The Short and Long-term Effects of Low Advanced Glycation End Product* Diet
Condition: Diabetes Type 2
MeSH terms: Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      The aim of this study was to examine the hypothesis that a diet low in advanced glycation end
      products (AGE) would provide short and long term improvement in metabolic and inflammatory
      parameters and serum AGE, Srage, carboxymethyllysine (CML) and methylglyoxal (MG) values in
      individuals with type 2 diabetes. Specifically, in order to observe the effect of AGE content
      on the results, diabetic patients who are followed up and who know the principles of low
      glycaemic index and glycaemic load nutrition suitable for diabetic patients, who do not have
      additional diseases and who do not smoke were selected.

      In recent years, it has been determined that AGE accumulation in the tissue has an effect on
      the pathophysiology of many diseases such as Alzheimer's disease as well as chronic
      complications of diabetes. However, the contribution of dietary AGE intake to this pool is
      controversial. There are studies with conflicting results in the literature on whether a low
      AGE diet is effective on metabolic and biochemical well-being. In addition, studies
      investigating the effects of reducing AGE content in the diet of people with no chronic
      disease are limited.

      In this study, the metabolic results of dietary modification in the short term of 2 weeks and
      in the long term of 3 months are determined. In addition, the results are analysed separately
      in type 2 diabetic and non-diabetic groups. Thus, the data showing the short and long term
      metabolic effects of dietary AGE levels for diabetic and non-diabetic patients will
      contribute to the literature.
    

Detailed description: 
      The study included 30 volunteers with type 2 diabetes and 30 healthy participants. During the
      initial interviews, participants were provided with training on low AGE (advanced glycation
      end-products) dietary principles. In the same session, measurements were taken and recorded
      for height, body weight, blood pressure, waist and hip circumference, and body fat
      percentage. Fasting blood glucose, HbA1c, c-peptide, C reactive protein (CRP), insulin, blood
      lipid levels, 1-5 anhydroglucitol (1-5 AG), AGE, Soluble AGE Receptor (sRAGE) , methylglyoxal
      (MG) and carboxymethyllysine (CML) levels were measured through blood samples.

      Participants were asked to maintain a dietary journal and were followed up through weekly
      online or face-to-face meetings. They were called in for a follow-up examination 2 weeks and
      3 months after the initial interview. Anthropometric measurements and blood tests were
      repeated.

      After the completion of a 3-month follow-up for all participants, measurements from both the
      short and long term resulting from the low AGE diet were analyzed by comparing them to the
      initial measurements, both for participants with and without diabetes.
    

Intervention name(s): low AGE diet education
Intervention type(s): Other
Intervention description(s): Participants were divided into ten-person groups. Each group was individually invited for a face-to-face meeting where they were provided with a 50-minute low-AGE diet education prepared in accordance with the recommendations of the American Diabetes Association and the Turkish Society of Endocrinology and Metabolism. During the first 20 minutes of the education, a PowerPoint presentation highlighted the importance of choosing plant-based, low-AGE foods and emphasized cooking methods such as boiling, steaming, and preparing meals with added liquids. Participants were advised against frying, roasting, and grilling. Additionally, information was provided on marinade techniques and the use of spices or ingredients such as lemon or vinegar to lower pH in meals. Following the education, participants were given a dietary diary to record their food intake and were asked to self-assess their diet adherence on a scale of 1 to 10 on a weekly basis.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Advanced glycation end products; diabetes; nutrition; diet