Don’t AGE before your time

How a process called glycation can age you prematurely, and what you can do about it

Ageing is inevitable and a clear sign that you made it. Be happy and embrace the wisdom of the ancient Stoics, who encouraged calm acceptance of matters not within our control. That includes time.

Equally, I advise against accelerating matters needlessly, and making yourself vulnerable to age-related diseases that could be avoided.

That means exposing yourself to as few advanced glycation end-products as possible.

Advanced glycation end-products (AGEs) are highly pathogenic compounds that make you look and feel older than you are and predispose you to a range of chronic diseases.

AGEs are created when sugars attach themselves to proteins and fats in the blood. You can see AGEs in action – they are responsible for the ‘browning’ effect you see in certain cooked foods, otherwise known as the Maillard reaction. They are also responsible for those deep dry lines you see in the mirror, otherwise known as the wrinkling reaction.

The creation of AGEs is a normal function of metabolism, and it is only when they are produced excessively that they become harmful. They do their damage in two main ways: they promote oxidative stress, causing free radical damage, and they greatly increase inflammation.

There is ample evidence to demonstrate how AGEs promote ill health. Those diseases most likely to arise through excessive AGEs production include diabetes, cancer, cardiovascular disease, kidney disease, and neurodegenerative diseases, including Alzheimer’s.

There are two types of AGEs: the ones the body makes (endogenous) and the ones that are present in food (exogenous), especially foods with a high fat content. The food itself does not naturally contain AGEs; it’s the cooking method that creates them. Cooking at high temperatures through grilling, frying or barbequing is the most potent method.

Exogenous AGEs are also derived from smoking, excessive UV light exposure and pollution.

Which is worse – endogenous or exogenous AGEs?

No contest here – your endogenous AGEs are the most pernicious. Endogenous AGEs appear faster and accumulate more extensively than exogenous AGEs. But don’t worry: there’s a lot you can do to reduce your load, as you shall see later on.

‘From this overview it follows that the contribution of exogenous glycation products to the potential adverse health effects may be limited for various reasons.’

Fortunately for us all, the quantity of exogenous AGEs present in food that can be absorbed by the gut is relatively low. Most AGEs pass straight to the colon where they are metabolised by the gut microbiota. Studies have found varying degrees of absorption - some estimates suggest 10%, others 20%. One recent study proposed 10%-30%.

How good or bad that is depends on how much you consume. If all your food is burnt to a crisp, 10%-30% is a heavy load of AGEs.

So what causes an overload of endogenous AGEs? The main cause is poor blood sugar control.

From skin to brain, via everything else

Collagen is a protein structure, the most abundant protein in the body. It is an integral part of connective tissue and is what gives skin its lovely, youthful elasticity.

Like all good things, collagen production declines naturally with age. Loss of elasticity and the appearance of lines are proof of that.

Elsewhere, there’s joint stiffness and bone, muscle and heart problems. The skeletal system is vulnerable because bone is 30%-40% collagen, so excessive AGEs exposure can lead to bone fragility and risk of fracture.

You can even see the effect of AGEs in the eye, in the crystallin (protein) structure of the lens, where AGEs accumulation can result in cataract, a metabolic disorder.

Older people, especially older people with diabetes mellitus or hyperglycaemia are especially vulnerable.

Elevated blood sugar promotes the formation and accumulation of AGEs. It is well known that people with diabetes are at higher risk of developing Alzheimer’s. That is why Alzheimer’s is sometimes called type 3 diabetes. Over 80% of people with Alzheimer’s disease have either type 2 diabetes or abnormal blood sugar levels.

Glycation is the link between diabetes and Alzheimer’s. Research has found that the brains of people with Alzheimer’s disease have particularly high levels of these AGEs, compared to people without the disease.

How to hold back the tide

First, reduce your own AGEs production

This means stabilising blood sugar. To do this, avoid added sugar and reduce your carbohydrate intake to a minimum. Starchy, sugary snacks are the worst offenders. If your diet is based on wheat, rice, pasta, corn and supplemented with snack foods in the form of crisps, chips, biscuits (cookies), pastries, bread, et al, not only will you pile on weight, you will produce very high amounts of AGEs, beyond what is to be expected with, well, age.

Fructose, the sugar used in the ubiquitous sweetener high-fructose corn syrup, is especially heinous. It is estimated that fructose is ten times more reactive than glucose in inducing glycation.

Carbohydrate reduction is a great way to lose weight, too, something that can also reduce glycation. Obesity is a significant cause of AGEs overload. Excessive body fat increases oxidation and inflammation in the body, and this promotes the glycation process, which in turn causes ever more oxidation and inflammation. A vicious cycle of dysfunction is the outcome.

Second, reduce your dietary intake of AGEs

When it comes to dietary sources, it is the method of cooking rather than the food itself that creates AGEs. Where appropriate, stew or steam your food.

Also avoid anything cooked in polyunsaturated oils, namely soya bean, sunflower and corn oils. Commercial seed oils are refined at very high temperatures, a process that generates oxidising free radicals and of course AGEs.

Third, arm yourself

Increase dietary intake and production of anti-inflammatory antioxidants to counter and disarm free radicals. AGEs are not a problem if your antioxidant store exceeds your AGEs generation.

Plant foods rich in polyphenols are a good source of anti-glycation antioxidants. Berries (blueberries, blackcurrents, strawberries) are among the richest source of polyphenols.

Dietary antioxidants play a key role, but the ‘master’ antioxidant, glutathione, is one your body makes.

Glutathione is made of three amino acids: cysteine, glutamic acid, and glycine. The richest dietary sources of all three amino acids are red meat, poultry, fish and dairy foods.

Although ready-made glutathione is found in some food sources (broccoli, asparagus, avocado, spinach) absorption is too poor to be of much value.

Don’t forget to exercise

Regular exercise is a great way to improve metabolic health, insulin sensitivity, and therefore blood sugar control. It decreases oxidative stress and reduces inflammation.

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Our friend the Stoic, Marcus Aurelius, liked to remind us that life is short and death is inevitable. I say don’t make it shorter or more painful than it needs to be. Stoicism teaches us that we should ignore what we can’t change and focus only on what is within our control. AGEs overload falls into the second category.