Final Verdict on Collagen Supplements

BBC Sounds, Music, Radio Podcasts Hi, I'm Xing Singh, and I'm Simon Jack, and together we host Good Bad Billionaire, the podcast exploring how some of the world's richest people made their fortunes . And we're back for a new season with a brand new lineup of billionaires. Yeah, global pop icon Beyonce. Hollywood movie director Steven Spielberg. Football superstar Christiana Renalo, anyone? And as ever, we're asking you to decide whether they're good, bad or just another billionaire. That's good, bad, billionaire. Listen first on BBC Sounds. Hello, I'm Greg Foot and welcome to a new series of S liced Bread, the show that investigates the wonder products promising to make you happier, healthier, or greener. Each episode, we follow the crumbs of evidence to find out if one of your suggested Wonder Products is indeed the best thing since Sliced Bread or Market ing BS. And to kick off this new batch of investigations we are doing something a little bit different . An update episode on a product that we have looked at before collagen supplements. Now we first looked at these back in november twenty twenty two, but as their popularity has continued to rise and as so many of you have been in touch about them, we wanted to see how the products, the claims and the science have changed. One of the listeners who dropped us an email was Cass Sanders from Hartfordshire, who wrote, Collegeen seems to be everywhere in the news. Could it now be SB or is it still possibly BS? Well, let's find out, shall we? Welcome to the studio, Cass. Thank you for having me. Pleasure. You've been seeing a lot of adverts for these then. Yeah, it's been all over my social media and ads online as well . Marine collagen, bovine collagen. Stick it into a milkshake and drink it and sometimes you've got pills as well. But they also seem to be a bit expensive and yeah, I'm bewildered. What are they claiming to do? Oh, everything make my skin look dewy and like a twenty seven year old . Rejuvenate my knees. Joint benefits. That's a really interesting one because it's something we didn't really have time to cover in our original colleagen episode. So let's definitely dive more into that today. When you emailed you told us that the people in the adverts all look incredibly shiny.. They are Is that an aspiration? It is. Okay. Have any of these adverts persuaded you to buy any collagen supplements? No, I am notoriously tight and sceptical, so that's why I contacted you. Good. I love that. And are there any particular brands that you've noticed? Elevate was one of them, Marine Anne Bovine, which apparently you have to use because the others won't work on their own. And you're not the only listener who's asked us about Elevate actually. Listener, Sarah pointed us to an Instagram ad that they put out describing their supplement as a Hollywood hair reset. There are also claims here around hair quality as well. Have you seen those? I have, yes, yeah, and I'm a bit on the Wispy and Flyaway side. Since menopause said that would be great as well. Well, you've touched on something big cast because collagen really does seem to be everywhere. I was actually cycling past a donut shop yesterday and I saw a sign outside for a collagen donut . It's called the Glow Nut. It's a sourdough doughnut with a raspberry compot e infused with vegan collagen supplement. I should have brought some in really, shouldn't I? Let me just share a handful of the emails that have been sent in slice it up read at bbcot y cast listener Suzy says she's been bombarded with adverts for collagen with claims that it will rejuvenate skin, hair and nails. Listener John is recovering from a stress fracture and wants to know whether collagen supplements can help with joint, bone, tendon and ligament health. And listen to Helen wants to know where the collagen comes from, asking whether it is ethically sourced and whether there are foods that she could eat that would be just as effective as the supplements. That's a good question. It is a good question. And just to say if you haven't listened to our previous collagen episode, it is available on BBC Sounds, but you don't need to have listened to that before this. We're going to get you up to speed . I thought a fun place to start would be to check in with the listener from our original episode Joe Nolton. We asked her to drop us a voice note. Here she is . Hi there. It's good to know you're still on the case with regard to collagen. I did stop taking absolute collagen after the episode as I didn't see any scientific evidence for it working or evidence on me and it was too expensive for just in case. I do keep an eye on what's new on the market and read the report on the clinical trial carried out for absolute collagen, but that didn't convince me to start again either. After stopping, I didn't notice any difference apart from my bank balance. Thanks , Joe. We also got back in touch with the two founders that we spoke to last time to ask for their recent trial data and comments. I'll be sharing those later and we'll discuss their absolute college and clinical trial too to do all of that and to ensure that we are on a firm foundation and that we will not wrinkle under pressure. Thank you. Cass and I are joined in the studio by two experts. Yes, it's going to be a joint effort, Kass. Oh no. I'm going to start yeah, I'm going to start now for it . Firstly, a big welcome back to our original collagen expert, dermatologist, Dr. Emma Wedgeworth. Hi Emma. Hi, Greg. Thanks for having me back. Thanks for joining us. And alongside Emma is an expert in reviewing evidence from University College London who's going to help us understand the strength of the data around all this. Welcome, Professor Jane Tierney. Thanks very much my first time here. Thank you. Have you had any experience at all coll with agen supplements? Well, it was funny just before I got invited onto the programme, I had some handed to me at Holburn Tube Station. It was this sash of stuff, a spicy margin and I had it disgusting. Well, I can testify to the taste having tried one of the sachets last time. Oh water . Okay, wow that wasn't quite the fruity delight that I was hoping for. However, they are popular, so if people like it and they feel it's working for them, then they're obviously cool with it. Jane, before we get to the studies, I'd like to get everyone back up to speed on the science. So I'm going to start with Emma and then come back to you later if that's okay. Yeah. Emma, let's do a super quick science recap. What is collagen? Collagen is a structural protein that makes up a lot of our connective tissues. So that's skin, joint s . And it's a really important part of the way that our skin in particular retains its structure. So collagen is like the sort of firm scaffolding of our skin. And how do we make it? Through cells called fibroblasts and these actually synthesize the different types of amino acids interchains, which then create a triple hel ix, which is almost like a rope like material. Gotcha. Okay, so collagen is a structural protein and the building blocks that it's made of are amino acids. Exactly right. And there are different types of collagen, aren't there? Listener Elizabeth said that she's seen type one and type two . Listener John said he's seen type three. Yep, there are over twenty five different types in our skin already. Absolutely. But the main one that we tend to see, particularly in skin is type I collagen. We do also have some type three collagen in our skin . And then type two is potentially more in other sorts of tissues. So for example, joints, tendons, those sorts of areas. What happens to our collagen as we age ? So many things, unfortunately. So we know that from our mid twenties onwards we lose about one percent of our collagen each year. It also is not as good quality so it becomes poorer, it doesn't hold things up as well as it used to, and it also degrad es more easily. We get more collagen degrading enzymes over time. So a real triple whammy. Now one brand, vollagen, which we'll come back to later, they list a number of quote signs that your collagen levels have stopped to decline. Their number one sign is wrinkles and fine lines. Is collagen the real culprit there? Collagen is partly the culprit, but when you look at our extracellular matrix, it's not just collagen. Collagen combines with elastin, which gives the sort of bounce to our skin fibrilin, which is like the springy part of our skin, and then also hyaluronic acid, which sits almost like a gel filling, and all of these aspects age , so we know that yes, collagen will reduce over time and it's inevitable, but it's not just collagen. They also list thinning hair and brittle nails. Is that down to having declining levels and quality of collagen? I'm a little bit less sure about that. Our hair is actually made up of another protein called keratin and whilst collagen is important for the matrix in which our follicles circin in which they actually produce our keratin, it's not directly related to the quality of our hair and our nails. So I'm a bit less convinced by that . Another symptom that Vollagen mentioned is one that might resonate with Eukas, joint pain or osteoarthritis . Yeah, since going to the gym more regularly I've been noticing my recovery times haven't been particularly brilliant and I feel it the next day. And do you feel it in your knees? Knees and elbows. We got in touch with director of the NIHR Leeds Biomedical Research Centre Professor Philip Conoran. Philip can't join us today, but he kindly did find some time to speak to us beforehand and here is what he said about coll agen and joint pain. In our joints we've got a number of different structures. We've got cartilage which acts as a shock absorbing lining layer, bone underneath that, and a layer of what I call cling wrap wrapped around inside the joint to lubricate it. Collagen is present in a couple of those. It's also in the tendons around our joints that hold the joints together . So it's a pretty integral part of multiple tissues In osteoarthritis, the common arthritis we all get as we get older there is definitely loss of cartilage and some damage to the bone underneath those areas. And in those areas collagen is lost . The question is is it the cause and we don't know the answer to that . So the natural loss and reduction in quality of collagen as we age could contribute to wrinkles and fine lines. Juries out at the moment will discuss a bit more about its contribution to thinning hair and brittle nails and a loss of collagen is linked with osteoarthritis but we're not quite sure whether that is a cause or a consequ . The big question though, of course, is whether eating or drinking collagen can actually do anything to boost collagen levels in our skin and our joints . Should we get stuck into the products? Tell me all about it . Now the first thing you might notice is that these products say that they contain collagen peptides. Have you seen that cass? Yes. Remind us what a collagen peptide is, Emma. So a peptide a small chain of amino acids which isn't as big as the full protein. Each individual amino acid is like a building block and then peptides are small chains of these two amino acids or three amino acids long. You also sometimes see hydrolyzed collagen. They essentially mean the same thing. Exactly. Hydrolysis is the process by which the collagen molecule is broken down into peptides. And why are they broken down? So if you eat collagen, it's relatively resistant to getting through your stomach and into your bloodstream . So what they've tried to do is to break them down into small peptides which get into the blood and then these act as small signals to actually stimulate fibroblasts. So when you're taking collagen supplements, that collagen is not just being integrated into your skin. What it's doing is providing a signal for your fibroblast to make collagen. And that's a really important point that you made in the previous episode. The idea isn't that these collagen peptides end up in your skin, is that they cue the fibroblasts to make more collagen in your skin. Exactly right. Very important. On to the second thing that you notice with these collagen supplements, and that's where they say the collagen peptides that they contain come from. They're either bovine collagen, such as Dosenco's pure collagen peptides, or they will be marine collagen, like absolute collagen's liquid sachets . So Emma, how do these products prepare these collagen peptides from bovine or marine sources? They take parts of the fish or wherever else it's coming from and use things like skin, bone , tendons, those sorts of things. I know this sounds horrible . And they extract the collagen and then break it down into the smaller peptides. And listener, Helen wanted to know how ethically these are sourced. Obviously, there is a whole ethical thing about whether you eat animal products, but it's not that it's particularly less ethical than actually eating fish and meat. I think they are the byproducts of this. Does it really matter whether it comes from cow or fish? I think it really depends who you ask. Some people say that for example fish is more pure, it's more easily absorbed, it contains more type one so very good for skin, whereas bovine might contain more type one and type three , but frankly, I don't think there is much difference . And I saw that you can now get products that offer a combo of both. Apparently you need it. You can't just rely on one. Elevate multi collagen super blend. It's advertised actually as a premium drinking chocolate that combines collagens from both sources, plus vitamin C, hyaluronic acid that you've mentioned, Emma, and biotin, more about that in a second, elevates say that their bovine collagen quote strengthens joints and supports overall structural integrity of skin and connective tissues. It was interesting to see this claim that bovine collagen is for joints. Emma, you've said Marine is more type one, bovine is one and three. All of those were skin related, you said earlier. Exactly. So actually I don't really think there is much behind the claim. Okay Cass, any questions on all this so far? I've had a look at all the different sorts of collagen and one of the ones that have come up recently of course is the vegan collagen and I'm not quite sure how you can have vegan collagen if it comes from animal protein. It's a very good question. Emma last time, you did mention that collagen is only found in animal products. It doesn't exist in plants . So what are these vegan collagen supplements? So it's just precursors. These are small parts of amino acids which actually can contribute to the synthesis of collagen. Vegan brands don't hide this vollagen who I mentioned earlier, who are a vegan brand of collagen, they say that it contains quote a complex of amino acids in the same proportion as those found in collagen. Exactly. And it's difficult to know what the benefits of taking the individual amino acids are over just eating a high protein diet, be that either an animal diet or a plant based diet . So it's hard to really understand the full sort of rationale of the vegan collagen supplements. Does that mean that the collagen donut with vegan collagen in it is out ? It may taste great, Greg, for which I would say go for it. So that might be an answer then to listeners' questions saying could I just eat a diet that's rich in amino acids? Unless you're taking something like, for example, bone broth, actually potentially you're not getting that same level of sort of peptide which actually creates the signal to then synthesize collagen. Interesting. Well Emmy, you just repeated that really, really key point that the idea isn't that you eat or drink these collagen build ing blocks, they travel to your forehead or your bad knee and then they actually rebuild the collagen proteins themselves. The real hope is that they trigger a response in your cells in those fibroblasts that you mentioned for them to produce more collag en. Yes, it's like a repair signal. But this all relies though on the collagen peptides that you're eating or drinking, making it through your stomach , being successfully absorbed through your gut lining, into your blood, and then getting to your skin or your hair or your nails or your joints . Emma, last time you said that you'd seen some evidence that this is happening , any update? There are studies which have essentially labelled and traced these collagen peptides and have shown that they are demonstrated within the skin after being ingested orally , as well as other sorts of studies in the lab which show that actually the potential ability of them to get to the skin is possible. But they get out loud enough when they get there though. Another good question can 't consuming collagen , as Elevate put it, support skin hydration and elasticity? Or in the words of do se and c decodreease the appearance of wrinkles . And how will I know if it's working? You can see measurable improvement if you go to the gym. Will I see measurable improvement if I take this coll ege E inm.ma, can you just remind us how studies might actually go about measuring the likes of skin hydration or elasticity or wrinkles? There are a number of different ways that these studies have done that. So for example, hydration, there is a tool called a corne er which actually from the outside measures the level of water within the skin . Then they are using microscopic techniques. There's something called confocal microscopy and that can show you a little bit about the collagen structure . And then people will judge their own skin, and they will also have expert grading of people's wrinkles and lines as well. How do you rate a self reported study against measurements from a corne re or confocal microscopy. It's difficult to know. I mean, this is aesthetics, right? So people actually want to see an improvement. If you see a small result in a corneometer, but it actually doesn't translate to someone feeling happier about their skin , then it feels a little bit pointless. So in some ways I think people's perception of how their wrinkles are looking and how they feel about their skin it's reasonably relevant . Well, let's have a look at some of these trials. Many listeners have asked for updates from our twenty twenty two episode. Thank you all. Back then when I spoke to Darcy Laceby from Absolute College and her company had just been fourth on the Sunday Times list of fastest growing companies. These days they frequently call themselves the UK's number one collagen brand . At the time, she told us this. The clinical trial that we're doing will be on our product, which I'm really excited about. It's a big trial over one hundred and fifty people, big placebo group, etc . Now that trial was completed and was published in twenty twenty four in the journal Dermatology Research and Practice Jane, it's time to bring you in. Thank you for waiting so patiently . We sent you this published paper. What did they do? They have done a randomized double blind controlled trial. It's the sort of trial that one would expect to be the sort of gold standard. The trial did involve one hundred and thirty people, so it was bigger than previous studies that had been done. And they did these very objective measures that Ema talked about focal microscopy, ultrasound, corne atis . And according to the paper after twelve weeks they found that the collagen intaking group had skin that was fourteen percent more hydrated , twenty three percent more elastic and twenty percent less rough than the placebo group. That sounds promising, Cass. It does, yeah . But as we've just been cautioned, fourteen percent does it actually show in my skin , exactly. Jane, you've looked at countless clinical trials before in your job. What did you think looking at this one from Absolute? Is it a good study ? From reading the paper, it looks pretty good. You know, they describe these measures in incredible detail . But the first bit that bothers me is they don't see how they've allocated people to the collagen in the placebo group. That's fundamental to a randomized tri al. The people that go into the two groups should be very, very similar. You're saying that just saying randomized isn't enough. That's enough. You think I think I'd rather have the more wrinkly people in that group and you may subvert the randomization. Anything else you spotted? There were more participants excluded from the collegian group than the placebo group. So if you exclude participants what you've done to get a fair comparison between the two groups starts to go a little bit blurry. Presumably because you could exclude people who haven't seen an effect . Exactly. Emma will know this very well from looking at scientific papers . You have to describe the strengths of the study, the limitations , the context and so on and so forth. From reading the paper, it just talks a lot about how brilliant their study is and how brilliant the college is it's not in any way critical. Is that a red flag? Definitely. Now this study is not just industry funded. All the authors listed look to be absolute college and employees and they all have the assign addmentress, which is the absolutee Collgian HQ. Is that a concern? I do think there's a bigger concern about not just the Absolute Collegen trial, but the other trials that are funded by industry. Why is that ? Because you can't help but want to influence the results of a study if you are employed by a company, maybe have shares in the company are a co founder of the company, which is one of the authors . And usually the people who report a study are the people who run the study , but it actually was done by Princeton Consumer Research. And if I might quote whatever your product does, we can provide the appropriate clinical efficacy trials to make your claims of fact by proving their efficacy. I just feel boring this morning. Wow . I think it is the world of cosmetics . It doesn't surprise me in any way. Hey, it's future Greg here, just to make a slight correction. The Princeton Consumer Research website actually said whatever your product does, we can provide the appropriate clinical efficacy trials to make your claims a fact by proving their legitimacy rather than by proving their efficacy . But that said , we reached out to them with Jane's concern that the statement implies that they, Princeton Consumer Research, are assuming the product claims are facts and then trying to prove them rather than being scientifically neutral from the start . And they replied to say we appreciate the point raised by your expert, just to say expert is in quote marks there . And they wrote, The wording in question is not intended to imply any predetermined outcome. And they go on to say that their role is to conduct appropriate clinical evaluation programmes to rigorously assess whether a given claim can be supported by evidence . Now I looked at their website a couple of days after we got that email and the line has been changed . It now says we will work with you to find the right protocol to get to the claims you want to make . And if your product is good enough, you will see the results you are expecting. There is no guarantee of results , just of a scientific protocol to prove the claims one way or another . We also reached out to Absolute Collegeon about Jane's points, but they didn't get back to us. Thought you might find all that very interesting . Now back to the studio . Now, absolute say that they ran the largest, most robust clinical trial of a colleague supplement ever. Jane, on paper, it has everything you want in a good study. It's placebo controlled, it has over a hundred people in it. They took decent scientific measurements , but you're saying there are significant concerns with it. So how are we consumers supposed to navigate this? I think that is really difficult because it was hard for me to understand exactly what they did. So I think it's very difficult to navigate. I mean, I have expectations from seeing sort of robust clinical trials and there were those red flags for me . That's not to say that it might do exactly what it says on the tin. That's a very good point. This discussion doesn't negate their claims. We're just looking at the strength of the study that they say backs up their claims. I agree. I actually think if a company goes too heavy on the science, I'm automatically feeling a little bit cynical. Frankly, if you could replace your collagen with oral collagen supplements, we would have the cure for all the collagen genetic disorders, for all the types of issues where we really see structural changes within the skin. I think there's also a real key movement for things like creams and supplements to become so scientific and for the science behind them to be very consumer facing that people are now feeling they need to do the trials that perhaps they don't need to do. Perhaps we just need to be transparent about, look, this could help a little bit, but it's not going to be the game changer that it is. I mean, obviously I'm not in marketing, Greg, and you can tell why, but I think it's really difficult for me as someone who has this very sort of clinical background to actually hold these studies up to the same type of standards that I do with a medical study because they're just never going to be there. We often talk about industry funded trials and quite often the response to that is well who else would fund them? I think pragmatically that's all it 's ever going to be funded by. I don't think anyone's going to give a big grant to looking into whether collagen improves the wrinkles or hydration of your skin when you could give a big grant in looking into pediatric cancer. I think in this world you have to expect that it is going to be industry funded, it could still be a reasonable quality. But I think it is a red flag and every time you read a study that's industry funded at the back of your mind you are just reading it in a slightly different way than you would if it was a completely object ive trial. I think this ties us nicely into the second update that I have. When I originally spoke to Papindicatora from Ingenius, he referred to an independent clinical trial of their supplement. Here is what he said. Over one hundred and sixteen women aged from thirty to sixty. So we have seventy seven percent experienced a reduction in fine lines and wrinkles . sixty two percent showed an increase in skin hydration and fifty five percent experienced an improvement in skin elasticity. We're actually in the process of getting our trial published and then it will then be peer reviewed . Ingenius have since put a page on their website that outlines the result s and concludes that ingenious collagen plus has been scientifically proven to improve skin quality in ninety eight percent of women. However, at the time of recording, we cannot see that the trial that they are referencing their website has been published . We dropped Papinda an email about this and he confirmed that they are still waiting on the International Journal of Cosmetics Science. He wrote that quote, We do not want to be published in any inferior online only journal. It is in review . With this level of journal, it just takes time. I think that's pretty unusual and there's nothing wrong with an online journal. An online journal allows everybody to see what you've done . And this comes up in some of these mate analyses that I think will come on to talk about. Publication in of itself is not a guarantee of quality, but it at least allows you to scrutinise. We contacted the journal themselves about this but we haven't heard back . Janie just mentioned a meta analysis. Since we put out our original episodes, we've seen quite a few meta analyses of the evidence around collagen supplements. Jane, tell us about what one is and why they are helpful. When you do a trial , it gives you just a piece of the story so it might be inconclusive . You may be not able to recruit enough participants for it to be reliable . A meta analysis is a bit like putting all the pieces of the puzzle together to get a clearer picture. The challenge is there's different dosing of the supplementations, there's pills, there's liquid s , different types of people, different age groups , menopos. Now that I've heard that's a critical factor or all the menopause of women in one of these studies but not in others, there's a lot of variability . So a couple of these metro analyses came out in twenty twenty three. There was another in twenty twenty five. There's also one this year, twenty twenty six, the biggest review yet called an umbrella review. You've taken a look at these, Jane. What do they conclude about collagen supplements? All this variability that I mentioned in these studies actually translates into the results. I see some studies that show no benefit of collagen, I see studies that show huge effects of collagen and these are all put together. In one methouse there'll be a different set of studies in another it will be another set of studies. If you imagine you take an average each time . It's going to look a bit different . Their conclusions often are in favor of collagen , but what worries me and one of the Metanalysis alluded to this is are the results being skewed by the industry fund as studies? Yes, I saw this for the twenty twenty five meter analysis . It said studies not receiving funding from pharmaceutical companies revealed no effect , while those receiving funding from pharmaceutical companies did show significant effects. And it may well be that the industry funding is skewing the results in favour of collagen, but there's all that other variability in there. It's very hard to pinpoint exactly what is driving any differences in the effects. So it's not that clear cut, but it's definitely interesting. Where does it leave you when it comes to what the evidence says for the impact of collagen supplements on our skin? I think it's incredibly messy . I'm not sure whether collagen is given these benefits by absolutely agree with Emma that they are being overstated . Okay, let's quickly go through nails, hair, and joints before we wrap up. Some collagen supplements do promise to do things like visibly transform hair and nails, that is from Absolute Collagen. Jane, we would have liked to have sent you a meta analysis to look at here, but as far as we could tell, we couldn't find any. There are some individual studies, so Absolute Collagen's clinical trial looked at hair, and they said that after twelve weeks, quote, Trichoscopy showed an average eleven percent improvement in scalp scaling and a twenty seven point six percent increase in the total amount of hairs counted versus placebo. Emma, you had question marks over the link between collagen and hair earlier What do you think of these results? Now here I'm thinking no, if you want to treat your scalp scaling, I can do that no problem with much better products than oral collagen. And as for hair growth, I think you want to be really careful about using oral collagen for hair growth. We actually do see a huge amount of hair loss. We know that one of the most effective things is to get in early with effective evidence based treatments. And actually I don't like it at all when people come to clinic and they've been using things which actually frankly don't work for their hair and they've lost a few years and more hair and then it's hard to get it back. So I'm actually going to say for hair and nails, I think I've got way better treatments than that. At Interest is one of those biotin because elevators say that their supplement is good for hair and nails, but not because of collagen, because of biotin. No, so essentially if, you are very biotin deficient, then yes, you may have problematic hair, but most of us have normal biotin levels and we do not need any more biotin for our hair to grow. The problem with our hair growth is sometimes due to our hormonal levels or the way that our hair follicles are aging or various other things. So I would say blanket biotin supplementation is not the treatment for most hair loss. Finally, then it's time to answer listener John's question about whether collagen supplements can help with joint, bone, tendon, and ligam ent health. We heard from arthritis expert Professor Philip Conhorn earlier how important collagen is to joints and bones. So there is sound basis for this theory, but what about it in practice? We asked Philipp what the research shows . There are a number of individual studies, some animal model studies, individual human studies where there were benefits seen in certain outcomes, but I'm looking at large well designed trials that show a significant benefit for a patient's pain or for how they move their joints, their function and that evidence is surely lacking. There's just an absence of large well designed trials that have positive benefits. You're saving me a fortune, mate . So there's a saying that the absence of evidence is not the evidence of absence. It doesn't mean that do not work , but we have to rely on poor quality evidence, which is all we have, and then alongside that, expert consensus. You mentioned earlier, Emma, when it comes to joints, that's all about type two collagen . Before I put the final question to both experts , there is a new kid on the collagen block. We haven't really talked about it yet. It is undenatured type two collagen. Cass have you seen this stuff? No, I haven't, but I'm getting excited . Does this one work? So we saw this available in quite a few places. Holland and Barrett sell capsules of this. This word undenatured sounds like a bit of a double negative, but it appears to mean that it has not been hydrolyzed or already broken down into small bits. So therefore we're talking about larger collagen peptides here, Emma. Presumably I'm not familiar with this particular product myself, but presumably under nature does mean that it's intact . Interestingly, it's not from cows or fish, it's avian collagen from chicken. These products offer much lower doses than other types of collagen naught point naught four of a gram. That's less than half of a tenth of a gram per dose. They're supposed to work differently to hydrolylyzed collagen by triggering certain parts of your gut that are connected to the immune system and reducing inflammation. But when we looked for studies , again, we found some preliminary evidence but nothing concrete. The biggest trial we found on sixty eight people with knee osteoarthritis last year found it had exactly the same effect as a placebo. That good . So let's try to pull all this together with the final question. Emma, let's start with you . Are collagen supplements that promise to firm up and hydrate your skin, reduce wrinkles, strengthen hair and nails. A theyre the best thing since sliced bread or are they marketing BS ? Okay, I'm going to reframe that a little bit. Do I take collagen supplements? And the answer to that is no . If I want to firm up my skin, if I want to hydr ate my skin, if I want to reduce lines and wrinkles, I'm going to put my money, time and effort into the top five things that can actually help. And for me, that's not collagen supplements. Number one, sun protection , number two, a good moist urizer and skin barrier protection. Number three, topical retinoids, number four, a really healthy lifestyle, no smoking , running , exercise, good diet, and number five, some carefully chosen treat ments, for example, botulinum toxin, things like that. Interesting. Over to Phillip now because we asked him whether collagen supplements were the best in since life spread for joints and arthritis or marketing BS, and he said this Nowhere near the toaster they are, nowhere near worth putting on your bread . It's all myth, I'm afraid, but somebody's making a lot of money . And Jane, having reviewed the evidence for these supplements, what do you think? SBLBS ? I think if they are the greatest things in sliced bread, it's impossible for me to judge that and it's absolutely laden and enslathered with market ing BS . Cass, final word goes to you. Will you be buying collagen supplements? No, I'll up my moisturizer and sunscreen. With that, I shall wrap up this episode of Sliced Bread. A big thank you to Emma Wedworth, Jane Tierney, Phillip Conan, and Cass Sanders. And if you're listening to this and thinking, Greg, I have a wonder product I would really like you to investigate, please do send it over either on email to slice to bread at bBC. co. uk or as a message or a voice note on WhatsApp two zero seven five forty three six eight seven Next time earwax Build up of earwax can affect anyone but with, fewer removal services being offered by GPs, can shop bought drops, sprays, picks, scrapers or syringes really help soften and remove it? I'll be finding out. See ya This episode of Slice Bread was researched by Phil Sansom and produced by Phil Sansom and me, Greg Foot. Our studio managers were Helen Williams and Elijah Waddington and Slice Bread is an audio North production for BBC Radio four . Hello, I'm Alan Davis and on BBC Radio four, we're off into alternate realities mapped out by science . This is Life Without