Collagen and high blood sugars are a bad combination.

Many people are concerned about the collagen in their skin and therefore supplement collagen hydrolysates that, over time, reduce skin wrinkles by increasing dermal collagen. There is also good evidence that increased collagen intake also improves joint health by promoting cartilage growth and increasing joint lubrication (glycosaminoglycans). Over the past five years, the evidence has become overwhelming: increased collagen intake does indeed improve skin, joint, and bone health. Because collagen is a structural tissue in the cornea, blood vessels, teeth, and cartilaginous discs between vertebra, collagen intake also influences the health of these structures. In short, collagen is an abundant and crucial protein in the human body.

But there is another dimension to collagen that is not often talked about: how collagen, a long chain of amino acids enriched in glycine, proline, and hydroxyproline, is susceptible to the process of glycation, i.e., glucose modification of proteins. All this means is that whenever blood and tissue levels of glucose (blood sugar) rises above 90 mg/dl, an irreversible reaction between glucose and collagen proteins take place. Increased glycation of collagen protein has been associated with:

  • Accelerated aging of skin
  • Accelerated brittleness in cartilage such as in knees, hips, and spine
  • Increased bone fragility that disrupts bone’s ability to dissipate stress, increasing potential for fracture. This is especially concerning when combined with osteoporosis.
  • Increased stiffness of arteries such as the aorta, a contributor to hypertension
  • Increased heart muscle stiffness, so-called left ventricular diastolic dysfunction that can result in a form of congestive heart failure
  • Impairs the immune response (reduced migration of T-cell lymphocytes into a skin wound, for instance)
  • Increased potential for skin aging, bone fragility, retinopathy, kidney disease, and other complications of diabetes

People with type 2 diabetes who experience prolonged and repetitive levels of high blood glucose are therefore exposed to massive acceleration of these phenomena succumbing, for instance, to accelerated skin aging, arthritis, bone fractures, hypertension, atherosclerosis, congestive heart failure, and kidney disease years, even decades, before non-diabetics.

And, by the way, several other sugars are also capable of glycating collagen, including fructose and ribose. Anyone consuming a lot of fructose, e.g., in soft drinks, or ribose to “treat” congestive heart failure or other conditions, needs to be aware that you are also accelerating the phenomena of glycation and aging.

Everything that we do in the Wheat Belly and Undoctored lifestyles must conform to the idea that we are replacing or correcting something in modern life that leads to the emergence of various health conditions. Before we began supplementing collagen hydrolysates, in previous times humans consumed the organs of animals, ate the skin, were more likely to gnaw on the tissues close to bone, then boil the bones, tendons, and ligaments to make soup—all sources rich in collagen. Modern collagen hydrolysates are therefore a convenience for most people who don’t eat organs, skin, or take advantage of bones, tendons, or ligaments. Likewise, people living as hunter-gatherers not relying on grains and processed foods overladen with sugar did not experience high blood sugars that caused collagen glycation.

The conventional medical “solutions” to the consequences of collagen glycation are to therefore inject skin fillers, surgically replace damaged joints, manage hypertension, etc. and to focus on developing pharmaceutical blockers of collagen glycation. Instead, I believe a better way to manage collagen and collagen glycation is to:

  • Not allow blood glucose to rise—In other words, avoid foods like wheat, grains, and sugars that raise blood sugar, thereby minimizing collagen glycation
  • Normalize insulin resistance—Addressing nutrient deficiencies common to modern people, especially magnesium, omega-3 fatty acids, and vitamin D, reduce insulin resistance that leads to lower blood sugars and less collagen glycation
  • Obtain plentiful collagen by eating the skin on chicken and fish, never buying skinless or boneless meats, slow-cooking tough cuts of meat to release connective tissue, etc. Supplementing collagen hydrolysates can be used as a convenience to augment intake.

And, while it does not address glycation, our L. reuteri yogurt that, via oxytocin, dramatically increases dermal collagen and, in preliminary evidence, stimulates collagen deposition in joint cartilage, adds additional advantage.