From the Guidelines
To improve the glycocalyx barrier, focus on a comprehensive approach that includes regular physical activity, a balanced diet, stress management, and adequate hydration, as these interventions can help reduce oxidative stress and inflammation, which are key factors in damaging the glycocalyx. The most recent and highest quality study, 1, emphasizes the importance of individualized medical nutrition therapy and behavioral modification to achieve and maintain a healthy weight, which can positively impact glycocalyx health. Key recommendations include:
- Engaging in moderate-intensity physical activity for at least 150 minutes per week, as suggested by 1 and 1.
- Adopting a diet rich in polyphenols, fiber, and nutrient-dense foods, while minimizing processed foods and added sugars, as recommended by 1 and 1.
- Ensuring adequate hydration with 2-3 liters of water daily.
- Managing stress through techniques like meditation, yoga, or deep breathing exercises, and prioritizing quality sleep of 7-9 hours nightly. Additionally, supplements such as sulforaphane, resveratrol, and omega-3 fatty acids may support glycocalyx health, although their effectiveness should be considered on an individual basis, as noted in 1 and 1. Overall, a holistic approach that incorporates lifestyle modifications and, when necessary, targeted supplements can help improve the glycocalyx barrier, thereby supporting cardiovascular health and reducing the risk of morbidity and mortality associated with its dysfunction.
From the Research
Improving the Glycocalyx Barrier
To improve the glycocalyx barrier, several factors can be considered:
- Metformin treatment: Studies have shown that metformin can improve glycocalyx barrier properties in db/db mice, a model of non-insulin dependent diabetes mellitus 2.
- Lifestyle modifications: Changing lifestyle habits, such as healthy diet and increased physical activity, can also improve glycemic regulation and reduce obesity, which may help prevent or delay the onset of developing type 2 diabetes 3.
- Insulin sensitivity: Improving insulin sensitivity, which can be achieved through metformin treatment or lifestyle modifications, can also help improve the glycocalyx barrier 4, 5.
Mechanisms of Action
The mechanisms by which metformin improves the glycocalyx barrier are not fully understood, but it is thought to involve:
- Enhanced exclusion and retention of 70 kDa dextrans in the vasculature 2
- Improved hydration of heart and kidney 2
- Increased insulin-mediated insulin receptor tyrosine kinase activity, which activates post-receptor insulin signalling pathways 5
- Suppression of gluconeogenesis and reduction of hepatic glucose output 4, 5
Additional Considerations
Additional studies are needed to fully understand the effects of metformin and lifestyle modifications on the glycocalyx barrier in humans. However, the available evidence suggests that these interventions may be beneficial in improving glycocalyx barrier properties and reducing the risk of cardiovascular complications in patients with diabetes 2, 6.