Dr Erik Reis discusses the role of fasting, caloric restriction and advanced modalities in aesthetics
The modern-day aesthetic practitioner knows patients no longer just want to look good, they want to feel good as well. There’s a growing public interest in integrative and nutritional modalities focused on optimising cellular health and metabolic function in the longevity and biohacking sectors.1,2
That’s why many clinics are now offering nutritional services, genetic/epigenetic testing and supportive modalities to improve metabolic and energy levels alongside aesthetic procedures.3 The question is: what is the best way to do that? How can we improve our clinical outcomes and patients’ lives simultaneously? And how does this change our current practices?
Non-invasive modalities like fasting, caloric restriction and non-thermal low-level laser therapy have recently gained popularity for weight management and longevity by enhancing mitochondrial health. Mitochondria are crucial for cellular function, influencing overall health and healing.4-7
These practices can offer significant benefits, including reduced chronic inflammation, improved gut and skin health, fat loss and optimised cellular function. When combined with personalised nutrition, exercise and healthy habits, they can lead to remarkable improvements quickly.
In my opinion, medical aesthetic practitioners are in the ideal position to provide these insights to help their patients optimise lifespan and healthspan. This article explores the scientific basis for these claims, examining how these non-invasive treatments impact skin, brain, body and cellular metabolism through mitochondrial health.8 Their benefits in combatting inflammation, improving aesthetics, optimising cellular function, enhancing healing, fat loss and promoting overall longevity and quality of life are also detailed.
The importance of mitochondria in ageing and longevity
Mitochondria are essential organelles responsible for producing the energy required for every cellular process in the brain and body. They also play a critical role in regulating inflammation and immune function, and are pivotal in discussing longevity and healthy ageing.9,10
Inflammation regulation
Mitochondria produce adenosine triphosphate (ATP) – cells’ primary energy currency. They also regulate inflammation, and dysfunction can activate the NLRP3 inflammasome, an inflammatory response protein complex. Healthy mitochondrial function reduces chronic inflammation and ensures appropriate inflammatory responses.11
Immune function
Mitochondria are essential for immune responses, activating various immune cells like macrophages, T cells and B cells. They produce signalling molecules that modulate immune cell activity, ensuring a balanced immune response and effective infection response. When mitochondria are unhealthy, these processes go awry.12
Longevity
Mitochondria are central to ageing.9 Their function and quantity decline with age, leading to reduced energy and increased oxidative damage, linked to age-related diseases.9 Caloric restriction and fasting enhance mitochondrial function and biogenesis by activating pathways like AMPK, NAD+ and sirtuins, promoting health and longevity. Non-thermal low-level lasers optimise cellular function and promote healing, while also dampening inflammation, further enhancing health and healing benefits.13
Fasting and caloric restriction
Fasting involves voluntarily abstaining from food for specific periods, ranging from intermittent fasting (e.g. 16/8 method, where individuals fast for 16 hours and eat during an eight hour window in a day) to extended fasting (lasting 24 hours or more).14 Caloric restriction, on the other hand, involves reducing daily caloric intake by a certain percentage, typically 20-40% of the recommended daily allowance, without malnutrition.14
Both practices have been shown to trigger a range of metabolic and molecular changes, including improved insulin sensitivity, reduced inflammatory markers and enhanced mitophagy/autophagy – a cellular recycling process that removes damaged components from old cells to be used as recycled goods for new cells or to be eliminated from the body.15
The mechanism of these changes is outside the scope of this article, but can be found in the studies provided.15-17 These anti-inflammatory and altered mitochondrial changes are thought to contribute to the antiageing effects observed with fasting and caloric restriction.16,17
So how does this translate to the aesthetic landscape? Addressing inflammation is critical for patients, especially those recovering from surgical procedures, traumatic experiences and daily stress in life. Inflammatory meals like processed shelf-stable foods and highly processed carbohydrates/sugars, lack of exercise, excessive adipose tissue, poor sleep and unhealthy habits like excessive drinking and smoking also cause prolonged inflammation.18
It is well known that chronic inflammation impacts healing, recovery and aesthetic procedure outcomes involving the skin.18 While short-term inflammation is beneficial, chronic inflammation leads to trouble, causing long-term damage and affecting digestion, sleep, energy, cognitive processing and overall wellbeing.
We also know that losing weight can have significant beneficial effects on low grade chronic inflammation, as excessive amounts of pro-inflammatory white adipose tissue promote dysregulated inflammation throughout the brain and body over time.19,20
Fasting and caloric restriction would typically be ideal for people with type II diabetes, elevated cholesterol/lipids, those wanting to lose weight and those generally looking to optimise their health. Since fasting has such a profound global reach on metabolism, in my view, its benefits and reasons are virtually endless.
It should be noted that fasting isn’t for everyone and is best performed under the supervision of an experienced and qualified medical professional. Fasting inherently places additional stressors on the brain, body and metabolic capacity via the requirements on cortisol production and change in metabolism from glucose to ketones (at times).
Those who are struggling with significant hormonal issues (like women in menopause or post-menopause), eating disorders and specific types of mental health problems may actually get worse with fasting protocols.
Some patients may struggle with initial stages of fasting due to blood sugar sensitivities, so be sure to check on patients frequently during the first few days/week of implementing a fasting program. It is suggested to use your best clinical judgement before implementing these protocols with your patients.
Fasting’s impact on skin and brain health
Fasting and caloric restriction are becoming popular for their ability to reduce inflammation, promoting healing in the brain, gut and body.21
Skin health
- Enhanced autophagy and skin rejuvenation: Fasting and caloric restriction upregulate autophagy, clearing cellular debris and promoting old skin cell renewal. This can potentially lead to improved texture, reduced wrinkles and a youthful appearance.22
- Reduction in oxidative stress and inflammation: These practices reduce reactive oxygen species (ROS) and pro-inflammatory cytokines (e.g., IL-6, TNF-Alpha, IL-1Beta), potentially resulting in healthier, more resilient skin which can mitigate acne, psoriasis and eczema. They also have a beneficial effect on the immune system, which can further dampen inflammation and underlying immune dysfunction like autoimmune-based skin reactions.23,24
- Improved collagen production: Fasting can potentially boost collagen synthesis, enhancing skin elasticity and reducing ageing signs through pathways like sirtuins and AMPK.21
Brain function
- Neuroprotection and cognitive enhancement: Fasting and caloric restriction stimulate brain-derived neurotrophic factor (BDNF), supporting neuron survival and growth, crucial for learning, memory and cognitive function. Elevated BDNF has been found to help protect against neurodegenerative diseases.25
- Enhanced mitochondrial function: These practices enhance mitochondrial biogenesis and function, increasing energy production and reducing oxidative damage which leads to better cognitive performance and reduced age-related decline.26
- Regulation of neuroinflammation: Fasting and caloric restriction modulate immune responses, reducing inflammatory cytokines and promoting anti-inflammatory molecules, maintaining neuronal health and protecting against cognitive impairments. When paired with non-thermal low-level laser therapy, these modalities further enhance mitochondrial function and blood flow throughout the brain.27
Non-thermal low-level laser therapy in cellular healing
Non-thermal low-level laser therapy (NTLLLT), a subset of low-level laser therapy, has demonstrated promising potential in improving mitochondrial and cellular health. NTLLLT works by emitting coherent and specific wavelengths of light that penetrate the skin and tissues, stimulating cellular processes and enhancing mitochondrial function.28
The treatment is suitable for all skin types, and is only restricted for those who are pregnant or suffering from active cancer.28 The major focus regarding lasers is the wavelength and amount of photonic energy.29
Since lasers induce a photochemical reaction on a cellular level, higher power settings usually result in photothermal reactions where we see surrounding tissues increasing in their temperature, but not in their cellular function.30
These higher temperatures can lead to degradation of tissue, the production of inflammation and reactive oxygen species and the denaturing of DNA/proteins.31 Laser therapy is commonly paired together with other aesthetic modalities, and when supported with healthy lifestyle changes such as fasting, can yield further clinical improvements in function and appearance.
Enhanced mitochondrial activity
NTLLLT increases the production of ATP in mitochondria via the upregulation of the electron transport chain, boosting cellular energy and enhancing overall function.32 We know wavelengths around 405 nm, 520-542 nm or 635 nm, paired with the correct frequencies and output, have the highest absorption rates for optimising cellular metabolism and mitochondrial function due to their ability to promote beneficial photochemical reactions.29 This is particularly beneficial in tissues with high energy demands, such as the skin, brain, muscles and gut.
Reduction of oxidative stress
NTLLLT helps reduce oxidative stress by enhancing the activity of antioxidant enzymes and reducing the production of ROS.
This can mitigate cellular damage and support healthier skin and brain function, while also dampening unwanted inflammation.33
Improved cellular communication and healing
NTLLLT promotes better cellular communication and accelerates the healing process by enhancing the function of reparative cellular pathways.34 This can lead to improved skin rejuvenation, the non-invasive elimination of adipose tissue and faster recovery from an array of aesthetic procedures like skin and hair treatments, body contouring and injections.35
An evolving area of research
Non-invasive modalities like NTLLLT, fasting and caloric restriction can offer promising benefits for skin health and brain function because of their potential to enhance autophagy, reduce oxidative stress and inflammation, improve collagen production and provide neuroprotection.
Furthermore, mitochondria play a crucial role in regulating inflammation, boosting immune function, promoting longevity and optimising healthy ageing. By integrating the functional medicine and stress-relieving practices in this article into a balanced and holistic wellness regimen, patients can unlock new levels of beauty, energy and cognitive vitality under your care. As research in this area continues to evolve, further insights will undoubtedly refine our understanding and application of these powerful strategies in the aesthetics specialty.
Dr Erik Reis is the founder of The Neural Connection Clinic in Edina, Minnesota, US and director of health and wellness and co-founder at Nobody Studios. With over a decade of clinical experience, he specialises in treating complex neurological, orthopedic, and metabolic disorders for patients across the globe. Dr Reis is a clinical educator for Erchonia.
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