.12 Pumpkin Seed Oil 159
14.6.13 Rosemary 159
14.6.14 Colloidal Oatmeal 159
14.6.15 Arnica 159
14.6.16 Oral Supplementation with Melatonin 159
14.6.17 Ageratina Pichinchensis Extract 159
References 159
Part III How to Use Functional Foodin Clinical Dermatology 162
15: Legal Aspects: How Do Food Supplements Differ from Drugs, Medical Devices, and Cosmetic Products? 163
15.1 Introduction 164
15.2 Micronutrients/Food Supplements 164
15.2.1 Definition 164
15.2.2 Legal Aspects 165
15.2.2.1 Harmonized Within the European Union 165
15.2.2.2 Responsibilities of the Member States 166
15.2.3 Conclusion 167
15.3 Medicinal Product/Drug 167
15.3.1 Definition 167
15.3.2 Legal Aspects 167
15.3.3 Conclusion 168
15.4 Medical Devices 169
15.4.1 Definition 169
15.4.2 Legal Aspects 169
15.4.3 Conclusion 170
15.5 Cosmetic Products 170
15.5.1 Definition 170
15.5.2 Legal Aspects 170
15.5.2.1 Raw Materials 171
15.5.3 Conclusion 171
15.6 Classification of Borderline Products 172
15.7 How Do Food Supplements Differ from Drugs, Medical Devices, and Cosmetics? 172
Take Home Pearls 175
References 175
16: How to Prove Safety and Efficacy in Nutrition-Based intervention Studies for Human Skin* 177
Core Messages 177
16.1 Introduction 177
16.2 Safety Assessment 178
16.2.1 Acute Oral Toxicity 178
16.2.2 Subchronical Oral Toxicity 179
16.2.3 Genotoxicity 179
16.2.4 Teratogenesis 179
16.3 Bioavailability Assessment 179
16.4 In Vitro Efficacy Assessment 180
16.5 In Vivo Efficacy Assessment 180
16.6 Conclusion 182
References 183
17: Beauty from Inside: Nutrition-Based Strategies in Cosmetic Dermatology 185
Core Messages 185
17.1 Cosmetic Role of Food Nutrients 186
17.1.1 Supply in Macronutrients 186
17.1.1.1 Proteins 186
17.1.1.2 Lipids and Essential Fatty Acids 186
17.1.1.3 Carbohydrates 186
17.1.2 Supply in Micronutrients 187
17.1.2.1 Vitamins 187
17.1.2.2 Oligoelements 187
17.1.2.3 Other Micronutrients 188
17.1.3 Supply in Water 188
17.1.4 Probiotics 188
17.2 Relevance of Nutritional Supplements 188
17.2.1 Nutritional Photoprotection 188
17.2.2 Prevention of Skin Aging 189
17.2.3 Skin Moisturization 189
17.2.4 Skin Barrier Function 189
17.2.5 Diet and Prevention of Acne Lesions 189
17.2.6 Nutritional Factors and Hair Beauty 190
17.2.7 Nutritional Factors and Nail 190
17.3 Concluding Remarks 190
References 190
Appendix 193
Index 198