POST PRANDIAL BLOOD SUGAR AND AGE FORMATION
Anytime there are significant levels of glucose in the blood, AGE formation occurs. As you recall AGE stands for advanced glycation end-products which is a fancy term for compounds made when glucose binds to lysine residues on various amino acids in the body initiating damage. Its technical description is the Maillard Reaction. You can however consume AGE’s as well as make them in your body. How many of you are in America’s epicenters of culinary delight? Cities such as SF, LA, NYC, New Orleans, Chicago and Duarte CA. Well OK not the last one but they do have a neat rehab hospital there. The same reaction occurs when the chef pan sears meats and fish or the browning of bread in the oven. This is where all the flavor comes from-high heat searing and it’s the AGE’s that taste so damn good (and a few other harmful things). The French company De Buyer in fact, makes super, high heat, sauté pans for just such an occasion of which I own several. However, it’s important to be cautious when ordering that pan-seared duck breast. That Maillard Mallard will triumph in the end and while browning bread wins the award for comfort food no such laurels can be made when discussing body compartments. Here’s a nice technical explanation for the reaction that occurs naturally in your body when sugars react with other elements.
In general, all molecules that have free amino groups, whether these are proteins, nucleic acids, low-molecular-weight amines and certain lipoproteins and lipids can be the target to initiate the Maillard reaction in vivo [in living systems]. Thus, the Maillard reaction is a type of…modification of molecules that takes place slowly and continuously throughout the life span and contributes to the development of normal aging or to some complications of diabetes, such as cataract formation, vascular narrowing and stiffening of collagen (Masoro 1991, Vlassara et al. 1994).
Other effects from high FIL’s are mitochondrial dysfunction, activation of the renin-angiotensin-aldosterone system leading to hypertension, and the generation of inflammatory cytokines as seen in the figure below:
We cannot allow these damaging effects to occur for any length of time. Now that you understand the gravity of the situation you’ll need to make some changes. The immediate action is to drastically reduce your insulin level. Sadly, we don’t have a tiny valve located in our belly buttons that when twisted counterclockwise shuts off insulin production. If only it were that easy! Sounding like the broken record that I am, there are several things you must do to reduce insulin secretion which may or may not be that easy. But it must be done if you want to become well again or preserve your good health. I understand that nobody wishes to have another stroke or a second heart attack but over the years some of us forget how scary and horrible those events were. Being very active for most of my life, I never forgot how frightening my heart attack was and the crippling effect it had on me. Because of that I am very careful most of the time. I say most because I’m not a monk and I do need a cupcake once in a while. Add to that the powerful addicting forces behind sugar and grains and we find ourselves back in the mix creating the next perfect storm for another cardiovascular event. Use whatever scare tactic you can conjure up to keep you on track. A patient of mine uses her little daughter as the prime mover for her escape to skinny land. She frequently says to herself “what happens to my daughter if I die?” Her answer is that “she’ll be sold for food to the giants living in the sky.” It worked.
The next figure shows the difference between obesity and “leanity” to coin a new term. At the top on the right the brain represents the hypothalamus or master gland. Under obese conditions with insulin resistance (diabetes or pre-diabetes) it secretes factors that ultimately increase both cortisol and aldosterone leading to bloating and hypertension. The pancreas keeps pumping out insulin since the obese patient’s cells do not respond to insulin in a normal way. Until it can no longer do it leading to beta cell (insulin producing cells) failure at some point in the future. Macrophages and fat cells produce oodles of inflammatory cell signalers causing systemic inflammation. While the liver pushes out far too much glucose adding fuel to the fire. These are just some of the effects we see in many Americans who are overweight or obese, have metabolic syndrome or diabetes.
At this point you are asking yourself or the stranger at the counter next to you, what do I do to decrease my fasting insulin level and PPBS? The short answer is join a gym, stop eating all processed foods including bread, and make a strong determination to get the excess body fat off any way you can. The easiest way that I have found is to stop eating all non-fibrous carbs. That includes all grains, white potatoes, sugar and sugary things. Trouble getting started? Stop eating bread. Often times that alone will significantly drop your fasting insulin level. In the long run it’s about lifestyle change not any particular diet. If you are looking for a DIET stop right there and go to Opra Magazine. If you are looking for a meaningful way to get fit and stay healthy then you’ll have to read my book when it comes out and keep reading these blogs.
 J. Nutr. September 1, 1998 vol. 128 no. 9 1442-1449