Sugar Makes You Fat, Sick and Also OLD

Study shows people with high blood glucose levels look older

We are no longer strangers to the effects of sugary treats and drinks on our waistlines and health, but scientists have now discovered that high sugar diets are causing our skin to rapidly age as well.


As reported in the UK newspaper The Telegraph, Dr David Gunn and his team discovered that the higher a person's blood sugar, the older their perceived age. Their study, conducted on over 600 50 to 70 year olds, found that each 1 mmol/litre increase in blood glucose levels increases perceived facial age by 5 months, and on average, a diabetic looked up to 2 years older than a person of similar age and lifestyle but with low blood sugar levels. 

Sugar - good on the lips but not so good once consumed

So how exactly does the sweet stuff make you look older? The answer is in a process called glycation. The sugar in your blood stream binds to proteins in your skin such as collagen and elastin, producing molecules that are known as advanced glycation end-products, or AGEs for short. AGEs cause collagen to become brittle and dry, causing wrinkling and sagging.
The effects are most pronounced as the skin ages, causing collagen and elastin production to naturally decrease after the age of 35.  

Dermatologists such as Fredric Brandt, MD, the creator of the highly successful Dr. Brandt range of skincare products, and Dr Aamer Khan, medical director of the famous London Harley Street Skin Clinic agree that a proper anti-aging regime should include the avoidance of high glucose foods for true effectiveness. Dr Khan was quoted in a recent interview, saying there was little point in application of expensive skin creams as a diet high in sugar would sabotage the growth of strong, healthy skin cells.  

Unfortunately, avoiding high glucose intake is not as easy as it sounds. Sugary substances and high-sugar foods such as candy and chocolate, and sugary soft drinks and juices are not the only foods that need to be avoided. High glycaemic index (GI) foods such as cakes, biscuits and white bread are also very easily converted by the body into simple sugars, and most processed foods including sauces and salty snacks often have sugar listed in their ingredients. Switch to low GI foods such as brown rice, multi-grain bread and non-wheat grains such as quinoa instead. The aim should be to ensure sugary substances makes up less than 10 percent of the total dietary intake. Regular consumption of green tea is also known to boost collagen formation while interfering with the glycation process.

The good news is that those who have tried it have discovered benefits such as smoother, younger-looking skin, within the first few days of changing their dietary habits. Some claim that this simple change has made them look up to 20 years younger, and with the added health benefits of a low sugar diet for the heart and body, you might even feel a lot younger too.

- Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email. 

The Miss Malaysia Controversy - Too White For Malaysia?

Kimberley Ann Estrop-Leggett
Miss Malaysia 2012

Recently there have been a few articles in the newspaper and on the internet about Kimberley Leggett, the 2012 Miss Malaysia title holder being 'too white'. These are the words of a journalist at The International Business Times, who wrote that Miss Leggett certainly resembled Europeans and North Americans much more than she did a country that was predominantly made up of Malays, Chinese and Indians.

I followed the development of this controversy with some amusement as people rose up to defend the Miss Malaysia program and its winner. The argument goes that the beauty pageant win was based on overall looks, presentation and ability, and was certainly never meant to conform to any defined racial looks.

Miss Leggett, certainly a very beautiful and personable young lady, who I previously have had the pleasure of meeting in person, owes her caucasian looks to her British father and Serani (mixed European and Malay) mother. Like Deborah Priya Henry, her Miss Malaysia predecessor, Kimberley Leggett probably represents the pan-Asian look that we previously discussed as the beauty ideal for many Asian women. The subject of her eligibility to compete as a representative of an Asian nation aside, certainly these women have the multi-racial looks that tend to earmark successful competitors at international beauty pageants.

Certainly as the world becomes more global, racial boundaries become less defined, and cultures and races intermarry, the ideals of beauty have similarly evolved. It also has been noted before that many previous winners of international pageants hail from Latin American countries such as Venezuela and Puerto Rico, where the majority of the population is comprised of mixed races.

Having no idea of the judging criteria or machinations of the beauty queen selection process, I cannot be the judge of the fairness of Miss Leggett's selection as the face of Malaysian beauty. However, as I have previously noted - in this article here, as a species humans tend to favor individuals from a mixed background, as they tend to have a 'genetically average' look - ie. do not have any of the negative characteristics that are seen in persons seen as typically Chinese or Indian or British, for example. Studies also suggest that we find these people more attractive as their genes have a greater variety and tend to give them advantages of better health.

To read more on genetic averages and understand more about this, here are some articles of interest:

Health Correlator - Pretty Faces Are Average Faces: Genetic Averages And Health

Discover Magazine - What Average Genetic Variation Can Tell Us Or Not 
The Mail Online: Brits Believe Mixed Race People Are The Most Attractive And Successful
Psychology Today: Mixed Race: Pretty Face?

What do you think about this theory of genetic averages? Do you agree that mixed race individuals tend to be more attractive? I've love to hear your feedback.

Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email. 

Botched Laser Treatments - Stay safe!

This article in today's The Star reports yet another case of laser treatments gone wrong at beauty salons in Malaysia. There have been many such cases, sometimes involving laser or IPL machines, but there have also been cases where botox, filler or 'nutritional' injections of questionable source or content have also gone horribly wrong, not just here in Malaysia, but in the region and throughout the world.

I would like to remind consumers to be wary when seeking any kind of treatment that involves a high degree of risk, or relies heavily on the skill of your service provider. Any time you are seeking to do a treatment such as lasers - a procedure that essentially damages the skin in a controlled way, in order to achieve a specific effect such as skin cell renewal or destruction of skin structures such as hair follicles - it is also vital that you have a certain amount of trust in the service provider.  You need to know that the person handling the machine has been well trained to understand what the effect of each turn of the dial or push of a button, on your skin will be. It is unfortunately much harder to be certain that the equipment they are using is reputable, reliable and has been thoroughly tested and calibrated to give the desired effects.

Scars, blisters and burns are some of the dangers of bad laser treatments

Even medically approved laser machines have vastly different modalities, and the protocol involved has to be carefully planned through tests and actual user feedback for maximum efficacy. Though there are protocols given by laser equipment companies, and sometimes expert users who have had personal experience with real-life hands on treatment, each service provider - which may be your aesthetic doctor, or an assistant under the supervision of the doctor - still needs to have the skill and knowledge to adjust the equipment to each patient's personal needs.

I spoke before of the risks involved when choosing laser or other beauty treatments by price sensitivity, but it is very important to realise that laser equipment in particular, can vary greatly in cost. A machine from a reputable laser company can cost upwards of USD100,000, whereas a cheap salon set can be had for merely USD1000. When you factor in the cost of disposables, manpower, and upkeep of premises, the fact that a treatment can be had for the cost of a cup of coffee and a slice of cake should alert you to be wary of the results to be expected.  

CosMed, MD

It's true - vitamins can make you look younger!

Botox Efficacy Improved By Zinc Supplementation

More reasons to hit the vitamin shelves - a recent study has shown that zinc supplements can help to boost the effectiveness of botox injections, not just in cosmetic applications such as wrinkle treatments, but also in medical treatments such as for eye spasms, migraines and bladder incontinence.

Oculoplastic surgeon Dr. Charles Soparkar showed that the duration and efficacy of a botox treatment was improved by up to 30% when a  mix of zinc and phytase was given in addition to normal botox injections. The result has been less frequent botox re-injections, and better effects from each treatment session, meaning patients save more in the long run. 

Botulinum toxin A is very highly dependent on the availability of zinc for it to work properly. It has been shown that botox injections do not work very well in low zinc conditions. However, many people are zinc deficient, due to zinc binding substances in our food. The addition of phytase works to inhibit the activity of these zinc binders, or phytates, so it helps the zinc to be better absorbed by the body. 

A new zinc supplement, Zytaze (USD60 - 80 per box) has been introduced in the US, specifically to be used in conjunction with Botox injections. Will it be available here in Asia? We will have to wait and see. 

Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email. 

How To Age Like A Celebrity And Look 30 Forever

There are some lucky people who never seem to face the ravages of time. Celebrities like Madonna, Tina Turner and Demi Moore are some examples, and despite being over 50, they manage look better than people 20 years their junior.

Christy Brinkley will celebrate her 58th birthday this year, but  her looks remain forever 30.

Aging is a process that is greatly affected by genes, environment, sleep habits and diet to name just a few factors, but since this is a cosmetic medicine blog, and my patients come to me to reverse the effects of time rather than prevent them, let's examine exactly how a face ages.

As the face ages, it undergoes significant and visibly identifiable changes

As the face ages, it undergoes significant and visibly identifiable changes. It begins with weathering of the skin, and changes to the texture, transluscence and variance in skin colour in the mid twenties. By the mid thirties, furrows and lines are visible in forehead and near the eyes. Loss of fat from the temples and upper cheeks may show by the age of forty, and the undereye area is one tell-tale sign of aging as the skin begins to sag and pouch. The neckline is also an age giveaway as it becomes loose and baggy during the fifties. By the sixties, the skin is noticeably lined and very loose and saggy as the cheek fat atrophies.

How to Turn Back The Clock

1. Loss of volume
Lipoatrophy, the loss of fat in the underlying facial structures means the facial skin begins to sag, the cheeks become sunken and gaunt, facial shadows become more pronounced and lips become flatter and thinner, jowls appear on the sides of the face, and the neckline is visibly looser.

The Fix: Thread lifting, fillers, Thermage

Thread lifting for jowls and sunken cheeks




Fillers for deep lines and for plumping cheeks, lips and sunken areas

Thermage for overall facial rejuvenation and collagen remodelling

2. Skin texture and pigmentation
Environmental effects such as sun exposure and air pollution, as well as hormonal changes and effects of diet all play a part in the appearance of the skin as we age. The skin also gets thinner and fine lines appear, while melanin deposits and surface damage all contribute to obscure the glow of healthy, young skin.

The Fix: Skin resurfacing

3. Wrinkles and lines
Wrinkles appear in forehead, eye, cheek and around the mouth, as a result of the loss of fat and also due to constant muscle movements.

The fix: Botulinum-A injections


There are many exciting techniques for holding back the ravages of time, and ensuring you look your best, even into your 50s and 60s. These treatments are best used in combination, for a natural look that is purely you, but just younger, brighter and refreshed, so you too, can look and feel like a star, no matter your age.

Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email.