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Less dietary AGE content may be an effective strategy to decrease diabetes and cardiovascular disease risks

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
First published March 30, 2016, doi: 10.3945/​ajcn.115.125427Am J Clin Nutr June 2016
vol. 103 no. 6 1426-1433

Diet low in advanced glycation end products increases insulin sensitivity in healthy overweight individuals: a double-blind, randomized, crossover trial


Abstract

Background: The consumption of advanced glycation end products (AGEs) has increased because of modern food processing and has been linked to the development of type 2 diabetes in rodents.

Objective: We determined whether changing dietary AGE intake could modulate insulin sensitivity and secretion in healthy, overweight individuals. Design: We performed a double-blind, randomized, crossover trial of diets in 20 participants [6 women and 14 men; mean ? SD body mass index (in kg/m[SUP]2[/SUP]): 29.8 ? 3.7]. Isoenergetic- and macronutrient-matched diets that were high or low in AGE content were alternately consumed for 2 wk and separated by a 4-wk washout period. At the beginning and end of each dietary period, a hyperinsulinemic-euglycemic clamp and an intravenous glucose tolerance test were performed. Dietary, plasma and urinary AGEs N[SUP]€[/SUP]-(carboxymethyl)lysine (CML), N[SUP]€[/SUP]-(carboxyethyl)lysin (CEL), and methylglyoxal-derived hydroimadazolidine (MG-H1) were measured with the use of mass spectrometry.

Results: Participants consumed less CML, CEL, and MG-H1 during the low-AGE dietary period than during the high-AGE period (all P < 0.05), which was confirmed by changes in urinary AGE excretion. There was an overall difference in insulin sensitivity of −2.1 mg ? kg[SUP]−1[/SUP] ? min[SUP]−1[/SUP] between diets (P = 0.001). Insulin sensitivity increased by 1.3 mg ? kg[SUP]−1[/SUP] ? min[SUP]−1[/SUP] after the low-AGE diet (P = 0.004), whereas it showed a tendency to decrease by 0.8 mg ? kg[SUP]−1[/SUP] ? min[SUP]−1[/SUP] after the high-AGE diet (P = 0.086). There was no difference in body weight or insulin secretion between diets (P = NS).

Conclusions: A diet that is low in AGEs may reduce the risk of type 2 diabetes by increasing insulin sensitivity. Hence, a restriction in dietary AGE content may be an effective strategy to decrease diabetes and cardiovascular disease risks in overweight individuals.

This trial was registered at clinicaltrials.gov asNCT00422253.
 
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