A pilot open-label study examines skin aging and the resulting reductions in body satisfaction
The participants reported significant improvements in skin satisfaction and body satisfaction after taking Collagen Booster for 6 months. More specifically, participants reported significantly higher body and skin satisfaction scores at the 3- and 6-month visits compared to their baseline visits.
Objective: In Western society, the dominant cultural association with aging skin is a lessening of satisfaction with one’s body image. Interventions are needed that can prevent and treat skin aging and the resulting reductions in body satisfaction. Methods: In an open-label pilot study, we examined the effect of a dietary supplement, Collagen BoosterTM by Reserveage Organics, which contains resveratrol and Biocell Collagen®, in women who displayed visible signs of facial skin aging. Participants (N=29) took an oral supplement of Collagen BoosterTM (1,000 mg of Biocell Collagen® and 100 mg of trans-resveratrol) daily for 6 months. They completed facial scans and self-report assessments of their skin and body satisfaction at baseline, 3 months, and 6 months. Results: Participants had significant improvements in their percentage of facial pores and ultraviolet spots from baseline to 6 months (Ps<0.05). Body and skin satisfaction also improved significantly from baseline to 6 months (Ps<0.05), and were positively correlated at the baseline, 3-, and 6-month assessment points. Conclusion: The findings provide preliminary support that the dietary supplement, Collagen BoosterTM, can reduce visible signs of facial skin aging and improve skin and body satisfaction. A randomized, placebo controlled trial is needed to verify our results.
Some studies have found that a young and thin appearance is a symbol of financial success, social acceptance, and interpersonal happiness for women.1–3 As individuals age, however, the skin’s appearance changes due to a variety of intrinsic and extrinsic factors (eg, sun damage, smoking, diet).4–6 Because of the emphasis some modern societies place on the importance of youthful-looking skin, it is not surprising that findings from recent studies indicate that aging skin has negative psychological consequences that become more pronounced with increasing age.7 These outcomes include reductions in self-esteem and social relationships, and increases in symptoms of anxiety and depression.8–11
Because many people have a negative perception of aging skin, effective, noninvasive, safe, and inexpensive interventions are needed that can reduce or even prevent the visible effects of skin aging, such as wrinkles and dryness, along with the resulting reductions in body satisfaction.12,13 Nutricosmetics represent a potential intervention to improve beauty and health. Nutricosmetics (also known as beauty pills, beauty from within, and oral cosmetics) refer to nutritional supplements that are taken orally to improve beauty and health, in particular the structure of the skin.14 Research is needed, however, to substantiate the potential skin and beauty testimonials and assumptions of many nutricosmetics.15
Currently, there is growing interest in both hydrolyzed collagen (or collagen hydrolysate) and resveratrol as nutricosmetical products to attenuate the negative effects of skin aging. Collagen fragmentation that occurs over time results in decreased structural integrity and impaired function of dermal fibroblasts.16 Because collagen-derived peptides have a variety of unique biological properties that have potential health benefits, they may slow the skin aging process. Schwartz and Park17 found that women who took a hydrolyzed collagen supplement (BioCell Collagen®) for 12 weeks had significant improvements in skin dryness/scaling and global lines/wrinkles. The women also had a significant improvement in the content of hemoglobin and collagen in the skin dermis.
There is also a growing interest in dietary bioactive antioxidant compounds, such as polyphenols, for their potential to improve both skin appearance and general health. Resveratrol is a polyphenol that has been researched extensively for its powerful antioxidant capacity.18–20 Like many other polyphenols, resveratrol has a chemical structure that gives it the potential to act as a beneficial antioxidant through electron delocalization and reactions of certain functional groups.21 Along with its ability to impact cellular functions, its protective qualities may prevent the alterations in the extracellular matrix of the skin that occur with aging.16 The functioning of the extracellular matrix has a large impact on the aging of skin, a result of fragmented collagen fibrils present in the matrix.
Resveratrol may specifically help reduce the intrinsic aging process (influenced by genetics), while restoring the skin and protecting it from the extrinsic (environmental) aging factors.22 Reactive oxygen species have been implicated in a number of age-related skin disorders. Oxidative stress has a large impact on the appearance of aged skin, and studies have been conducted to test the effects of nutricosmetics containing resveratrol on certain oxidative stress indicators. In the study conducted by Ghanim et al,23 resveratrol was linked to reductions in the generation of reactive oxygen species, and additionally led to decreases in the proinflammatory markers p47, TNF-α, IL-6, and SOCS-3. More specifically, resveratrol may support the function and structure of the skin by reducing the appearance of fine lines and wrinkles, and improving skin tone by reducing the impact of free-radical damage to the skin.24–25
Because healthy skin is associated with a youthful appearance, skin satisfaction may be related to body satisfaction.26 For women in particular, a youthful and thin physical appearance has often been found to be related to attractiveness.27–28 Changes associated with aging such as wrinkled skin and weight gain may take women away from societal ideals of attractiveness and may result in decreased skin and body satisfaction. Due to the potential reductions in body satisfaction as a result of changes in skin aging, research is needed to examine the effects of interventions that can potentially improve skin appearance, and thereby lead to improvements in both skin satisfaction and body satisfaction.
The purpose of the present study was to examine the effect of a dietary supplement (ie, Collagen BoosterTM by Reserveage Organics) designed to enhance skin health on outcomes related to visible signs of skin aging, as well as skin and body satisfaction. We hypothesized that participants would have increased skin satisfaction from baseline to 6 months and visible improvements in their facial skin (eg, reduction in wrinkles). We also hypothesized that skin satisfaction and overall body satisfaction would be positively related.
Participants were 29 healthy female adults who had visible signs of skin aging (mean [M] age=53.68, standard deviation [SD]=7.56, range=39–67; M BMI=25.80, SD=4.69). Facial skin condition was evaluated visually by a medical doctor before study enrollment. Only female participants were selected because of the established gender differences in skin physicality and the greater importance placed on skin appearance for women than men.29 Most of the participants were caucasian (79.3%), worked full time (44.8%), were married (51.7%), and had a college degree (75.9%). None of the participants had ever had Botox.
Women were recruited via an advertisement in the local newspaper regarding participation in an antiaging study. Eligibility criteria included women between the ages of 35 to 70 years who were generally healthy and were not receiving facial treatments or using antiaging serums or creams. At the baseline visit, participants signed an Institutional Review Board Informed Consent. They then completed a series of self-report measures and a brief medical/personal history questionnaire. Finally, the participants’ make-up was removed from their faces and they completed the facial scan. Participants were then given a 3-month supply of the supplement in capsule form, instructions for product use, and a daily diary to record product consumption. They were advised to contact the research center immediately if any adverse reactions were noted. All the assessments were obtained in a small private room at a dermatology clinic in Gainesville, FL. Participants were contacted by phone every month during the study to assess compliance and any adverse events. Supplement compliance was monitored via a daily supplement log and pill counts (ie, participants returned bottles and remaining pills were counted). The participants returned to the research center at 3 months to complete self-report measures and a facial scan and to receive another 3-month supply of the supplement. At the 6-month visit, the participants completed the self-report measures and the facial scan. To increase the response rate, participants were given a 6-month supply of the test product and received a free facial treatment upon completion of the study.
Supplement and Doses
The test product used in our study was Collagen BoosterTM by Reserveage Organics, which contains the Pro-Longevity Resveratrol blend and Biocell Collagen®. The Pro-Longevity Resveratrol blend is a blend of organic French red whole grape, organic muscadine red whole grape, and wild Polygonum cuspidatum standardized to contain a minimum of 50 mg of trans-resveratrol per capsule. The Biocell Collagen® (BioCell Technology, LLC) is a hydrolyzed chicken sternal cartilage extract composed of a naturally occurring matrix of hydrolyzed collagen type II (molecular weight range of 1–2.5 kDA), low molecular weight hyaluronic acid, and chondroitin sulfate. BioCell Collagen® is made from hormone- and antibiotic-free chicken sternal cartilage. The chickens used to collect the cartilage are not free-range and organic; however they are raised and processed according to relevant animal welfare laws. BioCell Collagen® is made via a patented manufacturing procedure that subjects the chicken sternal cartilage to various processes, including filtration, purification, concentration, hydrolysis, and sterilization to ensure consistent quality and safety. The patented process removes impurities and reduces the size of all molecules, making them highly absorbable and fast-acting. BioCell Collagen® is affirmed GRAS (Generally Recognized as Safe) and is non-GMO and gluten-free. Each capsule contained 500 mg of Biocell Collagen®, providing a naturally occurring composition of hydrolyzed collagen (300 mg), depolymerized chondroitin sulfate (100 mg), and hyaluronic acid (50 mg). The remaining 50 mg, derived from other natural components of the sternal cartilage, was not characterized further.
The participants were instructed to take 2 capsules daily of Collagen BoosterTM, for a total daily dose of 100 mg of trans-resveratrol and 1,000 mg of BioCell Collagen®. The dose of both trans-resveratrol and Biocell Collagen® in Collagen BoosterTM is considered to be safe and has been well-tolerated without associated adverse events in human studies.17,30 The supplement was manufactured in accordance with good manufacturing practices.
Medical/Personal History Questionnaire. The Medical/Personal History Questionnaire was a self-report measure that assessed the participant’s age, height, weight, ethnicity, education level, work status, and marital status, as well as overall medical and health status. Height and weight were used to calculate body mass index (BMI). Participants completed this questionnaire at the baseline assessment only.
Enhanced Image Pro II Multi-facial Analysis System. The Enhanced Image Pro II Multi-facial Analysis System (Enhanced Image Technologies, Charlotte, NC) is a quick and noninvasive technique that allows 2-dimensional information to be gathered from the skin’s surface using normal light, polarized light, and ultraviolet light.31 It uses light to gather information on the topography of the skin surface without contact. Its advantage lies in a very short recording time and in a touch-free recording method. For the purpose of this study, changes in skin tone (ie, level of darkness in overall skin), pores, wrinkles (ie, percent of area that depicts a wrinkle), and ultraviolet spots (ie, spots below the surface of the skin) were examined. Values range from 0% to 100% of area with lower values indicating fewer wrinkles, more even skin tone, and fewer spots (ie, lower number represents younger/healthier skin appearance).
Skin Satisfaction. An extensive review of the literature revealed no standardized skin satisfaction scale. Thus, for an in-depth assessment of skin satisfaction, we developed the Skin Satisfaction Scale, which assesses satisfaction with the following 10 areas: firmness, complexion, glow, pores, youthful appearance, fine lines, elasticity, wrinkles, smoothness, crow’s feet, tone, and overall skin satisfaction on a Likert scale anchored at the extremes of 1 (very dissatisfied) to 5 (very satisfied). Items were generated via searches of the literature and discussions with experts in the field. Content validity was established by having 4 experts in antiaging and body image research assess the individual items. Although this scale has not been scientifically validated, the internal consistency was good across all 3 assessments (see Table 3).
Effects of Supplementation. We also assessed the health effects of supplementation via the following 2 questions: (1) “Have you had any negative effects from taking the supplement in the last 3 months?” and (2) “Have you had any positive effects from taking the supplement in the last 3 months?” Participants completed this assessment with a YES/NO response at 3 months and 6 months. Women who responded YES were asked to describe the effects via an open-ended response.
Body Areas Satisfaction Scale. The 8-item Body Areas Satisfaction Scale was used to assess the subjective component of body image (T. F. Cash, unpublished data, 1990). Participants indicated their degree of satisfaction or dissatisfaction with the following body features: face (facial features, complexion); hair; lower torso; mid torso; upper torso; muscle tone; weight; and height on a Likert scale anchored at the extremes of 1 (very dissatisfied) to 5 (very satisfied). The Body Areas Satisfaction Scale has good psychometric properties (T. F. Cash, unpublished data, 1990), and for our study the internal consistency was high across all 3 assessments (alpha range=0.80–0.87; see Table 3).
Compliance was measured through the use of pill counts at both the month 3 and month 6 clinic visits. The mean compliance rate was determined by averaging the compliance levels obtained at both these visits.
Repeated measures analyses of variance (ANOVAs) were used to examine changes in dependent variables related to visual signs of aging (ie, facial pores and ultraviolet spots) and skin satisfaction. For significant F-values (P<0.05), post-hoc analyses were conducted using the Bonferonni test to examine time effects. Repeated measures analyses of covariance (ANCOVAs) were used to examine changes in body satisfaction over time, with BMI included in the model as a covariate. For significant F-values (P<0.05), post-hoc analyses were again used to examine time effects. Correlational analyses were conducted to examine the associations between age, BMI, body satisfaction, and skin satisfaction.
Adherence. Thirty-two women were enrolled in the study and 3 women did not complete the study, representing a compliance rate of 91%. The reasons for noncompliance were upset stomach (n=1) and failure to adhere to the dosage regimen (ie, missed more than 3 product dosing days during the study, [n= 2]).
Facial Analysis. Repeated measures ANOVA (dependent variables=baseline, 3 months, and 6 months data) for the visual signs of aging via the Enhanced Image Pro II Multi-facial Analysis System revealed significant reductions in facial pores (F(2, 27)=3.35, P<0.05) and ultraviolet spots (F(2, 27)=3.33, P<0.05). Post hoc analyses revealed significant improvements in facial pores and ultraviolet spots at month 6. However, there were no significant time changes in skin tone, wrinkles, and polarized spots (Ps>0.05; see Table 1).
Skin Satisfaction. Repeated measures ANOVA revealed significant time differences in skin satisfaction, (F(2, 27)=16.35, P<0.001). Post hoc analyses revealed that skin satisfaction was significantly higher at month 3 and month 6 compared to baseline (Ps<0.05). There was no significant change in skin satisfaction between the 3 and 6 month assessments. Skin satisfaction was positively correlated with body satisfaction, with several correlations being significantly related (r range = 0.19–0.62). Neither age nor baseline BMI was significantly correlated with skin satisfaction (P>0.05).
Body Satisfaction. Repeated measures ANCOVA (covariate=BMI) revealed significant time differences for body satisfaction at month 3 and month 6 compared to baseline, (F(2,54)=8.16, P=0.001). BMI, however, was significantly correlated with the baseline body satisfaction score (see Table 2). Post hoc analyses also revealed that BMI was significantly associated with body satisfaction, which was therefore used as a covariate in the repeated measures analyses with body satisfaction. Age was not correlated with body satisfaction (P>0.05).
Supplement Effects. Most (93%, n=27) of the participants perceived that taking the supplement had a positive effect. With regard to skin, 83% (n = 24) of the participants perceived positive changes to their skin appearance. The most common skin changes reported were improved skin tone, lighter age spots, softer skin, and diminished wrinkles and fine lines. In addition, 72% (n = 21) of the participants reported an increase in their energy level and exercise behavior.
Adverse events. During the 6-month study period, only 1 participant reported experiencing mild gastrointestinal discomfort (ie, upset stomach), and this participant withdrew from the study. No other adverse events were reported.
The positive relationships between body and skin satisfaction reveals that they are related yet distinct constructs.
The purpose of our study was to examine the effects of the dietary supplement containing trans-resveratrol and collagen (ie, Collagen BoosterTM by Reserveage Organics) on outcomes related to visible signs of skin aging, as well as skin and body satisfaction, in women who displayed visible signs of facial skin aging. Using an open-label design, we found that 3 months of supplementation coincided with significant improvements in objective signs of skin aging, and skin and body satisfaction; and that these improvements were still apparent at 6 months. Additionally, body satisfaction and skin satisfaction were found to be strongly related. The supplement was well-tolerated, and no participants reported experiencing severe adverse effects from taking the study product. One participant did report mild gastrointestinal discomfort (ie, upset stomach).
Consistent with our hypotheses, the participants reported significant improvements in skin satisfaction and body satisfaction after taking Collagen BoosterTM for 6 months. More specifically, participants reported significantly higher body and skin satisfaction scores at the 3- and 6-month visits compared to their baseline visits. This is consistent with the facial scan, which noted reductions in the percentage of facial pores and ultraviolet spots, from baseline to the 6-month visit. No significant changes in the percentage of wrinkles, polarized spots, and skin tone were found.
Body satisfaction was also found to be positively correlated with skin satisfaction. The positive relationships between body and skin satisfaction reveals that they are related yet distinct constructs. Our findings support the limited research revealing that skin aging is related to body image concerns.12 Changes in appearance associated with aging, including wrinkles, distances women from societal ideals of attractiveness, which often results in body dissatisfaction.26 The psychological impact of age-related appearance changes is exemplified by our cultural preoccupation with youth as the aesthetic ideal. Remaining young, of course, is biologically implausible over one’s lifespan. However, the appearance of youth continues to be held in the highest regard in modern Western cultures.33
Resveratrol may have the unique potential to protect the skin against the high oxidative stress levels to which skin cells may be exposed.34 Indeed, the skin may be constantly exposed to pro-oxidant environmental stress from several sources, including air pollutants, ultraviolet solar light, and chemical oxidants. Reactive oxygen species have been implicated in age-related skin disorders. Our findings provide further support that resveratrol may be a promising strategy to improve the visible signs of skin aging and skin oxidative stress.24 Additionally, our findings support previous research that has found that BioCell Collagen supplementation results in significant improvements in skin aging.17 The novelty of the product tested in the present study, Collagen BoosterTM, is that it contains both resveratrol and a unique collagen complex in 1 supplement. With regard to bioavailability of resveratrol, there is evidence that resveratrol and its metabolites accumulate within human cells in vivo in a tissue-specific manner, and this is highly dependent on the dosage. Further research is needed to examine methods to overcome the low absorption of resveratrol.35
This study had limitations. First, because this was a prospective study that lacked a control group, cause and effect relationships could not be established. Future researchers are encouraged to use double-blind placebo-controlled experimental designs with larger sample sizes to further examine the effects of this product, Collagen BoosterTM, with objective and self-report assessments of health and skin. Second, only women were selected for this study, because women place greater importance on skin than men.29 Future studies should examine the effects of resveratrol and BioCell Collagen supplementation in both men and women. Another limitation is the use of 2 potentially therapeutic substances together (ie, resveratrol and BioCell Collagen) without having groups that use them separately. It may be that 1 of the 2 ingredients resulted in therapeutic effects, and it is not possible to tell this from the current study.
This study also had strengths. First, the Skin Satisfaction Scale created for use in this study to better understand skin satisfaction, though not yet independently validated, had good internal consistency reliability scores. Future researchers are encouraged to examine the psychometric properties of this scale and its relationship to other health variables. Second, the study product was administered for a 6-month period, and participants reported a very high adherence rate during this time. Future studies are encouraged to examine longer-term administration with follow-up to determine the long-term health effects of this neutraceutical. Lastly, both objective (skin-imaging) and subjective (questionnaire) data were assessed and both showed improvements in parameters of youthful-looking skin.
In summary, the findings of our study indicate that a dietary supplement containing resveratrol and BioCell Collagen (Collagen BoosterTM) may improve some of the objective signs of aging (eg, reduction in ultraviolet spots), as well as both skin and body satisfaction. Additional experimental research is needed to confirm and clarify the benefits of collagen and resveratrol supplementation in the prevention and management of aging skin and overall physical and psychological health. Also, because many people are increasingly becoming concerned about youthful appearances at younger ages, future research should investigate the effects of collagen and resveratrol supplementation on skin and body satisfaction in younger populations.
Objective Measures of Skin Appearance
Scan Parameter Baseline(%) M (SD) 3 Months (%) M (SD) 6 Months (%) M (SD)
Skin Tone 50.10 (9.25) 49.57 (8.67) 49.37 (10.92)
Pores* 54.12 (7.39) 53.12 (5.35) 50.50 (6.39)
Wrinkles 20.37 (7.20) 20.75 (8.06) 20.12 (10.11)
Polarized Spots 29.12 (7.20) 30.00 (5.04) 30.37 (6.65)
Ultraviolet Spots* 46.03 (14.53) 45.46 (16.35) 41.00 (14.95)
Correlations Among Body Satisfaction (BS), Skin Satisfaction (SS), Age, and Body Mass Index
p < .05; ** p < .01; *** p < .001
Descriptive Statistics for Body Satisfaction and Skin Satisfaction
*Baseline scores were significantly lower than 3 month and 6 month scores. M = mean, SD= standard deviation. Alpha = internal consistency score.
Conflict of Interest Disclosure
Dr. H. Hausenblas and Dr. S. Anton serve on Advisory Boards and as consultants for Reserveage Organics or a related entity; however, neither receives a royalty from the sale of the Collagen Booster product.