Is Your Medication Aging You? Discussing Medicated Malnourishment with Mike Wakeman

Part 1, this conversation is split into two episodes, more on weight loss medication next week. 

Discover how medications influence micronutrient status, the impact of polyphenols on aging, and innovative approaches to long-term health and skin vitality in this engaging interview. Mike Wakeman shares his extensive research on natural compounds, evidence-based nutrition, and cutting-edge products designed to support longevity and well-being. 

This episode highlights the importance of considering the biological impacts of medications, lifestyle, and diet on aging and chronic disease. Mike Wakeman advocates for personalized, evidence-based supplement strategies, emphasizing natural compounds like polyphenols and innovative skin measuring techniques. Stay tuned for upcoming research on skin health and longevity products.

Key topics:

• How medications alter micronutrient levels, especially in aging populations
• Evidence-based insights into essential fatty acids and their source quality
• The role of advanced glycation end products (AGEs) in aging and chronic diseases
• Polyphenols in fruits and vegetables: their impacts on health and aging
• Innovations in skin health: anti-AGE compounds and skin fluorescence technology
• The influence of diet, lifestyle, and supplements in menopause and hormonal health

Timestamps:

• 00:00 - Introduction to Mike Wakeman’s background in nutrition and research
• 02:18 - Transition from pharmaceutical industry to evidence-based nutritional research
• 05:05 - The impact of medications on micronutrient deficiencies across populations
• 09:01 - The effect of chronic conditions like diabetes on B12 and other nutrient levels
• 12:20 - The role of AGEs in aging, chronic disease, and skin deterioration
• 16:12 - The significance of polyphenols: sourcing, organic vs non-organic, and their health benefits
• 19:23 - Technology to measure AGEs in skin and ongoing research in skin health
• 21:46 - Collagen supplements: marine vs bovine, effectiveness, and vitamin C synergy
• 25:00 - The chemistry of AGE formation: the Mallard reaction in food and body

Mike Wakeman is the researcher, pharmacist and the brains behind https://everanutrition.co.uk/

Connect with Mike Wakeman:

• LinkedIn

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Instagram: @montecarlotomarlow
YouTube: https://www.youtube.com/channel/UCwVSEldi1G2_w_mgaGkFmJA

Transcript

SPEAKER_01 0:07

Hello, welcome to Monte Carlo Tomalo. Welcome, Mike, to Monte Carlo Tomalo. We've just been having a chat pre-the recording, which I felt like we should have been recording, so we're we're gonna go. So can you introduce yourself and talk about where you started and how your career has evolved into what you're doing now? Briefly, because we'll touch upon everything in a bit more detail, but just do an introduction to yourself.

SPEAKER_00 0:34

Well, yeah. Hi, Krista, and thank you very much for inviting me on the program. So, yeah, my background is I started in pharmacy. Um, I was not really happy working in community pharmacy, so I moved into industry working for Glaxo, um, a division of Glaxo uh in sales and marketing. And to be quite honest, I found that quite dispiriting because I could see the amount of money that was being blown on advertising and promotion, you know, getting the more people to take more drugs type of thing. That's a very over, that's a very simple oversimplification of the situation. But it was disgraceful the amount of money that was being blown. And I I just happened across a company that was doing essential fatty acid research and moved in into that company, which was doing uh essential fatty acid research into omega-3s and omega-6s. One of the people that I was so fortunate enough to be a part of to work with was a guy called Professor David Horrobin, who is like a research leader is way before his time in terms of essential fatty acid research. And he managed to convince the Nobel laureate, um, Professor Sir James Black to come onto our board. So I think I'm probably the only person within the, or one of the few people within the industry that can actually say, I've worked alongside a Nobel laureate who was researching natural products. Sir James Black developed beta blockers, he developed H2 antagonists, he was responsible for a phenomenal amount of wealth within the pharmaceutical industry. He was really interested in essential fatty acids. So from there I started to look at evidence-based um, so we ended up taking nutritional supplements from being nutritional supplements to being lysis medicines uh for atopic eczema for premenstrual breast pain and for a number of uh conditions um within the UK. So there were prescription medicines that could be prescribed by doctors, and that really made me very interested in this evidence-based nutrition. I hate to use that as a term, but it was evidence-based nutrition because it proved that by supplementation you could have an effect, a beneficial effect, on conditions that at that time there was no treatment for. So, and that's where I started looking at um, like I say, evidence-based nutrition. And one of the first areas, and it was I was always looking for, well, there's that that's that bit done. What's the next bit? And there's always this, yeah, but yeah, there's no evidence that vitamin supplements supplementation has a beneficial effect. And then I've been working, looking at various areas, and it's like, what is the unequivocal areas that you do need supplementation in? So I looked at bariatric surgery, and people who've had bariatric surgery do need vitamin and mineral supplementation, and then I was investigating this and put together protocols around vitamin B, you know, all that sort of thing. And I came across this paper, a 2013 paper, that was um the impact that medication, it was by two Greek uh researchers, and it was something like the impact that um medications have upon micronutrients, story rarely told. And so I I I read the paper, then I went into the read it, then I went into the reference. It was like peeling an onion. The more I went into the the references, the more references I found that demonstrated that medications had an impact upon your micronutrient status. And obviously, in today's environment, more people are taking more medications. You know, they're not taking one or two, and as you get older, you take more medications. I was on the first intake in the on the master's in nutritional medicine uh down at Suring. And at that time, it was all about diet, diet, diet, and they were very anti-supplements. But I always remember the one thing, the one thing that I came away from the whole of the course was if you want to stay healthy in your old age, keep your teeth because they need everything that you need to eat. The thing is that obviously, as people age, their their diet gets worse because they do lose their teeth, they they don't improve their own.

SPEAKER_01 4:53

Yeah, they're on a soup diet.

SPEAKER_00 4:55

Exactly. And so basically, they're on these medications where their micronutrient intake is as a deficit, or there may even be a deficiency. And the more the more medications that they're on very often, the the greater that deficit can become. So that's where I got involved with that, and I published my I'm not published, I'm not promoting my book, but that's medicated malnourishment.

SPEAKER_01 5:20

Medicated malnourishment. We'll do a link to it though.

SPEAKER_00 5:23

Yeah, no, you can't, but at the moment, it's it's not a good thing. You can't get it anywhere.

SPEAKER_01 5:27

Okay, we just have to listen to you then get your own.

SPEAKER_00 5:29

So basically that was the whole rationale. So I from that looked at I developed an algorithm which looked at establishing people's micronutrient intake from the diet, and then the algorithm was able to it consisted of all the drugs in the BNF, all the drugs in the OTC drugs, and basically looked at the impact that um medications had upon micronutrient status, and then the algorithm added all those up and came out with a recommendation about changes to um to diet and where where necessary supplements are.

SPEAKER_01 6:04

And was this across the board? Would it be the same for male and female? Because there's so many studies that are made.

SPEAKER_00 6:09

It's very difficult to be able to differentiate because obviously in clinical trials, um, it's it's an amorphous mass of people, they say X amount of females, X amount of males, and they don't differentiate between the two. But that's sort of and one of the areas that I became particularly interested in was diabetes. Uh, I published this what it's been highly referenced a number of times now, looking at the impact that things like um proton pump inhibitors and metformin had upon things like vitamin B12. So within 12 months of taking that combination, a person can become vitamin B12 deficient, which because they're diabetic, a clinician interprets as being diabetic neuropathy, whereas in fact, it's a neuropathy that's a vitamin B12 deficiency that can quite easily be corrected by giving people.

SPEAKER_01 7:02

I was gonna say, is it as easy as taking that supplement or doubling it?

SPEAKER_00 7:07

I mean, is it absolutely and the the recommendations when I was looking at the bariatric surgery area, it's you need vitamin B12 um injections, which is obviously time consuming, it's painful, and it's costly. And I did a review that said, no, you don't. You can if you take a high enough dose of vitamin B12 as a supplement, you don't need to do that. So that was part and parcel of it. And since then I've been really interested in diabetes, and one of the areas that I stumbled across, a bit like I was saying about the Greek publication, was advanced glycation end products. Um, they're called AGES. Um, and they're particularly prevalent in diabetes and in other chronic conditions. And these compounds are formed when carbohydrates and proteins and fats and things like that combine together. So it's it's a non-enzymatic reaction, so it's going to happen anyway. But when you're having ultra-processed foods, it's temperature dependent, so you can imagine high levels of these compounds are being produced in ultra-processed foods. But when you consume foods that are high in carbohydrates and proteins, especially sugar, then you end up with lots of these AGES compounds in your body. And the classic AGES compound is HBA1, which, as you know, is a compound that is used to measure people's blood glucose levels in diabetics. The reason that that is used as a measure is because it's an extremely long-lived compound. You probably remember used to when people were looking at diabetics, they have to take these glucose drinks and then have their blood sugar levels monitored on a basis. But because this level because it's so long-lived, they basically um are a really good measure of the intake of carbohydrates, things like sugar and proteins. Um they're very long-lived. There's a whole host of them. It isn't just HBA1C, but there's a whole host of other compounds, these Ages compounds, and they're particularly involved in terms of chronic conditions like diabetes. So the higher the levels of these compounds in chronic conditions, it isn't just diabetes, it's coronary heart disease, it's even things like um in the lenses, cataracts and things like anything that's a long-lived molecule in the body, these ages like are attracted to, especially collagen. So that's sort of that's that's an area that I've been interested in for some time. And ages do what they say, they age you, basically. High levels of age.

SPEAKER_01 9:50

That's what it says on the tin. But exactly that um we were talking earlier because I said, Oh, let's try and focus on some subjects today, because we could talk for hours, but obviously the it led you to look at the the beauty supplement that you're that you make with your range um on a much broader scale than probably most other beauty supplements are even uh considering.

SPEAKER_00 10:17

Yeah, and I'm not like don't need a neck braid. No, you should patting myself on the back too much. But basically, the more I looked into these ages, the more I realized that they were associated with chronic disease. And as I said, in diabetes, people who have higher levels of ages tend to have higher levels of complications of diabetes, like leg ulcers and all the rest of it. So they are associated with worse outcomes in chronic diseases. So two or three ways that you can reduce the levels of AGES that in your body. One is to stop eating ultra-processed foods because they're high in them, but they are long-lived molecules, and as you age, they do tend to be retained in the body around. They do. And the other side of it is this is even better than the AGES acronym. In all cells, there's a receptor for AGE, and they're called rages, receptors for advanced glycation end products, and they do exactly what so if ages do what they say on the tin, rages do even more so on the tin. So when Ages interact with rages within the cell, they are responsible for creating a really inflammatory process. They they are the ages detrimental to health, but also within cells, they cause a lot of damage within cells. So they they you know they're not helpful. The other thing about ages that you and this comes back to the the beauty concept. The other thing when I was looking at it, I said ages love collagen, and collagen is a long-lived molecule. So if you think about in your skin, um you've got lots of collagen systems in the body, like veins, anything that's got lots of collagen in, they love it. And what happens is, especially in the skin where you've got bands of collagen, the ages form bonds between the bands of collagen. So whereas normally your collagen would slowly be replaced, what happens is that the the ages form these bonds and they make it very difficult for the collagen to be replaced in your skin.

SPEAKER_01 12:27

But it's frightening, Mike. What can we do to get rid of the ages?

SPEAKER_00 12:30

So basically, well, this like I said, you can reduce the the compounds, uh, the the levels of these compounds that you eat. The other thing is that you can a lot of um polyphenols, and this is the other area that um you you asking me to talk about. I've done a lot of research on polyphenols, and you were saying about how what we eat today isn't what we think we're eating. And polyphenols are a group of compounds that basically are expressed in fruits and vegetables, and they're there to protect the fruits and vegetables from attack from fungus, from bacteria, from UV radiation. They're bright, they tend to be brightly coloured, so they're anthocyanine. So if you think of a brightly coloured fruit or whatever, then that that's full of polyphenols. And I did some research a number of years ago. Obviously, the food that we eat now, if we're not eating organic food, heavily it has fungicides, it has pesticides, it has all the things in it that in in that that are being applied to the food that prevent the apples or whatever it might be that we're eating. So, what happens with these polyphenols is that they have to the the fruit or the vegetables have to be stressed in order to produce them. So if you're protecting the fruit or the vegetables from the stresses that would normally be produced to protect the fruit or the vegetables from being produced, then they're not going to be there in the fruit. So I did some research looking at apples, and we looked, we found a heritage orchard that had got all these different varieties of apples. And one of them was from the 13th century, it was unchanged from the 13th century. It was called the Pendragon apple. And what we did was we compared different varieties of apples, uh organic and non-organic, and looked at the levels of these polyphenols that we knew had beneficial effects in terms of health benefits, so like diabetes, cornery heart disease, all the rest of it. And when we looked at organic versus non-organic, there was a significant difference between the organic and the non-organic. There was a lot less in the non-organic compared to the organic. When we looked at this apple from the 13th century, which and the other thing is these compounds tend to be bitter. So obviously, the more now we're addicted to sweetness. So the cultivars of fruits and vegetables that we're producing, not only are they being protected from stress by fungicides, pesticides, but we're also producing fruits and vegetables that are less bitter. So this apple from the 13th century, this Pendragon apple, was red on the outside, was red on the inside. And I defy anybody to eat it as an eating apple.

SPEAKER_01 15:19

I've heard of these types of apples before, and also the kind of the whole the idea that you know we the bitter taste like ridiculous and things like that are so good for your gut, and even the minute they touch your tongue and they go into those digestified enzymes, that your body is craving that kind of bitter taste. There's a lot of arguments really about, you know, should you buy organic because it's so expensive. So what you're saying is really, if you can afford it, organic is gonna be giving you a lot more needed.

SPEAKER_00 15:48

The whole thing is, I think not necessarily organic, but just like farm-produced or something like that. You know, that where you know where it comes from. It's a bit like Michael Poling, you know, um in his books, it's like know where it comes from. But it was ironic that I published this paper about a month after the Food Standards Agency had done a review on there's no difference between organic and non-organic. And the only thing that they looked at was vitamins and minerals. They didn't look at the polyphenols, um, which have profound effects in terms of, and that's where I was coming from now, in terms of these ages. So a lot of these polyphenols have an effect in the body. So they will what they will do is they will break down the ages in the skin or wherever it might be, but also they can also prevent the ages from sitting on the receptors for rages, so they can act as almost like a an anti-age as an anti-age blocker. Um, so they they have a number of effects. And the interesting thing is, and this is a study that I'm now now that we've got the product on available for for sale, is the next study that I'm going to do to publish quite a lot on skin, um, looking at things like ingredients. So I did a study on krill oil, looking at things like skin elasticity, uh, trans epidermal water loss, hydration. And nobody had looked at essential fatty acids in skin before, but they demonstrated that they had a beneficial effect. So, what I want to do with the um product that I put together, which has got these anti-ages polyphenols in, is not only look at those parameters, but the most interesting thing about ages is, and this is another one that I love, is that they they fluoresce and because they accumulate in the skin, there's some guys in Holland that have developed a piece of uh technology that if you shine light of the right wavelength onto the skin, you can measure the amount of ages that a person has in their body. So when we when we do the study, which I'm about I'm going over to see the guy who I'm gonna be working with on the study tomorrow, in fact, is we'll look at the parameters that I've just described, which is the classic parameters that everybody always looks at, collagen supplementation. But none of the other products that I've developed or that are on the market, I should say, have got this anti-agis component to it. So what I want to do is look at not only the improvement in skin function, which I know is going to happen because of the ingredients we've got in there, but demonstrate that we have a physiological benefit in terms of reducing these levels of age in the skin, um, which should mean that people's skin looks help looks younger as as well. I'm really excited about that, and it's something that that I'm particularly interested in, but also I think has and and I'm not just looking here at beauty, but I'm thinking about other long-term chronic conditions where ages are implicated. So, as I said, you know, there's a like with coronary heart disease, and they're implicated everywhere you look. I've I've I've done a lot of research into these compounds. Everywhere you look, a lot of chronic endometriosis, PCOS, and I'm not saying that they're they're causative, but there's association between these conditions and high levels of ages because they they're so inflammatory. Yeah.

SPEAKER_01 19:15

Before we move on, I just wanted to go back to just quickly collagen when we were talking obviously about collagen in the skin. What do you think about collagen supplements?

SPEAKER_00 19:25

The the whole thing about collagen is it's it's become a price war at the moment, and people aren't necessarily that selective in terms of the collagen that they use. So you need to use the my the right molecular weight of dipeptides and tripeptides. Um, and if you've got that right, then there's there's also a heat to say, but I think that people will be using things like gelatin in there and stuff like that, you know.

SPEAKER_01 19:50

Well, what about the powder ones? Where do you have a a marine versus bovine preference?

SPEAKER_00 19:56

So the the thing is that with the marine and the bovine, they're different uh classes of collagen. So I I've combined marine and uh bovine together. Yeah because in the skin you don't just get one type of collagen, a type one or a type three, you get various versions of the collagen. So I think by combining the two together, it's and nobody knows what the right ratio is of one to the other.

SPEAKER_01 20:22

And what about taking vitamin C with the collagen? So the body is.

SPEAKER_00 20:27

Yeah, so we've I incorporated vitamin C in our product because obviously there's good evidence. I mean, there's an EFSA claim about vitamin C and collagen, not just in the skin, in bones and things like that. Um, um, so basically, yeah, and and we've got other micronutrients in there that are going to regulate collagen production. Um, so it's about providing, not just about which which is what most collagen products do containing hyaluronic acid, collagen, vitamin C, and all the rest of it. This whole thing about addressing the ages is really important. And I was gonna say the other thing about ages is, and this is a hot topic at the moment, is these zombie cells, senescence, where cells don't die. And one of the things that is responsible for producing senescence is this inflammation that I described about in the ages, they induce sed, they induce cells to become senescent. So they sit there and they would normally disappear, you know, the body would normally get rid of them, but they it's almost like they've got a protective shield around them. But that protective shield not only prevents them from being removed from the body, but they also produce um inflammatory compounds as well, things like inflammatory cytokine.

SPEAKER_01 21:46

But the ages are awful.

SPEAKER_00 21:48

They are, and and and that's one of the reasons, you know, the Chris Van Tulligan book and all the rest of it, talking about ultra processed foods. I think that this is one of the areas that they're missing. It isn't just about Oh, there's fibre removed from it, there's this, that, and the other. It's they're they're really high in these types of compounds. Um, and that's my next book.

SPEAKER_01 22:10

Well no, it yeah, it's fascinating. I mean, is there because obviously, you know, they are really the bad guy here. And you've said about if you're eating processed foods, what if you're eating a pretty balanced, good diet? Are you have you got less of them in your are they you tend to have less of them, yeah.

SPEAKER_00 22:27

I mean, yeah, it's I mean the the classic, I always say the classic age is it's called the mallard reaction, the the the the reaction that produces it happens, it's heat orientated, but it's happening in your body. If you've got lots of sugar in your diet, you're gonna have high levels of HBA1C, you're gonna have other compounds which are detrimental as well. So the classic mallard reaction is toast. When you put bread into a toaster and it goes brown, everybody thinks, oh, the toast is burning. It isn't, it's the heat which is causing this reaction to occur, where the sugar and the this is the mallard, it's called a browning reaction. It's where the sugar and the proteins in the bread actually uh produce these these age compounds, and those are the those are the compounds. So when you uh fry anything or grill anything or anything like that, there's a mixture of that's got high levels of sugar and and protein in it, then you're getting ages in there.

SPEAKER_01 23:24

So I'm not saying don't eat toast, but that's a classic example of so are you saying that um a raw food diet is is a pretty healthy.

SPEAKER_00 23:31

It's going to have less ages in, absolutely. Yeah, yeah. Um you know, things like steaming vegetables is going to reduce it as well. The problem is, I mean, you know, these compounds are so flavorsome, it makes I'm not saying don't eat, no, don't have a steak and don't do this, but moderation like try especially as I said, I I do believe that ultra processed foods are the most likely source in an unhealthy diet of ages compounds compared to a healthy diet.

SPEAKER_01 24:05

Yeah, interesting.