Doctor's Note

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  • Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. Be sure to check out other videos on aging. And there are 1,449 subjects covered in the rest of my videos–please feel free to explore them!

    • eggfarmer

      Dr. Greger,

      Firstly regarding AGE’s, most studies discuss forms of cooking (frying, roasting, boiling etc.) but make no mention of the impact microwaving has on AGE production?
      Could you illuminate us please? Also in an unrelated area, how do you feel about Evista vs.bisphophonates for early osteoporosis in the spine and as a means to slow down ostepenia in the hip?

      • DrDons

        The glycation reaction of sugar with a protein or fat occurs above 120 degrees. So microwaving food should also yield AGE’s. Cooking provides many benefits but varies from type to type see: for information. I don’t recommend any medications for osteopenia and only in isolated cases for osteoporosis. I would read the articles written by John McDougall MD in his newsletters especially the October 2004 newsletter.Got to his website, click on the Read More link under Hot Topics and click on Osteoporosis to see a list of these newsletters. Dr. Amy Lanou wrote an excellent easy to read and thorough book, Building Bone Vitality, for people concerned about bone health. I would recommend that you read that as well. Her conclusion about animal protein is not supported by the meta analysis reviewed by Dr. Greger: What is clear is that regular weight bearing exercise and good nutrition are important. I recommend a plant based diet along with weight bearing exercise. Getting repeat testing periodically to monitor BMD helps sort out this issue. It is important to work with your physician in weighing the benefits and risks of non pharmacologic approaches vs biphosphonates, estrogen and/or thiazide diuretics.

  • ebaker0460_98

    Can you offer any guidance for vegans and vegetarians. I just perused “Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet”. (URIBARRI, Journal American Dietetic Association June 2010 Volume 110 Number 6) With the exceptions of whole wheat bread and some olive oil, vegans do not eat the foods listed.

    • vegimator
      • Jordan Bray

        Is it okay and effective to take taurine for regular vegans just trying to minimize AGE’s? I mean these articles seem to recommend it for patients with renal failure, not particularly for every vegetarian/vegan. Perhaps a new study will give us better insight soon!

        • Yeah, that first link says:
          “Thus, a taurine supplemented low-fat vegan diet may be recommended as a strategy for minimizing AGE-mediated complications in diabetics and in patients with renal failure.”

          I don’t know how this applies to those who aren’t diabetic or have renal failure. Maybe the full text explains more but that costs money to read.

  • Are AGEs a specific type of free radical, or are they a totally different type of toxin?

  • organicsauce

    I have a question regarding the use of hydrogen peroxide internally. I’m not finding much information on the subject and I have a family member who’s looking into it based on some (limited) online research. Thoughts and feedback would be apprecaited.

    • Michael Greger M.D.

      Yikes! Hydrogen peroxide should never be taken internally. It can cause irritation of the gastrointestinal tract with nausea, vomiting, and foaming at the mouth (the foam may obstruct the respiratory tract or result in pulmonary aspiration). Within minutes of ingestion, confusion, coma, convulsions, cyanosis and cardiorespiratory arrest may ensue. Oxygen gas embolism in the brain may cause a stroke even after just a few sips. Most problems occur at concentrations >10%, but even dilute solutions can be toxic. If your family member wants to oxygenate their blood they should try exercising.

  • squidey

    What do you make of the study showing vegetarians had higher levels of AGEs? Im assuming they were unlikely to be consuming more AGEs in the diet so what is the likely cause? Could low carnosine be the issue? I think the researchers attributed it to higher honey (fructose) consumption.

    • vegimator

      This comment made me do some googling and you’re right. Veg*ns do have higher AGE levels according to several studies. Apparently taurine powerfully works against glycation so it’s probably not a bad idea to take 150-400 mg of taurine a day. I linked above to some relevant research.

      Note: I’m not a doctor.

    • The one study that found higher levels in vegetarians appears to have been a fluke. A larger study performed by the same research group (90 vegetarians compared to the original 19) did not find significantly higher AGE levels. McCarty’s hypothesis paper
      about taurine was published before the new data came out.

      • sf_jeff

        Disappointing… I was hoping vegetarians would have significantly lower levels. I wonder where they get the AGE intake.

      • Dr V

        Thrilled to see your point about the 2006 study and, as a PhD holder myself am impressed by your professionalism with research by others.

  • chewy

    are there AGES found in baked potatoes,air popped popcorn,plain puffed 100% whole grain brown rice cakes?

  • ebaker0460_98

    I have reviewed the tables at the back of the paper. The authors have included AGEs from a number of foods, albeit not enough that most followers of your posts probably eat.

  • LXB

    Let us make it practical: Where is a list of the foods that contain loads of AGEs? Without that your video is just futile…

    • Michael Greger M.D.

      Please click on the NEXT UP video above, to get the next video in the series (Avoiding a sugary grave) which does exactly that.

  • Sofia1

    Hello Dr.Greger. I am interested in finding the linkeage between A.G.E.s and male infertility. I hypothesise that the linkeage is probably O.S. (oxidative stress), R.O.S.(reactive oxygen species) and DNA fragmentation. But it is something I have to find evidence and the way it is happening. On the other hand, after watching a lot of your videos, I wonder whether the diet intake plays a second role or even the first role between A.G.E.s and male infertility. I would appreciate any kind of help. Thank you. (Excuse me for my rusty english)

  • At 1:00 this video claims there’s little we can do about endogenous AGE production (much from the methylglyoxal produced during normal glycolysis),


    We have an enzyme to deal with it, lactoylglutathione lyase (or Glyoxselase I), a transcriptional switch in Nrf2 (PMID: 22188542) which happens to turn on a bunch of protective enzymes including Glyoxselase I, and a common food chemical that induces the Nrf2 switch, sulforaphane (many citations, can’t find the original discovery).

    Where can we find sulforaphane? All of the cruciferous vegetables, from broccoli to wasabi, include the glucosinolate precursors converted to sulforaphane upon chewing. It appears cabbage has the highest sulforaphane content among cruciferous vegetables (sorry, kale)

    (see Farag et al. “Sulforaphane composition, cytotoxic and antioxidant activity of crucifer vegetables”. 2010).,

    • sf_jeff

      Thanks! Good to know.

    • drflora3rd

      Only upon chewing cruciferous veggies, or is it converted also upon blending,juicing or krauting?

  • Big Broccoli

    What are your thoughts on vegans/vegetarians supplementing with low to moderate doses of synthetic taurine and carnosine (or its precursor, beta-alanine) for the sole purpose of reducing endogenous advanced glycation end product creation and development?

    I know you generally don’t recommend supplements and that they can sometimes cause more harm than good, but these two amino acids can only be found in animals, so it seems there is no whole foods way to obtain the seemingly beneficial effects of carnosine and taurine for a vegan.

    I’m also particularly concerned because of the recent news that carnitine and choline are digested into TMAO. Perhaps I’m a bit paranoid that maybe taurine, carnosine, or creatine may have similar processes as carnitine that I don’t know about since they are all animal-based amino acids. By that same logic, would supplementing with carnosine and taurine continue to promote colonies of animal protein-consuming gut bacteria that I’m trying to eliminate by switching to a plant-based diet?


    • Our bodies make taurine and carnosine. The side-effects or potential harms with carnosine (or beta-alanine) supplementation seem to outweigh any potential benefit. Taurine supplementation doesn’t seem to have any side effects or potential harms (that I can find), so that would most likely be just a case of wasted money if our bodies are producing all we need. I also wonder about the TMAO thing since that was just discovered.

      • Puffy

        It’s carnitine that leads to TMAO, not carnosine.

        • Unless there is evidence that carnosine doesn’t cause TMAO, we can’t be sure. Besides, carnosine may increase your risk for cancer due to it’s effect on telomeres. I’m taking the safer route of trusting my body to make the correct amount of carnosine (and taurine, carnitine, creatine, etc) from other amino acids found in plant foods.

  • Dawn

    If you have Osteoporosis, is it better to not take medication like Fosomax and instead treat the bone weakness with plant based high calcium foods and exercise? I am taking the medication, but don’t like the side effects. Isn’t plant based nutrition and exercise a better and more effective remedy for Osteoporosis?

    • drflora3rd

      Please read the book Biological Transmutation by Dr. Kirvran or the chapter in The Secret Life of Plants about Biological Transmutation by Christopher Bird for the understanding about potassium, magnesium and silica-containing foods interacting with hydrogen, oxygen and carbon and turning into our bones’ calcium. The supplemental calcium or the foods high in calcium do not help our bone density and has never been known to approach a human bone; this element calcium lines the myelin sheath of our nerves and makes us feel more peaceful.

    • Thea

      Dawn: Have you read the book, “Building Bone Vitality: A Revolutionary diet plan to prevent bone loss and reverse osteoporosis?” It’s a great book, with a ton of science to back it up. It’s a quick read and focuses mainly on the benefits of a plant based diet – with details on what to focus on. It even has some recipes and menu plans. And a chapter addressing drugs.–Without/dp/0071600191/ref=sr_1_1_twi_1?s=books&ie=UTF8&qid=1424294474&sr=1-1&keywords=building+bone+vitality

      I’m not a doctor and can’t even begin to address the drug question. But I think this would be just the book for you to help you make some informed decisions.

      Hope that helps.

  • why some people have wounds that are not healing long time?

  • Are high pressure cooked beans high in AGEs?

  • Hendrik

    On the topic of the internally produced AGEs, it seems that fructose is much more effective than glucose in creating AGEs – see the link at
    Should we worry about how much fruit we eat in one sitting?