Fertility and Pregnancy: Extra helpings – Ep 4. Part of the ‘Food as Medicine’ online course series

Fertility and Pregnancy: Extra helpings – Ep 4. Part of the ‘Food as Medicine’ online course series


MELISSA ADAMSKI: Hi everyone.
We’re here to talk about AGEs, or advanced glycation
endproducts and some of the common questions we see
in research and practice. So Nic, I’m thinking about
AGEs and practice, how well are they absorbed
in the body when we have them from the diet, and then also what are some
of the ways that we could possibly measure
these so we could use information about these
in practice when talking to clients or patients? NICOLE KELLOW: That’s a good
question Mel. It’s pretty unknown at
the moment about what the absorption rate
of AGEs from food is but it’s been estimated
to be about 30 per cent of the AGEs that are present
in the diet are actually absorbed
by the body. The ways that AGEs can
be measured is again another contentious issue, because we can measure AGEs
in the blood, but it seems that the level
of AGEs that are circulating in the blood don’t seem
to have any relationship to the amount of AGEs
that people consume in food. One of the other ways
that we can measure AGEs is by looking at
the accumulation of AGEs over long periods
of time in tissue samples. So often skin biopsies can be
taken where they’re measuring the AGE accumulation
in collagen. There is another non-invasive
procedure called an AGE reader. And that’s a little desktop
machine that’s very small and you’re able to painlessly,
and very quickly, measure or get an estimate
for the AGE accumulation in skin tissue. And that seems to correlate
very well with the amount of AGEs that are found
in biopsies. So what happens is in
this machine, using this machine, we ask the person to use their
dominant forearm and place their arm over the machine
and it actually shines a UV light that’s harmless
over a period of about 12 seconds it shines a UV light
on the skin of the forearm. And what happens then is some
AGEs are actually fluorescent under certain
wavelengths of UV light and so that the machine
measures that fluorescence that’s given back,
that’s reflected back, and it gives us an indication
of what the long-term buildup of AGEs are over time. And this does seem to have
some correlation to a person’s long-term dietary intake
of AGEs. MELISSA ADAMSKI: Which is really
interesting because, there’s a lot of the time
we hear about, you know, these sorts of things
that may affect our health and diets related but measuring
can be a different issue. So when you’re counselling
patients sometimes you sort of have no idea where you’re
where you’re aiming with your recommendations. But when we think about AGEs
and say fertility do the — do we know whether
the that machine that you mentioned when it’s
looking at the skin, does that have any correlation
with perhaps the accumulation of AGEs within the uterus. NICOLE KELLOW: Good question!
We don’t know that yet — we’re about to commence
a study looking at the relationship between
that accumulation of AGEs and in skin and AGEs
in infertile women, so whether they’re
overweight or within the healthy weight range. MELISSA ADAMSKI: Well that’s
very interesting and it will be interesting
to see your results there Nic. So it sounds like in practice
at the moment it’s, it’s good to sort of look at
somebodies current medical history look at their diet
history really looking at the types of foods
they’re having, how they’re cooked etc. and then giving some general
advice around changing the diet to help reduce
potentially the dietary load of AGEs, especially in people that may be
at risk of say cardiovascular disease, or higher levels of inflammation
or infertility. NICOLE KELLOW: Absolutely
anybody with any metabolic disorder whether
it’s overweight, cardiovascular disease
or high cholesterol, pre-diabetes or diabetes. These are kind of red
flags to indicate to us that they probably producing
a high level of AGEs internally. And it’s important that they do
have a look at the dietary content the diet. MELISSA ADAMSKI: That’s right, so we can just get the load
off them and just help to reduce and stop
this accumulation as much as we can from an
external perspective. NICOLE KELLOW: Absolutely.
One thing I didn’t say earlier was although the dietary
absorption of AGEs is thought to be around 30
per cent we know that those remaining AGEs that don’t get
absorbed actually go through to the large intestine
because they’re they’re heavily glycated,
we can’t actually digest them. And so they go through
to the large intestine where they’re actually
encouraging the growth of more pathogenic bacteria. So research has been done
to show that unabsorbed AGEs are also a problem in the
large intestine. MELISSA ADAMSKI: That’s tying
in the microbiome there as well. So if we think now towards
sort of dietary patterns in the diet itself I’m already
thinking of some common questions that my patients
might ask me about what they can do about them and you know
we’ve seen lots of trends recently at opposite
ends of the spectrum. So one end we have sort
of raw dietary trends where people eat
predominantly raw foods and not cooked. And then at the other end we can
have sort of very high protein, low-carbohydrate
diets with a lot of, or potentially a lot
of barbecued and charred, charred meats there. So would
you say that, you know, an extreme sort of raw food type
diet is beneficial and a high protein, low-carb, charred meat diet
is non-beneficial, or would we be giving sort
of a more moderate message in the middle with people. NICOLE KELLOW: I’d probably be
giving a more moderate message. Certainly there are benefits
to a raw diet, it would be lower in AGEs.
However, you have to weigh up the food
safety issues if meats and so on are not
cooked properly. MELISSA ADAMSKI: Especially
from a pregnancy and fertility, or conception perspective. NICOLE KELLOW: Absolutely.
The other thing is that that yes, somebody who’s following
a low-carbohydrate diet usually by — sorry —
I just think, for somebody who’s following
a low-carbohydrate diet, usually that means that they’re
having a lot of animal-based products
in their diet to replace those carbohydrates. And we know
that animal products, particularly you know those
high-protein, high-fat, animal-based products
are naturally higher in AGEs, and the cooking
processes then can increase the AGE
content further. One thing that’s important also
to keep in mind is that the antioxidants
present in fruit and vegetables helped
to counteract some of this AGE formation
and so fruit and vegetables shouldn’t be
something that’s abandoned. MELISSA ADAMSKI: interesting.
So once again that’s some very interesting points then to give
us hints about how we talk to our patients
especially when they ask “what are the benefits of this
or “X” type diet I’ve heard in the news or “Y” type
diet I’ve heard in the news,” to help bring back to more
of those dietary guideline-based messages
around moderation and variety in foods as well. And I think that’s an important
message around the variety of cooking as well
because sometimes we can get a bit stuck on we always
have this for dinner or this for lunch but mixing
it up and having some cooked vegetables,
some raw vegetables. NICOLE KELLOW: Absolutely. MELISSA ADAMSKI: And so that
helps us get a lot of health benefits that way too. NICOLE KELLOW: Absolutely
variety is very important. You know we know that the
the wider variety of foods that you have
in your diet, the healthier you are
and the lower your risk of chronic disease.
And, you know, that wide variety
of different foods in your diet using different
cooking techniques, will ensure that you’re not — you’re not consuming too
much of a more toxic food component and a variety
of healthy, you know, the vitamins, minerals
and antioxidants. MELISSA ADAMSKI: Absolutely.
And then finally Nic, one other question we know
that or we’ve seen have research around AGEs
and fertility for women and the accumulation in the
uterus and the potential effects of that. But what about fertility
in males and AGEs, Is there any any evidence there
or any research that’s been done? NICOLE KELLOW: Yes there’s some
recent research looking at the effect of AGEs in males
and particularly around sperm function. Now excessive amounts of AGEs
don’t seem to have any negative effects on the motility
of sperm but they actually cause
a reduction in the quality of the DNA within the sperm.
And so the quality of the — of the sperm is adversely
affected by excessive AGE exposure. MELISSA ADAMSKI: So once again
it does take two to tango and so diet should be
considered for both, well, for couples — NICOLE KELLOW: Exactly.
So you know women and their male partner. MELISSA ADAMSKI: Yes absolutely.
Great. Well thanks Nic, I hope everyone’s found
that helpful when considering AGEs and their practice. They were just some
of our common questions that we get in this space. Hopefully it was helpful
for you. Thank you.

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