+APR+CME_SUPPL/Sugar-Sag--What-Is-Skin-Glycation--and-How-Do-You-Combat-It-_Figure2.png)
to 87 years old, the investigators showed that consumption of exogenous collagen (5 g, derived from fish) containing high concentrations of prolyl-hydroxyproline and hydroxyprolyl-glycine or placebo for 12 weeks resulted in significantly lower levels of skin AGEs (P<.05) and a slightly lower insulin resistance index (correlation between the rate of change in levels of AGEs and the rate of change in the homeostasis model assessment ratio, [HOMA-R values, an indicator of insulin resistance]). The study formulation was well tolerated, with no significant safety signals reported.30 Although larger trials in a broader study population are needed, these data suggest that consumable collagen peptides should be further studied as a possible intervention to manage illnesses related to the accumulation of AGEs.
Lastly, vitamin supplements (eg, vitamins B6, C, D, E) can also target the process of glycation since they can scavenge free radicals, preventing the generation of reactive intermediates involved in forming AGEs.1,15,31,32
Clinical Pearls From the Physician
Remember, it is important to counsel your patients on how to make their skin look healthier and protect it from external factors that may enhance the metabolism of AGEs and their toxic accumulation. Important lifestyle modifications include increasing the consumption of fruits and vegetables that are enriched with antioxidants and refraining from eating foods that are high in sugar, baked, fried, or roasted.37 Patients should also refrain from smoking and excess alcohol consumption.36,37 Incorporating a daily supplement that contains vitamins C, D, and E into one's daily regimen may also help maintain skin health, as these nutrients can aid in building a line of defense against AGEs and associated oxidative stress.32 Patients may also consider applying a daily moisturizer cream, sunscreen, or facial foundation to shield them from the unwanted effects of UV rays and pollutants (eg, aerosolized nanoparticles).38 Lastly, for patients who use makeup, using colored cosmetics that contain talc, kaolin, or oxide-based compounds (eg, titanium oxide, iron oxide) is advised.39,40 This is important as it can provide an additional layer of skin protection against the effects of environmental insults that cause glycation and speed up the aging process.
Remember, it is important to counsel your patients on how to make their skin look healthier and protect it from external factors that may enhance the metabolism of AGEs and their toxic accumulation. Important lifestyle modifications include increasing the consumption of fruits and vegetables that are enriched with antioxidants and refraining from eating foods that are high in sugar, baked, fried, or roasted.37 Patients should also refrain from smoking and excess alcohol consumption.36,37 Incorporating a daily supplement that contains vitamins C, D, and E into one's daily regimen may also help maintain skin health, as these nutrients can aid in building a line of defense against AGEs and associated oxidative stress.32 Patients may also consider applying a daily moisturizer cream, sunscreen, or facial foundation to shield them from the unwanted effects of UV rays and pollutants (eg, aerosolized nanoparticles).38 Lastly, for patients who use makeup, using colored cosmetics that contain talc, kaolin, or oxide-based compounds (eg, titanium oxide, iron oxide) is advised.39,40 This is important as it can provide an additional layer of skin protection against the effects of environmental insults that cause glycation and speed up the aging process.
