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A to Z: Nutrition for the Skin
Kenneth H. Cooper, M.D., M.P.H.

Unfortunately today more than ever, we are being bombarded with environmental "triggers" that stimulate the production of free radicals, which can cause a variety of diseases, including atherosclerosis. In addition, free radicals can accelerate the aging process of the skin, resulting in wrinkles and sunspots, not to mention an increased risk of skin cancer. A free radical is an unstable oxygen molecule that has become damaged due to factors such as cigarette smoke, air pollution, ultraviolet light, pesticides, radiation, emotional stress, and excessive exercise. This unstable oxygen molecule must find another electron to make itself complete, so it begins to start bombarding other molecules, resulting in injury to surrounding tissue. Free radicals are common in all people, and the body can, for the most part, defend itself with its endogenous antioxidants. "Endogenous" antioxidants are those antioxidants that are naturally in the body that serve as "free radical scavengers." However, these endogenous antioxidants can be used up very quickly and this is why it is important to take antioxidants in supplement form. These antioxidants are important in protecting you from disease and can help shield you from skin cancer, maintain youthful, healthy skin, and even help to promote and expedite the healing process after a surgical procedure.

To help you understand how an antioxidant works to protect you from free radicals, imagine the following scenario. A beautiful woman is walking down a dark alley all alone and suddenly a stalker comes out of nowhere with plans to harm her. Before the stalker gets to her, a young man jumps in front of her and kills the stalker, but is killed himself in the process. In this scenario, the woman is your body, the stalker is the free radical, and the young man is the antioxidant. Antioxidants merely "donate" the missing component to the free radical, making it complete and rendering it harmless. 

Although overall balanced nutrition is the starting point for successful healing of surgical wounds, the most recent research has placed emphasis on the role and intake of certain specific nutrients. These include the antioxidants vitamins C, E and beta carotene, as well as zinc, and the amino acid arginine. If you are considering plastic surgery, or have already had a surgical procedure to correct or rejuvenate a bodily feature, you know that you should anticipate some swelling, bruising and tenderness, but of most concern is the prevention of infection and the proper healing of the wound. A vitamin deficiency can result in a slow healing process or even hinder your body from effectively fighting a potential infection. Therefore, it is important to be sure to maintain a well balanced diet including a wide variety of fruits and vegetables. In addition, there are specific nutritional supplements that you may want to consider adding to your daily regime. However, it is necessary that you always check with your personal physician before starting any nutritional supplementation.

Vitamin A, in the form of beta carotene
Beta carotene is a pro-vitamin A, which means that once it enters the body it is converted to vitamin A. Carotenoids, including beta carotene, come in several different forms and are actually better absorbed in a supplement form than from foods. The carotenoids in foods are locked in a fibrous matrix that is difficult for the body to break down. Cooking the foods helps to break down the matrix, which helps to increase absorption, but overcooking could actually break down the nutrients in the carotenoids themselves. Carotenoid supplements, because they do not contain this matrix, are very well absorbed. The natural form of beta carotene comes from a type of algae, usually Dunaliella salina. The natural form of beta carotene has a different composition than the synthetic form. It actually contains a chemical, which is the primary antioxidant part of the vitamin. The synthetic beta carotene, which is water dispersible (acetate, and palmitate), does not contain this important element and has much weaker antioxidant properties. Beta carotene supplements, taken in doses of 5,000 IU a day can help in the wound healing process both before and after surgery. 

Arginine
Arginine is an amino acid, one of the building blocks that make up protein, and is responsible for the growth and continued health of bodies, including the skin. It has been linked to enhanced immunity and wound healing and can be found in foods such as fortified oat flakes, cooked oatmeal, wheat germ, cottage cheese, beef, and nuts. There are no official RDA's for amino acids and it is advisable to take these supplements only under a doctor's supervision. The best advice is to get this amino acid through your diet.

Vitamin C
The water soluble vitamin C plays an important role in the formation of collagen, which is important for the growth and repair of body tissue cells, gums, blood vessels, bones, and teeth. Vitamin C also has anti-inflammatory properties, which may also be useful in the reduction of swelling and tenderness of a wound. It is particularly important for smokers to take vitamin C supplements because epidemiological studies have shown that smokers have a significantly lower plasma level of vitamin C compared with nonsmokers. We also know from scientific literature that vitamins C and E can protect you from ultraviolet skin damage. 

There has been a lot of hype about the superiority of vitamin C with rose hips or esterfied vitamin C, as opposed to the synthetic form, ascorbic acid. There is not any truth to these claims. The body recognizes and absorbs all three types of vitamin C equally. The only reason why a person may want to consider taking a natural vitamin C is if they are allergic to citric acids. However, if you are allergic to pollen then you probably should take the synthetic vitamin C. My recommendation is to take 500 mg twice a day.

Vitamin E, d-alpha tocopherol
Vitamin E is a powerful antioxidant that fights the destructive effects of free radicals in the body. It also has anti-inflammatory properties that can help reduce the pain and swelling after surgery. However, it is also an anticoagulant (blood thinner). For this reason, I do not recommend that you take this supplement just before a surgical procedure. However, this vitamin should be a part of your daily vitamin supplement intake after surgery. According to a recent federal survey, 30 percent of U.S. adults are vitamin E deficient, a condition that can raise heart disease and cancer risks, according to the Center for Disease Control. Perhaps one of the main reasons why Americans to not get enough vitamin E is because it is impossible to get all you need from your diet. In fact, you would have to eat 40 cups of almonds to get the amount that the Cooper Clinic recommends. 

The best form of vitamin E is its natural form, d-alpha tocopherol. This form of vitamin E comes from sources such as soybeans and is five times more potent than the synthetic form dl-alpha tocopherol. In addition, some research has indicated that the dry form of vitamin E (succinate) is more easily absorbed then the oily form (acetate). Bottom line, you will have to pay a little more for this type of vitamin E, but this is an instance where you get what you pay for. I recommend 800 IU of d-alpha tocopherol after surgery and would urge you to continue to take this supplement indefinitely.

Zinc
Zinc is essential for normal pregnancies, growth and transmission if our genetic material. It is also required as an enzyme component of the eyes, liver, kidneys, muscles, and skin. Almost all of our cells contain zinc, with the highest concentration in the bones, prostate glands, and eyes. A zinc deficiency can result in a delayed healing of wounds; therefore, it is important to consume 15 mg a day from food sources such as lean meats, nuts, legumes, and whole grain products. However, if you are vegetarian or have a poor diet, zinc supplements might be a consideration if you are having a surgical procedure. It is not recommended to take zinc supplements long term, as there is a potential for zinc toxicity or zinc poisoning when taking zinc at higher doses. 

The best thing that you can do to prepare for a surgical procedure is to eat a healthy diet. Take a moment to critically assess your nutritional habits and try to fill the gaps. In addition, a good multivitamin is necessary to help you fight disease and to keep your skin healthy. 

Recognized through his writings and research as the leader of the international physical fitness movement, Kenneth H. Cooper, M.D., M.P.H., has been credited with motivating more people to exercise in pursuit of good health than any other person. As President and Founder of The Cooper Aerobics Center, Dr. Cooper has emphasized the importance of basic and epidemiological research to document unequivocally, the value of exercise in the practice of preventive, diagnostic, and rehabilitative medicine. Over the last three years, he has begun to do the same thing with vitamin supplementation. With the formulation of Cooper CompleteŽ vitamins in 1997, The Cooper Institute has recently embarked on a clinical trial to validate the necessity of good nutrition and vitamin supplementation in the prevention of disease. For more information about Dr. Cooper, The Cooper Aerobics Center, and the Cooper Complete vitamins, visit www.cooperwellness.com.

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