High Fat, High Sugar Diet Linked to Increased Fracture Risk

Peer Reviewed

Chronic consumption of a diet high in advanced glycation end-products (AGEs)—produced by sugar and fats cooked at high temperatures with dry heat (grilled, roasted, fried, or baked)—can negatively affect spinal health and vertebral quality, in addition to increasing the risk for other comorbidities including diabetes and osteoarthritis, according to findings published online ahead of print in the Journal of Bone and Mineral Research. These effects were primarily found in young female mice.
Domestic rat in a cage eating a cookie“Basic science studies on mice suggest a possible link between spinal degeneration, type 2 diabetes, and diets high in AGEs". Photo Source:123RF.com.“Our data suggest that mice fed low AGE diets have lower vertebral fracture risk and improved vertebral mechanical properties than mice fed high AGE diets,” explained principal investigator James Iatridis, PhD, Professor and Vice Chair for Research in the Department of Orthopaedics at the Icahn School of Medicine at Mount Sinai in New York City.

The clinical implications of these findings are that “Mediterranean diets or other more healthful diets that are low in AGEs are likely to promote a healthier spine, as well as being healthier in general,” Dr. Iatridis said.

The Link Between AGEs and Spinal Degeneration

“Basic science studies on mice suggest a possible link between spinal degeneration, type 2 diabetes, and diets high in AGEs, yet no definitive link or causal mechanism had been demonstrated,” explained Dr. Iatridis, PhD.

In addition to a poor diet, AGE accumulation in bone and serum also occurs with aging and is considered a potential cause of vertebral fractures in older men and women and is correlated with osteoporosis, according to the researchers.

In the present study, Dr. Iatridis and colleagues examined the effects of a high versus low AGE diet in female and male mice at 6 and 18 months of age. Multiple measurements of bone structure and function were taken.

Negative effects of a high AGE diet were found in 6-month-old female mice but not in young male mice. These effects included AGE accumulation in serum and cortical vertebrae, changes in bone mechanical structure and mechanics (eg, reduced trabecular bone mineral density and bone mineral fraction), reduced maximum load to failure, and reduced compressive and shear moduli, total fluorescent AGE accumulation, inferior vertebral microstructure, and mechanical properties. At 18-months, aging dominated the dietary effects of AGEs in both male and female mice; however, the high AGE groups (both male and female) showed significantly reduced cortical bone mineral density, reduced maximum strain and area under the curve, and the lowest mean values for shear and compressive moduli.

Can Drugs Block the Effects of AGEs on Vertebral Degeneration?

“Our prior studies have shown diabetic conditions in mice, that include high AGE accumulation in the spine, also result in poor vertebral quality and disc degeneration and can be at partially mitigated with anti-AGE and anti-inflammatory drugs. Eventual drug treatment is very possible since these drugs are already FDA-approved for other indications," Dr. Iatridis explained. "However, this research identified risk factors, and future studies are required to identify mechanisms for these effects, relevant patient selection criteria, and treatment options.

"Therefore, at this point we can only recommend improved diet and/or very safe therapeutics to be used as preventative measures for spinal pathologies,” Dr. Iatridis said.

Future Research

“We have recently initiated mechanistic studies to identify if AGE accumulation acts on the cells in the spine to create a catabolic shift, so that we can be more targeted about potential safe drug interventions to promote spinal health and to inhibit degeneration,” Dr. Iatridis explained. The researchers are specifically investigating how high AGE diets influence intervertebral disc degeneration and disc function. “We hope to present results from this study in 1-2 years,” he said.

This current study was funded by the NIH without any other relevant disclosures, Dr. Iatridis told SpineUniverse. “This NIH-funded study is part of a larger body of studies investigating how diet and diabetes influence spinal health and spinal surgery complications as ways to promote spinal health, to identify novel treatments for spinal pathologies, and to prevent musculoskeletal co-morbidities associated with diabetes,” he said.

Dr. Iatridis has no relevant disclosures.

Updated on: 09/03/19
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James C. Iatridis , PhD
Professor & Vice Chair for Research Leni and Peter W May Department of Orthopaedics Incahn School of Medicine at Mount Sinai

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