The Extra Scoop: Collagen and the Supplement Boom

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0:59Welcome to The Extra Scoop, our expert-led bonus episodes, giving you the need to know on the topics everybody is talking about. That's right, from gut health to sleep, hormones to skin, we are cutting through the noise with top experts, so there is no fluff, just facts. Exactly, it's all quick, practical, evidence-based advice to fit into your busy lives. So this is The Extra Scoop, let's get started.

1:28so as our listeners may know our extra scoop episodes are all about taking the topics that everybody's talking about and quickly breaking them down for you so that you have expert-led insights that leave you informed and empowered when it comes to your well-being and you love the episode where we discussed supplements so we wanted to bring in a leading expert to dive into a variety of supplements really for a deeper extra scoop. Now the supplement space can feel pretty overwhelming to say the least. There's so much conflicting advice. People don't know what to believe. And we wanted to explore questions like, is a balanced diet enough?

2:05And what about all the trending supplements we see online like collagen? And more recently, I think the subject of AI is probably going to crop up in this episode too. So to help us cut through the noise, We're joined by the incredible Dr. Karan Rajan, and you might have seen him on social media where he breaks down medical myths and shares honest science-backed advice in a way that's refreshingly clear, I have to say, and actually genuinely engaging. So we're excited to have you today. Welcome, Karan. Thank you so much for having me. It's a pleasure to be here. Thank you so much for joining us.

2:39I think, as we said in that intro, the world of supplements is so overwhelming. Most of us are being targeted by ads all day, every day of different supplements. You're always reading in various different magazines, like the eight things you need to take for X, Y or Z. And I guess just to start at the top, is a balanced diet enough? Like, do we fundamentally need supplements? Yeah, I think, you know, there is no black and white answer with these things. And it really varies depending on someone's circumstances, their age, their physiological requirements at a certain point in life, their activity levels.

3:16So there's so many factors which could influence whether someone does need a certain supplement. And I've changed and I've softened my stance so much over the years. And I'm now more accepting of the fact that actually supplements can be a useful adjunct to a lot of people's lives. And that's the key word, adjunct. I don't think supplements can replace a good nutritious diet and it can't be a crutch for that long term, but it can actually improve someone's health if taken for the appropriate reason. It's really true. And I think we know there's some evidence based reasons or at different stages in your life where obviously something is going to come into play.

3:54but the nutrition you get from food is just so powerful. But let's talk about this boom in supplements because the industry is just gigantic and we have to go straight in there with collagen because it's everywhere, isn't it? Skincare, all sorts of reasons now. So what exactly is collagen? Let's go there. And why is it getting so much attention? Yeah, this good collagen hype, I think when it first came around, I was very, very skeptical about collagen when I first heard about it over 10 years ago. And I still remain slightly skeptical, but I think now the needle has slightly shifted and there's more and more evidence behind it.

4:34And I really want to sort of, you know, break it down in detail. So collagen is a protein and we have these collagen proteins in our body. They're essentially, they're scaffold proteins that help maintain the integrity and structure of our skin and our hair and our nails, etc. So we need collagen. And I think after the age of 25, every year, we'll have some degree of collagen loss with time. And that contributes to wrinkles and fine lines and all of those cosmetic appearances. And when it comes to supplements, so collagen is a protein, the protein is broken down into smaller peptides, those peptides are then broken down into even smaller components called amino acids.

5:15And obviously, we can get those amino acids and peptides from food. When it comes to collagen supplements, now there's collagen creams and also the powders and pills that you can ingest orally. A lot of the time they're sold as hydrolyzed collagen. So they're already pre-broken down of these sort of peptides. And you might think, okay, if it's broken down into these peptides and amino acids, how different is it from any other source of protein? And this was my concern initially. However, looking at some of the research and looking at some of the science, collagen has a specific type of amino acid called hydroxyproline, which is specific for collagen.

5:53Now, we can't consume collagen supplements and assume all of that is going to make its way to the skin and contribute to skin health. Our body will decide what it does with those amino acids and those peptides, use it however it needs. However, there is some evidence, although limited, and it needs more research that the hydroxyproline amino acid can serve as some sort of signaling molecule and actually increase some degree of collagen synthesis in the skin. But this doesn't mean to say that collagen supplements are effective for skin health because we can talk about the studies and the quality of those studies and how they report the results in those studies.

6:40Ultimately, the lifestyle factors to maintain collagen are way more important, like avoiding smoking, sun protection, retinol potentially to stimulate collagen synthesis. All of those things are far more evidence-based and important for collagen sort of maintenance and prevention of significant loss. So I think just to kind of put myself in our listeners position, they are online and they're seeing these people, these influencers talk about, you know, these are the eight things I do for anti-aging or to keep my skin looking like this at 45 or whatever it is. And collagen's one of those blocks.

7:18People are pouring it into their coffees these days. It's in all these smoothies. It sort of feels, and again, you pick up the newspaper and various different lifestyle magazines, and it's talking about collagen will really support anti-aging. And what you're saying is that there's no kind of really, really robust evidence to show spending lots and lots of money on collagen supplements will necessarily do that as opposed to putting the time and effort into the lifestyle factors. Yeah, because ultimately, if you look at the risk profile of these supplements, and that's something someone should look at quite carefully, the risk profile, I don't think there is a huge worry that there's a lot of side effects with collagen.

7:58I mean, you need to make sure it's not contaminated with other stuff. But collagen itself, if you take it, it's not going to do much beyond draining your wallet. So, you know, if someone has the money and they see some effect from collagen and they want to continue taking it, fine. But, you know, make sure you're doing all those other things as well. And, you know, it comes back to the point that a lot of those studies on collagen, number one, a lot of industry funding. Number two, the outcomes and results are based on subjective reporting. You know, it sort of improves skin appearance based on someone saying, oh yeah, I took collagen for a month and I think that my skin looks better and more plump.

8:36So there's not these objective endpoints like you'd get with other nutritional studies where you're actually looking at blood glucose control, CRP and other sort of specific blood markers. So it's difficult to actually say collagen does X, Y, and Z if you take it as a supplement. What's so interesting is you use the word risk there and something I'm always hammering on about obviously in my line of work as well is do you know where the supplements come from a lot of things are not regulated on the online space as karen and i know we were both a target of the same ai crazy videos pretending to be us selling something that effectively we haven't vetted or vouched for so for the consumer it's incredibly important to know what's inside these pills and sometimes taking too much is equally dangerous.

9:23Could you just delve into the risk factor a little bit more there for people? Because I don't think people think, they just think what they buy online is what they get. Yeah. So, you know, I think it's pretty well established that the supplements industry is lacking a lot of rigor and regulation. And it's up to the supplement companies themselves to provide evidence of third party testing, safety, purity, quality, sourcing. So, you know, really quality supplements, they will spend tens of thousands to make sure they've got all of these high level testing for heavy metal contamination and whatnot.

9:59And then other sort of, you know, lower end supplement companies may not be able to afford or want to do, you know, jump through those hoops necessarily, either because their product is sourced from very cheap places. And so, yeah, you do need to do some degree of due diligence. And I think just because you see something and you've seen the purported benefits of it, that is just one step. But then you need to actually do your due diligence on that company. It may even be worth the extra five, 10 minutes of looking at that company online to see what third party testing they've done on the purity.

10:33Does it have a hundred percent of collagen in it? Or does it just contain 5 %? Like there was a recent creatine gummies scandal where there was a company, which I won't name here, claimed to have a certain amount of milligrams of creatine in their gummies and was found to have zero creatine in the gummies. And, you know, they've sort of gone out of business for now, but they're probably going to come back. But that itself, I was actually taking those creatine gummies. They tasted great and they tasted great because they didn't contain any creatine. They were just watermelon flavored sugar gelatin gummies.

11:05So they didn't do anything. So definitely be warned when it comes to supplements, you know, you need to just check. And that's a lesson for me. Thank you for being honest about that, because I think that in this world, people think that probably health professionals and people existing in the world of health and wellness don't ever fall for things. So it's really refreshing, I think, if we can bring that honesty to it, because it's so appealing, isn't it, to have something that will give you that quick fix, that tick box, that shortcut to some extent to various different health and wellness goals.

11:35And I think to your point, that is absolutely fascinating to see like how easy it is to market things without the research behind it. And as consumers, it's so overwhelming to navigate and know what to trust and what not to trust. Thinking about what people actually need when it comes to supplements, what's the advice for the kind of general population as to any kind of supplements they definitely need to have? Yeah, I think this comes back to that sort of point I made earlier. it really depends on someone's lifestyle. So for example, if I'm speaking about my own life, I flip-flop so much in supplements.

12:12So several years ago, I would regularly take vitamin D. In the UK, the NHS recommends during the winter months taking X amount of vitamin D. And it's particularly important if you have darker skin because the melanin limits some degree of vitamin D production as well compared to someone with fairer skin. And so I was taking vitamin D. Then I kind of just stopped it. And I thought, you know what? I'm sort of tired of taking these pills. And then in the last few months, I did a random blood test and found I was severely deficient for vitamin D. My levels were around 15.7 nanograms per ml, which is anything less than 20 nanograms per ml is severely deficient.

12:49And I didn't feel symptomatic. And then I took a lot of vitamin D. I experimented and tried a higher dose. And then I actually objectively felt a lot better after I was sufficient after that month of taking it. So that goes to show that I didn't feel any obvious ill effects, but I felt a lot better after supplementing with vitamin D. So, for example, I think vitamin D, most people would probably benefit from taking a vitamin D because you can't consume all of vitamin D from your diet. You can produce a certain amount from your skin being exposed to maybe 20 minutes of, you know, outdoors sunlight every day.

13:24For me, that's a huge part of my life. I also now and then I do take magnesium because magnesium is a cofactor for vitamin D. It also has some evidence that it may improve sleep time. So if I'm doing night shifts, I'm traveling sometimes to recalibrate my sleep. I do take magnesium. It's quite effective. And one thing I take and which I think everyone would probably benefit from in some form, even though I have a good diet with a lot of fiber, I take psyllium husk every day. and psyllium husk if you can get over the mouth feel and how it like feels in your mouth it's quite like gelatinous and viscous it's actually a great thing just to supplement your fiber amount because you've probably heard the recommendation that most people should be consuming somewhere between 25 and 38 grams of fiber a day i consume around 40 45 grams of fiber a day on a you know daily basis but there is no real upper limit on fiber if you eat more that's fine and so i just get an extra 10 just to almost cover my bases with the psyllium husk as well.

14:27So for me, vitamin D, magnesium, psyllium husk, and I think prebiotic fibers as well are quite effective. I've tried a few over the years. So prebiotics are specific types of fibers which can manipulate and influence the microbiome. I think they can be effective as well. But as I said before, different points in different people's lives, like pre-pregnancy, preconception, collagen, choline, B12, folate, I think really think you need to see what your lifestyle is like and maybe even do a blood test panel once a year and see what is required for you. And there are very good supplements and also very bad supplements and stuff in the middle, which kind of won't make much of a difference.

15:09And be open to that for sure, I would say. What you've just said actually echoes why it's such a difficult industry to navigate because it's based on unique requirements most of the time. I think there's a few things in the UK that obviously we highly recommend and we pretty much enforce like vitamin D. Omega-3 is something as well. People that don't consume many oily fish obviously should be thinking about, but then where do they start? It's an overwhelming marketplace. People are looking at cod liver oil supplements versus algae-based supplements. And the algae is preferable, I think, from research as well with quality.

15:43but it's so so interesting that you've said this works for me but to everybody listening what's in your diet and current said get a blood profile and i could not agree more because your gp well you're a doctor current you will know but i often do encourage my clients you don't have to spend money to get this blood test you can sometimes ask for it on the nhs and the only thing it pretty much won't be able to tell you is calcium of course but that's important later on in life as well, midlife onwards, or for women during different phases. Iron, of course, for anemia, there's just so many things, isn't there?

16:18Which is why we can't just bash supplements and say they don't have a place because they do to fill the gaps. But on a blanket level to say, everyone go out and supplement with this one thing. You just can't unless it is pregnancy or vitamin D, I think, or omega-3. Yeah, omega-3 is a really good one that I forgot to mention because the podcast I just recorded with a guest was basically about omega-3s and I couldn't agree more. Most people, if you look at universally, most governments recommend two or more pieces of fatty fish or oily fish per week. And realistically, how many people hit that target?

16:53I know I don't. I do eat salmon now and then, but I don't eat two or more pieces a week. And vegetarians and vegans, they may not be getting that as well. I mean, they have other positive things in their lifestyles, which could actually mitigate or compensate for the lack of omega-3. But I really think, yeah, omega-3, if you're not eating enough fish or you don't eat fish at all, and especially the sort of algal oil, which is the sort of most abundant world source of omega-3s, is really important. And just educating yourself on that because omega-3 is one word, but it consists of three different types of omega-3 fatty acids, two of which the DHA and EPA you get from fish.

17:36And the other one you get ALA, you get from plant foods, and that doesn't convert well enough to the other two. So it's a lot of education that a lot of people need to do for themselves as well. And this is not something I learned in medical school. This is something I learned over the years through self-education. I absolutely love this big focus though on no one size fits all, because I think that it's so much in the kind of marketing and the hype of this industry. You have this, everyone must take this, everyone must take that. This will change your life. And I think that's what makes you feel like, oh, I'm doing it wrong by not taking collagen, by not taking creatine, for example.

18:08And it's so reassuring and refreshing to hear that from you both. I think one question, you mentioned magnesium a minute ago, and whilst collagen is such a hype at the moment, I think magnesium is one of the other big, big supplement hypes. And I would love a 101 on that. I think certainly seeing a lot of content around magnesium really supporting stress and sleep. But I know Ree has also said, you know, be careful with it because it can also just give you diarrhea. So what's the 101 on magnesium? Yeah, exactly. There is definitely a hype around it. And I guess, you know, there's some extent it will be a placebo effect and they take a pill or a powder and they feel better.

18:47But also if they're not getting enough magnesium from their diet and then they take magnesium and then feel good, there's that sort of, you know, attributional bias where you think, wow, this is doing it rather than actually just making sure you're getting your daily recommended amount. There are so many different types of magnesium, you know, there's certain types and formulations, which will be better for sort of the brain mood anxiety, and some which will be better for sort of bowel health and some for relaxation. The ones associated with the sort of brain mental kind of de-stressing magnesium, magnesium glycinate, threonate, those formulations are better for that sleep, brain stress levels.

19:23Magnesium citrate and magnesium oxide, usually better for the bowels, have a more laxative effect. So it's really going through, you know, each different types and learning which is the one which may be most efficacious for you. I don't think magnesium is like a game changer necessarily for any one person if you focus your diet on making sure you get enough magnesium. Things like dark chocolate, pumpkin seeds, dark greens, all of these things are abundant in magnesium. So ensuring first and foremost, your diet is as maximized as it can be in magnesium. And it's not very difficult to get your 100 % RDA if you just look up what are the richest sources of magnesium.

20:04After that, for me, I had a bout of insomnia about, I want to say about 10 years ago now, 11 years ago when I first started as a doctor adjusting to night shifts, I tried everything under the sun for my insomnia. And then I finally tried magnesium just to add it into my mix. And it certainly helped from then. So it's been a go-to thing now and then for me when I want to recalibrate my sleep. It's not something I take every single day. So again, down to what you're saying about personalization, it's really a trial and error sometimes with supplements as well. I couldn't agree more. And then it's about what quantity people take and the guidance out there.

20:43I think I would just ask everybody just to put a little bit of a detective hat on before you purchase and before you consume, because there's pros and cons to everything. And Corinne was doing night shifts, he's working in an extremely difficult job, and you probably were very depleted, I can imagine, at that point in your life of everything. It's so hard, that type of job role. And I'm sure lots of people listening are like, oh, I might give that a go, but just do your research first. And then can I ask you as well about some of the biggest misconceptions that you have seen? I mean, there are so many, it's a very big question, but what is the biggest thing that's really got you going, Oh, I want to do a video on this on my socials.

21:21Cause this has got me, got me riled. Yeah. I mean, there's so many things, right? Where do you start? And I think, you know, if we continue that supplement conversation, it's a lot of these really newer age, vague supplements, which have been around for thousands of years in other cultures. And they've then finally found themselves in Western culture. And they've been sort of rebranded as some sort of miracle cure. We've seen that with a lot of herbal remedies and things like green tea extracts and ashwagandha. Those have become increasingly popular. And my massive word of caution for those specifically herbal extracts, the red yeast extract as well, a lot of these things in high doses can cause liver damage.

22:09And there's a lot of publications on them. Green tea, for example, that's great to drink. It's got catechins and polyphenols. It's great for your health if you're having it once or twice a day. Green tea extract in capsules in high doses, that actually can seriously cause liver damage and there's publications on that. So any herbal remedies, supplements are medications, they're chemicals. They can interact with drugs you're taking, blood thinners and increase the side effect profile of those, make them work less effectively and they can actually cause side effects as well if you've got other specific conditions.

22:43So definitely be mindful of those things. Don't just think they're sort of little treats that you can take to reward yourself, they are medications. Some of them can be powerful. Ashwagandha, for example, can have interactions if you've got thyroid issues. They can interact with thyroid medication. So be highly, highly critical of any supplement you take. And if you are taking other medications, blood pressure, blood thinners, whatever, discuss those with your doctor. It's such great advice. And as I said earlier, we also want these quick fixes. I myself have bought ashwagandha when in moment of stress being like, everyone keeps saying this will take my stress away instead of actually dealing with the stress.

23:23And guess what? There's no kind of miracle fix. It didn't instantly remove all the various stresses of work and childcare juggles, et cetera, that were going on in my life. But it's so tempting to want those easy answers. And I guess on the, to kind of round off the conversation, we've spoken so much about being, yeah, having that detective hat on, looking at your own lifestyle, what do you actually need right now and not necessarily what are you influenced by, by other people or articles, et cetera. If people are really trying to focus on those foundations that we spoke about right at the beginning with collagen, that actually your diet, your sleep, your stress, et cetera, are ultimately more powerful really than many other things that you can add on.

24:02Do you have any kind of wise words, tips, a few takeaways for our listeners as to how to build those healthy foundations to your point that you could then add supplements to, but your first and foremost focus is how do I create the foundations of a healthier life? Yeah, and I think it really is that, right? If you think about health as the roof of a house, it's held up by so many different pillars. Nutrition is a big pillar, but it's just one of those pillars. You can have the best nutrition in the world, but if you're sleeping terribly, you're not moving at all, and you're socially isolated, those are not great things to do, right?

24:38So nutrition vices, so alcohol, smoking, look at that. Can you cut back on those things? How can you focus in your sleep and dial in? Can you get a bit more movement every day? And you don't need to be, you know, Instagram curated and perfect with all of those things. It's just increasing it by a little bit. We know, for example, you know, if you're just walking 2000 steps a day and for every thousand steps more that you take, there's a massive reduction in morbidity and disease and mortality as well and death just by increasing a little bit more. So a thousand more steps per day. So keep doing that.