In episode #125, Dr. Jill interviews Dr. Mark Tager on the topic of Building Skin Beauty From Within. Dr. Tager shares his knowledge on the benefits of eating natural foods for skin beauty and offers some great tips on how to improve your complexion from the inside out!
Key Points
- Top Four areas that you need to know in order to have healthy, glowing skin at all ages
- What 3 key foods should you avoid in order to have the best looking skin
- How we can use lasers and other skin procedures to optimize our skin’s appearance as we age
- What are the top nutrients for healthy skin
The Guest
Mark J. Tager, MD
Website: https://www.drtager.com/ and https://www.changewell.com/
Book: Feed Your Skin Right https://www.amazon.com/Feed-Your-Skin-Right-Personalized/dp/0971625042
Dr. Tager is one of the country’s leading health educators. He is most passionate about building skin health and beauty through combinations of personalized nutrition, intelligent supplementation, and aesthetic treatment. He has served as the founding Vice President of Marketing for Reliant Technologies, where he launched the Fraxel® laser and introduced the science of fractional photothermolysis to physicians around the world. He has also served as Chief Marketing Officer for Syneron. Most recently, Dr. Tager created the 40-hour CME course on Personalized Nutrition for Practitioners on behalf of The American Nutrition Association. He serves as Director of Practice Management for Miami Cosmetic Surgery and is on the faculty of Duke Integrative Medicine. His most recent book is Feed Your Skin Right: Your Personalized Nutrition Plan for Radiant Beauty. He did his medical training at Duke Medical School and Family Practice at the University of Oregon. He lives in San Diego where he is Chief Enhancement Officer for ChangeWell Inc.
Dr. Jill
Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs.
Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names.
A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.
The Podcast
The Video
The Transcript
#125: Dr. Jill interviews Dr. Mark Tager on Building Skin Beauty From Within
Dr. Jill 0:13
Hello everyone, and good afternoon! Welcome to another Dr. Jill Live episode. I'm here with my friend Mark Tager, and I'm going to introduce him in just a moment. If you want to catch other episodes, we've got over one hundred on my YouTube channel, just under my name. You could find us on iTunes, Stitcher, or wherever you listen to podcasts. If you've been enjoying these podcasts and the amazing guests that I have, you can certainly go there and give a rating and review and help us reach more people.
Dr. Jill 0:38
Doctor Tager, it is so exciting to be here with you today. Thank you for taking the time to join me and share [information] about your new book.
Dr. Tager 0:45
It is my pleasure; it is great to be with you, Jill.
Dr. Jill 0:47
[It's great to be with] you too! Years ago, I remember us doing work on speaking and training, and you've trained lots and lots of physicians. So we have a long relationship and have known each other in all of these different worlds, and I'm super excited about your latest project. Before I do, I have to formally introduce you, so people know who you are and what you've been doing.
Dr. Jill 1:05
Dr. Tager is one of the country's leading health educators. He's most passionate about building skin health and beauty through combinations of personalized nutrition, intelligent supplementation, and aesthetic treatment. He has served as the founding Vice President of Marketing for Reliant Technologies, where he launched the Fraxel® laser and introduced the science of fractional photothermolysis to physicians around the world. He has also served as Chief Marketing Officer for Syneron.
Dr. Jill 1:37
Most recently, he created the 40-hour CME course “Personalized Nutrition for Practitioners” on behalf of the American Nutrition Association. He serves as Director of Practice Management for Miami Cosmetic Surgery and is on the faculty of Duke Integrative Medicine. His most recent book [is] Feed Your Skin Right: Your Personalized Nutrition Plan for Radiant Beauty. He did his medical training at Duke Medical School and Family Practice at the University of Oregon. He now lives in San Diego.
Dr. Jill 2:03
I'm just absolutely delighted to have you, Dr. Tager. So many fun accolades. I always love stories, [and I know] you do too. Tell me, how did you get into skin [care]? Way back, years ago, you were teaching physicians how to speak and how to do their businesses, and this is more of a recent journey. So, tell me more about how you got here.
Dr. Tager 2:22
Well, I still train physicians and healthcare professionals to be irresistibly powerful communicators. But my passion for nutrition goes back to medical school, where I started the first nutrition training class for medical students in the United States. Even today, physicians only get about 17 hours of nutrition training in their entire experience. So I did some research with a biochemist, and that got me really looking at this whole field of personalized nutrition. From there, I moved into integrative medicine, where I set up an institute of preventive medicine in Portland, Oregon. I was the Director of Health Promotion for Kaiser Permanente in the Northwest.
Dr. Tager 3:10
Twenty years ago, I got involved with aesthetics, and I just thought, “Wow, this is interesting!” I was invited to become the Chief Marketing Officer for a laser company called The Fraxel® Laser where you put these little, tiny, 150-micron holes in the skin to rejuvenate and resurface it. So now, half of my life is in integrative functional [medicine], and half of my life is in aesthetics. And this book, Feed Your Skin Right, is really my attempt to bring it together.
Dr. Jill 3:44
Gosh, I love that, Dr. Tager. I don't like the term ‘anti-aging,' because it [sounds] like we're fighting against something that's inevitable, right?—we all age. I loved it when I first moved to Boulder. I felt like I found my tribe because, compared to maybe LA—no harm against LA or Miami—some of these cities are known for lots of cosmetic procedures and plastic surgery. I have no problem with that. So if you're listening, you have no problem at all. But for me personally, I'm like, “How do I age well?” I want to have wonderful skin, and like you talked about, from the inside out, it starts there. But I have no problem with microneedling or some of these kinds of laser [treatments] as long as we're optimizing the actual skin. So tell us a little about—you obviously have had lots of experience with nutrition; we'll talk about that. I want to talk a little bit about lasers. Where do you start with the skin? How do you have this glowing, not anti-aging, but beautifully well-aged skin?
Dr. Tager 4:34
I get asked the same four questions that I've been asked for years and years: “What should I eat?” “What supplements should I take?” “What topical should I apply?” And “What procedure should I have?” Everyone wants a really quick answer: “What do I do? What do I do?” And there is an easy answer: It depends. There's no other person on the planet with skin that's the same as yours, so we all need a personalized approach. Most of it—60%–70%—is what you eat. Now, you and I both know that, as clinicians, if we see a patient, we cannot out-supplement their crappy diet; it's just not going to happen. So, most of the beauty from within really starts with diet. And then on top of that, you want intelligent supplementation.
Dr. Tager 5:26
Now, how do you determine intelligence supplementation? You look at your nutrigenomics, your food sensitivities, and your microbiome, and you start to craft a program that's just right for you. So we've spent all this time and energy and maybe $150 billion smearing stuff on our face; most of it just sits on the top of the skin. Look, there are a lot of things that are important, [such as] molecules that get into the skin. But in reality, the best way to get important nutrients into the skin is through the gut into the bloodstream and by tickling the vagus nerve to innovate the skin as well.
Dr. Jill 6:11
Such a great answer. Like you, I've been through my [own] journey. I had cancer and then Crohn's and then mold illness. My skin has reflected it at certain times; now you can see it's pretty clear. But I can tell you all the different things—gut- and toxin-wise—that had massively affected it. If you would have seen me, maybe six or seven years ago, at the worst of the mold, I was full of cystic acne. I knew it was a gut problem because there were fungal metabolites and bacterial metabolites and then the toxin problem. So I love that you talk about that because no amount of product would fix that. When I was at my worst, it really came on. I always say—especially when it's an environmental toxin or gut issue—it took 6–18 months to heal. For most people, it takes a while.
Dr. Tager 6:52
Absolutely! Some of that you can see starting really early. Take acne, for example, and be in your perimenopausal or teenage [years]. The three foods that we know contribute are sugar, dairy, and unhealthy fats. Throw into that a little zinc deficiency and a loss in some hormones, stir it up and those pimples are popping. We see that, so I think even just starting young and getting people to work on their diet [is beneficial].
Dr. Tager 7:24
Particularly sugar, I think, is really such an evil because of glycation. When we have sugar attached to hemoglobin, we have A1C; we see that as a marker for diabetes. We also have sugar that attaches to collagen. When it does that, it makes the collagen more brittle, and that's translated into fine lines, wrinkles, these little guys here [pointing to the area above the upper lip] that a lot of people get, and crepiness in the cheeks.
Dr. Tager 7:58
It's really funny. I will sit with the same patient, usually a female but not always, and say, “Look at this A1C of 8.0. If you don't clean up your diet, you're going to get a heart attack, a stroke, or diabetes.” But then to that same person, you'll say, “If you don't cut down the sugar, you're going to make your wrinkles worse!”
Dr. Jill 8:22
And they listen, right?
Dr. Mark Tager 8:24
And they listen. I think, for our practitioners listening to today, we all strive to get our patients into this room called ‘wellness,' ‘well-being,' and ‘optimal health.' Well, one of the biggest doors—in fact, you could drive a truck through it—is aesthetics, vanity, and how we look. So, I really think it's time for these disciplines to come together. It's time for aesthetic professionals to do a process of inquiry. It's time for the integrative folks to do a process of inquiry to start helping patients and guiding them to beautiful skin from within.
Dr. Jill 9:06
I love it! Like you said, I'm always with a patient, and I may look at their numbers for cholesterol, their numbers for diabetes, or their numbers for inflammation, and that's my concern because I know where that leads, but I always have to check with them, “What matters to you?” And it might be walking one more mile to be able to walk with her grandchildren, or it might be something very practical. And when it comes to our ‘billboard' to the world…
Dr. Jill 9:28
I'll just tell you a really quick story, Mark. I remember in the worst of the mold, I had literally red bleeding circles around my eyes because of so much inflammation. I remember sitting in a car one day, and I couldn't even go into the meeting I was going to go into because I was crying and thinking: “I'm supposed to be a healer,” and my billboard, “my walking face to the world, looks horrendous. No one would believe that I can heal because I can't heal myself right now.” Of course, it was just time, inflammation, and mold. But I love that you say that because every one of us is a walking billboard for our internal health systems. Even if we think cosmetics don't matter, they do, because that vibrancy, the shine, and the way we show up in the world, a huge portion [of that] is [reflected by] our skin. This does matter. So I just want to validate [that] because it may seem superficial; I don't think it is.
Dr. Tager 10:16
It is not superficial at all. It reflects on our self-esteem; it is the mirror of how healthy we are inside as well. When I talk about procedures, of course, I live in the west—on the left coast, the west coast—and there is a lot of really bad plastic surgery, and a lot of people undergo a lot of procedures. What I talk about in my book, Feed Your Skin Right, are those procedures and those things that are bio-stimulatory.
Dr. Tager 10:48
If you do hyaluronic acids, or if you do neurotoxins—for the most part, the facials that we usually do during the microdermabrasion are all external—they're all [for] the epidermis. But when we start stimulating the dermis to produce more collagen and elastin and something called GAGs—glycosaminoglycans, big word—[which] is a good sugar and a good protein that gets together and attracts and holds water, that's when they inject hyaluronic acid. That's, in fact, what they're doing. But you can do that naturally, and the way you do that is to provide your body with those nutrients. So, what do you need for great-looking skin?
Dr. Jill 11:34
So, you said no sugar, no bad fats, no dairy, and I would say gluten. Could that be a trigger for some people?
Dr. Tager 11:42
Gluten is certainly a trigger. It's a trigger for the 1% with celiac [disease] and the 6% with non-celiac gluten sensitivity.
Dr. Jill 11:53
So that's the ‘no' list. Let's talk about what to add.
Dr. Tager 11:56
Yes. The great thing about the pandemic was that I went from being a New York City boy traveling 150,000–200,000 miles a year for the 37 years I've been married to staying home for two years and building a garden. I am out in my garden. I go out in the morning, I leave my phone in the house, and I talk to plants. But then, I look at all these different colors, and I think there are 5,000 vital nutrients in these plants whose job it is to protect the plants from UV damage. And then these plants are going to give me the fiber that the good bugs in my gut need to chomp on and create, not just butyrate, which heals the lining of the gut, which is important for the enterocytes, but also the acetate and the propionate that go into the circulation and are so important for the healthy skin barrier.
Dr. Tager 12:58
You know, we've got leaky gut, and I know you've talked about this; you're one of the world's experts. But we also have leaky skin, and these are both parts of the innate immune system, and we've got to have nice, tight junctions in the skin as well.
Dr. Jill 13:13
Oh, wow! So plants, obviously, this is core, I totally agree; a variety [of] multi-colored leafy greens. We talked about bad fats. What would you say are good and bad [fats]?
Dr. Tager 13:24
The real issue was that before World War II, the ratio of the essential fatty acids—there are three kinds—[specifically], omega-6 to omega-3, was about 3-to-1. Well, after World War II, with all the refined corn, safflower, and sunflower oils, and all the processed foods, that ratio—and you've seen it in patients—jumps up [from] 18-20 to 1. We talk a lot about an anti-inflammatory diet. Now, what happens when you get that imbalance from all those omega-6s? They get shunted down a pathway that creates inflammatory molecules—prostaglandins. So what happens is that you really want to get those guys down and the omega-3s up. You want to lean on sardines, salmon, and flaxseed, and then the monounsaturated oils [like] olive and avocado. I think that's just a great, great, great way to help protect the skin barrier because all of those are protective of the skin barrier and the myelin sheath of the nerves as well.
Dr. Tager 14:38
My other pet peeve, I'm going to give you my rant. One of my rants is that up to 92% of Americans do not get the estimated average [daily] requirement for choline. Choline is an essential fat; it is critical for the myelin sheath and the coatings of the nerves. For about [nearly] two, three decades now, we go and get egg white omelets. Now, some people obviously have some issues with the protein in eggs—we'll put that aside—but for most of us, the calories in the yolk come from fats, yes, but from choline and from the B vitamins. All the stuff we need for skin, hair, nails, and healthy nerves, we've been throwing out. For your listeners, please skip the egg-white omelets.
Dr. Jill 15:33
I love this! I just want to repeat a couple of important things. It's funny; just a few days ago, I was thinking about fats and: “How do we talk to patients about them?” I think the two biggest culprits that probably have the worst fats in them would be fried foods of any sort, especially commercially [like when] eating out, and then commercial dressings. I'm not going to name names. Even at your organic stores and markets, I looked at the shelf, and I found one organic olive oil-based dressing—one! Even all these good organic brands use safflower, sunflower, or canola—which is horrendous.
Dr. Jill 16:07
I want to say that out loud because if you're not either making a dressing or using something simple with an olive oil or avocado base, those commercial dressings, if you have a salad every single day, add up. I think like a car with the oil change, you get the wrong oil [and it can cause damage]. And these are literally the cell membranes—the phospholipids that communicate. So, if you have the wrong trans, saturated, or even the wrong types of seed oils, you are going to affect your brain, your nervous system, and your skin. So I love saying those two things because it gets practical to the listener. Fried foods and your commercial dressings—those are the big culprits, right?
Dr. Tager 16:39
Absolutely. Also, when you look at all of those commercially produced foods, look at that line item that says “added sugars.” The average American takes in 100 grams of added sugar a day, but it really should make up about 10% of the daily intake; that would be 200 calories or about 40 grams. So you want to keep that added sugar consumption at 40 grams and under. I think that's important; the [right] fats are important. There are some ceramides also; in dermatology, we use ceramides after invasive procedures for barrier protection. But there are also ceramides that come from rice and peach ingredients that are very nice as well. I think those can be important, also.
Dr. Jill 17:33
I love that! Again, [I'll mention] another practical thing for the listener because they're just coming to mind, tips that I've learned. I eat a really clean diet: Gluten-free, dairy free, sugar-free, and all that stuff. But I think the more important thing is that if I go to a restaurant, the sauces, marinades, and dressings—those are the things that have added sugar and the wrong fats. Even if you're eating out and you eliminate sauces, marinades, and dressings, those are the things that are like the topping on the cake, and those usually have the culprits. You can actually ask the chef to make your fish or your salmon without the sauces, marinades, dressings, and [other] things. And when you get to the salad, if you always ask for olive oil and vinegar, you're pretty safe. And it's simple, but it's not simple, because otherwise there are lots of dangerous things if you eat out a lot.
Dr. Tager 18:14
My go-to is olive oil, a little balsamic [vinegar], a little dijon mustard, and a tiny bit of honey, with a little salt and pepper, and that's the go-to salad dressing in the Tager house. Sometimes I will substitute lemon for balsamic [vinegar]. But I can't remember buying a commercial salad dressing, at least for the last 20 years. It's expensive, it is laden with all the wrong stuff, and I think you could make it better yourself.
Dr. Jill 18:50
Okay, I love this! This can be a recipe. We're going to post it underneath, like “Dr. Mark Tager Simple Recipes.” “Skin Salad Dressing,” right? This is awesome! So we talked about nutrients and about what to eat and not eat. Then, you talked about what to put on your face, and let's talk a little bit about that—the things there.
Dr. Tager 19:09
Yes, I advocate a four-part process. Certainly, put sunblock. You want to go with a mineral-based block. You want to keep away from these benzones—Lord knows we don't need more chemicals on our skin. If you look at the average woman, she probably puts on 15 products on her skin and scalp every day, and we just don't need more bad stuff. You know, [you want to get] a zinc and titanium mineral block. And you want to find one that you are going to use that's not chalky. I vary; I get three or four that I like that are pretty light. So that's that.
Dr. Tager 19:52
And then, for many people, retinol is a really good thing because normally our skin turns over every 35–36 days, up to 40 days. As you age, it turns over slower. The retinoids increase the speed at which your skin turns over. Now, it's tricky because you've got to find the right one for you. It can be very irritating and very drying. You put a little bit on at night; maybe you do it intermittently. Hit and relax, hit and relax—mix it up with exfoliation. But that's a trial-and-error process. Now there are some people with really sensitive skin who just can't do retinoids—that's just the way it is.
Dr. Tager 20:34
The next thing you're going to want to do is look at the bioactive molecules. There, you've got a choice. This is a trial-and-error process because you don't know what's going to work best for you. So you've got a hand of cards: We've got peptides, growth factors, exosomes, vitamin C, vitamin A, the B vitamins, herbal products, and herbal ingredients. And it's really just a matter of finding out what works for you. So I think that those are the components.
Dr. Mark Tager 21:12
You need some barrier protection, obviously. You need a good moisturizer. I don't think that people need something for “under my eyes” and “my left ear lobe vs. my right ear lobe.” Most of the product that's a moisturizer is really there to keep the water in at night. You need thicker stuff at night than you do in the daytime. In the daytime, obviously, you can have your SPF; at night, you're going to go with your retinol.
Dr. Jill 21:40
I love it! What a beautiful overview. And like you said, it is trial and error. I'm just going to tell you a little funny trick that I learned. I took capsules of NAD, and I would take a little of the powder and put it in my hyaluronic acid, and it was one of the best results on my personal skin that I've ever had. So I love the idea of NAD. In fact, we developed a little bit of a NAD serum and cream. But the idea is that you could literally take powder from NAD and put it in your—
Dr. Mark Tager 22:06
Yes. I didn't mention NAD in my litany of all the bioactives, and NAD is really important. There are some good products out there, or, as you mentioned, you can open a little bit—
Dr. Jill 22:20
I love to do science experiments on myself. So I was like, “Wow, this stuff is really good!” Let's talk about lasers and procedures, because I love playing with lasers, and I've done some of those myself—nothing invasive, nothing with any knives. But I do enjoy microneedling and some of those [other] things. Tell us, from an expert like you, I'd love to know for the women out there who maybe want to delve into that a little bit, what would be the few things that you'd most likely recommend?
Dr. Mark Tager 22:48
We are intentionally wounding the skin. We're creating inflammation, which stimulates healing. Now, I am going to go back to another pet peeve, and then I'll come back to this statement. A lot of people take collagen peptides, and they think, “This collagen is going to go right here and is going to find this area that needs support.” That's not going to happen. One of the purposes of wounding the skin, particularly when we do it with heat, with thermal wounding, [is to] get the collagen in the skin to shorten and unravel. Essentially, it becomes dead, and it becomes a scaffold on which new collagen is made.
Dr. Mark Tager 23:34
Now that new collagen is made with the amino acids that come into the bloodstream plus vitamin C and iron. We need those, so without vitamin C, which we don't get enough of, and without iron, which many women don't get enough of, we're not going to make collagen. But that wounding gives the body the instructions [as if it were to] say: “Hey gang. Come on over here and let's make it better than ever.” We call that process “collagen remodeling.” It actually takes, in many procedures, 6, 8, 10, or 12 weeks before we actually see the end result.
Dr. Mark Tager 24:13
Now we have created with the fractional laser the very first fractional remodeling. So, in other words, before them, we used to take off whole sheets of skin. If you went too deep, you could get a white porcelain face—there was a long healing time. So we create these little, tiny wounds that are the width of a hair follicle, and we actually hit about 20% of the skin with a treatment. But the heat down in the dermis actually heated the entire dermis and created something called ‘heat-shock proteins,' which participated in the response. So now we can wound the skin with heat, cold, or radio frequency [which] is also with heat. We can do it with ultrasound or mechanically with microneedling.
Dr. Mark Tager 25:03
We started off with microneedling; now they've added radio frequency to it to get a thermal response. I think that these are, for the most part, safe procedures in the hands of a competent person. And it's good to stimulate. It's also good to take some of the brown spots off and these potentially cancerous or precancerous lesions to get skin resurfacing. So that's a good thing. So I'm an advocate for that, and I think that there are some other devices that are interesting to me. Some of these LED low-level light therapies are interesting for getting mitochondrial stimulation.
Dr. Jill 25:54
Are you talking about red light types of therapies?
Dr. Mark Tager 25:56
Yes. There's good science there. It takes a while; you've got to commit to it. If you took someone for a procedure and they were really red and inflamed, you could stick them under red light, and 30 minutes later, it looks like almost nothing had happened to them. So it does bring down inflammation. I think some of these low-level light treatments are good as well.
Dr. Jill 26:27
Also, the low-level [light]—I've seen so many devices for sale at home; the other things you need to have a professional. But it feels to me like some of the red light therapies, people could safely do at home. Would you say that's true?
Dr. Mark Tager 26:35
Yes, sure. But there is an issue with this as well because there are so many devices on the marketplace—oh, my goodness! Companies flood the market; you don't know what you've got. There are a few good, reputable companies whose products I like, but there's a lot of junk out there too. And it does take a little time. There are others that cover the whole face. Having a great esthetician is really—
Dr. Jill 27:13
I agree. The first thing you said that I loved was that you really have to personalize. I have products too for patients' skincare, but it's so individualized because everybody's skin is different, and you have to see what works for you and what kind of outcome you want, [as well as] what you're willing to do or pay for because these things all cost money too.
Mark Tager 27:35
We haven't talked about the one thing that you and I know a lot about, and you know more [about it] than I do, and that is supplements. We talked about food, we jumped to topicals, and then we went to lasers, but there's this whole big chunk in the middle that we haven't talked about. You know more about this field than I do, but we can have a very fun discussion on this. I mentioned that you can't out-supplement a crappy diet. Supplementation really needs to be intelligent. You need to understand why you're taking a supplement.
Mark Tager 28:17
For me, the professional-brand supplements or the ones that are created with your line, for example, where you really paid attention to sustainability, purity, traceability, and quality, and there are no contaminants in there, all of that is where there's enormous confusion in the marketplace. What do I take? Do I need supplements, [or] don't I need supplements? Should I take a specific supplement for skin health and beauty? Sixty to eighty percent of people say they're taking a multivitamin, but should they take something for skin health and beauty? And then how did they determine who needs a little bit more zinc, more vitamin D, or more vitamin E? Or who has the tendency to break down collagen faster?
Dr. Jill 29:08
I want to mention, really quickly, multi[vitamins]. You have this thing going that's so important; I don't want to interrupt you. But with multi[vitamins], I have my pet peeve; I am not a fan of multivitamins. There are good-quality ones out there, don't get me wrong. And for someone, if that's all they're going to take—an 18-year-old kid, [for example]—that's okay. But the truth is, so often it's just one size fits all, and there are actually low levels of everything. Some people don't need, for example, extra vitamin D or something [else]. They might have had a polymorphism or a genetic thing, and some people need way more riboflavin, niacin, or vitamin D.
Dr. Jill 29:45
I always think of it as a chef in the kitchen; like I'm cooking and creating a recipe for my patients. But I just wanted to mention too that sometimes [taking] multivitamins, if that's all you're going to do, is okay. But I will say I'm not a huge fan, and I'm much more of a fan of targeted nutrition. I hope that's okay to say here, live, but I think it's really important.
Dr. Mark Tager 30:02
I am in violent agreement with you because I use the term “intelligent supplementation.” For example, let's take nutrigenomics. There are two pieces to it. Your genes determine how you metabolize and handle nutrients. It's why you may like the taste of cilantro, [whereas] it tastes like soap to me. You may handle alcohol and caffeine [well]. Alcohol, you may detoxify and break down differently than I do. That's one piece.
Dr. Mark Tager 30:36
The other piece, of course, is that foods turn on or off the genes that make us healthy or ill. But the other point about that is that I think skin nutrigenomics—nutrigenomics in general—can really provide some very helpful information. I use myself as an example. My vitamin D [level], left to its own devices, is about 18 when it should be 50, 60, or 70, particularly in an era of infectious disease.
Dr. Jill 31:05
Mark, do you have the VDR mutation?
Mark Tager 31:07
I've got two. I've got the GC. I've got two mutations, as does my daughter.
Dr. Jill 31:07
Me too. I'm just like you. I totally understand this.
Dr. Mark Tager 31:16
If I say to people, “I take 50,000 units a week,” they're like, “Oh my goodness, you're overdosing yourself.” And you know where that 50,000 [units] gets me?—to about 50 [units]. It gets me to just about where I need to be. So I think that this concept of individual variability in terms of our needs—vitamin C, zinc, how we handle sugar, how we handle caffeine—[is so important]. You know, you hear these stories: “Caffeine is bad for you”; “Caffeine is great for you”; or “Caffeine doesn't do anything… ” and they are all true.
Dr. Jill 31:52
It depends on your cytochromes, right?
Dr. Mark Tager 31:55
Exactly. It depends on how good your liver is at metabolizing that. Now, fortunately, I got good genes from my mom and dad, so I could drink a lot of coffee.
Dr. Jill 32:04
Me too.
Dr. Mark Tager 32:07
This is my 11th book, and I couldn't have done it without the coffee.
Dr. Jill 32:13
So I heard you say vitamin C, vitamin D, and zinc. Again, this is very personalized, so you don't want to just go out [and purchase supplements] without your doctor's recommendations. What would be maybe the top five [supplements] that are so core that you can't live without [them] if you're not getting them from your food?
Dr. Mark Tager 32:29
They called essential fatty acids ‘essential' because they're essential. Vitamin C—we've lost the ability to manufacture that. Plus, so much of the food that we get is trucked in and oxidized; there's just not a lot of vitamin C in there, so you really have to work hard. If you've got a genetic variant that says you need more than just this recommended amount, or if you're a vegan or vegetarian, you've got to work to create the collagen from the three amino acids and you need vitamin C, that's important.
Dr. Mark Tager 33:07
I think we've seen people with zinc and vitamin E [deficiencies]. It's a little challenging on vitamin E because most of the research has been done on the alpha-tocopherol side of vitamin E. There is a whole other movement that said, “Maybe it's not the tocopherols; maybe it's the tocotrienols that are most important.” So we're in this sort of shifty phase now where we can look at the genes for the tocopherols, but we're not sure that means as much. Vitamin E is certainly important. But then we also have genes that accelerate collagen breakdown. So if you've got a gene that accelerates what's called MMP, which breaks down collagen, that just says that you need to pay more attention to that. Or if you have a gene for increasing pigmentation or glycation, if you've got the gene for increased glycation or the creation of glycation end products, advanced AGEs, that's good feedback to know.
Dr. Mark Tager 34:13
Now, ultimately, you have to change your behavior. You're going to have to change what you eat, you're going to have to change your exercise, you're going to have to get a good night's sleep, you're going to have to learn to manage stress, and then you can take—once you're done with all that good stuff, the hard stuff—the supplements, [which is] the easy part. That's easy; the hardest thing is getting people to make [changes in their lives].
Dr. Mark Tager 34:37
For years I've counseled people on lifestyle, and as you do and as so many of our listeners who are professionals do, we sit in that room, we make eye contact, we lean in, we mirror their body, and we attend [to them]. We're right there in their presence, and the real question in our minds is: What's it going to take to turn on that light in the minds and hearts of that other person so they get it and start caring for themselves? That is the big behavior change riddle that we all deal with.
Dr. Jill 35:14
Yes. I love this because the topic is so relevant. Again, it's that billboard to the world, and this is really relevant to my listeners, and to all the people you've taught. It's such wonderful practical advice. I would expect nothing less from you, Mark. Where can people find you? Where can they get a copy of your book?
Dr. Mark Tager 35:31
Yes, so let's do a couple of things. First, I'll have to tell you a story. This is the cover of the book. Now, I went and gave a talk to 200 male and female estheticians. I had five covers, and I said, “Which one do you guys like the best?” The one that I liked the best came in last—no one liked it. This was the majority.
Dr. Jill 35:54
And show us one more time now that we know the story.
Dr. Mark Tager 35:58
Now you know the story; this was the cover.
Dr. Jill 36:00
Oh, interesting. It's got all the good stuff around.
Dr. Mark Tager 36:01
It just popped and it related.
Dr. Jill 36:04
I love it. Isn't it funny?
Dr. Mark Tager 36:05
I'm somebody that was much more clinical than that; “I'm Dr. Tager, I have to have a very clinical… ” And they said, “No, it needs to be fun.” So you can get me @drmtager. Professionals can hit me up on LinkedIn. I've got a website, drtager.com where you can find out more. And I've got a course. The book is on Amazon. That's the easiest way to get books. And then I'm creating an online course that will be out in about two months called “Inside Skin Beauty”. It's for professionals, and it's nine hours of how to put a “Beauty From Within” course into your practice.
Dr. Jill 36:50
Oh, I love that, Mark. I'll be sure and share this with our professionals. And I want to learn more because, it's funny, the one thing I'd love to expand in my own clinic is aesthetics. I can do the inside part with my eyes closed, but I want to do more for people [in this aspect]. And it's funny because I have compassion because I've been to [a place in my life] where my face looked so awful, reflecting my inner health. I know how it feels. It's so shameful to go out in public [with], you know, acne or whatever. So I have a lot of passion for that too, for people suffering because a chronic illness often does affect our skin. So I love what you're doing. What would be one last takeaway or thing that you'd give to our listeners from this area or from any area of your life?—just any sort of takeaway that we can give to the listeners.
Dr. Mark Tager 37:35
Okay, we're going deeply philosophical here. Before I do that, though, I will say that having known you all these years, I've never seen you do anything but glow from the inside out.
Dr. Jill 37:45
Thank you!
Dr. Mark Tager 37:47
Always, your presence is magnificent, powerful, and engaging. You could probably be covered with pimples, and I would never know it because you glow from the inside out.
Dr. Jill 38:00
Oh thank you!
Dr. Mark Tager 38:02
We'll go back to my little story about the garden. What I get from that, in addition to the mindfulness and the being there and just blotting everything else, I thought about this and that is: Personal growth is an analog process; it's not digital, and it's not overnight. It is this gradual—you know, I guess I'm Chauncy Gardener—analog process of going out and pruning and adding a little water and adding a little fertilizer and watching things day to day grow and change and having a little feedback. So it's the doing and the feedback, in sort of an analog process in which you are attending, and your intention is one of personal growth and development.
Dr. Jill 38:51
I love that. What a great way to end because it encompasses everything we talked about in all areas. I love the garden analogy, I love your work, and I would say the same for you, Mark. You glow and bring such beautiful energy to everyone around you. You inspire me and so many other physicians. Thank you for your work and presence in the world, and I love that we can talk about this and that I can keep supporting you here as well.
Dr. Mark Tager 39:16
Same here. Thanks so much, Jill!
Dr. Jill 39:17
You're welcome!
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