The Collagen Diet

CHAPTER 1

The Essential Nutrient That Disappeared from Our Diets

Why Embracing This Ancient Dietary Staple Can Restore Your Health

We live in an era of unprecedented abundance. The food supply in the United States contains about 3,750 calories per person, per day. That’s a thousand calories more than we consumed daily just two hundred years ago, according to the U.N. Food and Agricultural Organization, and far more than any of us needs. (Women require 2,000 calories, on average, and men 2,500.) Our ancient ancestors, who had to hunt wild game and gather berries to scrape together enough calories to feed their families, would undoubtedly be astonished by our effortless access to sustenance. And envious.

But here’s the paradox: Despite the availability of food, many of us are plagued by surprisingly poor health. Nearly half of the people in the United States suffer from chronic conditions like diabetes, joint pain, heart disease, osteoporosis, gastrointestinal problems, inflammation, and cancer, undermining their ability to participate fully in daily activities and often cutting short their lives. Odds are, at least a handful of people you care about are affected by one or more of these persistent health problems. And the situation is likely to get worse, since most of these conditions become more prevalent with age—and our population is rapidly graying. Ten thousand people in the United States will turn sixty-five every day from now through the end of 2029, according to the Pew Research Center. The scope of the looming problem is mind-boggling. And here’s what makes it even more tragic: Chronic health conditions can be traced, in large part, to our modern diet.

Food is called sustenance for a reason. It is meant to sustain us—not only to provide fuel for our bodies but also to heal them, to give us the nutrients we need to look and feel our best, and to provide us with ample energy to face the demands of our increasingly stressful lives. But here’s the catch: We need to eat the right foods. And that’s the problem we’re facing now. The two “staples” of the typical Western diet, sugar and refined carbs, fill our bellies but shortchange our health. By providing largely empty calories, they pack on pounds, undermine our bodies’ ability to function on a cellular level, fuel inflammation, and increase our risk of every single chronic condition that’s rampant today.

We no longer live with chronic hunger or the persistent threat of starvation, as our ancestors did. But we are starved for true nourishment. A variety of studies over the past decade have found that many of us don’t get enough calcium, potassium, fiber, folic acid, magnesium, iron, and vitamins A, C, and E—nutrients that are indispensable for building strong muscles, bones, blood vessels, skin, and immune systems. Other compounds that were plentiful in our ancestors’ diets, like phosphorus, silicon, glucosamine, and sulfur, are missing from our everyday meals as well.

But there’s a lesser-known substance that’s notably absent from the typical Western diet—one that I believe can help us reverse our spiraling health issues and give all of us the best shot at a long, robust, active life. It’s called collagen. It’s the most abundant protein in the body, and a growing database of research shows it is vital for the structural integrity and healthy, long-term functioning of our bodies.

Our ancestors’ diets were rich in collagen. Today, we consume almost none. But thanks to recent research showing that it can do everything from regenerating new tissue to bolstering your immune system, it’s finally getting its due. I’m a huge fan of collagen. And I believe that by the time you’ve finished this book, you’ll understand why—and you will be, too.

MEET THE INGREDIENT THAT JUST MIGHT CHANGE YOUR LIFE

Collagen is a strong, springy, fibrous substance that is woven into dozens of your body’s tissues. It’s responsible in large part for the firmness and elasticity of your skin, the strength of your nails and bones, and the pliability of your cartilage, tendons, muscles, gut lining, and blood vessels. It even encases your organs. On a functional level, collagen gives you flexibility and strength, allows your joints to move fluidly without aches and pains, and plays a role in everything from wound healing to gut health to cardiac health. It’s the glue that holds you together. Indeed, the word collagen is derived from the Greek word for glue, kolla.

There are sixteen different types of collagen, but about 90 percent of the collagen in your body is either type I, II, or III—or some combination of the three. (I’ll explain each type in the next chapter.) Those three predominant types share the same molecular structure—a woven rope–like shape known as a triple-stranded helix, which gives them their strength and flexibility.

Because it plays a vital role in so many diverse aspects of health, adding collagen to your diet is one of the best ways to fight off both the visible and invisible signs of aging and keep you feeling vibrant as the years tick by. For instance, a recent study published in the journal Nutrients looked at the effects of oral collagen supplementation on the skin of aging mice, a reasonable stand-in for human skin. (Studies that rely on taking widespread biopsies are often performed in mice instead of humans, for obvious reasons.) After eight weeks, not only did their skin have more collagen, but its ability to repair frayed collagen fibers had improved, its antioxidant enzymes were more active, and the skin itself was firmer.¹ It changed the tissue quantitatively and qualitatively, according to the researchers, effectively turning back the clock and making the skin’s structure and appearance years younger.

As you get older, it becomes increasingly vital to get this substance from your diet. Here’s why: In your mid-twenties, your body’s natural collagen production begins to decline at a rate of about 1 percent per year—a drop-off that accelerates in your forties and fifties. By the time you reach your early fifties, you produce roughly 30 percent less natural collagen than you did in your twenties.

Waning collagen is a normal part of the aging process, but it is fueled by certain lifestyle habits, including sun exposure (ultraviolet radiation damages the skin’s collagen-building cells), smoking, stress, poor gut health, consuming too much sugar, and inflammation (which often stems from poor diet and lifestyle habits). Molecules of sugar, for instance, form what’s known as “advanced glycation end products,” or AGEs, which can attach to the collagen and elastin in your skin, causing wrinkles and loss of elasticity and putting you at risk for inflammation-related skin conditions like acne and rosacea.

As a result, it’s critical to replenish this diminishing source of youth and vitality, and the most important way to do that is with food. But the typical Western diet has been largely stripped of collagen. Every time you remove the skin from a chicken breast or put the tendinous gristle in the dog’s bowl, you’re throwing away an opportunity to bolster and sustain your body’s collagen. And, as you’ll learn in the coming pages, those are just two examples of the opportunities you’re almost surely missing to bolster your body’s collagen and take advantage of its regenerative effects.

There’s no medical test to gauge how much collagen you have, but, honestly, you don’t need one. It’s easy to recognize when this fundamental substance is becoming dangerously low. Collagen deficiency makes itself known through

By getting enough collagen in your diet, you can prevent—and treat—many of these problems. Here’s one example: In 2018, German researchers reported on the results of a study looking at collagen and bone loss. For the trial, they enrolled postmenopausal women whose bones were thinning. Some of the women consumed 5 grams of a collagen supplement every day for a year, while the others were given a placebo. After twelve months, the collagen group had significantly greater bone mineral density in their spines and the top of their femurs (the bone most associated with broken hips), while the placebo group’s bones had become more fragile.²

I’m always wary when someone tells me a single substance has such broad and diverse effects, and frankly, you should be, too. But there’s a simple explanation for why collagen can and does have an impact on so many different parts of your body: Like an invisible suit of protective armor, it’s woven into a multitude of tissues, from the outermost layer of your skin to the innermost layer of your blood vessels.

Everywhere it’s found, it serves to strengthen, fortify, build, and renew tissue at a cellular level. It’s one of our best defenses against the ravages of age—and a powerful weapon for strengthening whole-body health and wellness. I’ve been recommending collagen to patients, friends, and family for the past decade and have seen remarkable examples of improved health and healing.

For instance, in 2018, my dear friend and colleague Jordan Rubin and I debuted a program called the Multi Collagen Makeover, which contains many of the same components as the Collagen Diet plan. As the program took off, dozens of participants sent us revealing feedback. As Debbie Fong, one participant, said, “I’m on day 21, and I feel like I’m reversing in age. I’ll be sixty at the end of this year and I can see all the physical changes on the outside, so I can only imagine what it’s doing on the inside of my body. My face glows now, and my skin is getting firmer. The bags under my eyes are diminishing, and the drooping under my eyelids is disappearing. My jawline is starting to reappear. Totally amazing!”

A growing body of research supports that type of anecdotal experience. Indeed, a 2019 review of the literature published in the Journal of Drugs in Dermatology concluded that oral collagen supplements increase the elasticity, hydration, and density of aging skin’s collagen-rich dermis (the layer that determines, in large part, whether your skin is smooth or wrinkled)—all without any adverse side effects.³

New studies in this burgeoning field are revealing additional uses for collagen all the time. For instance, collagen is now being combined with stem cells to help regenerate knee and shoulder cartilage in those with injuries and arthritis. And resorbable forms of the substance are being used to dress oral wounds and promote dental healing.

In the coming chapters, I’ll explain in detail the exciting studies on collagen and their results, which show it can improve the health of your skin, gut, joints, and more. But first, it’s important for you to know a bit more about this substance so you’ll better understand why it can have such powerful effects.

EVERYTHING OLD IS NEW AGAIN

Although collagen is on its way to becoming the “it” dietary ingredient (especially in supplement form), it’s far from new. This humble protein formed the backbone of our ancient ancestors’ diets, which were made up of wild meats and bone broth as well as vegetables, berries, herbs, and spices. In the days when food was scarce, humans used every edible part of the animal. They brewed collagen-rich broth from the bones, tendons, and cartilage of fish, chicken, and beef, and they routinely ate organ meats, ligaments, and tendons, all of which are teeming with life-giving collagen. As it turns out, their thrifty approach to food use may have offered them protection against some of the most common ailments that plague many of us today.

Take arthritis. This public health menace affects an estimated 54 million to 91 million adults in the United States (the higher number includes people who haven’t received an official diagnosis), causing chronic pain and forcing nearly half of sufferers to limit their daily activity. However, when researchers from Harvard and several other universities recently compared skeletons from modern people to those of hunter-gatherers and early farmers—skeletons that were as many as six thousand years old—as well as bones from the nineteenth and early twentieth centuries, they found that knee osteoarthritis is at least twice as common today as it was in prehistoric and early industrial times.⁴

All of the skeletons were from people who were fifty or older, and the researchers controlled for age, body mass index, and other confounding factors. Even so, osteoarthritis affected just 6 to 8 percent of the prehistoric samples and those from the 1800s and early 1900s, while skeletons from the 1900s to early 2000s showed a rate of 16 percent. And that’s lower than the 23 percent the Centers for Disease Control reports.⁵ Moreover, it is estimated that by 2040 nearly 26 percent of U.S. adults will be afflicted by the condition.

While the relatively recent rise in obesity has undoubtedly played a role in the uptick, weight only explains a fraction of the increase, according to the researchers’ calculations. Their conclusion: In order to prevent this debilitating condition, we should try to adhere more closely to the physical activity and dietary patterns of our early ancestors. And here’s what our ancestors ate: veggies, berries, herbs, and collagen, collagen, collagen.

Our forefathers’ high-collagen diets may also have protected them from common gastrointestinal conditions that afflict far too many people today. In a study published in Nature Communications, researchers analyzed the gut bacteria of the Hadza, a foraging tribe in western Tanzania.⁶ The Hadza, who still live entirely on wild game, roots, and berries, just as our ancient ancestors did, not only have radically different gut bacteria from the average modern urbanite but also have zero incidence of irritable bowel syndrome and Crohn’s disease.

Studies like these support the intriguing idea that collagen has historically played an important role in human health. Although our ancestors originally consumed the collagen-rich parts of animals for practical reasons—when food is scarce it makes sense to get every ounce of nutrition you can out of every food source—they undoubtedly benefited physically from the approach. And there’s ample evidence that a number of cultures around the world learned the value of this substance and began to utilize it as a cure for a variety of ailments. Indeed, collagen has featured heavily in traditional healing modalities around for world for centuries.