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

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.

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.

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.

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.

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.