Sugar Consumption Affects both Intrinsic and Extrinsic Aging

As we age, different parts of our bodies age at different rates. The skin, which is the largest organ of our body, ages just like our other organs. But when we see someone in public or meet someone new, can we really tell how their internal systems are aging? One of the things that we associate most strongly with aging is the deterioration of the skin, as it is the first thing we see and therefore catches most of our attention. Skin is the most exposed part of our body, and its health can be severely influenced by factors in our environment. One of the most universal signs of aging is wrinkling of the skin, caused by a loss of elasticity over time. 

The skin is constantly subject to changes in internal health and environmental conditions in its role as the interface between the external and internal environments of our body. Thus, skin aging is categorized as either intrinsically (chronological and genetic factors) or extrinsically driven (environmental factors). Intrinsic aging is generally not modifiable as it depends on your age and genetics – factors that are not easily influenced. On the other hand, factors that drive extrinsic aging of the skin can be impacted by behavioral or lifestyle changes to combat or mitigate the effects of the given environmental stimulus. Some of the most common environmental factors that drive extrinsic aging are sun exposure, dry climate, air pollutants, smoking, and even nutrition. Although it is often overlooked, nutrition can significantly impact the rate of skin aging and is a great way to reinforce our skin health.  

We experience a steady increase in the rate of non-enzymatic glycation, also known as a binding of sugar molecules to our proteins, as we age. This process also includes collagen, an essential structural component for our skin. Glycation of collagen proteins can cause cross-linking between them rendering them incapable of being repaired through the normal remodeling process. The more cross-linking that occurs, the stiffer the collagen matrix gets, resulting in stiffness and loss of elasticity of the skin and increases in pore size. While glycation is a normal process that escalates with age, hyperglycemia (chronically elevated blood sugar) can further exacerbate the rate of non-enzymatic glycation.  

Diet is not only a major source of glucose and fructose required for glycation, but many foods also contain pre-formed advanced glycation end products (AGEs). AGEs are formed by the Maillard reaction – the process responsible for the browning we see on some of the foods we cook. The best way to avoid formation of AGEs from cooking is to use water-based cooking methods like poaching, blanching, stewing, or steaming.

The development of glycated collagen is severely accelerated in conditions of abnormal glycemic control, most notably diabetes. Fortunately, improving glycemic control can show dramatic reductions in glycated collagen formation of up to 25% in as little as 4 months. Because glycation is not a reversible process, the focus must be placed on prevention, and starting early will have the most substantial impact on skin health. Incorporating healthy lifestyle habits such as regular exercise and prioritizing a healthy diet low in pre-formed AGEs can significantly improve metabolic health and glycemic control and reduce the rate of skin aging. 

Dr. Rohan Bissoondath,
Medical Director

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