The Dr Louise Newson Podcast - 109 - Looking after your future health with Professor Gordan Lauc

Episode Date: July 27, 2021

Gordan Lauc is a Professor of Biochemistry and Molecular Biology, and the Chief Scientific Officer at GlycanAge. In this episode Dr Louise Newson feeds her inner geek and enjoys a fascinating conversation with Gordan as he describes his groundbreaking research into glycan molecules and their role in aging and disease processes. Even though scientist's understanding of the biological importance of glycans is still developing, ‘glycoscience’ has now become a vital field in life and medical sciences. Aging is the accumulation of damage in your body over time, caused by a long-term over-activation of the immune system. Analysing your body’s glycan molecules is a way of discovering your biological age and helps you know whether your current lifestyle is optimal for good health as you age. It is possible to lower your biological age by changing your diet, exercise, sleep habits and stress levels. Professor Lauc’s top 3 tips: If you’re interested in finding out more about your biological age and future health, you can get a test from www.glycanage.com that uses a pinprick of your blood and analyses your glycans. You can receive a report that will advise you on healthier changes you might need to make to your habits and lifestyle. Don’t be afraid of finding out more about your future health, it can be a very useful warning signal and potential negative changes to disease processes can be halted and reversed. Nourish your health and take care of it. We were not made to live into our 80s or 90s, so invest in your health and do something about it. Do something today for the good of your health tomorrow.   GlycanAge is giving away a 15% discount to our listeners and donating a further 15% to @themenocharity for every test purchased with the code 'NEWSONHEALTH15'.   You can find Gordan Lauc on social media at: Twitter: @gordanlauc LinkedIn: gordanlauc   You can also find GlycanAge on social media at: Instagram: glycanage Twitter: glycanage Website: https://glycanage.com/

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsome, a GP and menopause specialist, and I'm also the founder of the Menopause charity. In addition, I run the Newsome Health Menopause and Well-Being Clinic here in Stratford-upon-Avon. So today I have with me, Professor Gordon Loutf, who is a scientist and researcher who I've been dealing with for a few months now, and I'm absolutely fascinated with his research. Some of you might know that I have an immunology degree as well as a medical degree and I say there is a bit of geekiness in my brain. So welcome, Gordon. It's a real privilege having you here today. Thank you for meditation. It's fun to work with you and talk to you. So just explain to our listeners who you are and what you do and a bit about your

background if that's okay. So I work in a field called glycobiology. So we study glycons and glycans are kind of additions to proteins. So proteins are the molecular robots which do all the work in our body, most of the work in our body. Well, glycons are kind of add-ons to these proteins which make them work better, which regulate them, which control them. And the majority of proteins which appeared in evolution after we became multicellular are actually glycosylated. and the glycans are a fascinating field which has been neglected for a couple of decades because they are structurally very complicated.

So contrary to proteins to DNA which are linear, it's just a sequence of letters. Glycans are branch structures, very complicated. So until maybe a decade ago, it was not easy to analyze them. But now we have tools and we can look into glycans and we can learn what glycans

do in how we can use them to understand biology, to understand why people are different, to understand why people change with time. And this is what I do. This is my fun. My fun are glycans. So just explain how did you get into glycans? Because like you say, lots of people don't know about but even as a scientist, like you said, it's been neglected. But how did you decide to get into it in the beginning? This was 29 years ago. I was. doing my PhD at the time in Germany. And my boss came with a brand new kit developed by the Berger-Mainheim at that moment and say, let's try to use this new kit to look into glycans. These are these new strange modifications which nobody really understand. And I was always

interested for kind of a big challenge, when something is big and unknown. I like to do it. And I stayed in the field for over 30 years now. We did many, many different type analysis. And initially it was difficult because it was a new field. Nobody was understanding what we were doing. They were thinking this is irrelevant. They don't do anything. But maybe for the last 10 or 15 years, this is really a booming field.

And I think now the glyco biology is considered to be one of the last frontiers of science, where we are actually learning how cells communicate, how we communicate with the environment. For example, all pathogens are binding to glycans. Influenza, even the SARS-Cov2 virus, they all bind to glycans, and this is how they get into interaction with us. It's absolutely fascinating,

and I think we very much focus, certainly, as doctors in the end disease sometimes, and then we just focus on treatment of that disease, whereas sometimes in medicine if I get confused or I'm trying to work out what's wrong with a patient, I try and take it back to more of a cellular level and to try and work out what should be going right

and then what goes wrong. And I think it can be really useful because we can get very lost and tied up with symptoms and a treatment. But actually it's what goes wrong in the body and it's not a disease doesn't happen overnight, does it? It's a gradual and it's a multi sort of faceted. You know, even if you think of cancer, for example,

It's not just someone has cancer or they don't. There's lots of hits that can happen, aren't there? And their cells that can change the cells. And even infection, you know, a lot of us have had COVID, but we've had very different responses to COVID. And I'm sure the Blycons have a role in that, don't they? So when we think about disease, so usually we feel some kind of a pain,

something is wrong, something is not functioning. And then we go to a physician and say, you know, save me. Give me a magic pill. I want to be healthy again. But normally, this is already a very late stage. So when you start feeling pain, when there is something really wrong, this means that all the compensatory mechanisms which we have have already failed. And idea of modern medicine would be that we try to detect disease even before it has any visible symptoms. because once there are symptoms, it's very hard to revert everything back to the normal physiology.

So usually what is the main burden today are so-called chronic diseases, and they are called chronic because once you get it, you keep it and you have it and you can't get rid of it, most of the times. And what is fascinating about glycans is that first they contribute to disease developments or changes in glycans help this development disease. and we can see these changes, sometimes even 10 years before the actual diagnosis. For example, in cardiovascular diseases, in diabetes, we can see glycans changing up to a decade before. So kind of a general idea we have at the moment is let's try to identify biomarkers.

We work on glycan biomarkers. Other people work on genetic biomarkers and so on. And you test the healthy person. You do it as a routine checkup. and then you see that these glycans are already moving in a bad direction. And then you can make a relatively simple intervention, maybe a dietary intervention or a lifestyle intervention, kind of sleep little more, don't be under so much stress,

lose these extra few kilos. And what we see then, that actually glycans can improve. And we did a number of studies which showed that actually decision we make now can change our glycans in a way that they will either postpone or even completely prevent development of some diseases. And I think this will have to be the future of medicine globally because nobody is able to pay for the increase in the cost of the healthcare. There is no country in a world which can cope with increasing costs of health care.

So instead of spending more and more money to keeping sick people alive, let's try to invest more money in keeping people healthy for longer and then have this disease period shorter. Yeah, which is so important, isn't it? Because it's all very well living to a certain age, but it's a journey that goes to there. And certainly even a disease such as type 2 diabetes wasn't actually that common when I was a medical student in the 80s and 90s.

And now it's just spiraled out of control. And certainly in the UK and the USA and some of that's related to obesity and dietary changes. And it is reversible, but actually, well, not always, but it often can be reversible. But then it's very hard when people have then got the diagnosis. And you want to just like you say, take a step back and actually you want to be warned what's coming around the corner. and I sort of think of it like when we measure blood pressure, you know, blood pressure isn't a disease, but we're trying to prevent strokes and heart attacks. And since blood pressure treatment is so much better, the incidence of heart disease has come down. But it's quite a crude measurement

doing someone's blood pressure, isn't it? It's not looking so much in. But there's lots of reasons why people have blood pressure. Sometimes, you know, if they smoke, if they eat the wrong things, and they don't exercise, it's overweight. And that's very crude, whereas the glycans are a lot more refined. don't they? Because it's a real biological process that's going on. And first, they also change before the blood pressure goes up. So we can see on a glycans today that the blood pressure, which will probably increase in a couple of years. And one type of glycans, which we mostly focus at the moment, are glycons attached to immunoglobulins. Immunoglobulins or antibodies, these are the main weapons we have

in our immune system. They're attacking all the viruses, bacteria, everything, which is attacking us, and they are regulated by glycans. And when we are young, they have a form of glycons which are suppressing inflammation. But as we are getting older, these glycans change in a way to promote inflammation. We don't know really why this happens. We are trying to understand, but we know that this happens with aging, and we know that in older people, this is starting. to promote inflammation.

And when we think about inflammation, so inflammation is kind of local hard reset. When there is something wrong with our computer, we press a reset button and then everything resets. So inflammation does the same thing locally. Goes to part of a body, kills everything around, and it rebuilds it.

And if this is happening too frequently, on too many locations in our body, we have something which is called low-grade chronic inflammation. We are inflamed all the time, which is wasting huge amount of energy. And that if we can suppress this inflammation, first, people have more energy. And second, all this inflammation is leaving scars. So inflammation is involved in all the cardiometabolic diseases, the heart attack, the stroke, the diabetes, metabolic syndrome.

It's all related to inflammation. And these glycans are actually one of the regulators which suppress inflammation. And for example, there is even a medical treatment where people are given immunoglobulins, which are generally coming from young people, to suppress inflammation. So some of the inflammatory diseases are being treated with immunoglobulins, where you get immunoglobulins from other people. and some people have their own immunoglobulins, which are good, which are suppressing inflammation, while others are more pro-inflammatory.

And this correlates with age, but not perfectly. So there are some people who would be 10, 15, 20 years older in their IgG glycom. So they could be 30, and their immunoglobulins will have glycans like people of 50 years of all. But also the vice versa. There are people who are 60 or 70, and their immunoglobulins are 20 or 30 years, they look 20 or 30 years younger. And we know that these molecules regulate inflammation. And if you can do something to improve your immunoglobulins in a way that they start to suppress inflammation, you're actually helping yourself a lot.

And we did a number of studies showing that even simple things like weight loss can help. So losing weight in most of the people will suppress this inflammatory potential humanoglobulin. Also, some type of exercise, but not every. For example, there is a belief that if you eat too much, you just have to exercise more and then it will be fine, which is very wrong. You cannot sweat out what you eat. And we have shown now many times already that overtraining is also doing damage. So if you think that by going to gym every day, exercising for hours, you can actually fix your problems. This is wrong.

Too much exercise is bad. But there are some types of exercise which are better than the other. And it's not always the same for every person because we are all different. There is no standard human. And you cannot give a single recipe for everybody what to do. But with these glycans, which we measure, we can get a phyllis. feedback. So you can do something, I don't know, start doing yoga, and then after three and six months, check whether this works. For example, my glycons are horrible. I'm, I'm 25 years old and

then my chronological age. No way. I live too quickly. I had three kids before I was 25. So this is kind of where and there. So first thing which I try to do, I try to kind of sweat it out, I exercise for hours every day. And I even lost 10 kilos. I'm a little bit overweight all the time. But when I was exercising too much effect was not very good. Because this weight loss was being kind of counter-affected by exercising too much. And too much exercise is pro-inflammatory.

So I learned on my own experience that I should control my glycans with diet, not with exercise. And some other people, it's stress, it's sleeping, is hormones, especially in women, hormones are very important. Well, we need to talk about that. Yes. But it is very interesting. We'll talk about hormones in a minute. But it is this whole balance, which I think so many of us have got it wrong and we'll just look at one thing in isolation. You know, I have friends that only exercise because it means that they can eat more. And I just think that's horrendous actually because it's not good for their body. And then even just looking at sleep, the biological processes that occur when we sleep are fundamentally important. Yet so many people are not sleeping properly or not having a good sleep hygiene or a good routine or they're lying in at the weekends and getting too less sleep in the week. And it has these detrimental effects.

And certainly I know years ago when I did my immunology degree, one of the professors there kept talking about this pro-inflammatory state. And at the time, I couldn't really understand it because I thought, well, these are the cells that kill bacteria. They must be good. So how can they be harmful? But actually it's taken me a long time to get my head around the fact that when they're programmed wrong, you get this low grade, as you say, chronic sort of long-term inflammation, which is really detrimental to so many organs in our body.

And even looking at something like osteoporosis, which a lot of people will think, well, that's more of a physical condition because it's the bones becoming weaker. But it's not. It's a biological process as well, isn't it? And again, it's related to this pro-inflammation and even dementia as well. And some people think some types of clinical depression as well are associated with it's all there, isn't it? You know, we've known it for a long time, but it's trying to see it in a laboratory setting as well and match it is really important. So there are two very important aspects. First, we cannot separate our mind from our immune system because hormones are signals. Neurons are signaling. What we think is generating molecules. And for example, stress is a basic physiological response which would evolve to keep us alive

when somebody wants to eat us. That's the basic. stress evolutionary. You're an animal, somebody wants to eat you, you activate the stress response, which will keep you alive for the next few minutes. So you have to run away. And to get the energy for running away from a predator or to fight the predator, you have to get energy from somewhere. And one of the places where you're getting energy from is the immune system. So when we activate our stress hormones, adrenaline, cortisol, they're shutting down the immune system. And not only immune, they're shutting down the reproductive system, they're shutting down the digestive system.

And that's all fine if it's three minutes that you have to run away from a predator. But if you are understressed every day because you don't like your boss or your job is too demanding or there's a traffic jam, when you keep activating the stress response, then your immune system gets confused.

And then you have a lot of problems. And the immune system is not only killing, bacteria, it also has to kill the tumor cells. It has to avoid killing your own cells. So immune system has to be in a constant balance of attacking and ignoring. And if you attack too often, then they're out immune diseases. So your immune system is killing your own body and then you get things like lupus, arthritis or whatever. And if you do not activate your immune system enough, then you get infective diseases or you get tumors. So immune system is the balance, affected by hormones.

So it is really the most intricate network we have in our body because, you know, when you think about this COVID virus. So this is the virus which wants to use us to multiply. And it just spread around the world. And this is not the first virus. This is happening all the time. Actually, approximately 50% of our genome are the scars of the viruses from the past. To all evolution, the viruses were attacking animals, and some of their genome stayed in our genome.

And this is the eternal war. We fight this war forever, and we fight it with our immune system. And if you mess up with your immune system, then you are not able to fight this war anymore. And we are losing. So it's a very complicated, very intricate, very individual. And especially nowadays, we have another problem. And that is that until maybe 100 years ago, maybe 50% of children would not live through puberty.

They would be killed before puberty by different infective diseases. And this is not happening now for several generations. So we have people with a immune system, which is actually. not really capable of fighting a virus. And then the pandemics like this comes, and the majority of people will fight it off. So over 99.5% of people coped with the COVID without problems. But some individuals got in a very bad condition.

And of course, 0.5% is maybe not many, but you multiply this with 6 to 70 million people in a country, and you have many sick people. So, you know, immune system is very complicated. We have to learn about it. And I think glycans are one of the important elements we are learning about, in particular, because this is something we could change. Because, you know, some people are afraid of doing, for example, genetic tests. They don't want to know whether they are under higher risk.

And I could understand that if this is not actionable. So if somebody tells you you you're at higher risk, there's nothing you can do. You can only be scared for the rest of your life. And then maybe one can say, you know, okay, I don't want to know. I don't care. But glycons are actionable. So if you do a test and you show that your glycans are bad, there are things you can do to improve them. And this is particularly relevant for women, which we will probably touch up later.

Well, we can touch on now because I think it's really important, and we were talking about all the different cells that fight infection and regulate inflammation. And every single cell has a receptor for estrogen on them, doesn't it? So as some of you've heard me talk before, you know, the menopause when we lose our hormones is not just about symptoms. It's about a big change to our body because our bodies have to adapt without estrogen. But actually, if you look even just at our immune function cells,

they have estrogen receptors on them. So the estrogen is really important the way that it regulates them. It can genetically reprogram them. It can increase the number of them. It can change the way they work as well. And this is why there's an increased risk of diseases and the diseases we've already talked about, so heart disease, diabetes, osteoporosis, dementia,

even clinical depression. Because without the estrogen, there's this pro-inflammatory state. that is going on in a lot of people's bodies. And you've done some research, haven't you already, Gordon, showing that the glycan age can get worse quite quickly almost without estrogen. So we do a lot of research trying to understand how IGG glycans are changing and what is regulating them. And we know that there are over 40 genes in this network.

It's a very complicated network. But one of the very strong factors are hormones, and in particular estrogens. So we did one placebo-controlled, randomized study. Actually, the study was done over 10 years ago in US, but we got samples. So in this study, the menopause was chemical induced. They were given a drug which is stopping the production of all hormones. And then half of them were put on estrogen supplementation,

and half of them were given placebo. And they didn't know what were they receiving. And what we analyze, we analyze these immunoglobulin glycans and something we call the glycan age, which is a composite index, which is kind of simplifying this IGG glycan story. And the woman, which were put on placebo, within six months, on average, aged, I think around nine years, on average. Some are even more, some a little bit less. But this is a very drastic change in a couple of months. and the other group which was receiving estrogen supplementation, they did not.

So obviously, just taking away estrogen is changing our glycans from young glycans to old IgG glycans, which are then promoting inflammation. So this study we published maybe a little bit less than a year ago, but this was artificial study. So there's hormones where artificially stopped. So then we did another study, and we did this together with a Tim Specter at the King's College, London. He was tracking nearly 2,000 women for 15 years, with several blood samples taken over 15 years. And in that period, approximately 500 women entered menopause.

So we had a sample while they were still having a regular period. And then another sample was when they were already in menopause. So we could see what happened before and after. And we observed that in this, on average, seven-year period between two time points, women were aging at least twice as fast than before or after. So when I say aging, I'm talking about this glycan age, which is a measure of biological age or immune age, this old and young immunoglobulin glycons. but obviously also the normal loss of hormones

associates with a significant change in IGG glycans, which are becoming pro-inflammatory. And these pro-inflamatory glycans, we know they are contributing to cardiovascular events, like heart attack and stroke. And we also, a couple of years ago, we did another study where we were looking at 27,000 people with samples taken 20 years ago, and they were around 400 people who had a heart attack or stroke.

And actually, one of these glycans was the best predictor whether a woman will get the heart attack or stroke in the future. So these changes in glycans are first predicting potential disease development and also contributing. Of course, we have to be careful because most of this is still research. So this is not a diagnostic market we can go and do in your hospital because we are still doing a lot of research. But for example, with people like you who specialize in this field, we can do the measurement. We can do this. We call it a research-only test where we can measure immunoglobulin glycans. And then you can look at them and explain to a patient, you know, these glycans, they're doing some kind of a damage to you.

maybe we can improve them and let's see what we can do. How much hormone, what kind of, I'm not an expert in different type of HRT. I read the bit, it's very complicated field, but I think I even read it's very important whether you get it transdermally or orally. Yes, I'm very impressed. It's a bit complicated. It's not complicated, Gordon. It's because people are scared and don't know, but you're absolutely right.

The transdermal through the skin estrogen is the best because there's no risk of clot stroke, it goes straight into bloodstream, but also it's estradiol, it's the pure natural hormone, whereas when it's taken orally, it gets converted into other types of estrogen. And some of these are actually pro-inflammatory. And some of you listening might have heard me talk before about the weight changes that can occur during the menopause, and often people find they put on weight, and the body actually produces a very weak type of estrogen from fat cells. but that type of estrogen is pro-inflammatory, so it's very different to the estrogen in HRT that we give as a patchedgen or spray. So what we want to know is if we use HRT and use a transdermal oestradial cordon, can it reduce our glycone age, so it reduce our biological age?

Well, there is no published study on this topic yet. We have strong indications that this could be happening. But I think we have to do more research because I think something which is very important that every person is a different. So we know that in some woman, surely this will improve their black age. In some, maybe it will not. Maybe you need a little bit more of hormones, or maybe it takes a little bit more time, or maybe there is some other factor which could be affecting because, for example, the weight gain is moving glycans into the pro-inflammatory arena.

So if you are gaining weight and in the same time taking hormones, maybe the effect will not be so strong. Or also overtraining is doing the same thing. So if somebody is starting to take hormone, but in the same time goes training like crazy, this could also have another effect. So I think, you know, we cannot simplify things. I think it's very important that, every person, woman or man, speaks to their physicians. They know best what to do and they have to be guided. These are not things you should do for yourself because, you know, health is something which, you know, there is a reason why medical doctors go for such a long time to study and then to specialize and they need experience. So I would not claim anything that would work universally.

but I think there is a very high probability that by taking hormones, these things will improve. And when we look cross-sectionally, yes, women taking hormones do look younger than the woman not taking hormones. And also when we did this study on twins, we saw an effect, for example, that women who were gaining weight as they were getting older, they were aging faster than women who were either losing weight or not getting,

gaining weight. So there are many factors. Well, I'm a scientist, I'm a researcher. For me, this is, I say it's a fun for me because I enjoy doing research. And I don't have the responsibility of individual patients. So I'm never seeing the patients. I'm just seeing the samples and the numbers and looking into curves and trying to understand what is happening. While on individual level, we have to be careful because things are complicated. Absolutely. And what's really important, Obviously, with anything that I do as a doctor, but especially menopause, is giving people individualised advice, and we can absolutely never say that two people, two women are the same. But I'm very interested in the menopause as thinking of it as a long-term hormone deficiency with health risks.

And all the diseases that increase during the menopause that we've discussed, actually we know from good studies reduce when people have estrogen in HRT. Even at long-term studies over two decades have shown that women reduce. their incidence of all these diseases. So just thinking simplicity that, you know, it's bound to be related to this pro-inflammation that occurs and that can be reversed by estrogen. So there's a huge amount of work that needs to be done.

And I really hope that going forwards we can do a lot more together because I think it's such an exciting field looking at the menopause as more than just something that causes a few hot flushes. So I'm very grateful for your time. today, Gordon. It's been really interesting and I know for those listening, it's fairly scientific, but I think it will really give you a flavour for maybe what's going on in our bodies and how incredible our bodies are actually. It's amazing that we don't fall over

more often actually with disease. But before I finish Gordon, I'm just going to ask you for three take-home tips actually. So for people who want to know a bit more about what we've been talking about, what you've been talking about the glycans, how would they find out more information or what are the three things that are the most important about the conversation that we've just had? So something, what we already did, we translated part of the research into a test which is available. So there is a company called Glycan Age, which is now selling this test. And it's a relatively small company yet, but it's still doing a lot of research. So Glycanage.com, there is a lot of information about research, science, and one can actually do the test. It's a test you can

do at home. This is not a diagnostic test, so it's go to the website, buy it, get a sample collection kit, collect a drop of blood from your finger, and mail it back to the lab and you get some kind of a feedback. I think the other important thing is that people often ask me, I don't want to know, I'm afraid to learn whether I look older. And then I tell them, you know, it's an early warning signal. You want to get an early warning. You don't want to hit into a road end or whatever. So don't be afraid of warning signals. Check on time because you can improve it. And I think the other thing is that to this company,

they actually try to guide people. So they have counselors, advisors, whatever. It's complicated. So I think one thing is we can do something about it. Second thing, I think what is important is that we are all kind of spoiled. We think that we will keep healthy. forever and if we get ill, we want to get the magic pill and get healthy again. This does not work that way. So health is something we have to nourish and take care of it and we have to do something

today to stay healthy for the next two or three decades because, you know, we were not made to live in our 80s or 90s. There is no evolutionary pressure to keep us alive. So this all the time after maybe late 40s, it's a kind of bonus we got with our civilization. And we have to invest into our health, and it's doable. And for example, my friend David Sinclair claims that aging is a chronic disease, which we should be able to manage. And maybe we could live in up to 150, 180, who knows? That's not essential, but, you know, it won't be bad, maybe.

So I think if you ask me what are the messages, is try to stay healthy and try to monitor as much as you can and improve. Excellent. Really good advice and it's not just one thing. It's a multitude of things that we need to look at and address. And, you know, not kid ourselves, actually, that what we're doing isn't harming us. So lots of food for thought. And thanks ever so much for your time today.

It's really appreciated. Thanks Gordon. It was a pleasure to talking. Thank you. For more information about the perimenopause and menopause, you can go to my website, menopausedoctor.com.uker.uk. Or you can download our free app called Balance, available through the App Store and Google Play.