Glycative Stress Research
Online edition : ISSN 2188-3610
Print edition : ISSN 2188-3602
Received : February 13, 2024
Accepted : March 2, 2024
Published online : March 31, 2024
doi:10.24659/gsr.11.1_21

Original article

Effect of polyphenols from water chestnut pericarp on hair-related quality of life
in healthy middle-aged, and older subjects: A randomized, placebo-controlled,
double-blinded, parallel-group, comparison study
Takuto Yamasaki 1), Shoko Takeshita 1), Chihiro Tomiya 1), Takashi Koikeda 2)
1) Hayashikane Sangyo CO., LTD., Shimonoseki, Yamaguchi, Japan
2) Shiba Palace Clinic, Tokyo, Japan

Abstract

Purposes: This study aimed to investigate the impact of continuous intake of polyphenols from water chestnut pericarp on
thinning hair and the decline in hair-related quality of life (QOL) in healthy middle-aged and older Japanese subjects. The
study employed a randomized, placebo-controlled, double-blinded, parallel-group design.
Methods: The participants in this 24-week study were healthy Japanese males and females aged 40 to 64 years. They wererandomly assigned to either the Trapa bispinosa Roxb. pericarp polyphenol (TBPP)-containing food group (containing 25 mgof polyphenols from water chestnut pericarp) or a placebo food group. The primary outcome was the hair-related quality oflife assessed by the Skinex29 score. Secondary outcomes included a visual analogue scale (VAS) questionnaire, assessmentof hair and scalp condition, evaluation of scalp moisturization, and measurement of advanced glycation endproducts (AGEs)
in blood plasma.
Results: The TBPP group showed significant improvement in the composite score of Skindex 29, VAS questionnaire
regarding hair volume, hair diameter, and the amount of pentosidine (one of AGEs) in blood plasma compared to theplacebo group. Moreover, the TBPP group exhibited a significant decrease in the amount of carbonylated protein compared
to pre-ingestion. No adverse events were reported during the TBPP-containing food intake period.
Conclusion: Polyphenols derived from water chestnut pericarp prove to be an effective food material that enhances healthby addressing thinning hair and improving QOL in middle-aged and older males and females.

KEY WORDS: Trapa bispinosa Roxb. pericarp polyphenol (TBPP), thinning hair, quality of life (QOL),
		

glycative stress, clinical study

Introduction
One inevitable aspect of human aging is thetransformation in physical appearance. Although alterationsin appearance themselves may not directly impact physicalhealth, they can contribute to a self-negative emotional state
known as body dissatisfaction 1). Elevated body dissatisfaction
stands as a potential precursor to mental disorders, including
eating disorders and dysmorphophobia 2, 3). Conversely, positivechanges in appearance have been linked to enhanced mental
health, exemplified in instances where makeup application
instills self-confidence and satisfaction, particularly observedin Japanese women 4). In alignment with the World HealthOrganization’s ( WHO) definition of health as “a state ofcomplete physical, mental and social well-being and not
merely the absence of disease or infirmity ”, it becomes

evident that preserving and enhancing mental healthnecessitates attention to age-related changes in appearance.
Within the Japanese population, thinning hair emerges
as a notable factor influencing an individual’s impression.
Studies on impression formation among Japanese adults 5)
indicate that both individuals with thinning hair and thosearound them harbor negative stereotypes towards thinning
hair, leading to negative emotions and potential impacts
on interpersonal relationships. Thinning hair, being aconspicuous marker qof aging, has been associated with adecline in quality of life (QQL), for example, in patients withandrogenetic alopecia (AGA) 6) . This suggests that the more
severe the hair thinning,q and the longer the AGA period of apatient, the lower their mental QOL, and the more likely they
are to become emotionally depressed and passive in social
activities. Based on the aforementioned, it is thought that

Corresponding to: Takuto Yamasaki
Hayashikane Sangyo Co., Ltd.
2- 4 - 8 Yamato-machi, Shimonoseki, Yamaguchi 750-8608, Japan
TEL: +81-832-67- 0094 Fax: +81- 832-67- 0192 e-mail: tyamasaki@hayashikane.co.jp
Co-authors: Takeshita S, stakesita@hayashikane.co.jp;
Tomiya C, ctomiya@hayashikane.co.jp: Koikeda T, jimukyoku@mail.souken-r.com_ 21 _

Glycative Stress Research 2023; 11 (1): 21-32(c) Society for Glycative Stress Research

Hair Quality and Polyphenols from Water Chestnut Pericarp

thinning hair impairs health as defined by the WHO due tothe decline in mental QOL and passivity in social activities.
Hair, originating and growing from specialized tissues
known as hair follicles in the skin, undergoes a cyclic process
called the hair cycle, consisting of the anagen, catagen,and telogen phases. Disruptions in the hair cycle, resulting
in thinning hair, can be caused by various factors 7), one ofwhich is glycation reaction, a known inhibitor of hair follicle
formation and growth. Glycation reaction produces advanced
glycation endproducts (AGEs) through the interactionof sugars and aldehydes with proteins and amino acids.
Accumulation of glycative stress, involving AGEs and theirintermediates, induces cellular and tissue stress, leading to
inflammation and contributing to age-associated changes inappearance 8). According to a previous report, in mice, N ε(carboxymethyl)lysine (CM L), a type of AGEs, delays hairfollicle formation, and at the same time, morphologicallyweakens hair, that is, worsens the condition of cuticles,
making hair thin 9). Based on these facts, it is thought that
reducing glycative stress in vivo contributes to the prevention
and improvement of thinning hair.
This study centers on water chestnut (Trapa bispinosaRoxb.) pericarp extract as a potential means to mitigate
glycative stress in humans. Trapa bispinosa Roxb., an annual
aquatic plant belonging to the Trapa genus of Lythraceae
family, is commonly consumed, bears fruits in autumn, andits pericarp is dried and used in the preparation of healthy
tea and herbal medicine 10). Previous in vitro 11) and humanclinical trials 12) demonstrated that Trapa bispinosa Roxb.
pericarp polyphenol (TBPP), obtained through hot water
extraction, possesses anti-glycation effects. Components
of TBPP, such as ellagic acid and gallic acid, have also
exhibited anti-glycation properties 13). Moreover, studies onhair removal mouse models have confirmed the positive
impact of consuming Trapa bispinosa Roxb. pericarp extract
on hair growth and cuticle improvement 14).
Based on this background, TBPP emerges as a potential
candidate for improving thinning hair through its antiglycation effect, with anticipated positive effects on QOL
that has diminished due to thinning hair. Therefore, thisstudy recruited healthy middle-aged and older Japanese
men and women experiencing concerns about thinning hair,conducting a 24-week randomized, placebo-controlled,
double-blinded, parallel group comparison study on TBPP
intake with the objective of enhancing QOL impacted
by thinning hair. This report presents the findings of ourinvestigation.

Methods
1. Study design

In this randomized, placebo-controlled, double-blinded,parallel group comparison study, two groups were assessed:
the TBPP group, consuming TBPP-containing food, and theplacebo group, consuming a placebo food. This study was
conducted with approval from the Shiba Palace Clinic Ethics
Review Committee (Chairman: Dr. Motonori Sano, Tokyo,
Japan) granted on August 9, 2022, in compliance with the“ Declaration of Helsinki (amended at the 2013 Fortaleza
General Assembly)” and the “ Ethical Guidelines for Medical

and Biological Research Involving Human Subjects (2021
Ministry of Education / Ministry of Health, Labor andWelfare / Ministry of Economy, Trade and Industry Public
Notice No. 1),” and with the written consent of the subjects
who had been provided with a full explanation of the objective
and methods of this study, in an effort to protect the safety
and human rights of the subjects (study implementation
period: October 20, 2022 –April 27, 2023). In addition, theinformation of this study was registered to the University
Hospital Medical Information Network (UMIN) Clinical
Trials Registry ( UMIN ID: UMIN000049039).

2. Test food setting/intervention

The water chestnut pericarp extract used, manufactured
by Hayashikane Sangyo Co., Ltd. (Shimonoseki, Yamaguchi,
Japan), was incorporated into TBPP-containing food. The
TBPP-containing food included 100 mg of water chestnut
pericarp extract (containing over 25 mg of TBPP), corn starch,and calcium stearate in hard capsules (Sankyo Co., Ltd., Fuji,
Shizuoka, Japan). The placebo food, with no water chestnut
pericarp extract, contained starch decomposition products andcaramel coloring that would not affect the hair and scalp, in
identical-looking capsules with corn starch and calcium
stearate. All test foods were designed to be indistinguishable
in sensory aspects and appearance, and differed minimallyin terms of content, such as energy and sodium. The
composition of each test food is shown in Table 1.
Each group consumed one capsule of TBPP-containing
food or placebo food daily before breakfast with water or
lukewarm water. The intake period was set as 24 weeks, andobservations were conducted three times, namely, before test
intake, 12 weeks after intake, and 24 weeks after intake.

3. Participants

The subjects of this study were healthy Japanese
men and women aged 40 to 64, experiencing thinning haircompared to their 20s. Inclusion criteria included consent to ahaircut of the targeted area by a professional, commitment tomaintaining their hair styling, hair dyeing, and hair washingmethods, and agreement to have approximately 10 -15 strandsof hair cut and collected from near the root at the top of thehead by a professional.
Exclusion criteria covered allergies to test foodcomponents, thinning hair attributed to diseases, previous
alopecia diagnoses, such as male or female pattern baldness,current alopecia diagnoses (male pattern baldness, alopecia
areata, infection, scarring, drugs, accompanying symptoms
of systemic diseases, trichotillomania, and physiologicalhair loss), previous experience of hair transplantation, or
individuals scheduled for hair transplantation during thestudy period, regular steroid use for hay fever or allergic
rhinitis, difficulty maintaining lifestyle habits during thestudy period, difficulty keeping a journal, pregnancy,
breastfeeding, or plans to become pregnant or breastfeed
during the study period, use or application of drugs that
may affect examination results, consumption of healthfoods that may affect the study results on a daily basis, skinallergy symptoms and skin sensitivity, regular visits to adermatology clinic, participation in other clinical trials, useof hair wash products, such as shampoos, claiming to have

_ 22 _Glycative Stress Research

Table 1. Composition of test foods.
Ingredients

Combination ratio(per capsule 234 mg)

・water chestnut pericarp extract

42.73 %

・Corn starch

35.74 %

・Edible hard capsule

20.94 %

・Calcium stearate

0.59 %

・Colorant (caramel color)34.19 %

・Starch degradation products

26.92 %

・Edible hard capsule

20.94 %

・Corn starch

17.09 %

・Calcium stearate

0.86 %

Test food
TBPP
containing
food

Placebo food

TBPP, Trapa bispinosa Roxb. pericarp polyphenol.

hair growth effects, underlying diseases [diabetes mellitus
under medication treatment or diabetes with complications,chronic respiratory disease, chronic heart disease (including
hypertension), chronic kidney disease, chronic liver disease(excluding fatty liver and chronic hepatitis), chronic blood
disease (excluding iron deficiency anemia), and neurologicaldisease and neuromuscular disease associated withimmune abnormality, chromosomal abnormality, severe
psychosomatic disorder (the state where severe physicaldisability and severe intellectual disability overlap)], anddrug treatment or outpatient treatment.
Recruitment of participant applicants was done bySouken Co., Ltd. (Tokyo). Before the start of the study,
informed consent was sought from each participant applicant
individually, and their consent to participate in this study
was obtained following full explanation that participating inthis study was on a voluntary basis, and that they would not
suffer any disadvantage even if they did not consent.

4. Selection, randomization, and blinding

Based on the data and preliminary study results of ourprevious study on usefulness, the required number of subjects
was calculated, and the target number of subjects was 24 foreach group, accumulating to a total of 48 subjects.
Α third party allocator not directly involved in
the implementation of this study randomly (simple
randomization method) allocated the subjects using a random
number table generated using a computer so that age andgender would be equal in each group. In addition, until thenumber of subjects to be analyzed after study completion
was fixed, the allocator did not disclose the allocation results
to anyone.

5. Assessment items

For efficacy assessment, the primary outcome was
the measurement results of Skindex29, a hair-related QOL
questionnaire. In addition, to obtain secondary outcomes,
a visual analogue scale (VAS) questionnaire with uniquely
set wordings, assessment of hair and scalp conditions,assessment of scalp moisturization, and measurement of
AGE amount in blood were performed.
1) QOL questionnaire
Skindex29 was used as a method to assess scalp/hairspecific health-related QOL. In this study, it was conductedin the form of an online questionnaire after changing parts
stated as “skin/skin condition” in each question to “scalp/
alopecia” in accordance with instructions in the manual.
Before answering, the subjects were informed that “thefollowing questions will ask to what extent alopecia bothered
you in the past week,” and each of the 29 questions were to
be answered by the scores of 1: “never,” 2: “almost never,”3: “sometimes,” 4: “often,” and 5: “always.” The higher thescores, the more severe the concerns about scalp/alopecia.
2) VAS questionnaire
The VAS method was employed to gauge concerns
related to hair conditions. The questions were set as “thedegree of concern” on 19 items including “ hair loss,”“visibility of parting and scalp,” “low hair volume,” “hairthinness,” “lack of elasticity and firmness,” “dryness,”“spreading,” “waviness,” “lack of shine,” “poor root growth,”“poor combing and difficulty in setting,” “scalp stickiness,”“scalp odor,” “scalp acne,” “scalp dryness,” “scalp hardness,”“dandruff,” “split ends and hair breakage,” and “grey hair.”Participants provided responses moving a cursor on a scalefrom “ I am not concerned ” (0 points) to “ I am concerned ”(100 points).
3) Measurement of hair and scalp conditions
Digital photographs were taken of three areas: the top,
back, and front of the head.
Additionally, the number and diameter of actively
growing hair were assessed through a haircut of the targetedarea and phototrichogram analysis. The haircut of thetargeted area was conducted approximately 3 cm to the rightof the head midline and covered an approximate area of 1 cm
× 1 cm, starting from the intersection of the line (horizontalline) connecting the head midline and the top of the left andright ear helices. The corresponding area was trimmed using_ 23 _

Hair Quality and Polyphenols from Water Chestnut Pericarp

clippers, leaving 1 cm of hair. The haircut of the targeted area
area was photographed using a multi-distance scope GOKO
EV-6HD (Goko Imaging Devices Co., Ltd., Kawasaki,
Kanagawa, Japan). The number of hairs and hair diameter inthis area were assessed through image analysis.
To evaluate hair loss, the number of hairs shed during
hair wash was counted.
A professional hairdresser conducted the hair wash
using a shampoo without hair growth or treatment effects.
After rinsing for more than 3 min with warm water(approximately 40 ℃ ), the number of hairs that had fallenout during the wash was assessed.
As an additional measure to assess skin aging andoxidative stress, carbonylated proteins were quantified withreference to the method of Iwai et al. 15), The stratum corneumof the forehead was collected by tape stripping using
cellophane tape. The collected stratum corneum was fixed
to a glass slide, stained with 0.1 M 2-morpholinoethane
sulfonic acid-Na (pH 5.5) buffer solution containing 20 μM
FTCZ (fluorescence-5-thiosemicarbazide) for carbonyl groupstaining. Fluorescence images were taken under a fluorescencemicroscope, and the amount of carbonylated proteins in thestained images was calculated as fluorescence area using
ImageJ (Wayne Rasband, National Institutes of Health,Bethesda, MA, USA).

criteria were identified for potential exclusion. The criteria
extended to subjects with measurement values distinctly
determined as abnormal. Finally, any subjects presenting
other clear reasons deemed appropriate for withdrawal were
included in the criteria for potential exclusion.
Subjects meeting any of the aforementioned criteria,
underwent review during a case review meeting. Subsequently,
unless special reasons warranted an exception, these subjects
would be excluded from the pool of subjects for analysis.

4) Assessment of scalp moisturization
To gauge scalp moisturization and barrier function,measurements were taken for skin moisture content and watertranspiration amount. The Corneometer CM825 (Integral
Corporation, Tokyo) served as the measuring device for skinmoisture content, while the portable TEWL meter VapoMeter(Keystone Scientific K.K., Tokyo) was employed to quantify
the skin water transpiration amount. Both assessments wereconducted on the forehead hairline to ensure a representative
measurement of the targeted area.

1. Subject background5) Blood test
To assess glycative stress experienced by the subjects
and the anti-glycation effect of the test foods, changes
in blood AGEs during the study period were examined.
Specifically, two types of AGEs, pentosidine and CML,
were analyzed from the subjects’ blood plasma using the
ELISA method. This measurement process was conductedby Fushimi Pharmaceutical Co., Ltd. (Marugame, Kagawa,Japan).

6. Statistical analysis

1) Subjects for statistical analysis
In considering subjects for analysis, certain criteria
for exclusion were established. These criteria encompassed
various scenarios: firstly, subjects experiencing delays inobservation date extending beyond one week; secondly,
those found to have significantly violated instructions
pertaining to subject management during the study period;
thirdly, instances where major concerns arose regarding
data reliability due to issues in examinations; furthermore,
subjects with non-use days (when fixed daily usage was notmet) surpassing 15 % of scheduled use days were also taken
into consideration for exclusion. Additionally, participants
found to have violated participation criteria and met exclusion

2) Efficacy assessment
All tests followed a two-tailed approach, with asignificance level set at less than 5%. Temporal comparisons,in relation to pre-intake values within each group, utilized
Dunnett’s test to assess each actual value for both primaryand secondary outcomes, taking into account the multiplicity
of tests. Furthermore, to examine intergroup significant
differences for each value, the difference values for bothprimary and secondary outcomes, in comparison to preintake values within each group, were verified and assessedusing an unpaired t-test.

Results
A total of 115 healthy Japanese men and women (54and 61, respectively), aged 40 to 64, who were conscious ofthinning hair compared to their 20s, voluntarily participatedin this study following a detailed explanation of its content.
After screening, 59 subjects (25 men and 34 women) met
the eligibility criteria and were enrolled in the study. The
participants were then divided into the TBPP group (29subjects: 12 men and 17 women) and the placebo group (30subjects: 13 men and 17 women). Throughout the study period,
three subjects from the placebo group withdrew for personalreasons, leaving 29 subjects (12 men and 17 women) in the
TBPP group and 27 subjects (11 men and 16 women) in theplacebo group who successfully completed all predeterminedschedules. Upon deliberation in the case review meeting
regarding data handling for each group, it was determinedthat three subjects (two subjects in the TBPP group and a
subject in the placebo group) were confirmed to have taken
medications or supplements that could affect the results ofthe study, nine subjects (five subjects in the TBPP groupand four subjects in the placebo group) had significant
abnormalities in the measured values after assignment, six
subjects (four subjects in the TBPP group, two subjects in theplacebo group) had a medical history that met the exclusion
criteria contrary to the participation criteria after the study
was confirmed, and eight subjects (three subjects in the TBPP
group and five subjects in the placebo group) had difficulty
maintaining lifestyle habits due to their own circumstances.
These subjects met the exclusion criteria for analysis subjects
and were judged to be unsuitable for evaluation of efficacy.
Consequently, the number of subjects eligible for analysis
amounted to 15 (eight men and seven women) in the TBPP
group, and 15 (six men and nine women) in the placebogroup. The flow of these subjects are shown in Fig. 1.

_ 24 _Glycative Stress Research

Enrollment

Evaluation of eligibility (n=115)
Excluded (n= 56)• Selection criteria were not met (n= 56)• Other reasons (n = 0)

TBPP group

Placebo group

Received the intervention (n = 29)

Received the intervention (n = 30)

Follow-up

Lost to the follow-up (n = 0)

Lost to the follow-up (n = 3)

Analysis

Allocation

Randomization (n = 59)

Analyzed (n = 15)
Excluded from the analysis (n = 14)

Analyzed (n = 15)
Excluded from the analysis (n = 12)• Personal circumustances (n = 3)

• Exclusion criteria from analysis were met• Exclusion criteria from analysis were met

Fig. 1. Flow of participant’s progress in a clinical study
TBPP, Trapa bispinosa Roxb. pericarp polyphenol.

2. Efficacy assessment

2.1 Skindex29
Table 2 presents the actual measurement values of
Skindex29 scores, the amount of change compared to before
intake, and the results of statistical analysis. Notably, in the
TBPP group, the amount of change in total scores 24 weeks
after intake was significantly lower compared to the placebogroup. Temporal comparisons of actual measurement values
to before intake, revealed significant reductions in the threesubscales of emotions, symptoms, and functions, as wellas total scores, at both 12 and 24 weeks after intake in the
TBPP group. Conversely, in the placebo group, temporalcomparisons to before intake showed no significant
fluctuation in scores.
2.2 VAS questionnaire
Table 3 illustrates the actual measurement values of the
VAS questionnaire, the amount of change compared to before
intake, and the results of statistical analysis. Notably, in the
TBPP group, the amount of change for Q3 at 24 weeks after
intake was significantly lower compared to the placebo group.
Temporal comparisons of actual measurement values to before
intake revealed that Q12 at 12 weeks after intake, and Q 3,
5, and 7 at 24 weeks after intake, showed significantly
lower values compared to before intake exclusively in the
TBPP group. Additionally, only in the placebo group, Q1
and 11 at 12 weeks after intake, and Q 9 at 24 weeks after
intake, displayed significantly lower values compared tobefore intake. Furthermore, in both the TBPP group and theplacebo group, Q1 and 2 at 24 weeks after intake showedsignificantly lower scores compared to before intake.

2. 3 Measurement of hair and scalp conditions
Fig. 2 showcases cases where an improvement in hair
was observed on the entire head and the targeted area ofhaircut in the TBPP group.
Furthermore, Table 4-a provides actual measurement
values of the number of hairs and hair diameter obtainedby phototrichogram from haircut of the targeted area, theamount of change compared to before intake, and statisticalanalysis results. Significantly higher changes were observedin the TBPP group compared to the placebo group for hairdiameter at 24 weeks after intake. Temporal comparisonsof the actual measurement values of the number of hairscompared to before intake revealed significantly higher
values at 12 weeks after intake than before intake exclusively
in the TBPP group. Additionally, both the TBPP group andthe placebo group exhibited a significantly larger number ofhairs at 24 weeks after intake compared to before intake. The
temporal comparison of actual measurement values of hairdiameter compared to before intake showed significantly
larger hair diameter at both 12 and 24 weeks after intake
than before intake in both the TBPP group and the placebogroup.
Table 4-b presents actual measurement values of thenumber of fallen hairs collected from hair wash, the amountof change compared to before intake, and statistical analysis
results. According to the analysis results, no significant
difference was observed in temporal comparisons for boththe TBPP group and the placebo group, and no significant
difference was confirmed in the intergroup comparison.
Additionally, Table 4-c illustrates the quantified valuesof carbonylated protein collected by tape stripping, the_ 25 _

Hair Quality and Polyphenols from Water Chestnut Pericarp

amount of change compared to before intake, and statisticalanalysis results. No significant difference was found between
the groups in the amount of change in quantified values fromweek 0. The temporal comparison of quantified values tobefore intake revealed significantly lower values at 24 weeks
after intake only in the TBPP group.
2. 4 Scalp moisturization
Table 5 presents actual measurement values of skinmoisture content and skin water transpiration amount, theamount of change compared to before intake, and statisticalanalysis results. No significant difference was found between
the groups in the amount of change from before intake.
The temporal comparison of actual measurement values ofskin moisture content compared to before intake showedsignificantly lower values at 12 and 24 weeks after intake
in the TBPP group. Additionally, the temporal comparisonof actual measurement values of skin water transpiration
amount compared to before intake revealed significantly
higher values at 12 weeks after intake in both the TBPP
group and the placebo group.
2. 5 Blood test
Table 2 presents actual measurement values ofpentosidine and CML, which are plasma AGEs, the amountof change compared to before intake, and statistical analysis
results. The amount of change in plasma pentosidine amount
24 weeks after intake was significantly lower in the TBPP
group compared to the placebo group. In the temporalcomparison of actual measurement values to before intake,plasma CML amount was significantly lower 12 weeks and
24 weeks after intake in the placebo group.
3. Adverse event
No adverse event with a cause-and-effect relationshipwith the test foods in this study occurred in the TBPP groupand the placebo group.

Discussion

For Japanese individuals, age-associated changes inappearance pose risks for mental disorders due to body
dissatisfaction 1- 3). Thinning hair, a notable age-associatedchange in appearance with established negative preconceptions
in both the person with thinning hair and the people aroundthem 5), contributes to a decline in mental QOL and influences
socialization frequency 7, 16). Additionally, the use of thinninghair treatment drugs, such as minoxidil and finasteride, hasbeen associated with improved QOL alongside addressing
thinning hair concerns 17, 18). This suggests that addressing
thinning hair concerns can positively impact QOL. Considering
the importance of maintaining good mental and social states,aligning with the WHO’s definition of health, this study
focused on individuals concerned about thinning hair. It
aimed to assess the effects of oral TBPP intake on the
decline in QOL associated with thinning hair. The study
employed a randomized, placebo-controlled, double-blinded,parallel group comparison design with healthy middle-aged
and older Japanese men and women aged 40 – 64 as the
subjects.

Table 2. Skindex29.
Measured value
TBPP

EmotionSymptom

Function

Total score

Amount of change from 0 w
Placebo

TBPP

Placebon

Mean ± SDn

Mean ± SDn

Mean ± SDn

Mean ± SD0w

1533.8 ± 23.0

15

24.3 ± 17.9

15

―

15

―

12 w

15

23.7 ± 21.6 **15

18.7 ± 16.8

15 -10.2 ± 15.2

15

-5.7 ± 14.8

24 w

15

21.3 ± 22.5 ***15

18.8 ± 15.9

15 -12.5 ± 10.6

0w

15

16.7 ± 11.3

15

12.6 ± 10.4

12 w

15

10.5 ± 8.7 ***

15

24 w

15

11.7 ± 9.9 **0w

15

21.2 ± 19.8

12 w

15

15.3 ± 15.3 *

24 w

15

0w
12 w
24 w

15

-5.5 ± 11.0

15

―

15

―

12.9 ± 9.7

15-6.2 ± 6.7

150.2 ± 11.1

15

13.3 ± 12.3

15

-5.0 ± 5.2

150.7 ± 12.2

15

14.9 ± 16.8

15

―

15

―

15

12.6 ± 15.2

15

-6.0 ± 10.2

15

-2.2 ± 9.5

13.6 ± 16.2 **15

12.6 ± 17.2

15

-7.6 ± 7.0

15-2.2 ± 13.0

1524.5 ± 17.1

15

17.6 ± 12.4

15

―

15

―

15

17.0 ± 13.8 **15

14.8 ± 12.8

15

-7.5 ± 9.8

15-2.8 ± 8.8

1515.8 ± 15.5 ***15

14.9 ± 13.7

15

-8.7 ± 6.0

15-2.6 ± 9.5 †*p < 0.05, **p < 0.01, ***p < 0.001, significantly different from 0 w by Dunnett - test. † p < 0.05, significantly different between groups by independentt -test. TBPP, Trapa bispinosa Roxb. pericarp polyphenol; SD, standard deviation.

_ 26 _Glycative Stress Research

Table 3. VAS questionare.
Measured value
TBPP

Q1.
Hair loss
Q2.
Visibility ofparting and
scalp
Q 3.
Low hairvolumeQ 4.
Hair thinness
Q 5.
Lack ofelasticity andfirmness
Q 6.
Hair dryness
Q 7.
Hair spread

0w

Mean ± SDn

Mean ± SDn

Mean ± SD

1578.4 ± 23.1
59.3 ± 33.4

15

78.7 ± 16.2
61.5 ± 25.2 *

15

―

15

―

48.7 ± 25.2 **78.0 ± 24.4

15

67.9 ± 25.6
51.3 ± 25.7 **15

71.5 ± 24.3
60.7 ± 32.8

1547.7 ± 25.3 **74.0 ± 22.6

15

62.8 ± 25.2
54.1 ± 23.5 **15

73.3 ± 23.1
68.7 ± 21.3

15

56.6 ± 21.1 **65.8 ± 26.9

15

67.9 ± 22.4
55.6 ± 22.0

1565.2 ± 25.1
62.9 ± 24.4

15

54.3 ± 21.3 *60.1 ± 31.6

15

54.1 ± 34.4
50.2 ± 26.8

15

63.1 ± 25.5
60.5 ± 30.6

15

54.0 ± 25.8
62.2 ± 24.8

15

71.8 ± 27.9
49.3 ± 25.4

15

56.8 ± 26.3
58.7 ± 27.4

15

48.8 ± 22.6
53.8 ± 24.4

15

43.1 ± 22.8 *48.1 ± 24.3

15

56.5 ± 30.0
52.5 ± 32.7

15

49.7 ± 25.1
22.3 ± 21.4

15

28.7 ± 23.7
30.9 ± 24.7

15

48.7 ± 25.9
48.8 ± 20.7

15

41.4 ± 25.4
50.2 ± 28.9

15

49.9 ± 30.5
51.7 ± 24.4

15

46.1 ± 29.3
51.9 ± 29.6

15

15

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15
15
15
15

Q 9.
Lack of shine 12 w
in hair
24 w

15

0w

15

12 w

15

Q 10.
Poor hairroot growth

15
15

24 w

15

Q 11.
0w
Poor combing 12 w
and difficulty
24 w
in setting
0w
Q 12.
12 w
Scalp
stickiness
24 w

15

0w

15

Q 13.
Scalp odor
Q 14.
Scalp acne
Q 15.
Scalp drying

15
15
15
15
15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w
Q 16.
12 w
Scalp hardness
24 w

15

0w

15

Q 17.

12 w

Placebo

n

15

0w

TBPP

Mean ± SD

24 w

Q 8.
12 w
Hair waviness
24 w

Placebo

n
12 w

0w

Amount of change from 0 w

15
15
15

15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15
15

56.5 ± 23.9 **81.3 ± 12.3

15 -19.1 ± 28.7
15 -29.7 ± 28.7
15―

69.1 ± 19.0
64.1 ± 18.9 **15 -10.1 ± 23.8
15 -26.7 ± 24.7

69.4 ± 22.6
60.5 ± 22.9

15

63.3 ± 23.1
61.1 ± 24.2―

15 -10.8 ± 24.6
15 -23.9 ± 26.4
15―

15 -17.3 ± 24.8
15 -22.3 ± 23.5
15―

15 -12.1 ± 19.9
15 -17.1 ± 24.3
15

―

15
15

-8.9 ± 14.8
-6.1 ± 13.9 †

15

―

15
15

-3.5 ± 10.9
-7.9 ± 25.0

57.7 ± 21.1
53.3 ± 24.1

15 -11.2 ± 17.8
15 -19.9 ± 23.3

69.4 ± 25.1
67.5 ± 26.7

15

―

15

―

15

-4.6 ± 11.0

15

61.7 ± 25.5
75.1 ± 22.3

15 -16.7 ± 18.7
―
15

15

-1.9 ± 21.4
-7.7 ± 17.2

15―

66.7 ± 27.3
63.4 ± 24.8

15

2.1 ± 17.0

15

-8.4 ± 28.6

69.5 ± 21.8
63.8 ± 27.0
62.7 ± 17.8
74.3 ± 25.4

15 -10.2 ± 19.0―
15

15 -11.7 ± 20.1―
15

-2.3 ± 12.4
15 -10.9 ± 16.4
―
15

15

15

15

-5.7 ± 25.1
-6.7 ± 14.4

15―62.3 ± 32.1
65.1 ± 22.6

15
15

-5.9 ± 24.9
-9.9 ± 22.0

72.6 ± 32.2
69.3 ± 28.1

15

―

15

―

15

-2.6 ± 17.9

1562.7 ± 26.1 *66.1 ± 26.9

15

-9.1 ± 22.7―

15

-3.3 ± 13.3
-9.9 ± 15.3

15―67.5 ± 26.6
55.7 ± 23.5

15

9.6 ± 28.3
15 -12.9 ± 16.4
―
15

15

73.3 ± 17.5
54.5 ± 27.2 *15

61.4 ± 19.3
49.8 ± 23.7

15

1.9 ± 27.3
-8.0 ± 21.1

15―

50.1 ± 28.9
49.5 ± 27.4

15 -10.7 ± 12.4
15 -5.7 ± 21.8

46.4 ± 29.3
46.7 ± 31.4

15

―

15

-4.0 ± 19.6

43.6 ± 27.9
42.3 ± 29.0

15

-6.9 ± 16.1―

32.7 ± 26.0
34.7 ± 22.1

15

61.5 ± 21.7
58.9 ± 25.1

15

15 -11.9 ± 21.2
15 -9.1 ± 19.6

1.3 ± 20.3
15 -10.4 ± 28.4―
15
15 -18.9 ± 30.2
15 -11.9 ± 23.9
15

―

15
15

0.3 ± 33.9
-0.3 ± 34.3

15

―

15
15

0.3 ± 29.5
-2.8 ± 28.6

15

―

15

15

6.4 ± 17.0
8.6 ± 22.1

15

-9.7 ± 26.9
-7.6 ± 23.4

15

―

15

―

15

0.1 ± 29.6

15

49.7 ± 24.8
58.1 ± 25.1

15

-7.3 ± 18.7―

57.9 ± 27.9
_ 27 ±_ 20.7
57.6

15

43.3 ± 27.4
40.2 ± 28.4

15

15

-2.6 ± 23.8
15 -11.9 ± 24.6
―
15
15

15

-0.3 ± 22.5
1.5 ± 13.8

15-0.3 ± 15.5
-0.5 ± 17.1

15

―

15

―

15

5.8 ± 20.7

15

-3.1 ± 31.3

Q 14.
Scalp acne
Q 15.
Scalp drying

0w

15

12 w

15

24 w

15

0w

15

12 w

15

24 w

15

0w

15

Q 16.
12 w
Scalp hardness
24 w

15
15

0w

15

12 w

15

24 w

15

0w

Q 18.
Split ends and 12 w
hair breakage
24 w

15

0w

15

12 w

15

24 w

15

Q 17.
Dandruff

Q 19.
Gray hair

15
15

15

―

15

―

15

6.4 ± 17.0

15

± 24.715 34.7 ± 22.1
15
8.6 ± 22.1
30.9
Hair Quality
and Polyphenols
from Water Chestnut
Pericarp―±±
15 61.5
15
48.7
21.7
25.9

15

-9.7 ± 26.9
-7.6 ± 23.4

15

―

15

22.3 ± 21.4
28.7 ± 23.7

15
15

48.8 ± 20.7
41.4 ± 25.4

15

50.2 ± 28.9
49.9 ± 30.5

15

51.7 ± 24.4
46.1 ± 29.3

15

51.9 ± 29.6
46.0 ± 25.2

15

53.7 ± 31.6
44.3 ± 31.0

15

43.7 ± 23.0
76.2 ± 25.7

15

81.4 ± 20.5
78.8 ± 16.2

15

15
15
15
15
15
15
15

42.3 ± 29.0
32.7 ± 26.0

58.9 ± 25.1
49.7 ± 24.815150.1 ± 29.6
-7.3 ± 18.7

58.1 ± 25.1
57.9 ± 27.9

15

―

15

15

57.6 ± 20.7
43.3 ± 27.4

15

-0.3 ± 22.5
1.5 ± 13.8

15-0.3 ± 15.5
-0.5 ± 17.1

15

―

15

―

40.2 ± 28.4
38.1 ± 27.6

15

15

15

5.8 ± 20.7
-0.1 ± 14.2

15

-3.1 ± 31.3
-5.2 ± 30.1

53.9 ± 27.9
46.4 ± 27.2

15

―

15

―

15

-9.5 ± 26.3

15

49.6 ± 24.1
83.2 ± 17.8

15 -10.0 ± 29.4
―
15

15

-7.5 ± 25.3
-4.3 ± 24.2

15―

76.9 ± 21.9
77.9 ± 14.0

155.2 ± 20.9
2.6 ± 23.4

15

-6.3 ± 13.7
-5.3 ± 14.9

15

-2.6 ± 23.8
15 -11.9 ± 24.6
―
15

15

*p < 0.05, **p < 0.01, ***p < 0.001, significantly different from 0 w by Dunnett-test. † p < 0.05, significantly different between groups by independentt - test. TBPP, Trapa bispinosa Roxb. pericarp polyphenol; VAS, visual analogue scale; SD, standard deviation.

Fig. 2. Visual changes in the group of subjects who took TBPP (as an example).
"#$%!&!'#()*+!,-*.$/(!#.!0-/!$12)3!24!()56/,0(!7-2!0228!9:;;!<*(!*.!/=*>3+/?!
TBPP, Trapa bispinosa Roxb. pericarp polyphenol.

!

_ 28 _!

Glycative Stress Research

Table 4. Evaluation of hair and scalp.
a) Evaluation of hair in target area
Measured value

Amount of change from 0 w

TBPP
n
Number ofhairs(/cm 2 )Placebon

Mean ± SD

TBPP

Placebo

Mean ± SDn

Mean ± SDn

Mean ± SD

0w

15 177.2 ± 35.9

15 189.8 ± 34.5

15

―

15

―

12 w

15 182.6 ± 36.8 *15 195.5 ± 39.4

15

5.4 ± 7.1

15

24 w

15 191.7 ± 39.0 ***15 207.3 ± 39.4 ***

15

15

15

73.4 ± 13.0

1579.8 ± 8.3

1514.5 ± 10.3―

5.7 ± 8.0
17.5 ± 11.6

15

―

15

78.8 ± 10.8 **83.9 ± 11.1 ***15

84.1 ± 8.3 ***86.0 ± 10.0 ***15

5.3 ± 6.4
10.5 ± 6.1

15

4.3 ± 3.8
6.2 ± 4.8 †0w
Hair Diameter
12
w
(μm)
24 w

15

15

15

15

b) Counting the number of fallen hairs
Measured value

Amount of change from 0 w

TBPP

Number of
fallen Hairs

Placebo

TBPP

Placebon

Mean ± SDn

Mean ± SDn

Mean ± SDn

Mean ± SD

0w

15

15

―

15

―

15

15

60.3 ± 47.0
55.4 ± 35.8

15

12 w

84.9 ± 93.6
60.3 ± 47.0

15

15

66.9 ± 51.1

15

64.4 ± 57.6

15

-24.6 ± 102.6-18.0 ± 72.6

15

24 w

-1.8 ± 36.3
7.2 ± 63.9

15c) Measurement of carbonylated protein
Measured value

Amount of change from 0 w

TBPP
nFluorescentArea(μm 2 )

Placebo

Mean ± SDn

TBPP

Placebo

Mean ± SDn

Mean ± SDn

Mean ± SD

15

―

15

―

15 -16,514 ± 39,828

15 -10,868 ± 26,321

15 -26,771 ± 35,399

15 -13,835 ± 27,576

0w

15 63,350 ± 32,316

12 w

15 46,836 ± 30,875

15 48,560 ± 25,469
15 37,692 ± 21,445

24 w

15 36,579 ± 19,176 *15 34,726 ± 18,269*p < 0.05, **p < 0.01, ***p < 0.001, significantly different from 0 w by Dunnett -test. † p < 0.05, significantly different between groups by independentt - test. TBPP, Trapa bispinosa Roxb. pericarp polyphenol; VAS, visual analogue scale; SD, standard deviation.

Table 5. Amount of AGEs in blood plasma
Measured value
TBPP

pentosidine(ng/ml)CML(μg/ml)Amount of change from 0 w
Placebo

TBPP

Placebon

Mean ± SDn

Mean ± SDn

Mean ± SDn

Mean ± SD0w

1549.6 ± 10.6

15

47.3 ± 9.7

15

―

15

―

12 w

15

49.1 ± 13.1

15

46.1 ± 10.1

15

-0.6 ± 8.9

15-1.2 ± 8.4

24 w

15

46.9 ± 11.7

15

49.5 ± 11.7

15

-2.7 ± 6.2

152.1 ± 5.4 †0w

15

4.6 ± 1.015

5.1 ± 0.5

15

―

15

―

12 w

15

4.5 ± 0.915

4.8 ± 0.6 *15-0.1 ± 0.7

15-0.4 ± 0.4

24 w

15

4.3 ± 0.715

4.6 ± 0.6 **15-0.3 ± 0.7

15-0.5 ± 0.7*p < 0.05, **p < 0.01, ***p < 0.001, significantly different from 0 w by Dunnett - test. † p < 0.05, significantly different between groups by independentt - test. TBPP, Trapa bispinosa Roxb. pericarp polyphenol; AGEs, advanced glycation endproducts; CML, N ε-(carboxymethyl) lysine; SD, standard
deviation.

_ 29 _

Hair Quality and Polyphenols from Water Chestnut Pericarp

Table 6. Moisture retention of scalp
Measured value
TBPP

Scalp moisture
content
Watertranspiration(g/m 2 h)

Amount of change from 0 w
Placebo

TBPP

Placebon

Mean ± SDn

Mean ± SDn

Mean ± SDn

Mean ± SD0w

1550.0 ± 11.1

15

46.3 ± 13.0

15

―

15

―

12 w

15

37.6 ± 9.9 **15

40.1 ± 10.2

15

-12.4 ± 11.0

15

-6.2 ± 9.1

24 w

15

39.8 ± 15.8 *15

43.1 ± 12.5

15

-10.2 ± 18.7

15

-3.2 ± 18.00w

15

17.5 ± 5.7

1518.6 ± 7.6

15

―

15

―

12 w

15

28.7 ± 17.2 **15

28.1 ± 9.3 ***15

11.2 ± 15.3

159.5 ± 7.6

24 w

15

18.7 ± 8.4

1516.5 ± 4.6

151.2 ± 8.1

15

-2.0 ± 6.8*p < 0.05, **p < 0.01, ***p < 0.001, significantly different from 0 w by Dunnett-test. TBPP, Trapa bispinosa Roxb. pericarp polyphenol; SD, standard
deviation.

In this study, changes in QOL associated with thinninghair served as the primary outcome, assessed throughSkindex29 ( Japanese version). The English version of
Skindex29, developed by MM Chen et al. in 1997 19), is aquestionnaire exploring the impact of skin condition on
individuals’ QOL. The Japanese version, introduced by
Fukuhara S et al. in 2004 20), has been utilized in studies
investigating the correlation between Japanese individuals’
skin condition and QOL 21). The Skindex29 questionnaire
comprises 29 questions categorized into three subscales:
seven questions for “symptoms,” 10 questions for “emotions,”
and 12 questions for “functions.” In the Japanese context,
it is permissible to adapt the questions from “skin/skincondition” to “scalp/alopecia.” This adaptation, known as
the Hair Specific Skindex29 in English, is globally accepted,
evidenced by its use in countries such as Korea and Spain,with several reports detailing surveys conducted using thisquestionnaire 7, 16). In other words, using Skindex29 in theformat that surveys “scalp/alopecia” is a method that has
gained academic consensus for assessing changes in QOL
associated with thinning hair. The results of this study ( Table2 ) demonstrate a significant improvement in the total scoresof Skindex29 24 weeks after the intake of TBPP-containing
food compared to the placebo group. Skindex29 questions
gauge the extent to which subjects were concerned about
thinning hair in the past week, and the total scores reflect
the condition of hair and scalp within a specified timeframe.
The findings indicate that TBPP intake relieves concerns
about thinning hair within a certain period. Furthermore,in the temporal comparison to before intake, the subscale“emotions”, “symptoms”, “functions” and the total scores
exhibited significant improvement exclusively in the TBPP
group. The “functions” subscale assesses the impact ofthinning hair on interpersonal relationships and social
activities, suggesting that TBPP intake may mitigate thedecline in social activities attributed to thinning hair in thisstudy.
In examining secondary outcomes, the VAS questionnaire
results ( Table 3 ) reveal a significant improvement inconcerns about “low hair volume” 24 weeks after TBPP
intake compared to the placebo group. Notably, changes in
the appearance of hair volume, particularly at hair whorls,
appeared to improve in several cases among both men andwomen in the TBPP group ( Fig. 2 top, back).

The phototrichogram results, employed to assess haircondition ( Table 4-a), indicate no significant difference inthechange of the number of hairs. However, there was asignificant increase in hair diameter 24 weeks after TBPP
intake compared to the placebo group. In addition, visually,
cases of improved hair thickness in the targeted area ofhaircut have been observed ( Fig. 2 targeted area). For
reference, a study on the efficacy of adenosine in Japanesewomen, utilizing a similar phototrichogram method,
confirmed the suppression of a decrease in hair diameter,
denoting an improvement in thinning hair among women 22).
In parallel, this study’s outcomes, akin to those with adenosine,
affirm that TBPP exhibits the potential to enhance hairthickness, marking an improvement in thinning hair. These
results suggest that the increase in hair diameter observed in
the TBPP group contributes to a positive perception of hairvolume, thereby enhancing hair-related QOL.
The increase in hair diameter observed in individuals
consuming TBPP may be attributed to an enhancement in thescalp environment, particularly the hair follicles. As the haircycle repeats, and the anagen phase shortens, smaller hairfollicle sizes may impede the formation of sufficiently thickhair shafts, leading to thinning hair 23). Hair follicle formationand growth are crucial for maintaining hair thickness. The
mechanisms suppressing hair follicle formation and growth
include the accumulation of AGEs due to in vivo glycation
reactions and oxidative stress. AGEs, particularly CML,
have been associated with inhibiting hair follicle formation by
suppressing the expression of the Sonic Hedgehog gene (SHHgene), a critical gene in this process 9). AGEs accumulate
with age 8), suggesting a potential link between age-related
thinning hair and AGEs. In addition, active oxygen is also
involved in the suppression of hair follicle formation, andit has been reported that lipid peroxides produced in hairfollicles expedite the catagen phase in hair cycles 24, 25).
Thus, oxidative stress caused by UV light and ageing is
also considered as a cause of thinning hair. TBPP, with its
anti-glycation effect, demonstrated in vitro to suppress thegeneration of pentosidine, CML, and 3-deoxyglucosone,
which are AGEs, and the effect of decomposing α-dicarbonylbonds characteristic of AGEs 10). Furthermore, TBPP, derived
from the pericarp of Trapa, as Trapa bispinosa Roxb.,
possesses antioxidant effect 26), and it has been reported that,among the components of TBPP, polyphenols, such as gallic_ 30 _Glycative Stress Researchacid and ellagic acid, possess strong antioxidant properties
27, 28). In addition, the authors have previously confirmed that
TBPP has antioxidant effects (data not published). Based onthese previous reports, focusing on the anti-glycation effectand antioxidant effect of TBPP, indicators for assessing
glycative stress and oxidative stress in the subjects were
established in this study.
Glycative stress in the subjects was assessed bymeasuring the plasma AGE content. In addition, oxidative
stress in the scalp of the subjects was assessed by measuring
the carbonylated protein amount in the stratum corneumof their scalp. As carbonylated protein is produced when
proteins and lipid decomposition products on the stratum
corneum of the epidermis are combined by active oxygen, itfunctions as an indicator of skin oxidation level 25). The study
results showed that compared to the placebo group, the blood
pentosidine amount significantly decreased 24 weeks after
intake in the TBPP group. In a previously conducted placebocontrolled human trial, it has been reported that compared
to a placebo, the blood pentosidine amount significantly
decreased 12 weeks after intake in the group that consumed
100 mg of water chestnut pericarp extract of the same amountas in this study 12). Compared to the previous human trial, theperiod from intake to manifestation of effects was longer
in this study, but this is thought to be due to differences instudy settings. Thus, the effect of TBPP-containing foodin reducing the blood pentosidine amount, as in previous
reports, was also demonstrated in this study. In addition,
based on the results of carbonylated protein quantification, in
the temporal comparison to before intake, the carbonylated
protein amount significantly decreased only 24 weeks after
intake in the TBPP group. In this study, lipid peroxides in thesebum and in vivo active oxygen amount were not measured,
so the effects of oxidative stress on the hair follicles of thesubjects could not be assessed. However, it has been reported
that carbonylated proteins in the stratum corneum of the scalp
are produced by the oxidative stress to the scalp 25), thus it
was found that TBPP may reduce oxidative stress in the scalpof the subjects in this study. In future studies, by assessing
oxidative stress markers and changes in hair/scalp caused by
TBPP intake, it may be possible to more accurately confirm
the association between the antioxidant effect and thinninghair improvement effect of TBPP. Based on the above
results, it can be suggested that TBPP is a food material that
contributes to alleviating the suppression of hair follicle
formation through its anti-glycation and antioxidant effects.

expected to be an effective food material that maintains andimproves health by improving concerns about age-associatedthinning hair, and contributing to maintaining mental QOL
and desires for social activities.

Conflict of interest
This study was outsourced to SOUKEN Co., Ltd.
by Hayashikane Sangyo Co., Ltd., and was conducted at
SOUKEN Co., Ltd. and Shiba Palace Clinic. Test foods were
provided by Hayashikane Sangyo Co., Ltd., and data collection
and statistical analysis were performed by SOUKEN Co., Ltd.
The authors Takuto Yamasaki, Shouko Takeshita, andChihiro Tomiya are employees of Hayashikane Sangyo Co.,
Ltd., and Takashi Koikeda is the director of Shiba Palace
Clinic. Shiba Palace Clinic and SOUKEN Co., Ltd. have notreceived any financial support from Hayashikane Sangyo
Co., Ltd. other than for the cost of this study.

Funding

Conclusion
The results of this study showed that the oral intake of
TBPP-containing water chestnut pericarp extract at 100 mg
per day for 24 weeks improves temporary concerns about
thinning hair. In addition, it is thought that the improvementof hair diameter is involved in the improvement of concerns,
and it was suggested that the maintenance of hair follicle
formation attributed to the anti-glycation effect of TBPP is
involved in the improvement of hair diameter. Furthermore,in this study, in the TBPP group and the placebo group,no adverse event with a cause-and-effect relationship withthe test foods occurred. Based on these findings, TBPP is_ 31 _

No competitive research grants were obtained.

Hair Quality and Polyphenols from Water Chestnut Pericarp

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