AGEs, Oxidative Stress and Inflammation, Oh my!

ages inflammation pcos Aug 20, 2021
AGEs and PCOS

Advanced glycation end products (aka AGEs) are the end products of a chemical reaction called the Maillard reaction. This chemical reaction between amino acids and sugars in the presence of high heat is what gives browned food that distinctive, delicious flavor. As a side note, AGEs are also produced naturally in our bodies as we age but these are usually formed more slowly. 

Unfortunately, these tasty glycated proteins have been proposed to be among the main mediators of several diseases such as type 2 diabetes, obesity, metabolic syndrome, cardiovascular disease, aging, inflammation, and neurodegenerative disorders. Along with these conditions, there is also research implicating serious problems that arise from AGEs in the female reproductive system, specifically how they affect the ovaries and that they may contribute to PCOS.

The receptors for AGEs are found all over the body but are most abundant in the heart, lung, skeletal muscle, vessel walls, and the ovaries. Interestingly, one study showed there was a stronger localization of AGEs and the receptor for AGEs in the ovaries of women with PCOS. Other studies have shown that serum levels of AGEs are elevated in women with PCOS compared to women without PCOS. This makes sense given that chronic inflammation and increased oxidative stress have been proposed in the disease progression of PCOS. AGEs are themselves inflammatory and cause oxidative stress in the body and may be linked to the metabolic and reproductive abnormalities seen in PCOS. In another study that asked the question, “Do advanced glycation end products (AGEs) and their receptors play a role in female reproduction,” the authors concluded that “AGEs might contribute to the etiology of PCOS and infertility.”

AGEs in the blood correlate with inflammatory markers and oxidative stress, and the accumulation of AGEs induces oxidative stress and inflammation. Oxidative stress and inflammation are also closely associated with insulin resistance, another contributing factor in the PCOS condition. Another study concluded that AGEs could play a role in the development of insulin resistance seen in PCOS. AGEs may also play a role in the development of obesity.

Diamanti-Kandarakis and her group published a 2013 study that showed AGEs might be responsible for ovulation failure that characterizes PCOS by interfering with LH action and thus impaired follicle development delaying ovulation. Altogether several studies show that AGEs have a negative impact on the female reproductive system. 

So what can women with PCOS do about the AGEs problem? Currently, there are drugs being researched including inhibitors of AGE formation, inhibitors of AGE absorption, and metformin for the reduction of AGE levels. But an even easier way to lower AGE levels is through diet. The good news is, dietary AGE restriction has been shown to reduce inflammation markers and lower AGE levels. 

Fruits and vegetables are low in AGEs. Eggs are a good source of protein that is low in AGEs. On the opposite end, most dairy products, processed foods, BACON, and fast foods are typically high in AGEs.

Another way to lower AGEs is by your cooking method. Slow cooking methods at lower temperatures such as stewing, poaching, steaming, and slow roasting are all ways to lower the amount of AGEs when cooking meat. The worst ways to cook meat that will produce higher levels of AGEs is through high heat cooking like searing, broiling, frying, and high temperature roasting. 

You can counteract the damage from AGEs by eating a diet high in antioxidants, herbs, spices, fruits and vegetables. You can also take antioxidant supplements as recommended by your healthcare provider. Making these small changes will make a difference! You can lower your overall inflammation and improve your PCOS symptoms.

Have you tried any of these changes and seen a difference? Let me know!


References:

Cordain, L. (n.d.). Rage of Ages: Advanced Glycation End Products. The Paleo Diet®. https://thepaleodiet.com/rage-of-ages-advanced-glycation-end-products. 

Diamanti-Kandarakis E, Katsikis I, Piperi C, Kandaraki E, Piouka A, Papavassiliou AG, Panidis D. Increased serum advanced glycation end-products is a distinct finding in lean women with polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf). 2008 Oct;69(4):634-41. doi: 10.1111/j.1365-2265.2008.03247.x. Epub 2008 Mar 19. PMID: 18363886.

Diamanti-Kandarakis E, Piperi C, Kalofoutis A, Creatsas G. Increased levels of serum advanced glycation end-products in women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2005 Jan;62(1):37-43. doi: 10.1111/j.1365-2265.2004.02170.x. PMID: 15638868.

Diamanti-Kandarakis E, Piperi C, Patsouris E, Korkolopoulou P, Panidis D, Pawelczyk L, Papavassiliou AG, Duleba AJ. Immunohistochemical localization of advanced glycation end-products (AGEs) and their receptor (RAGE) in polycystic and normal ovaries. Histochem Cell Biol. 2007 Jun;127(6):581-9. doi: 10.1007/s00418-006-0265-3. Epub 2007 Jan 5. PMID: 17205306.

Merhi Z. Advanced glycation end products and their relevance in female reproduction. Hum Reprod. 2014 Jan;29(1):135-45. doi: 10.1093/humrep/det383. Epub 2013 Oct 30. PMID: 24173721.

Uribarri, J., del Castillo, M. D., de la Maza, M. P., Filip, R., Gugliucci, A., Luevano-Contreras, C., Macías-Cervantes, M. H., Markowicz Bastos, D. H., Medrano, A., Menini, T., Portero-Otin, M., Rojas, A., Sampaio, G. R., Wrobel, K., Wrobel, K., & Garay-Sevilla, M. E. (2015). Dietary advanced glycation end products and their role in health and disease. Advances in nutrition (Bethesda, Md.), 6(4), 461–473. https://doi.org/10.3945/an.115.008433

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