Dietary Restriction of Advanced Glycation End-Products (AGEs) in Patients with Diabetes: A Systematic Review of Randomized Controlled Trials.
Study Goal
The researchers aimed to review randomized controlled trials on low-dietary AGE interventions in diabetic patients to assess effects on inflammation, glucose, and lipid outcomes.
Results Summary
A low-dietary AGE pattern reduced circulating AGEs and showed consistent benefits for oxidative stress and inflammation, but effects on glycemic and lipid parameters were inconsistent and modest.
Population
Patients with diabetes, age > 18 years
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low-dietary AGE (L-dAGEs) interventions | decrease | circulating AGEs | patients with diabetes | 3/3 studies | A reduction in circulating AGEs was documented | #1 |
low-dietary AGE (L-dAGEs) diet | no change | glycemic parameters | patients with diabetes | - | No particular differences were documented | #2 |
low-dietary AGE (L-dAGEs) diet | decrease | glucose levels | patients with diabetes | one out of six studies (1/6) | Reductions in glucose levels were observed | #3 |
low-dietary AGE (L-dAGEs) diet | no change | HbA1c | patients with diabetes | 0/6 | HbA1c did not change | #4 |
low-dietary AGE (L-dAGEs) diet | no change | HOMA | patients with diabetes | 0/3 | HOMA did not change | #5 |
low-dietary AGE (L-dAGEs) diet | neutral | lipid profile | patients with diabetes | one out of four studies (1/4) | Lipid profile changed | #6 |
low-dietary AGE (L-dAGEs) diet | decrease | oxidative stress | patients with diabetes | 3/3 studies | beneficial effects | #7 |
low-dietary AGE (L-dAGEs) diet | decrease | inflammatory markers | patients with diabetes | 4/4 studies | beneficial effects | #8 |
low-dietary AGE (L-dAGEs) diet | increase | adiponectin | patients with diabetes | - | adiponectin increases | #9 |
low-dietary AGE (L-dAGEs) pattern | decrease | AGEs accumulation | patients with diabetes | - | may minimize AGEs accumulation | #10 |
low-dietary AGE (L-dAGEs) pattern | decrease | oxidative stress | patients with diabetes | - | have beneficial effects | #11 |
low-dietary AGE (L-dAGEs) pattern | decrease | inflammation indices | patients with diabetes | - | have beneficial effects | #12 |
low-dietary AGE (L-dAGEs) pattern | neutral | glycemic parameters | patients with diabetes | - | effects are inconsistent and modest | #13 |
low-dietary AGE (L-dAGEs) pattern | neutral | lipemic parameters | patients with diabetes | - | effects are inconsistent and modest | #14 |
Advanced Glycation End Products (AGEs) are formed through non-enzymatic reactions between reducing sugars and proteins, nucleic acids or lipids (for example through hyperoxidation). In diabetes, elevated glucose levels provide more substrate for AGEs formation. AGEs can also be ingested through the diet from foods cooked at high temperatures, or containing much sugar. The present work aimed to review all published randomized controlled trials (RCT) on low-dietary AGE (L-dAGEs) interventions in patients with diabetes. Pubmed, Scopus and Cochrane databases were searched (until 29 February 2024) with appropriate keywords (inclusion criteria: RCT, patients with diabetes, age > 18 years, outcomes related to inflammation, glucose, and lipids; exclusion criteria: non-RCTs, case-series, case reports and Letter to the Editor, or animal studies). The present review was registered to the Open Science Framework (OSF). From 7091 studies, seven were ultimately included. Bias was assessed with the updated Cochrane Risk of Bias tool. A reduction in circulating AGEs was documented in 3/3 studies. No particular differences were documented in glycemic parameters after a L-dAGEs diet. Reductions in glucose levels were observed in one out of six studies (1/6), while HbA1c and HOMA did not change in any study (0/6 and 0/3, correspondingly). Lipid profile also changed in one out of four studies (1/4). More consistent results were observed for oxidative stress (beneficial effects in 3/3 studies) and inflammatory markers (beneficial effects in 4/4 studies). Other athero-protective effects, such as adiponectin increases, were reported. Limitations included the small sample size and the fact that dietary and physical activity habits were not considered in most studies. In conclusion, a L-dAGEs pattern may minimize AGEs accumulation and have beneficial effects on oxidative stress and inflammation indices, while its effects on glycemic and lipemic parameters are inconsistent and modest in patients with diabetes.