While the world obsesses about fats and carbohydrates, there are other issues that muddy the
macronutrient waters and have implications for coronary plaque prevention and reversal.
Endogenous and exogenous glycation and lipoxidation are two important areas to know about.
Because there are two general pathways by which AGEs and related products are generated—endogenous and exogenous glycation and lipoxidation—there are two separate groups of strategies to reduce exposure to them.
Minimizing Endogenous Glycation
To reduce endogenous glycation, start by avoiding foods that increase blood glucose. In the New Track Your Plaque Diet, we eliminate all products made with wheat, as the unique wheat carbohydrate amylopectin A
increases blood sugar higher than nearly all other foods and provokes the reactions of endogenous glycation. (The amylopectin A of wheat also triggers de novo lipogenesis
(formation of triglycerides from carbohydrates), which then cascades (via VLDL-LDL interactions) into formation of small LDL particles.) We also eliminate “junk carbohydrates” made with corn, cornstarch, oats, and sugars. We avoid high-glycemic index foods like candy bars because of their capacity to raise blood sugar to high levels, but we also minimize low-glycemic index foods because they raise blood glucose less high
—but still quite high. Most of the foods consumed in the New Track Your Plaque Diet are therefore zero
glycemic index, such as raw nuts and seeds, non-starchy vegetables, olives, olive oil, coconut oil, and meats, poultry, and fish. Following this approach, exposure to endogenous glycation that develops from food is minimized—it’s still occurring at a slow, “natural,” rate, but excess
glycation has been reduced or eliminated.
The common test, hemoglobin A1c (HbA1c), or glycated hemoglobin, while used to assess blood sugar, also reflects the rate of protein glycation that has been occurring over the preceding 60 days, in this case glycation of hemoglobin. An ideal rate of glycation is reflected by keeping HbA1c 5.0% or less, meaning the contribution of high blood glucose to glycation of long-lived proteins has been reduced to its low natural rate. (Conversely, the high HbA1c experienced over years by diabetics and pre-diabetics with HbA1c in the 6.0%, 7.0%, even 10% range reflects markedly accelerated levels of endogenous glycation and thereby accelerated diseases of aging, including atherosclerosis, hypertension, cataracts, arthritis, and cancer.)
Minimizing Exogenous Glycation
Recall that the reactions that promote exogenous glycation (and lipoxidation) are increased by heat and longer cooking times. Exogenous glycation is therefore best managed by using lower temperature cooking and for the least amount of time whenever possible. Beef, for example, should be eaten rare to medium, not well-done. (Chicken and pork, of course, should be thoroughly cooked due to issues of contamination and infestation, regardless of AGE content.) It means that boiling, steaming, sautéing, and low-temperature baking (350° F or less) should be used whenever possible. Minimize use of broiling, high-temperature baking (450° F or higher), deep-frying, and barbecuing. Shorter cooking times also limit exogenous AGE formation, so aim for the minimum amount of time to obtain the desired level of “doneness.”
Interestingly, using acidic marinades like vinegar and lemon juice substantially discourage AGE reactions. Marinating beef in either liquid, for instance, reduce AGE content by over 50% (Uribarri 2010).
Nutritional supplements that reduce AGEs
In addition to avoiding foods and methods that cause endogenous and exogenous glycation to develop, there are several nutritional supplement strategies that can further reduce one or both classes of AGES:
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