1 April 2019

Inflamm-ageing is a term coined to describe one way in which the immune system runs awry with age. Like a malfunctioning thermostat, the level of inflammatory response is consistently too high, leading to tissue damage

One of the root causes of inflammation is the accumulation of sugary metabolic wastes known as advanced glycation end-products, and it’s not merely a coincidence that the acronym for Advanced Glycation End-products spells out AGE!

Research shows these molecules can cause oxidative stress and inflammation, two mechanisms implicated in the ageing process. Inflammation and oxidative stress have also been associated with many chronic diseases crippling our healthcare system today, including diabetes, cardiovascular disease, and obesity.

What Are AGEs?

Advanced glycation end-products (AGEs) form through an interaction between a protein and a sugar (fat can also be a part of these reactions) that are in some cases very hard for our biochemistry to break down. Some types of AGEs can form cross-links, glueing together important proteins such as those making up the supporting extracellular matrix scaffold - that provide structural support of our cells. The properties of our elastic tissues such as skin and blood vessel walls are comprised from this particular structure of the extracellular matrix, and cross-links degrade that structure, preventing it from functioning correctly - basically forming wrinkles on the skin and a hardening or narrowing on the arteries - any which way it doesn't sound great!

In the food production industry, there is a reaction called the “Maillard reaction” which occurs when cooking something with protein and sugar. This reaction creates the browning and crusting you might associate with baked goods or that caramel crust on the top of a Crème brûlée. The Maillard reaction also occurs in the human body. It is a step in the formation of advanced glycation endproducts (AGEs) and I’m sure you’ll agree, now you know what it is, you don’t want that happening inside you!

AGEs derived inside the body mainly arise due to excess blood sugar and/or oxidative stress (Oxidative stress is an imbalance between free radicals and antioxidants in your body). Outside the body AGEs generally, come from food and smoking.  

AGE’s and Inflammageing

AGEs affect the body in many different ways:

  1. They can alter protein structures, which in turn changes the function of that protein
  2. They impact communication between cells, generally through one of the receptors, called a RAGE receptor. AGE’s bind to RAGE receptors which sets off an inflammatory response - and boom we have more oxidative stress.  

The toxic effect of AGEs begins long before any sign of disease - when we are still healthy. The body has a limit to the amount of AGEs it can filter out each day. Over time, the body's natural defences can be reduced to the point that AGEs begin to build up. Our defences can be depleted long before a disease sets in, so at best, AGEs speed up the ageing process, but worst, they lead to the onset of debilitating disease.

How to Reduce Your AGEs   

The first place to look when trying to reduce your AGEs level is the foods you consume. As a general rule of thumb, foods high in fats and protein are at a greater risk of developing AGEs, especially when cooked at high temperatures -  basically “throwing a sausage on the barbie” is not the best way to keep your AGE count low.

Here is a list of the AGE content in some selected foods: 

Avoid Processed Foods  

Commercially processed foods generally incorporate thermal processing to increase shelf-life, and enhance taste. The heating processes lead to Maillard reactions, which produce AGEs - in the pursuit of science here is an example I cooked to show your here (but did not eat!).

Cooking and prepare foods yourself from fresh & natural ingredients, and you will already be taking a significant step toward better health–and lower levels of AGEs.   

The Best Cooking Methods

The best option is to cook food using a low heat and in some type of moisture.

Frying, grilling and roasting meat will lead to higher levels of AGEs in food than poaching, stewing, and steaming. If you wish to sauté or stir-fry something in a pan over heat, choose a low to medium heat rather than a high heat, add a bit of oil and a splash of water and you will have lower levels of AGEs in the final product. The type of fat you cook your meat in can also have an effect on the level of AGEs - don’t heat a liquid oil like olive oil so high that it smokes -  you’ve “oxidised” the fat then and created AGEs.

Marinating is another way to mitigate your AGEs, together with enhancing the flavour.

Cooking in spices is another way to reduce the level of AGEs in foods. Studies have shown promising results demonstrating AGEs-inhibitory effects of several common spices, including, cumin, thyme, rosemary, and sage and using food is far more beneficial than taking these in a supplement.

Antioxidants and Anti-Inflammatory Diet  

And so consuming a diet rich in antioxidants plays a key role in mitigating the negative effects of AGEs. One in vitro study found that quercetin, a flavonoid found in many plant foods including berries, broccoli, kale, apples, capers, onions, tea, tomatoes, nuts, seeds, and grapes, reduced the effects of AGEs.

Another antioxidant, gallic acid, which is a polyphenol found in many plant foods with known anti-inflammatory has also been shown to mitigate the damaging effects of AGEs. Some good food sources include pomegranate, blueberries, plums, strawberries, and walnuts. One study found that one of the polysaccharides found in pomegranates led to a 28 percent reduction of AGEs. Other foods, beverages, and herbs rich in anti-inflammatory and antioxidant activity, such as green tea and curcumin, will likely provide benefits as well, but only when eaten it seems.

My colleague Dr Micheal Mosley conducted a study on humans a few where they asked one group to consume a teaspoon of turmeric every day for six weeks, ideally mixed in with their food. Another group were asked to swallow a supplement containing the same amount of turmeric, and a third group were given a placebo, or dummy pill. The results:

We didn't find any changes in the group taking the placebo," MM commented. That was not surprising.

"The supplement group also didn't also show any difference," he went on.

That was surprising and somewhat disappointing.

"But the group who mixed turmeric powder into their food," he continued, "there we saw quite substantial changes. It was really exciting, to be honest. We found one particular gene which showed the biggest difference. And what's interesting is that we know this particular gene is involved in three specific diseases: depression, asthma and eczema, and cancer. This is a really striking finding."

Based on the above, the best way to reduce your level of AGEs and mitigate the negative impact on your health is to:  

  • Avoid highly processed foods  
  • Cook foods in low heat for a long period of time with sufficient moisture

  • Consume lots of fruits and vegetables to ensure you have copious amounts of beneficial antioxidants, especially quercetin and gallic acid

  • Don’t smoke and avoid second-hand smoke

  • Enjoy green tea, fresh turmeric tea and pomegranate juice

I will be talking more about this area at my next Functional Day Retreat - Taming Inflammation, Inflamm-ageing & Autoimmunity, and giving tons of practical information and ideas in The Workshop: Taming the Inflammatory Fire; a practical and seminar based session after lunch.