Diabetes and Advanced Glycation End Products: Why They Matter And How You Can Reduce Them

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If you have diabetes, you’ve likely been told to control your blood sugar… about a thousand times. Websites and other information sources (yes, including The Diabetes Site) are quick to offer ideas on how to lower your blood sugar, what foods you should eat for better blood sugar, and how you can avoid having a high. It’s a well-meant but exhausting pattern.

Depending on how up-to-date you are on the latest health trends, you may have heard of advanced glycation end products, or (rather fittingly) AGEs. Researchers have been discovering more about the sinister role AGEs play when it comes to disease development, especially for people with diabetes.

AGEs form when fat or protein combines with sugar in the bloodstream, and they actually alter intracellular signaling, which means cells aren’t able to function as they’re supposed to, and AGEs release inflammatory molecules and free radicals. This contributes to diabetic complications like retinopathy, neuropathy, atheroscelerosis (blood vessel hardening), and slow wound healing.

Everyone, diabetic and otherwise, forms AGES from normal body processes and from the food we eat, but people with diabetes can develop them more quickly because of the higher availability of blood sugar, accelerating health complications. This accelerated AGE formation is the reason high blood sugar is so detrimental to our health. Here we’ll talk about how AGEs form and how to reduce them (even when you can’t lower your blood sugar).

AGE Formation

At the most basic level, AGEs form when proteins or lipids become glycated, that is, attached to sugars in the bloodstream. This glycation causes the protein or lipid to rearrange at a molecular level and become an AGE.

These AGES build up in the blood vessel walls where they can compromise vessel function and contribute to the vascular complications of diabetes (neuropathy, retinopathy, and nephropathy). Blood sugar levels and the amount of oxidative stress in the blood vessels contribute to the rate of AGE formation.

One of the things that makes AGEs so damaging to the body is their ability to crosslink and make formations between proteins. These links alter cell structure and function. AGEs can also link with other cells and contribute to oxidation and inflammation. AGEs can change LDL cholesterol so that it’s more readily deposited on blood vessel walls, and the cross-linking action of AGEs contributes to blood vessel stiffness. AGEs wreak havoc on our blood vessels.

The other sources of AGEs

We can also acquire AGEs from outside sources, such as tobacco smoke. But a more controllable source of AGEs is our food. Our diets are a significant source of “highly reactive AGEs,” according to the American Diabetes Association.

According to an article published by the American Diabetes Association, “There is apparently a direct correlation between circulating AGE levels and those consumed.” We may not always be able to control our blood sugar, but we do have some control over our diets. There is a direct correlation between the amount of AGEs in our blood and tissue damage, and the amount of AGEs in our blood can be reduced by avoiding or limiting certain foods.

Reducing AGE Consumption

The way food is cooked has an effect on its AGE content. Heat processing creates more AGEs, especially dry heat. In fact, food manufacturers can and do increase the flavor of certain foods by incorporating synethetic AGEs. The American Diabetes Association notes that, “the AGEs content of the Western diet has increased vastly in the past 50 years, as has the quantity of food consumed.”

AGEs are already present in uncooked animal products, especially those high in fat, and dry heat methods like grilling, broiling, roasting, searing, and frying increase AGE content. AGE production can be reduced by using moist cooking methods, shorter cooking times, cooking at lower temperatures, and by using marinades with acidic ingredients like lemon juice or vinegar. Acidic ingredients have a protective effect. Vegetables, fruits, whole grains, and milk have few AGEs to start with, and have relatively few even after they are cooked.

PubMed Central published a paper that included a list of foods and their associated AGE content. Notice that roasted cashews have 50 percent more AGEs than raw cashews! Reducing the amount of processing of our food is an easy way to cut down on our AGE consumption.

We can reduce our AGE consumption by increasing the amount of fish, legumes, vegetables, fruits, and whole grains we eat while reducing solid fats, fatty meats, processed foods, and full-fat dairy products, and those recommendations are in line with what the American Heart Association already recommends for heart health. Even when eating those foods is not an option, cooking by poaching, steaming, stewing, and boiling can significantly reduce a meal’s AGE content.

Photo: AdobeStock/Daniel Vincek

Photo: AdobeStock/Daniel Vincek

Conclusion

People with diabetes need to be especially careful about the amount of AGEs they put into their bodies since they will already make AGEs at an accelerated rate. Controlling blood sugar is of course ideal, but real life is rarely ideal. Knowing that eating too much of certain foods can accelerate the complications of diabetes (and contribute to poor health in general), is hopefully yet another reason to be mindful of what we put in our mouths. So enjoy a plate of steamed veggies, and stay healthy, friends!

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Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.
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