Dry Skin

Transcript:

TERESA: Welcome to Dishing Up Nutrition brought to you by Nutritional Weight & Wellness. We are a Minnesota company that specializes in real food nutrition education and counseling. My name is Teresa Wagner, a Registered and Licensed Dietitian. And I have a cohost today with me and her name is Leah Kleinschrodt, also a Registered and Licensed Dietitian.

LEAH: Yes. Good to see you again, Teresa. And at the time we're recording this show, you know, here in Minnesota, it's January, it's midwinter here in the Northern Hemisphere, and it is brutally dry outside.

TERESA: Yeah, I heard this weekend, it's supposed to be negative two, feels like 20 below.

LEAH: Yeah, can't wait. So yeah, with that brutal cold comes the brutal dryness as well. This is a great time of year to kind of pause. Check out the skin on your hands, especially like for me, it's that area between the thumb and the forefinger.

If you're able to, this might be a time, hey, take off your socks, see how the skin on your heels or like on your toe knuckles are doing. How are they holding up? Does your skin in these areas, do they look healthy? If you're lucky, maybe they look a little tan because you got away on a tropical vacation recently.

You know, do they look hydrated and smooth? Or, does the skin in those areas look kind of dull and pale, flaky and cracking? How many times have you put lip balm on your lips today? Does your Amazon or your Target cart have a different lotion or salve or balm or moisturizer for like every different part of you?

Or are you someone who's prone to nosebleeds in the dry air? You know, if any of these things ring a bell for you, then you've come to the right corner of the podcast world. Today, we've got a great show for you about how to deal with dry skin and as many things when it comes to skin conditions, “healing and nourishing the skin is actually an inside job”.

And I want to mention, like, I love that quote. I took it from Erin Holt, who is another functional medicine nutritionist out on the East Coast. So I love that quote from her that just actually we have to look inside to see actually what might be contributing to things on the outside.

TERESA: Yeah. I love that. It's so true. There are definitely some things that we can do externally to help support our skin through these drier months. Or if you live in a drier climate, like those moisturizers, you were talking about it, and we can have humidifiers. We can exfoliate, not, you know, not over bathe, right? Not get the water too hot.

LEAH: Yep.

TERESA: All those things that we learn here in this dry climate.

LEAH: Yep.

The importance of drinking enough water

TERESA: But often the internal environment within us often gets overlooked. So yeah, I like that quote that you said too. It's an inside job. I don't think that we could start a conversation about hydration without first talking about water.

LEAH: Of course.

TERESA: So are you drinking enough water? Do you find you're less thirsty and not inclined to drink as much water during the winter? And I find this is so true for me as a runner even. I don't run in the temperatures that we were just naming, but if it's 20 and above, I'll go out for a run. And I was laughing with a fellow runner about how, you know, I can go for an hour run, come back and not even need a drink of water.

LEAH: Yeah.

TERESA: Whereas in the summer, it's a completely, completely different story. How is it that that thirst mechanism just isn't triggered in the same way in this cold? So that not having that thirst could be a contributing factor and then drinking water, even if you drink at room temperature, it still feels cold when it's so cold outside.

LEAH: It definitely can, right? And, you know, what is the right amount of water? It's one of life's like million dollar questions, right? Yeah. And it's a question I get frequently from clients also, like how much water is enough water? What we've often said, take your body weight, divide it by two. That's the number of ounces that you should be drinking.

That's a decent metric to use. And I do think that that is a reasonable metric for some people. Not necessarily for others. I guess I rarely push people past 100 ounces or so of water per day. And I would say 80 ounces usually is a little bit more typical for what I'm recommending. You can also pay attention to the color of your urine. The goal is to have it be kind of this light, pale, yellow color.

TERESA: Lemonade, right?

LEAH: Yeah. That lemonade color. And it's a way to then track your hydration throughout the day. Cause hopefully you're going to the bathroom and urinating at least several times a day.

TERESA: So, yes, what we drink is important and how much water we're drinking. But I do like to remember that we get a decent amount of water from our fruits and vegetables. So score another point for those real food and carbohydrates, right?

LEAH: Yeah.

TERESA: Most fruits and vegetables have 85 to 90 percent water content. Even foods like yogurt or cottage cheese are about 80 to 85 percent water.

LEAH: Mm hmm.

TERESA: And like I said earlier, if a cold beverage doesn't sound good to you during these cold months, dishes like soups and stews and hot herbal teas or bone broths are other ways to push up your fluids without having to drink plain water. And Leah, I will say, I get the side eye from clients more often than not when I bring up bone broth.

LEAH: Same.

TERESA: Are you a bone broth or a tea drinker? Do you have any recommendations for that?

LEAH: Oh, those are really great questions. I wish I liked tea more. I call it grass water. And now to be fair, I don't mind a good cup of tea here and there, especially if I want to warm up or if I just want something other than water.

At our offices, we carry a few brands of organic teas, including Choice organics and Yogi teas. And actually I had discovered Yogi teas, gosh, I think back when my husband and I were dating, so this is like 12, 14 years ago, somewhere in that range. And like, they have a really, I think, great wide variety of teas to choose from. So like you can find maybe those one or two go to flavors or profiles for you.

There is a local tea store that's close to our St. Paul office called Tea Source, and they do a really lovely red berries herbal tea. To me, it feels almost a little bit more like juice than an actual tea. Maybe that's why I like it. I do think it's better as an iced tea in the summer, so again, not necessarily seasonally appropriate right now, but I have had it warm also. So tea is absolutely an option. There's lots of different ways to go about that and then I…

TERESA: Can I tell you something about tea though that I've discovered cause I'm not a huge; I'll drink green tea, but I just do it

LEAH: Because you know it's good for you, right?

TERESA: Right. So in the winter I can do that. In the summer I won't. But for our bedtime people if you're looking to do a tea before bedtime, I found this great berry flavored sleepy time tea. So it's got some, I think it's passion flower and chamomile and just some like calming herbs in it.

LEAH: Yeah.

TERESA: And it's got a nice berry flavor, but what I do, cause it's still like, you know, how teas don't have a very strong flavor and maybe some people are looking for a little more sweetness to it; I will add a scoop of our Reacted Magnesium Powder, which has stevia in it, so then I'm getting some magnesium for sleep, and it's adding sweetness to that tea, and it's great if you have cravings before bed, and another way to hydrate.

LEAH: And a way to promote relaxation, sleep, that wind down time. So like a three for one, you can almost say.

TERESA: I just love it. It's my nighttime ritual.

LEAH: Love that. Bone broth: I definitely understand the hesitancy around bone broth. I same, I get kind of the side eye from people and like, you really want me to drink a mug of that? So, I, I know I'm personally hit or miss with how consistently I make bone broth in my instant pot. And most of my clients, they prefer to save it for making those dishes, like a good soup or a stew or something versus like actually drinking a straight up mug of it.

But let's remember that bone broth is also a wonderful source of collagen, which is the main protein that makes up our skin. So if your skin has some repair work to do, and kind of what comes to my mind right now too, is like, our healthcare workers. So my skin is dry, but I'm also not washing my hands 25 times a day working in a hospital in a clinic setting, like working hands on with patients too.

So, I have seen clients that come in and they have these cuts or like their hands just kind of almost get torn apart by the scrubbing and the soaps and everything like that. So like someone who has that rough, dry skin like that might want to think about having some collagen, whether it's from bone broth or something like our Key Collagen in the mix to help do some of that repair work for the skin. So that can just be a nice, helpful tool in the toolbox.

Electrolytes: another tool to help with hydration

TERESA: Yeah, that's a great idea. I love that. Another tool that we can use in order to help with hydration are electrolytes. This is one of my favorite ways to flavor up my water while also leveling up the hydration I get from the water. If you think about it, our blood has water in it, of course, but it also has sodium, potassium, magnesium, chloride, calcium, and other ions floating around in it. So it makes sense that doing some water with some of these nutrients helps to match up with our inner biochemistry.

LEAH: Yeah, absolutely. And quick, just quick little personal story on this particular topic. So during my first postpartum experience with my son, so this is six years ago now, I was not prepared for the hydration demands of that full time, like round the clock nursing. I thought, and I'm sure I was a pretty good water drinker going into pregnancy and postpartum.

But I remember after those first few weeks of nursing and the milk supply really ramping up, I had the worst chapped lips I've ever had in my entire life. In my postpartum brain fog, it didn't occur to me right away that I needed to actually be like slamming water all the time to keep up with those demands.

And eventually I figured it out and I, like, my strategy ended up being, like, wherever the common places were that I was nursing, whether it was in my son's room, on the couch, in my room or whatever, I just made sure like there was water stashed at all of those places so I never got stuck somewhere without having water.

So that helped my lips significantly. Now fast forward to postpartum number two with my daughter, I actually made sure to stock up on some high sodium electrolytes before giving birth. And I actually found it much easier to stay hydrated on a lower volume of water compared to that first postpartum experience with my son.

So even now, I don't let our household run out of those electrolytes like you, Teresa. It's just one of those easy ways to just help. It flavors the water a little bit, and it also helps match that inner biochemistry. And we were talking about this before we recorded, but my kids have been struggling a lot with chapped lips, also kind of on that topic, so I think even more so this year than in the past for some reason. So in addition to the chapstick, I’m also giving them a little bit of electrolytes in their water most just to help.

TERESA: Yes. It, electrolytes. Like you said, it can be so helpful in the context of dry lips and dry skin. And I, you know, with your kids, it's just, I, with my daughter, I just keep saying over and over, stop licking your lips, stop licking your lips. So I might have to try some with her too. I wonder if she'll like that salty taste or not.

Healthy fats are hydrating

There's another way though, that we can hydrate our skin besides water. And that's with healthy fats in our diets and supplements. So let me get a little “sciencey” here for a minute and explain some anatomy. The outermost layer of our physical skin is called the stratum corneum. Part of this layer is made up of a lipid matrix.

It is believed that this matrix should be made up of 50 percent ceramides, which are like this waxy, fatty molecule; 25 percent cholesterol, and 10-20 percent free fatty acids. This lipid matrix makes our skin waterproof, so to say, or in a sense, it seals water into our skin cells and also helps prevent excessive water loss.

And maybe, I don't know, when you're watching TV, you've seen skincare products on TV or in the store that have ceramides added to them. Well, now maybe it makes sense why they're there. And who would have thought that we needed cholesterol for our skin to function well?

LEAH: Yeah, I mean, who would have thought, indeed, that's actually not one of the first things I would have thought about either, like, even after working here, we think about it for our hormones and for heart health and all of that stuff, but not necessarily for skin.

So maybe that's just another reason to keep adding some eggs and some seafood and some steak into your eating plan. And while we're at it, don't forget to use some butter with those eggs. Mash some avocados onto your taco salad and spread some peanut butter or almond butter on your apple or banana for a quick snack. Every bite of these healthy fats matters for your skin.

Omega-3 & 6 fatty acids: crucial for skin barrier function

But I also want to call out some very special fatty acids that are crucial for skin barrier function. And those are omega-3 fatty acids and omega-6.

TERESA: Those beautiful omega-3 fats have been shown to improve skin dryness, roughness, and reduce water loss from the skin. Omega-3s also decrease inflammation, which helps skin integrity and keeps things intact. The thing with omega-3 fats is that you have to be really intentional if you're going to get enough through diet alone.

According to a study published in the BMJ Open in 2021, 68 percent of adults and 95 percent of children fall short of the dietary guidelines omega-3 recommendations. The recommendations are 1 to 1.6 grams of omega-3s per day. That's about 3 ounces of salmon or sardines every single day. Or 13 ounces of shrimp every day. So that could, that could get a little pricey.

LEAH: A little pricey. I mean, I love shrimp, but I'm not sure I can get behind 13 ounces of shrimp a day. Like that's a lot. Yeah, so, and then omega-threes, there's, here's one other little nuance with those omega-threes. So you'll hear about flax seeds and flax seed oil and walnuts and chia seeds and actually even canola oil having omega-threes. But this is a plant form of omega-3s called ALA.

ALA has to be converted to EPA and DHA in the body to have many of the beneficial effects that you were just talking about a minute ago, Teresa. We humans do this conversion in the liver, but we only convert about 5, maybe 8 percent or so of that ALA to EPA, and only about 0.05 percent of ALA To DHA.

So it's not really a great return on investment compared to like if you just actually ate EPA and DHA in the form of the animal sources of omega-threes. So in other words, you could eat your heart out of walnuts and flax seeds and just still potentially not get the skin or inflammation benefits that you're looking for when it comes to those omega-threes.

And don't get me wrong, there's plenty of other reasons to eat walnuts and flax seeds and chia seeds. They're great fiber, some, some other great nutrients in them. They're just not going to be your go-tos, your best go-tos for those omega-3s.

TERESA: Yeah, that's such a great distinction to highlight because I think sometimes we just look up those numbers online and we think, oh, well, this is fantastic. We're just obviously, our body, if we eat it, that's what we're going to absorb, but we know that there's more to that, and so it's really good that you pointed that out.

LEAH: Or that, like, an omega-3 is an omega-3 is an omega-3, and that there's actually some differences, there's actually some, like, again, like, just some nuance to the story.

TERESA: Mm hmm.

LEAH: So on that note, we'll have, we'll take a quick break and then we will actually continue our conversation about nutritional solutions for dry skin. So we'll be right back.

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TERESA: Welcome back. You are listening to Dishing Up Nutrition's weekly podcast. Before we went to break, we were talking about omega-3 fatty acids and its role in skin hydration. And we were just about to talk about some ways that we can get some omega-3s in our diet through food and just how often we need to eat that too, that we really need that daily dose so that can get, that can get kind of tricky. If you are able and willing to eat some kind of fatty fish even once or twice a week, your skin is going to thank you for it.

LEAH: Yeah.

TERESA: And I've got to say, I was able to get some halibut from a local fisherman that goes up to Alaska and brought back some halibut and salmon. But since we talk about salmon so often, I thought I would share more of a recipe for halibut.

LEAH: Love it.

TERESA: Now, halibut is not as rich of a source of omega-3s as salmon is. It's about 500 milligrams or a half a gram per four ounce serving. So it's not quite as strong, but I know for a lot of people out there, some fish are just too fishy and halibut being a white fish, for those people who will tolerate more white fish than some of the others, this might be a good option.

So what I've been doing with this fish is I just do a very light dusting of a gluten free flour on it. And it's just because I want to build just a little bit of a crust on it when I'm cooking it. So just a dusting of a gluten free flour and then salt and pepper. And that's, that's really about it.

LEAH: That's simple.

TERESA: And then what I do is just get a stainless steel pan, relatively hot. I'm going to be putting butter in the pan, so I don't want it, I want it to melt, but I don't want it to burn. So once it turns brown, I don't really like that. So I keep the temperature hot enough, so it doesn't, so it'll be hot, but not browning that butter and then also adding avocado oil.

So I can bring that temperature up a little hotter. And so we have those two melted in there. And really just searing it on both sides. Well, maybe searing, I'm cooking it through. So obviously it's not just a sear, but building that crust for about four, maybe six minutes, depending on how thick that halibut is, and then flipping it over once.

And then doing the same thing on the other side. And it's great. I mean, it's, that's what I love about fish. It's so simple. You don't have to put a lot of culinary flair on fish. Cause it's just so good in and of itself. And so that's, that's been kind of my favorite and my kids really like it too. I love it when that happens. If we have one thing that everybody likes, I mean, Hallelujah.

LEAH: Like the unicorn meal where it's like everyone can sit down and enjoy it.

TERESA: Everybody's happy.

LEAH: Yeah. Love that idea.

TERESA: For those who keep fish at a broomstick's distance or just don't get fish in on a daily or even weekly basis, this would be a time to look at quality omega-3 supplementation like our Nutrikey Omega-3 1000 or Omega-3 Extra Strength liquid or the softgels.

One to two softgels per day would get you in that range recommended by the dietary guidelines. However, like many of my clients, if you need to make up ground and recover from an omega-3 deficiency, going higher in your dose for a while will help close that gap quicker. Depending on how someone's skin looks and how much inflammation they may have, I don't hesitate to go up to three or even up to six soft gels per day for a few months.

LEAH: Mm hmm. Yeah, I do the same thing. Omega-3s are just one of those cornerstone supplements that I recommend all the time for clients because they just do so many great things for us and really, honestly, a good portion of my clients come in already using an omega-3 supplement because they know it's important, but omega-6 supplements, now that's much less common.

Overviewing omega-6 fatty acids & their importance for dry skin

So that's something. When I bring that up in a consultation, that's usually something new that people are hearing about. So we're going to pivot off of the omega 3s here for a minute, and we're going to talk about the flip side of the coin, which is those omega-6s. Now, we actually get a lot of omega-6 fatty acids in our standard processed foods American diet, mostly because everything is cooked or it uses vegetable oils, soybean oil, corn oil, more of those refined seed and vegetable oils.

And research shows that we typically get a ratio anywhere from like 15 to 1 to 20 to 1 of omega-6s to omega-3s. That's kind of like standard American diet. A better ratio would be more like two to one or three to one. So like we're kind of blowing that one out of the water.

TERESA: In a negative way.

LEAH: Yes, in a negative way, yeah. So we can start to close that gap and kind of shrink that ratio back down by kicking those refined oils to the curb as much as we can and increasing our omega-3 intake. But just like we talked about all omega-3s are not equal, not all omega-6s are created equal either. So there is a special form of omega-6 fatty acids called GLA, which stands for gamma linolenic acid.

This particular omega-6 is anti-inflammatory. It may increase some of those ceramides that we talked about earlier. It increases the synthesis of those ceramides and may improve skin barrier function overall.

TERESA: I love GLA. Personally, I use GLA seasonally. I only take GLA in the winter months when it's so dry. And the way I can tell that it's working is that my cuticles don't crack. Once my cuticles start cracking, I'm like, okay, it's time to start the GLA.

LEAH: Yeah. So you take your vitamin D and up your vitamin D and boom, time for some GLA also.

TERESA: Yeah exactly. GLA is found directly in some unique oils like evening primrose oil, black currant seed oil, and borage oil, but you're not going to find these types of oils on the store shelves. These need to be taken as a softgel or a liquid supplement. We can eat whole foods that contain linoleic acid like different nuts and seeds and even some meats and then our liver, it converts that linoleic acid to GLA.

However, like the omega-3s, the conversion process from linoleic acid to GLA works okay in some people and hardly works at all in other people. So if you are someone who eats walnuts and almonds, cashews, pumpkin seeds, and you still struggle with a lot of dry, cracking skin, you may be someone who does not turn linoleic acid into GLA very well.

LEAH: Right. So in that situation, again, like we might consider doing a trial with some supplementation. So our Nutrikey GLA-160 is made from borage oil. And usually when I'm getting somebody started on this, I commonly recommend four to six softgels a day to help with those dry tissues. This amounts to 640 milligrams to 960 milligrams of GLA per day.

So again, we're going a little higher dose. I'd say most people don't need this much GLA super long term. But again, by the time we're seeing dry skin or we're seeing other symptoms like hormone hormonal symptoms, which we're not even going to get into that today, we're already digging out from a GLA fatty acid deficiency. A lot of times I will say we need those higher doses at least for, again, probably a few months.

Vitamin C’s role in skin health

TERESA: Yeah, agreed. Well, before we wrap up our show today, I think we'd be remiss if we didn't discuss one very familiar nutrient when it comes to skin health and one less familiar nutrient for skin health. The familiar nutrient is vitamin C. Like ceramides, this is a popular ingredient added to many skincare products for its anti-aging effects and to enhance hydration.

I feel like this one makes a lot of sense. We know that vitamin C is needed for our body to make collagen protein, which helps with the firmness and the integrity of our skin. Scurvy, which is a severe vitamin C deficiency, is actually a disease where the collagen can't form in skin, gums, and mucous membranes.

And the skin literally starts to unravel. And you can bruise very easily and even bleed to death. On the other hand, when you have enough vitamin C and collagen, your skin cells are, I guess how I would describe it as, like, glued together.

LEAH: Yeah. Yeah.

TERESA: The skin cells that are better glued together retain water better.

LEAH: Yeah. That makes a lot of sense. And I know when I'm one of those people, when I hear that term skin health, like one of my first thoughts is vitamin C. Oh yeah, that one makes a lot of sense. And you're right. It's like you go through the skincare aisle and like probably 10 out of 12 products have vitamin C added to it. So again, like everyone's caught on to that.

TERESA: Right. They're in some sort of orange or yellow packaging.

LEAH: Yeah, absolutely. Makes you think of the sunshine or an orange or something like that.

Calcium: also helpful for skin integrity

But okay, so that's the popular one, but the other less familiar nutrient that is helpful for skin integrity is calcium. In short, calcium also helps with that kind of process of keeping the skin cells glued together and keeping our skin more like, leak proof. And I had to kind of rack my brain a little bit and think about, okay, well, what foods could we find in a whole food diet that have both vitamin C and calcium together?

And I admit I did jump into a quick little Google search on that also. But some of the foods that popped up were, you know, I was, I was hoping they wouldn't be too off the wall, but things like yams and sweet potatoes, that's one example. Watermelons, squash, raspberries, like most of the berries made that list.

Plums, oranges, broccoli, limes, avocados, and then actually some of our seafood items like crab, mussels, and squid. I mean, people probably aren't eating a ton of those, but we're eating some of those other like real food types of carbohydrates. And, you know, they might not be hugely rich, I would say in calcium, probably more rich in vitamin C, but these are examples of natural foods where you get that one, two punch together with the vitamin C and the calcium.

TERESA: Yeah, I think that that's really interesting. I would not have come up with that list if you said, what are some calcium rich foods that also have vitamin C? That's a good quiz even for a dietitian, right?

LEAH: Yeah, if I was on a game show and had to answer that, I probably would have been like, well, maybe we take some yogurt and put some fruit in that, like, do a combo like that, which is, you know, it's a popular snack that we'll recommend for clients too, but again, two for one.

TERESA: Right.

LEAH: Can't go wrong there.

TERESA: I just want to point out that many of those fruits and vegetables are hitting skin hydration from several different angles. So that's wonderful, right? It's got a high water content. There are electrolytes like potassium and magnesium. There's vitamin C and calcium. So for the listeners out there, could you see yourself eating a cup or two of vegetables and some fruits at every meal throughout the day to address your dry, rough skin? I think it sounds like a delicious way to do it.

LEAH: Yeah, I agree.

TERESA: Are there any gaps in your day where you're skipping over some of those colorful additions to your plate or to your bowl?

LEAH: Mm hmm. Or maybe you're someone who already does great with a variety of fruits and vegetables, but maybe you're someone who followed a low fat or low calorie diet for years or even decades, and now you need to level up on the quality and quantity of your fat.

Or maybe you just hate water and everything it stands for. I've had those people too. So staying hydrated with liquids has been a long standing challenge. Hopefully this show has covered wherever you're at and helped you think about some of those next steps to address your dry skin, and if you're still looking for help and relief or just needing some other fresh ideas, take the time, give our offices a call and ask some more questions or schedule a one-on-one consultation with Teresa or I or one of our colleagues.

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TERESA: Our goal at Nutritional Weight & Wellness is to provide each and every person with practical, real-life solutions for everyday health through eating real food. It's a simple, yet powerful message. Eating real food is life-changing. Thank you for listening and have a wonderful day.