How to Reduce the Ravages of AGEs

Although you may not have heard of AGEs (advanced glycation end-products) yet, they are worth knowing about because they can wreak havoc upon your body.   AGEs are harmful compounds that form when protein or fat combine with sugar in the bloodstream, a process known as glycation.  AGEs are highly reactive and promote oxidative stress and inflammation. AGEs can clog very small blood vessels, especially in the kidneys, eyes, heart and brain and may be a cause of some of the complications of diabetes and heart disease. They accelerate the aging process and are linked to the development and worsening of many chronic diseases such as type-2 diabetes, insulin resistance, atherosclerosis and other cardiovascular diseases, liver disease, chronic kidney disease and Alzheimer’s disease. (1,2)

The formation of AGEs is part of normal metabolism, but, when their level becomes excessively high, health problems develop.  Both high sugar and high fat levels in the blood as well as inflammation in the body increase the formation of AGEs.  (2,3)

AGEs not only form within the body, they also exist in foods.  They are naturally a part of uncooked protein-rich and fat-rich animal-derived foods and cooking these foods adds to the problem by causing the formation of new AGEs within these same foods.  High-heat, dry cooking methods like grilling, roasting, searing, broiling and frying can increase the formation of new AGEs by 10 to 100-fold over those present in the food’s uncooked state. (2,3)

Highest AGE levels are found in beef and cheeses, followed by poultry, pork, fish, lamb, and eggs.  Higher fat and aged cheeses (Parmesan and cheddars) contain more AGEs than lower-fat cheeses such as reduced-fat mozzarella, skim milk cheddar and cottage cheeses. High fat spreads (butter, cream cheese, margarine, mayonnaise) are also very high in AGEs followed by oils and nuts. Roasting increases the AGE content of nuts. (2,3)

Even the type of cooking fat used leads to differing amounts of AGEs.  For instance, scrambled eggs prepared with a cooking spray, margarine, or oil had approximately 50% to 75% less AGEs than if they had been cooked with butter. (2)

Carbohydrate-rich foods such as vegetables, legumes, fruits, whole grains, and low-fat milk contain relatively few AGEs, even after cooking.

It is helpful to know that there are cooking methods that can prevent AGE production.  Using moist rather than dry heat for cooking (steaming, stewing, boiling and poaching) and adding acidic ingredients such as lemon juice or vinegar will reduce the generation of new AGEs (2).

Your body has natural ways of getting rid of harmful AGE compounds. However, as humans age over decades of AGE ingestion and formation, the body can become overwhelmed and unable to keep up with their elimination.  Thus AGEs accumulate in cells and in the bloodstream.  High amounts of AGEs are linked to chronic inflammation, many chronic diseases and are associated with premature aging.   (2,3).

Until recently, cooking methods were the primary way to reduce dietary AGEs.  Little was known about the possible effects of a change in diet composition.  In August 2024, new data from a previous trial compared weight loss and AGE levels in participants following a vegan diet to that of participants following a Mediterranean diet.  (5)

  

CAN I PROTECT MYSELF FROM AGEs?

ABOUT THE NEW STUDY (5)

Participants in this study were adults, aged 30–76 years, with a body mass index between 28 and 40.  They were randomly assigned to eat one of two diets…

• A low-fat vegan diet made up of fruits, vegetables, grains and legumes with no restrictions on portion sizes.
• A Mediterranean diet made up of 2 to 3 servings per day of fresh fruits, 2 servings a day of vegetables, 3 servings per week of legumes, 3 servings per week of fish or shellfish, 3 servings a week of nuts or seeds and 50 grams daily of extra virgin olive oil (provided to participants); consumption of cream, butter, margarine, processed meats, sweetened beverages, pastries and processed snacks was discouraged.

Each participant consumed the first assigned diet for 16 weeks, then went back to their regular diet for a four-week washout period before switching to the opposite diet for a further 16 weeks.  Participants in both groups were free to eat all the food they wanted within their assigned diet pattern.

Alcohol was limited to one beverage/day for women and 2 beverages /day for men.

Dietary AGE intake was derived from self-reported dietary intake records.

AGE scores were assigned to each food item from a published database of AGE content.

Weekly classes specific to the diet they were eating were provided to the participants.  These offered nutrition education, recipes, meal plans and group support.

 

RESULTS OF THE NEW STUDY (5)

AGE levels in the participants eating a low-fat vegan diet were decreased by 73%.  These participants also experienced an average weight loss of 13 pounds and improvements in their total cholesterol, LDL-cholesterol and insulin sensitivity.

In the participants eating a Mediterranean diet, there was no reduction in AGEs or weight loss.

In this trial, the largest dietary sources of AGEs were meat, added fats, and dairy products.

The reduction in AGEs on the low-fat vegan diet came mainly from excluding meat consumption (41%), minimizing consumption of added fats (27%) and avoiding dairy products (14%).

The conclusion from this study was that eating a low-fat vegan diet was linked to a reduction in AGEs along with accompanying weight loss.  Conversely, eating a Mediterranean diet was not associated with any weight loss or lowering of AGEs.

 

ADDITIONAL INFORMATION FROM OTHER STUDIES

Reductions in dietary AGEs through the consumption of a low-fat vegan diet have been reported previously in overweight adults (6) and in postmenopausal women (7).  Both of these trials used a control (habitual) diet as a comparison.

Earlier trials have shown that using lower heat and moist cooking methods can reduce the AGEs from food, resulting in lower insulin resistance in obese people with metabolic syndrome. (8,9)

Transitioning to a low-fat vegan diet can also achieve significant reductions in dietary AGEs simply through the increased quality of the diet without changing cooking methods. (6)

Plant-based diets cut the risk of developing metabolic syndrome and type-2 diabetes in half.  The lower intake of AGEs when eating plant-based may partly explain these benefits.  (10,11)

Note: Metabolic syndrome is when a cluster of two or more conditions occur together to increase your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. (12)

 

SUMMING UP (3,4)

Because of their link to the development of and aggravating effect on many chronic diseases, you do not want harmful inflammatory compounds like AGEs to accumulate in your body as you age.

It is not yet completely clear how AGEs exert their deleterious effects on human health.  Continuing investigations will add to our knowledge about AGEs and their effects on health as well as the steps that can be taken to minimize the damage they might cause.  However, it is not too early to consider transitioning to a diet that is rich in plant-sourced food and limited in animal-sourced food.  That is a positive move towards healthy aging.

 

 SOURCES:

1  Jiao, L., Kramer, J.R., Chen, L., Rugge, M., Parente, P., Verstovsek, G., Alsarraj, A., El-Serag, H.B.  Dietary consumption of meat, fat, animal products and advanced glycation end-products and the risk of Barrett’s oesophagus.  Aliment Pharmacol Ther. 2013 Oct; 38(7):817824.

2  Uribarri, J., Woodruff, S., Goodman, S., Cai, W., Chen, X., Pyzik, R., Yong, A., Striker, G.E., Vlassara, H.  Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet.  J Am Diet Assoc.  2010 Jun; 110(6): 911–916.

3  http://www.berkeleywellness.com/healthy-eating/food-safety/article/abcs-ages-advanced-glycation-end-products

4  Luevano-Contreras, C., Chapman-Novakofski, K.  Dietary Advance Glycation End Products and Aging.  Nutrients. 2010 Dec; 2(12): 1247–1265.

5  Kahleova, H., Znavenko-Miller, T., Barnard, N.D., Uribarri,J., Holubkov, R.  Dietary advanced glycation end-products and their associations with body weight on a Mediterranean diet and low-fat vegan diet: a randomized, cross-over trial. Frontiers in Nutrition. August 8, 2024.  Doi.org/10.3389/fnut.2024.1426642.

6  Kahleova, H., Znayenko-Miller, T., Uribarri, J., Holubkov, R., Barnard, N. Dietary advanced glycation products and their associations with insulin sensitivity and body weight: A 16-week randomized clinical trial. Obes Sci Pract. 2023. 9:235–242. Doi: 10.1002/osp4.646.

7  Kahleova, H., Znayenko-Miller, T., Uribarri, J., Schmidt, N., Kolipaka, S., Hata, E., et al. Dietary advanced glycation end-products and postmenopausal hot flashes: A post-hoc analysis of a 12-week randomized clinical trial. Maturitas. 2023. 172:32–38. Doi: 10.1016/j.maturitas.2023.03.008.

8  Vlassara, H., Cai, W., Tripp, E., Pyzik, R., Yee, K., Goldberg, L., et al. Oral AGE restriction ameliorates insulin resistance in obese individuals with the metabolic syndrome: A randomised controlled trial. Diabetologia.  2016. 59:2;181–192. Doi: 10.1007/s00125-016-4053-x

9  de Courten, B., de Courten, M., Soldatos, G., Dougherty, S., Straznicky, N., Schlaich, M., et al. Diet low in advanced glycation end products increases insulin sensitivity in healthy overweight individuals: A double-blind, randomized, crossover trial. Am J Clin Nutr. 2016. 103:1426–1433.

Doi:10.3945/ajcn.115.125427.

10  Rizzo, N., Sabaté, J., Jaceldo-Siegl, K., Fraser, G. Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: The adventist health study 2. Diabetes Care. 2011; 34:1225–1227.

11  Tonstad, S., Butler, T., Yan, R., Fraser, G. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009. 32:791–796.

12  https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916