Low advanced glycation end product diet improves the lipid and inflammatory profiles of prediabetic subjects

J Clin Lipidol. 2016 Sep-Oct;10(5):1098-108. doi: 10.1016/j.jacl.2016.07.001. Epub 2016 Jul 9.

Abstract

Background: Prediabetes is associated with risk for cardiovascular disease, and the first step in its management emphasizes lifestyle and diet modifications; however, modern diets are high in advanced glycation end products (dAGEs), derived from processing methods that exert a pivotal role in promoting atherosclerotic risk.

Objective: We studied the effect of low vs standard dAGE diets (L-dAGEs vs S-dAGEs) on lipid profile, inflammation, and cardiovascular risk in prediabetic subjects.

Methods: A 24-week randomized dietary intervention was conducted on 62 prediabetic subjects. We evaluated lipid profile, endogenous secretory receptors for AGEs, high-sensitivity C-reactive protein, arterial stiffness, and intima-media thickness.

Results: After 24 weeks, patients with L-dAGEs showed a significant reduction of total cholesterol, apolipoprotein B, and low-density lipoprotein compared with controls (5.26 ± 1.09 vs 5.53 ± 0.87 mmol/L, P < .05; 0.77 ± 0.25 vs 1.16 ± 0.13 mmol/L, P < .05; and 3.53 ± 0.93 vs 3.68 ± 0.7 mmol/L, P < .05); with respect to baseline, high-sensitivity C-reactive protein levels were significantly reduced in the L-dAGEs group (0.21 [0.11-0.69] vs 0.12 [0.08-0.48] mg/dL, P < .05) but not in the S-dAGEs group. Endogenous secretory receptor for AGEs was similar in both the groups at baseline and at the 24-week follow-up. With respect to baseline, L-dAGE patients showed a significative reduction of intima-media thickness (0.77 [0.73-0.81] vs 0.73 [0.70-0.75] mm, P < .05). We did not observe the same reduction in S-dAGEs. No difference in arterial stiffness was found from baseline to follow-up in both the groups.

Conclusions: L-dAGEs improved the lipid and inflammatory profiles of prediabetic subjects and seemed to reduce atherosclerotic burden compared with a standard diet. Further studies are needed to recommend this dietary regimen for prevention of cardiovascular risk in prediabetes.

Keywords: Cardiovascular risk; Inflammation; Low dietary advanced glycation end products; Prediabetes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Apolipoproteins B / blood
  • C-Reactive Protein / analysis
  • Carotid Arteries / diagnostic imaging
  • Carotid Intima-Media Thickness
  • Case-Control Studies
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Diet*
  • Female
  • Glycation End Products, Advanced / analysis
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Prediabetic State / metabolism
  • Prediabetic State / pathology*
  • Pulse Wave Analysis
  • Risk Factors
  • Ultrasonography

Substances

  • Apolipoproteins B
  • Cholesterol, LDL
  • Glycation End Products, Advanced
  • C-Reactive Protein
  • Cholesterol