Can diet affect the creation of advanced glycation end-products?
On a podcast recommended to me (I'm not sure whether it's called "Sports Nutrition" or "Endurance Planet") Ben Greenfield talked about inflammation, advanced glycation end-products (AGEs) and carbohydrates (especially sugar). He claims (IIRC) that simple carbohydrates will lead to increased creation of AGEs, which leads to increased inflammation.
I wanted to learn more about that, so I read the Wikipedia article about it, but didn't see any mention of that connection. (The Wikipedia page says AGEs may be formed inside the body through "normal metabolism and aging".) Is there evidence of a connection between sugar intake, AGEs and inflammation?
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Berin's explanation hits on a bunch of seriously good points, but as a diabetic who's taken a very keen interest in the whys and wherefores of my disease, I think I can fill in some of the blanks here.
Firstly, it's important to understand that all carbs you eat will eventually boil down to sugars. The particulars vary based on the kind of carb, but I will start with the basics and get down to the specifics.
Increased carb consumption is going to inevitably lead increased formation of AGEs simply because there are more glycemic materials to make the AGEs with. The question becomes, how much of your carb intake is available as glycemic material? That gets a little complicated. You can get an idea by looking at the glycemic index of the foods you eat. The lower the index, the fewer glycemic materials are coming out of that food. So table sugar or white rice would give you a lot, but rye bread is going to give you a lot less.
Now, the hairy particulars: Glycemic index is completely dependent on what you eat together. A bowl of dry cheerios would have a relatively high glycemic index, but a bowl of cheerios with whole or raw milk (which has lots of fat in it) is going to have a much lower glycemic index, because the fat and protein in the milk will buffer how fast the carbs are absorbed, and even how many are absorbed at all. It doesn't make sense to stop eating a bowl of cereal for breakfast if you are still snacking on a Snickers at lunch. The available glycemic material in your body is not going to be significantly affected. The basic rule of thumb, though, is that the more fat and protein you are consuming with carbs, the slower those carbs are going to get absorbed.
Also, the 'tired pancreas' theory is indeed well known among diabetics; we refer to it as pancreatic exhaustion. It's a leading cause of type-2 diabetes, and even some cases of type-1 diabetes as well, where the pancreas is completely exhausted. Essentially, an organ being tired is roughly the same as a muscle being tired. If too much has been demanded of an organ for too long, it will be unable to keep up with the demands and simply conk out. The distinction here isn't between 'good' and 'bad' insulin, but rather one's insulin capacity. A healthy pancreas can excrete large amounts of insulin in a short amount of time, to properly respond to a high-carb meal. A tired pancreas can excrete less insulin, so it takes longer and longer for blood sugar levels to come back down. An entirely exhausted pancreas can excrete almost no or near no insulin, so for practical purposes blood sugar will never come down, since the person will have to eat again before the glucose from his/her last meal can be sunk.
The Wikipedia article you referenced provides a link between AGE and hyperglycemia (common with diabetes). Essentially, hyperglycemia and hypoglycemia are both related to the pancreatic function. The pancreas secretes insulin to store elevated sugar levels (hyperglycemia) as fat. In insulin resistant people, the pancreas has to secrete more insulin than in people with normal pancreatic function.
The only link then to the food you eat and AGE is through the pancreas--or essentially the amount of carbs/fats/sugars you take in. If you have these in excess (defined as in greater quantity than your pancreas can process), you will have hyperglycemia or you will get really fat. Essentially, if you keep feeding your pancreas more than it can handle you will increase your AGE levels.
A healthy pancreas needs time to work and time to rest. Unfortunately western diets are full of far more carbs/sugars/fats than your body can ever use. For many people, we consume so much our pancreas never gets a chance to rest--increasing the risks of diabetes and the AGE levels you asked about. When the pancreas gets tired from overwork, the quality of the insulin goes down and the quantity goes up. Essentially, in healthy people your pancreas will secrete more insulin than you need and trap too much blood sugar as fat--causing you to be irritable and hypoglycemic.
Later in the article, AGE causes complications in the kidney, which gets rid of waste products in the blood. It seems that AGE affects are cumulative and will remain a factor even if you get the pancreatic function under control. Any more than this, I can't say.
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