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Clinical Focus Diet and Nutrition

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Aesthetics Journal

By looking at inner wellness, health nutrition and skincare together, we can provide the ultimate skincare programme and screen for potential disease risk factors. During the GP assessment, we talk through all aspects of a patient’s current health, screen for diseases, and perform blood and urine tests. We offer an advanced body composition analysis (called ‘Seca’ Testing), which assesses a number of parameters, including muscle and body fat percentage, body mass index, hydration and cellular activity levels. This is followed by an in-depth consultation with our dietician, who will advise on all aspects of nutrition, review patients current diet and lifestyle and recommend diseasespecific dietary plans. For example, patients with irritable bowel syndrome may be started on the FODMAP diet, while patients with acne may be started on a low glycaemic index diet and one favouring foods known to be beneficial for the skin. According to dietician Lucy Jones, “Your food intake represents the foundations of good skincare. The right nutrition can support healthy skin, reduce acne and even skin ageing. For those wanting to look and feel good, we can address health from the inside out in our comprehensive MOTs and health checks.” Let’s use acne vulgaris as a case study; a common issue seen both in general practice and dermatology clinics. The literature examining the link between diet and acne has been very mixed over the years. However, there is now a growing body of epidemiologic and experimental evidence that suggests there could be a strong relationship between diet and acne.3 The evidence is more convincing for high glycemic diets, compared with other dietary factors such as the dairy-acne connection.1 Dairy ingestion appears to be weakly associated with acne, and the roles of omega-3 fatty acids, antioxidants, zinc, vitamin A, and dietary fibre remain inconclusive.1 Dermatologists and dietitians continue to debate and research the potential relationship between diet and acne. Most experts would agree, however, that diet does have an impact for most patients and the best dietary approach is to address each acne patient individually, carefully considering the possible benefit of dietary counselling.2 Personally, I have seen fantastic results in 40

the management of acne vulgaris. As an example, I have been seeing a 25-year-old female (Patient A) from London, with a history of acne vulgaris since the age of 17. She has been treated with topicals, oral antibiotics and Roaccutane in the past, unfortunately with poor results. At the time of presentation to me, she was taking oral Lymecycline and using topical Benzylperoxide. A low glycaemic index diet, rich in antioxidants and omega-3 fatty acids has totally transformed her skin. Patient A said, “I have battled with my acne for years. For me, medicine was just one part of the puzzle. Good skin care was another part of the puzzle. Nutrition was the missing piece of the puzzle and now I have great skin.” Nutrition and protection against environmental exposure Other examples of the benefits of using nutrition in skincare can be found by looking at the way in which nutrition can protect our skin from environmental damage. A diet rich in carotenoids is known to prevent cell damage, premature skin ageing, and even skin cancer. Cutaneous carotenoids can be enriched in the skin by nutrition, and a diet rich in antioxidants has been shown to increase free-radical protection after UVA/UVB irradiation.9 Antioxidants naturally occurring in the skin are superoxide dismutase, catalase, alpha-tocopherol, ascorbic acid, ubiquinone, and glutathione, and many of them are inhibited by UV and visible light.4 The antioxidant diet should contain large amounts of vitamins A, E, and C, grape-seed extracts, coenzyme Q10, and alpha-lipoic acid.4 The most highly recommended foods include: avocados, berries, dark green leafy vegetables, orange-coloured fruits and vegetables, pineapples, salmon, and tomatoes. During the early planning stages of the ‘Nuriss’ brand and my clinic, I believed that having input from a dietician was an essential part of our patient journey. This belief was based on my own working experience, rather than in-depth research on the matter. I wanted to give my patients something that had always been missing from practices where I have worked Aesthetics | January 2015

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previously. I was also aiming to create the ‘ultimate’ clinic where patients could access healthcare, skin care and nutrition support under one roof. In recent years, our patients seem so much more interested in the idea of using nutrition as a medicine and are happy that we endorse that ethos at Nuriss too. The feedback from patients so far has been fantastic and, whilst not every patient needs to see a dietician, those that don’t need it seem reassured that we are able to offer them access to this service, if required. For those that do need and want nutritional support, the seamless transition from doctor to dietician, works well here. The only difficulty was working out how to integrate this service into our practice. It was unlikely that we would require a dietician every day, so from a business perspective I also had to assess the costs of time and resources when setting up the clinic. The solution seemed to be to allocate set times/ days of the week for this service, So far, this seems to work well within our clinic. In summary, I believe that the future of skin care lies in a holistic approach. By looking at inner wellness, health, nutrition and skincare together, we can provide the ultimate skin care programme. Dr Anita Sturnham Dr Anita Sturnham is an experienced GP and a skin specialist. She is an ambassador for Unilever SkinCare and a medical expert for Superdrug, previously appearing on television to share her expertise. She currently works as a General Practitioner, combining NHS duties with private practice, recently opening her own clinic, Nuriss, in London. REFERENCES 1. Thiboutot DM, Strauss JS, ‘Diet and acne revisited’, Arch Dermatol, 138 (2002), p.1591-1592. 2. Anderson PC, ‘Foods as the cause of acne’, Am Fam Physician, 3 (1971) p,102-103. 3. Katta R, Desai SP, ‘Diet and Dermatology: The role of dietary intervention in skin disease’, J Clin Aesthet Dermatol, 7 (2014) p.46-51. 4. Fuchs J, Huflejt ME, Rothfuss LM, Wilson DS, Carcamo G, Packer L, ‘Acute effects of near ultraviolet and visible light on the cutaneous antioxidant defense system’, Photochem Photobiol 50 (1989) p.739-744. 5. Solauri E, ‘Probiotic in human skin disease’, Am J Clin Nutr 73 (2001), p.1142-1146. 6. Pillai S, Oresajo C, Hayward J, ‘Ultraviolet radiation and skin aging: Role of reactive oxygen species, inflammation and protease activation, and strategies. Review’. Int J Cosmet Sci 27 (2005), p.17-34. 7. H. Sies, W. Stahl, ‘Carotenoids and UV protection’, Photochem. Photobiol. Sci, 3 (2004) p.749-752. 8. Yaar M, Gilchrest BA. Aging of skin. In: Freedberg IM, Eisen AZ, Wolf K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick’s dermatology in general medicine, vol 2. New York: McGraw-Hill; 2003. p. 1386– 98. 9. Eicker J, Kurten V, Wild S, Riss G, Goral- czyk R, et al. 2003. Beta-carotene sup- plementation protects from photoaging- associated mitochondrial DNA mutation.Photochem. Photobiol. Sci. 2:655–59 10. Health and Care Professionals Council. http://www.hpc-uk. org

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Aesthetics January 2015  

Weight Loss & Body Contouring

Aesthetics January 2015  

Weight Loss & Body Contouring