Report
Skin photoprotection and consumption of coffee and polyphenols in healthy middle-aged Japanese females Yoichi Fukushima1, PhD, Yoshinari Takahashi2, B Agr, Yusuke Hori2, PhD, Yoshimi Kishimoto3, PhD, Kaedeko Shiga3, MSc, RD, Yuiko Tanaka3, MSc, RD, Erika Masunaga3, MSc, RD, Mariko Tani3, PhD, Mihoko Yokoyama4, MD, and Kazuo Kondo3, MD, PhD
Wellness Communications Section, Nestle Japan Ltd, Tokyo, Japan, 2Department of Clinical Research, TES Holdings Ltd, Tokyo, Japan, 3Institute of Environmental Science for Human Life, Ochanomizu University, Tokyo, Japan, and 4Yokoyama Skin Clinic, Tokyo, Japan 1
Abstract Background Reactive oxygen species are known to mediate skin photoaging, which results in the formation of pigmented spots and wrinkles. Coffee is the largest source of polyphenols, which supplies a large number of antioxidants in one’s daily life. However, little is known about how much coffee and polyphenol consumption influences skin health. In this study, a cross-sectional survey of the diet, environmental factors, and skin conditions was conducted in healthy Japanese females to explore the influence of coffee
Correspondence Yoichi Fukushima, PhD Wellness Communications Section Japan Ltd Nestle NYK Tennoz Bldg 2-2-20 Higashi-Shinagawa Shinagawa-ku Tokyo 140-0002 Japan E-mail: [email protected]
and polyphenol consumption on skin conditions. Materials and methods Non-smoking, healthy female subjects with moderate sun exposure in their daily lives were recruited for this study (n = 131, age range: 30–60 years old) and recorded their food and beverage intake and life circumstances using questionnaires. The skin water content, transepidermal water loss, and elasticity were measured on the cheek of each subject using non-invasive methods: a Corneometer, a Tewameter, and a Cutometer, respectively. Wrinkles and pigmented spots were evaluated using digital photograph images. Results Consumption of coffee and total polyphenols from all sources and from coffee
Conflict of interest: None
showed a statistically significant correlation towards a decrease in pigmented spot scores (P < 0.05). Subjects with high total polyphenol consumption from coffee or chlorogenic acids (the third tertile group) showed the lowest score of ultraviolet pigmented spots (P < 0.05). Conclusion Coffee and polyphenol consumption was associated with low facial pigmented spots in Japanese middle-aged females. We speculated that coffee helps protect human skin from photoaging, and polyphenols, including chlorogenic acids, may contribute to the decreased hyperpigmentation of pigmented spots.
Introduction
410
Skin aging is influenced by multiple factors, including chronological, environmental, and genetic factors.1 Sunlight, especially ultraviolet light (UV), is the major external environmental factor of skin aging called photoaging2,3 and tumorigenesis.4 Solar UV light exerts adverse effects on the skin via direct DNA damage and indirect oxidative damage of cellular components, such as membrane lipids, proteins, and sugars,5 which cause functional and structural alteration of the skin, leading to epidermal hyperplasia, melanin pigmentation,6 and wrinkle formation6–8 in chronically sun-exposed skin. International Journal of Dermatology 2015, 54, 410–418
Food and beverages containing antioxidants may be beneficial for protecting from skin photoaging. Antioxidative vitamins, flavonols, and carotenoids have been shown to be beneficial food components for photoprotection.9–13 Vegetable and fish consumption is shown to be associated with a low amount of wrinkles in sun-exposed skin in the elderly,14 and the consumption of green and yellow vegetables is also associated with fewer wrinkles.15 We previously reported that about half of total polyphenol consumption originates from coffee on average, and a greater amount of coffee increased the consumption of total polyphenol.16 Coffee polyphenol, such as ª 2014 The International Society of Dermatology
Fukushima et al.
Coffee, polyphenols, and pigmented skin spots
chlorogenic acids (non-flavonoid polyphenol), is an important source of antioxidants17–19 in our daily life, and such a high consumption of antioxidants from coffee may contribute to reducing the risk of diseases related to oxidative damage. Growing evidence of the health benefits of coffee has started to accumulate, indicating that coffee intake may reduce the risks of morbidity and/or mortality of diseases associated with aging, type 2 diabetes,20–22 liver diseases,23 heart diseases,24,25 and some cancers,26,27 whose benefit could be exerted by the antioxidant power of coffee to a large extent. However, there are no studies examining the possible protection of skin from photoaging by the consumption of coffee. Non-invasive methods used to analyze skin conditions, such as measurement of skin water content, transepidermal water loss, elasticity, wrinkles, and pigmented spots, have been developed,28–30 which are valuable in characterizing skin conditions. In this cross-sectional survey, we aimed to determine the skin conditions of Japanese females using those non-invasive methods and to characterize how food factors, including the consumption of coffee and polyphenols, influence skin conditions.
Report
Materials and methods Study design and subjects This study was conducted in accordance with the principles of the Declaration of Helsinki. Healthy, non-smoking Japanese females, aged 30–60 years, were recruited (n = 171) from a website of a contract research organization. We selected 131 subjects who did not have any of the exclusion criteria, which included: subjects with chronic disease; medications; skin diseases or skin complaints (e.g. nevus, melasma, and macules); or who had undergone chemical peeling, laser therapy, light therapy, or hyaluronic acid injection; regular treatment at a facial aesthetic salon; pregnant or lactating women; regular activity that potentially exposed the subject to sunburn, such as tennis, golf, body-boarding, ski/snowboarding (at least once a month); or outdoor activities in the summer, including mountain climbing and swimming in the sea (at least once a year) every year after 25 years old; intentional sun tanning without a sunscreen, for example while swimming in the sea, swimming in an outdoor pool, or attending an athletics festival. The profile of the subjects in this study is shown in Table 1. Each subject visited the clinic in July 2011 to measure her skin conditions and to fill in the questionnaires.
Table 1 Profile of subjects in this study
Number of subjects (number) Age (years) Body weight (kg) BMI (kg/m2) Energy consumption (kcal/d) Exercise (METs h/week) Alcohol intake (g/d) Coffee consumption (ml/d) Total polyphenol (mg/d) Total beverage intake (mg/d) Ex-smoker, number (%) UV protection Sunscreen and sun protect cosmetics, number (%) Sun shade or hat, number (%) Long sleeves, number (%) Others, number (%) Activity with sun exposure in the past Outdoor sportsb, number (%) Activity in summerc, number (%)
Total subjects
Group 1a (low coffee consumption)
Group 2a (middle coffee consumption)
Group 3a (high coffee consumption)
131 44.4 8.0 51.8 6.5 20.8 2.2 1649 481 6.2 15.2 2.7 5.2 334 356 1279 864 1566 783 25 (19.1)
42 42.4 8.1 52.4 7.0 21.0 2.3 1537 445 6.1 12.3 2.6 6.2 17.2 28.6 500 314 1158 542 7 (16.7)
42 45.8 8.3 52.0 7.4 20.6 2.2 1665 536 7.5 22.0 2.1 3.4 228 87.5** 1151 410** 1375 549 9 (21.4)
47 45.0 7.4 51.2 5.3 20.8 2.2 1735 451 5.1 9.4 3.3 5.6 713 320** 2089 796** 2100 850** 9 (19.1)
126 108 28 12
(96.2) (82.4) (21.4) (9.2)
12 (9.2) 13 (9.9)
42 31 9 3
(100.0) (73.8) (21.4) (7.1)
4 (9.5) 5 (11.9)
40 37 9 6
(95.2) (88.1) (21.4) (14.3)
3 (7.1) 3 (11.9)
44 40 10 3
ANOVA
0.115 0.636 0.806 0.150 0.761 0.596 0.000 0.000 0.000
(93.6) (85.1) (21.3) (6.4)
5 (10.6) 3 (6.4)
Mean SD. a Subjects were divided into three tertile groups based on coffee consumption. b Number of subjects who did the outdoor sports including tennis, golf, body boarding, snowboarding and skiing at least 5 years before. c Number of subjects who did outdoor activities in summer including mountain climbing and sea bathing once in a few years. **P < 0.01 Tukeys test (vs. Group 1). ª 2014 The International Society of Dermatology
International Journal of Dermatology 2015, 54, 410–418
411
412
Report
Fukushima et al.
Coffee, polyphenols, and pigmented skin spots
Non-invasive measurement of skin conditions Skin condition measurements were conducted under the control of a physician. After washing her face, each subject was completely sedentary for 20 minutes in an Environmental Control Room, at 22 1 °C and 50 10% relative humidity. Subjects were in the decubitus position on the bed, and skin assessments, including those of skin moisture content (Corneometer CM825: Courage+Khazaka Electric GmbH, Cologne, Germany), transepidermal water loss (Tewameter TM300: Courage+Khazaka Electric GmbH), and skin elasticity (Cutometer MPA580: Courage+Khazaka Electric GmbH) were conducted. The measurement of skin water content and transepidermal water loss was at the top point of the left cheekbone. The measurement point of skin elasticity was at the center point of the cheek between below the left earlobe and the edge of the mouth. If there was a mole or inflammation at the measurement site, another nearby point was selected for measurement. Pigmented spot scores were measured by the facial image analysis system VISIATM Evolution (Canfield, Fairfield, NJ, USA) using optical polarized light (brown pigmented spots) and ultraviolet light (UV pigmented spots; Fig. 1).28 Hyperpigmented spots evaluated by the imaging system were regarded as solar lentigenes, because subjects with pigmented nevi, melasma, and/or macules had been excluded according to the exclusion criteria described above. The skin color was expressed as L* (lightness), measured using a spectrophotometer (CM-2600d; Konica-Minolta, Tokyo, Japan). Questionnaires on lifestyle, diet, and environmental conditions A food frequency questionnaire was conducted using a Brief, self-administered Diet History Questionnaire (BDHQ) to calculate energy and nutritional intake, and alcohol consumption.31 The lifestyle of each subject, including smoking and activities with sun exposure, and actions geared towards any usual sun protection were recorded using the questionnaire. Exercise level was expressed as metabolic equivalents (METs) calculated by information from the same questionnaire.32 The consumption of foods and beverages
(b)
(a)
(e)
0.709
(f)
(c)
2.572
(g)
International Journal of Dermatology 2015, 54, 410–418
containing polyphenols was recorded through questionnaires aimed at calculating polyphenol intake.16 The consumption of total polyphenol was estimated based on a previous analysis using a modified Folin Ciocalteu method.16 The consumption of chlorogenic acids was estimated using the following concentrations for each coffee type: instant coffee (50 mg/ 100 ml); brewed coffee (deep roasted: 30 mg/100 ml; shallow roasted: 50 mg/100 ml); espresso (150 mg/100 ml); and cafe au lait (30 mg/100 ml), based on measurements using highperformance liquid chromatography.16,33
Data analysis The numerical data are presented as mean SD. The correlations and partial correlations using control variables, age, and body weight among survey items were evaluated by the correlation coefficient calculated using regression analysis. We divided the subjects into three tertile groups using consumption levels of coffee, antioxidants, and nutrients. Subjects with the same consumption amount at the cut-off point were allocated to one of the groups, resulting in different numbers of subjects in the tertile groups in some conditions. A comparison among the groups was first analyzed using the analysis of variance (ANOVA), then Turkey’s test for multiple comparisons was used. IBM SPSS Statistics 19 (SPSS Japan, Tokyo, Japan) was used, and a P-value
Skin photoprotection and consumption of coffee and polyphenols in healthy middle-aged Japanese females Yoichi Fukushima1, PhD, Yoshinari Takahashi2, B Agr, Yusuke Hori2, PhD, Yoshimi Kishimoto3, PhD, Kaedeko Shiga3, MSc, RD, Yuiko Tanaka3, MSc, RD, Erika Masunaga3, MSc, RD, Mariko Tani3, PhD, Mihoko Yokoyama4, MD, and Kazuo Kondo3, MD, PhD
Wellness Communications Section, Nestle Japan Ltd, Tokyo, Japan, 2Department of Clinical Research, TES Holdings Ltd, Tokyo, Japan, 3Institute of Environmental Science for Human Life, Ochanomizu University, Tokyo, Japan, and 4Yokoyama Skin Clinic, Tokyo, Japan 1
Abstract Background Reactive oxygen species are known to mediate skin photoaging, which results in the formation of pigmented spots and wrinkles. Coffee is the largest source of polyphenols, which supplies a large number of antioxidants in one’s daily life. However, little is known about how much coffee and polyphenol consumption influences skin health. In this study, a cross-sectional survey of the diet, environmental factors, and skin conditions was conducted in healthy Japanese females to explore the influence of coffee
Correspondence Yoichi Fukushima, PhD Wellness Communications Section Japan Ltd Nestle NYK Tennoz Bldg 2-2-20 Higashi-Shinagawa Shinagawa-ku Tokyo 140-0002 Japan E-mail: [email protected]
and polyphenol consumption on skin conditions. Materials and methods Non-smoking, healthy female subjects with moderate sun exposure in their daily lives were recruited for this study (n = 131, age range: 30–60 years old) and recorded their food and beverage intake and life circumstances using questionnaires. The skin water content, transepidermal water loss, and elasticity were measured on the cheek of each subject using non-invasive methods: a Corneometer, a Tewameter, and a Cutometer, respectively. Wrinkles and pigmented spots were evaluated using digital photograph images. Results Consumption of coffee and total polyphenols from all sources and from coffee
Conflict of interest: None
showed a statistically significant correlation towards a decrease in pigmented spot scores (P < 0.05). Subjects with high total polyphenol consumption from coffee or chlorogenic acids (the third tertile group) showed the lowest score of ultraviolet pigmented spots (P < 0.05). Conclusion Coffee and polyphenol consumption was associated with low facial pigmented spots in Japanese middle-aged females. We speculated that coffee helps protect human skin from photoaging, and polyphenols, including chlorogenic acids, may contribute to the decreased hyperpigmentation of pigmented spots.
Introduction
410
Skin aging is influenced by multiple factors, including chronological, environmental, and genetic factors.1 Sunlight, especially ultraviolet light (UV), is the major external environmental factor of skin aging called photoaging2,3 and tumorigenesis.4 Solar UV light exerts adverse effects on the skin via direct DNA damage and indirect oxidative damage of cellular components, such as membrane lipids, proteins, and sugars,5 which cause functional and structural alteration of the skin, leading to epidermal hyperplasia, melanin pigmentation,6 and wrinkle formation6–8 in chronically sun-exposed skin. International Journal of Dermatology 2015, 54, 410–418
Food and beverages containing antioxidants may be beneficial for protecting from skin photoaging. Antioxidative vitamins, flavonols, and carotenoids have been shown to be beneficial food components for photoprotection.9–13 Vegetable and fish consumption is shown to be associated with a low amount of wrinkles in sun-exposed skin in the elderly,14 and the consumption of green and yellow vegetables is also associated with fewer wrinkles.15 We previously reported that about half of total polyphenol consumption originates from coffee on average, and a greater amount of coffee increased the consumption of total polyphenol.16 Coffee polyphenol, such as ª 2014 The International Society of Dermatology
Fukushima et al.
Coffee, polyphenols, and pigmented skin spots
chlorogenic acids (non-flavonoid polyphenol), is an important source of antioxidants17–19 in our daily life, and such a high consumption of antioxidants from coffee may contribute to reducing the risk of diseases related to oxidative damage. Growing evidence of the health benefits of coffee has started to accumulate, indicating that coffee intake may reduce the risks of morbidity and/or mortality of diseases associated with aging, type 2 diabetes,20–22 liver diseases,23 heart diseases,24,25 and some cancers,26,27 whose benefit could be exerted by the antioxidant power of coffee to a large extent. However, there are no studies examining the possible protection of skin from photoaging by the consumption of coffee. Non-invasive methods used to analyze skin conditions, such as measurement of skin water content, transepidermal water loss, elasticity, wrinkles, and pigmented spots, have been developed,28–30 which are valuable in characterizing skin conditions. In this cross-sectional survey, we aimed to determine the skin conditions of Japanese females using those non-invasive methods and to characterize how food factors, including the consumption of coffee and polyphenols, influence skin conditions.
Report
Materials and methods Study design and subjects This study was conducted in accordance with the principles of the Declaration of Helsinki. Healthy, non-smoking Japanese females, aged 30–60 years, were recruited (n = 171) from a website of a contract research organization. We selected 131 subjects who did not have any of the exclusion criteria, which included: subjects with chronic disease; medications; skin diseases or skin complaints (e.g. nevus, melasma, and macules); or who had undergone chemical peeling, laser therapy, light therapy, or hyaluronic acid injection; regular treatment at a facial aesthetic salon; pregnant or lactating women; regular activity that potentially exposed the subject to sunburn, such as tennis, golf, body-boarding, ski/snowboarding (at least once a month); or outdoor activities in the summer, including mountain climbing and swimming in the sea (at least once a year) every year after 25 years old; intentional sun tanning without a sunscreen, for example while swimming in the sea, swimming in an outdoor pool, or attending an athletics festival. The profile of the subjects in this study is shown in Table 1. Each subject visited the clinic in July 2011 to measure her skin conditions and to fill in the questionnaires.
Table 1 Profile of subjects in this study
Number of subjects (number) Age (years) Body weight (kg) BMI (kg/m2) Energy consumption (kcal/d) Exercise (METs h/week) Alcohol intake (g/d) Coffee consumption (ml/d) Total polyphenol (mg/d) Total beverage intake (mg/d) Ex-smoker, number (%) UV protection Sunscreen and sun protect cosmetics, number (%) Sun shade or hat, number (%) Long sleeves, number (%) Others, number (%) Activity with sun exposure in the past Outdoor sportsb, number (%) Activity in summerc, number (%)
Total subjects
Group 1a (low coffee consumption)
Group 2a (middle coffee consumption)
Group 3a (high coffee consumption)
131 44.4 8.0 51.8 6.5 20.8 2.2 1649 481 6.2 15.2 2.7 5.2 334 356 1279 864 1566 783 25 (19.1)
42 42.4 8.1 52.4 7.0 21.0 2.3 1537 445 6.1 12.3 2.6 6.2 17.2 28.6 500 314 1158 542 7 (16.7)
42 45.8 8.3 52.0 7.4 20.6 2.2 1665 536 7.5 22.0 2.1 3.4 228 87.5** 1151 410** 1375 549 9 (21.4)
47 45.0 7.4 51.2 5.3 20.8 2.2 1735 451 5.1 9.4 3.3 5.6 713 320** 2089 796** 2100 850** 9 (19.1)
126 108 28 12
(96.2) (82.4) (21.4) (9.2)
12 (9.2) 13 (9.9)
42 31 9 3
(100.0) (73.8) (21.4) (7.1)
4 (9.5) 5 (11.9)
40 37 9 6
(95.2) (88.1) (21.4) (14.3)
3 (7.1) 3 (11.9)
44 40 10 3
ANOVA
0.115 0.636 0.806 0.150 0.761 0.596 0.000 0.000 0.000
(93.6) (85.1) (21.3) (6.4)
5 (10.6) 3 (6.4)
Mean SD. a Subjects were divided into three tertile groups based on coffee consumption. b Number of subjects who did the outdoor sports including tennis, golf, body boarding, snowboarding and skiing at least 5 years before. c Number of subjects who did outdoor activities in summer including mountain climbing and sea bathing once in a few years. **P < 0.01 Tukeys test (vs. Group 1). ª 2014 The International Society of Dermatology
International Journal of Dermatology 2015, 54, 410–418
411
412
Report
Fukushima et al.
Coffee, polyphenols, and pigmented skin spots
Non-invasive measurement of skin conditions Skin condition measurements were conducted under the control of a physician. After washing her face, each subject was completely sedentary for 20 minutes in an Environmental Control Room, at 22 1 °C and 50 10% relative humidity. Subjects were in the decubitus position on the bed, and skin assessments, including those of skin moisture content (Corneometer CM825: Courage+Khazaka Electric GmbH, Cologne, Germany), transepidermal water loss (Tewameter TM300: Courage+Khazaka Electric GmbH), and skin elasticity (Cutometer MPA580: Courage+Khazaka Electric GmbH) were conducted. The measurement of skin water content and transepidermal water loss was at the top point of the left cheekbone. The measurement point of skin elasticity was at the center point of the cheek between below the left earlobe and the edge of the mouth. If there was a mole or inflammation at the measurement site, another nearby point was selected for measurement. Pigmented spot scores were measured by the facial image analysis system VISIATM Evolution (Canfield, Fairfield, NJ, USA) using optical polarized light (brown pigmented spots) and ultraviolet light (UV pigmented spots; Fig. 1).28 Hyperpigmented spots evaluated by the imaging system were regarded as solar lentigenes, because subjects with pigmented nevi, melasma, and/or macules had been excluded according to the exclusion criteria described above. The skin color was expressed as L* (lightness), measured using a spectrophotometer (CM-2600d; Konica-Minolta, Tokyo, Japan). Questionnaires on lifestyle, diet, and environmental conditions A food frequency questionnaire was conducted using a Brief, self-administered Diet History Questionnaire (BDHQ) to calculate energy and nutritional intake, and alcohol consumption.31 The lifestyle of each subject, including smoking and activities with sun exposure, and actions geared towards any usual sun protection were recorded using the questionnaire. Exercise level was expressed as metabolic equivalents (METs) calculated by information from the same questionnaire.32 The consumption of foods and beverages
(b)
(a)
(e)
0.709
(f)
(c)
2.572
(g)
International Journal of Dermatology 2015, 54, 410–418
containing polyphenols was recorded through questionnaires aimed at calculating polyphenol intake.16 The consumption of total polyphenol was estimated based on a previous analysis using a modified Folin Ciocalteu method.16 The consumption of chlorogenic acids was estimated using the following concentrations for each coffee type: instant coffee (50 mg/ 100 ml); brewed coffee (deep roasted: 30 mg/100 ml; shallow roasted: 50 mg/100 ml); espresso (150 mg/100 ml); and cafe au lait (30 mg/100 ml), based on measurements using highperformance liquid chromatography.16,33
Data analysis The numerical data are presented as mean SD. The correlations and partial correlations using control variables, age, and body weight among survey items were evaluated by the correlation coefficient calculated using regression analysis. We divided the subjects into three tertile groups using consumption levels of coffee, antioxidants, and nutrients. Subjects with the same consumption amount at the cut-off point were allocated to one of the groups, resulting in different numbers of subjects in the tertile groups in some conditions. A comparison among the groups was first analyzed using the analysis of variance (ANOVA), then Turkey’s test for multiple comparisons was used. IBM SPSS Statistics 19 (SPSS Japan, Tokyo, Japan) was used, and a P-value
