Advanced glycation end products in foods and a practical guide to their reduction in the diet

Dietary Pattern, Sputum DNA Methylation, and Lung Health: An Epidemiological Study in People Who Ever Smoked

BACKGROUND

We previously identified a sputum 12-gene methylation panel that predicts lung aging and risk for lung cancer.

RESEARCH QUESTION

Can the sputum methylation panel be used as a readout to derive a dietary pattern beneficial for lung health? Is this dietary pattern associated with various subjective and objective lung health phenotypes? Does this relationship vary among people who currently smoke vs previously smoked?

STUDY DESIGN AND METHODS

Using the Lovelace Smoker Cohort (LSC), we employed the least absolute shrinkage and selection operator regularized Poisson regression to define a dietary pattern for sputum. Associations of the dietary pattern with objective and subjective lung health measurements were examined using generalized linear and Cox models in the LSC and the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening trial.

RESULTS

The Dietary Pattern for Healthy Lung (DiPHeaL) includes low consumption of processed meat, and high consumption of dark green vegetables, tea, alcohol, and fruit juice. In the LSC, a higher DiPHeaL score (1 SD) was associated with better FEV1 (by 96.1 mL/s), FEV1/FVC ratio (by 1.83%), and respiratory quality of life (by 4.9 for activity score), and decreased cardiopulmonary mortality (by 47%) in participants who previously smoked (all P values < .05), but not in participants who currently smoke. Moreover, effect sizes of the DiPHeaL score on respiratory quality of life measures were greater among participants who previously smoked with airway obstruction compared with those without. Associations with cardiovascular and respiratory mortality were replicated in PLCO participants who previously smoked . A higher DiPHeaL score was also associated with lower lung cancer incidence in participants who previously smoked, as well as reduced COPD incidence and lung cancer mortality regardless of smoking status in the PLCO.

INTERPRETATION

We defined a novel dietary pattern for lung epigenetic aging, which linked to lung health measurements. Participants who previously smoked, especially those with airway obstruction, may benefit the most from nutritional modification.

Intricate relationship among major heat-induced harmful by-products and modulating role of lipid and protein oxidation in seafood: A comprehensive review

Seafood is an important constituent of our diet and well-known for its high-quality proteins and lipids (especially polyunsaturated fatty acids). While thermal processing imparts unique flavors to seafood, it also generates heat-induced harmful by-products (HHBs), such as polycyclic aromatic hydrocarbons (PAHs), heterocyclic aromatic amines (HAAs), and advanced glycation end-products (AGEs), which pose a serious threat to human health in the long run. This manuscript provides an overview of the formation mechanisms of PAHs, HAAs, and AGEs, and their occurrence in seafood. The main body of it deals with their potential crosstalk and the modulatory role of lipid and protein oxidation in their formation. Additionally, major strategies for the control of HHBs as well as their impact on the nutritional and sensory quality of seafood in the last two decades are also reviewed. Finally, challenges associated with the control of multiple HHBs in seafood and future outlooks are discussed. Literature data support that different types of HHBs are formed from different and yet subtly interconnected pathways, such as the Maillard reaction, pyrolysis, and lipid and protein oxidation. In particular, certain precursors (e.g., reactive amino acids) and intermediates (e.g., reactive carbonyls) are key intersections. However, only limited literature has been available thus far on the simultaneous control of multiple HHBs. Given their potential health hazards, more comprehensive studies with the aid of advanced analytical techniques and software will be needed to unravel their intricate relationships, which would facilitate the establishment of strategies to achieve simultaneous control of multiple HHBs.

Dual roles of methylglyoxal in cancer

Cancer treatment currently includes a variety of approaches. Chemotherapy, targeted therapy, and immunotherapy are combined based on cancer characteristics to develop personalized treatment plans. However, drug resistance can hinder the progress of treatment over time. Methylglyoxal (MG) is a metabolite with hormesis, exhibiting both pro-tumor and anti-tumor actions depending on its concentration during cancer progression. The MG-related metabolic pathway is being explored in the development of anti-cancer drugs, focusing on reducing MG stress or exploiting its cytotoxic effects to inhibit cancer progression. This article investigates the dual role of MG in cancer, emphasizing its effects on cell metabolism and tumor progression. It proposes MG capture therapy for the pre-cancerous stage and MG toxicity therapy for the cancer stage, contributing to the development of precise and individualized cancer treatments.

Plant-Based Diet and Erectile Dysfunction: A Narrative Review

Evidence shows that the consumption of plant foods, particularly those in their whole form (fruits, vegetables, whole grains, nuts, seeds, and legumes from which no edible part has been removed), improves cardiometabolic risk factors and is associated with reduced risk of cardiovascular diseases (CVDs), diabetes, cancer, chronic kidney disease and mortality compared with animal (meat, fish, eggs and dairy) and nonwhole plant foods (sugar-sweetened beverages, refined grains, etc.). Erectile dysfunction (ED) is considered a strong predictor of CVD. The underlying defect in arteriogenic ED is endothelial dysfunction. A plant-based diet focused on whole plant foods could enhance penile erection as it improves endothelial function through various mechanisms. First, it provides nitrates, L-arginine, and L-citrulline, substrates for nitric oxide production. In addition, this diet lowers low-density lipoprotein cholesterol, trimethylamine N-oxide, postprandial triglycerides, advanced glycation end product, inflammation, and vasoconstrictors levels, contributing to higher nitric oxide concentrations, increased endothelial progenitor cells preservation and decreased arterial stiffness. This review explores the epidemiological evidence of a plant-based diet emphasizing whole plant foods on ED and the potential biological pathways involved.

Non-enzymatic modification of aminophospholipids induces angiogenesis, inflammation, and insulin signaling dysregulation in human renal glomerular endothelial cells in vitro

AIMS/HYPOTHESIS

Advanced glycation end-products (AGEs) formation in proteins are involved in healthy aging and a variety of diseases including Alzheimer's disease, atherosclerosis, and diabetic complications. However, the biological effects of the non-enzymatic modification of aminophospholipids (lipid-AGEs) at cellular level are poorly understood. This study aimed to investigate the effects of lipid-AGEs on angiogenesis, inflammation, insulin signaling, and mitochondrial function in human renal glomerular endothelial cells (HRGEC), exploring their potential role in the pathophysiology of diabetic nephropathy (DN).

METHODS

HRGEC cells were exposed to non-enzymatically modified phosphatidylethanolamine (PE) by AGEs (lipid-AGEs), non-modified PE (nmPE) (aminophospholipid without modification), employed as a negative control, and lipopolysaccharides (LPS) as a positive control. Angiogenesis was assessed through vascular network formation metrics, including capillary area, junction density, and endpoints, under different extracellular matrices. Gene expression of inflammatory and angiogenic markers was quantified by RT-qPCR. Insulin signaling components, including IRS1 and AKT phosphorylation, were evaluated by immunoblotting. Mitochondrial function was assessed using high-resolution respirometry to determine ATP production rates from glycolysis and oxidative phosphorylation.

RESULTS

Lipid-AGEs induced dose-, time-, and matrix-dependent angiogenesis, with effects comparable to LPS, particularly in Engelbreth-Holm-Swarm extracellular matrix (ECM) (capillary area increase: 25 %, p < 0.05). Lipid-AGEs significantly upregulated the expression of inflammatory genes IL8 and NFKB (p < 0.05), and the angiogenesis-related markers TGFB1 and ANGPT2 (p < 0.05). Insulin signaling was disrupted, as lipid-AGEs enhanced inhibitory phosphorylation of IRS1 (Ser-1101, 1.8-fold increase, p < 0.01) and modulated AKT (Ser-473) and p42/p44 ERK activation. At lower doses, lipid-AGEs reduced eNOS phosphorylation (p < 0.05) impairing insulin responsiveness. High-resolution respirometry revealed that lipid-AGEs reduced basal oxygen consumption rates (OCR) by 20 % (p < 0.05), with no significant changes in glycolytic ATP production.

CONCLUSION

Lipid-AGEs induce angiogenesis, inflammation, and insulin signaling disruption in HRGEC, contributing to endothelial dysfunction. These findings underscore the potential role of lipid-AGEs in age-related decline of renal function, as well as the pathogenic potential in DN highlighting their relevance as therapeutic targets for mitigating vascular and metabolic complications in diabetes.

Cooking methods affect advanced glycation end products and lipid profiles: A randomized cross-over study in healthy subjects

Thermal treatments used in ultra-processed foods (UPFs) lead to advanced glycation end products (AGEs). UPFs and serum AGEs are associated with cardiometabolic disease. We explore differential cooking methods as a mechanistic link between UPFs and detrimental health outcomes through a randomized cross-over cooking method trial in healthy subjects using identical ingredients and a deep profiling analysis. We show that low-AGE-generating cooking methods such as boiling and steaming decrease serum AGEs, improve lipid profiles, and increase serum protein 4E-BP1. In contrast, high-AGE-generating cooking methods such as grilling and baking increase fecal butyrate. In sum, this suggests that low-AGE-generating cooking methods should be considered in cardiovascular risk prevention. Since current dietary guidelines focus on ingredients, but not cooking methods, our results suggest that culinary techniques should be considered as an important factor in cardiometabolic preventive strategies and future dietary trial design. This study was registered at ClinicalTrials.gov (NCT06547190).

Method validation for analysis of advanced glycation end products in mouse muscle tissue using liquid chromatography-tandem mass spectrometry

Advanced glycation end products (AGEs) in food and biological samples have been analyzed using several chromatographic and immunological methods, but no studies have quantitatively analyzed the major AGEs, Nε-carboxy-methyl-lysine (CML) and Nε-carboxy-ethyl-lysine (CEL), in muscle tissue. In this study, a quantitative profiling method using ultra-performance liquid chromatography-tandem mass spectrometry in mouse muscle tissue was developed and validated. For extraction, acid hydrolysis and solid-phase extraction were performed. The CML and CEL were well separated and analyzed within 5 min in multiple reaction monitoring mode. The method was validated against ICH guidelines to evaluate the linearity, limits of detection and quantification, matrix effects, recovery, accuracy, and precision, and the validated approach was applied to muscle tissue from aged mice to establish a baseline for the typical range of CML and CEL. This quantitative profiling method has the potential to be applied in the study of diseases influenced by AGEs.

Association between enteral carboxymethyllysine intake and daily glycemic variability in critically ill adults: A retrospective cohort study

BACKGROUND

Advanced glycation end-products (AGEs) can enter patients' circulation through exogenous sources, such as enteral nutrition formulae. Circulating AGEs, specifically carboxymethyllysine, can promote insulin resistance and activation of pro-inflammatory pathways leading to oxidative stress, cell death, and organ failure. Suboptimal kidney function increases the risk of elevated circulating AGEs because levels are controlled through urinary excretion. Our aim was to determine associations between carboxymethyllysine intake and glycemic control as well as clinical outcomes in critically ill patients and explore these in the subset of patients with an acute kidney injury (AKI).

METHODS

This was a retrospective cohort study. Data were extracted from electronic medical records. Patients were eligible if they were ≥18 years and received enteral nutrition, with known carboxymethyllysine content, for ≥3 days. AKI was defined using the Kidney Disease: Improving Global Outcomes guidelines. Linear and logistic regression models were used to determine adjusted associations.

RESULTS

Between 2015 and 2021, 2636 patients met the eligibility criteria, with 848 (32%) patients having an AKI. Most were male (n = 1752, 67%) with a median (interquartile range) Acute Physiology And Chronic Health Evaluation III score of 59 (45-77). For every 10-μmol increase in carboxymethyllysine provision, mean blood glucose increased by 0.05 mmol (95% CI, 0.03-0.07), and the odds of dying increased by 16% (odds ratio = 1.16; 95% CI, 1.06-1.27). A subgroup analysis indicated these associations persisted in patients with AKI but not in those without.

CONCLUSION

Carboxymethyllysine intake was associated with increased mean blood glucose and odds of dying in our study cohort.

RAGE gene polymorphism (rs1800625) and type 1 diabetes mellitus: A potential new model for early diagnosis and risk prediction

Studies have associated advanced glycation end-products (AGEs) and the polymorphism of the AGEs receptor (RAGE) gene with clinical disorders, such as diabetes, in certain ethnic groups. However, its association with type 1 diabetes mellitus (T1DM) in Egyptians has not yet been explored. The aim of this study was to investigate the association between the RAGE gene polymorphism rs1800625 and T1DM susceptibility in Egyptians. A case- control study was conducted with 177 T1DM patients and 177 age- and sex-matched healthy controls. Variables included glycemic markers (fasting blood glucose (FBG), postprandial blood glucose (PBG), hemoglobin A1c (HbA1c)), anthropometric measurements (waist circumference, body mass index (BMI)), lipid profile (total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL)), renal function (albumin-to-creatinine ratio (A/C ratio), serum creatinine), and history of hypertension and smoking. Genotype distribution and allele frequency of the RAGE rs1800625 polymorphism (TT, TC, CC genotypes; T and C alleles) were assessed. This study identified the RAGE rs1800625 polymorphism as a significant genetic factor associated with T1DM susceptibility. The CC genotype was significantly more prevalent in patients compared to controls (29.9% vs 11.9%; OR: 3.62; 95%CI: 1.87-6.97; p < 0.001). Similarly, the C allele was more common in patients (54.5% vs 41.0%, OR: 1.73; 95%CI: 1.28-2.33; p < 0.001). Multivariate analysis revealed that HbA1c (adjusted OR (aOR):  12.97; 95%CI: 4.00-42.05; p < 0.001), FBG (aOR: 8.96; 95%CI: 1.59-50.47; p = 0.010), and the rs1800625 polymorphism (aOR: 1.82; 95%CI: 1.146-2.876; p = 0.010) were significant predictors of T1DM. In conclusion, a genetic association was found between the RAGE gene polymorphism rs1800625 and T1DM susceptibility, with the CC genotype and C allele being more common in T1DM patients. FBG, HbA1c, and rs1800625 were identified as key predictors for T1DM, with HbA1c being the strongest. These findings highlight the importance of integrating genetic and metabolic factors in managing T1DM.

Association Between High Dietary Advanced Glycation End Products and Periodontitis

OBJECTIVE

The study aimed to provide evidence for a relationship between a high dietary intake of advanced glycation end products, and periodontitis.

MATERIALS AND METHODS

A total of 2334 adults from the National Health and Nutrition Examination Survey (NHANES) during 2003-2004 were included in this study. Binary regression analysis was conducted to measure the association between periodontitis and dietary advanced glycation end products (AGEs), and two adjusted models were constructed to further explore the relationship.

RESULTS

Participants with AGEs intake above 21.41 U/kcal had a higher prevalence of periodontitis compared to those with lower AGEs intake. After fully adjusting for associated factors, the odds ratios for periodontitis in relation to higher AGEs intake were 1.229 (95% confidence interval 1.015-1.488, p = .034), 1.349 (95% confidence interval 1.157-1.642, p = .003), and 1.331 (95% confidence interval 1.088-1.630 p = .006), respectively.

CONCLUSIONS

Our cross-sectional study reveals a strong association between periodontitis and AGEs.

CLINICAL RELEVANCE

An association between advanced glycation end products in the diet and periodontitis implies the importance of the quality of food intake for good oral health.

PRINCIPAL FINDINGS

The consumption of dietary advanced glycation end products is associated with an increased susceptibility to periodontitis development.

PRACTICAL IMPLICATIONS

These findings contribute to recognizing the harm of advanced glycation end products in various foods to periodontitis, and guiding clinical oral education.

AGEs in cooked meat: Production, detection, and mechanisms of its inhibition by plant extracts

With the growing demand for food safety and nutrition, the challenge of ensuring the quality of cooked meat products while reducing the accumulation of AGEs during processing needs urgent attention. In this study, the patterns of AGEs production, detection methods, quality contribution, and molecular mechanisms of its inhibition by natural plant-based extracts (NPBE) in cooked meat products were comprehensively reviewed. NPBE can effectively reduce the accumulation of AGEs in meat by binding to AGEs precursors and reducing glycosylation sites. It has also been shown to significantly remove off-flavour, and inhibit protein carbonylation. The potential for synergistic inhibition of AGE formation using NPBE and exogenous physical field treatments such as pulsed electric fields, microwave irradiation, thermal cycling of air, and ultrasound was emphasized, as well as the urgent need for the development of portable AGE detectors integrated with artificial intelligence and big data analytical models. This study indicates the future research direction for inhibiting the generation of AGEs in cooked meat products, which can promote and guide the practical application of NPBE in cooked meat products.

Comparison of Metabolic and Hormonal Profiles between Low-Advanced Glycation End Products (AGEs) and Standard AGEs-Containing Weight-Loss Diets in Overweight Phenotype-A PCOS Patients: A Randomized Clinical Trial

This study aims to investigate the effects of a low-advanced glycation end products(AGEs) diet versus a standard AGE-containing weight-loss diet on metabolic and hormonal profiles of overweight phenotype-A polycystic ovary syndrome(PCOS) patients.A randomized controlled interventional study.A total of 44 Rotterdam phenotype-A PCOS patients aged 19-35 were enrolled between January 2022 and May 2023. They were randomly assigned to 12-weeks of an energy-restricted Standard-AGEs diet(S-AGEs) or an energy-restricted Low-AGEs diet(L-AGEs). At baseline and after 12-weeks of intervention, weight loss, oligo-amenorrhea, hormonal profiles, plasma lipid profiles, and inflammation markers were evaluated. During the intervention, 8 participants from the L-AGEs group and 6 from the S-AGEs group dropped out. Completers had similar baseline characteristics to dropouts. In the per-protocol analysis, similar weight loss was observed in the L-AGEs(n = 14) and S-AGEs(n = 16) groups compared to baseline weight [-8.4 [-10.3 to -5.8] vs. -5.2 [-8.8 to -4.6] kg, respectively, p = 0.183]. However, in the L-AGEs group, fasting glucose levels decreased significantly more compared to the S-AGEs group (-8.5 [-11.5 to -3.5] vs. -0.5 [-3.7 to 0.7] mmol/L, respectively, p = 0.027). Following the diet intervention in the L-AGEs group, the waist-to-hip circumference ratio, LDL-cholesterol, TNF-α, total testosterone (TT), free-androgen index (FAI), and anti-Müllerian hormone (AMH) levels significantly decreased compared to baseline levels, while sex hormone-binding globulin (SHBG) levels increased. In contrast, there was no statistically significant change in these parameters in the S-AGEs group.In addition to weight-loss, reducing dietary AGEs intake resulted in significantly greater improvements in metabolic and hormonal profiles among phenotype-A PCOS patients. Clinicaltrials.gov registration no. NCT05830487.

Nutritional Support of Chronic Obstructive Pulmonary Disease

Background: COPD is a heterogenous disease of the respiratory tract caused by diverse genetic factors along with environmental and lifestyle-related effects such as industrial dust inhalation and, most frequently, cigarette smoking. These factors lead to airflow obstruction and chronic respiratory symptoms. Additionally, the increased risk of infections exacerbates airway inflammation in COPD patients. As a consequence of the complex pathomechanisms and difficulty in treatment, COPD is among the leading causes of mortality both in the western countries and in the developing world. Results: The management of COPD is still a challenge for the clinicians; however, alternative interventions such as smoking cessation and lifestyle changes from a sedentary life to moderate physical activity with special attention to the diet may ameliorate patients' health. Here, we reviewed the effects of different dietary components and supplements on the conditions of COPD. Conclusions: COPD patients are continuously exposed to heavy metals, which are commonly present in cigarette smoke and polluted air. Meanwhile, they often experience significant nutrient deficiencies, which affect the detoxification of these toxic metals. This in turn can further disrupt nutritional balance by interfering with the absorption, metabolism, and utilization of essential micronutrients. Therefore, awareness and deliberate efforts should be made to check levels of micronutrients, with special attention to ensuring adequate levels of antioxidants, vitamin D, vitamin K2, magnesium, and iron, as these may be particularly important in reducing the risk of COPD development and limiting disease severity.

Uncovering the possible link between dietary advanced glycation end products and mortality risk: A systematic review and meta-analysis

BACKGROUND

Recently, observational studies have focused on dietary advanced glycation end products (dAGEs) as predictive risk factors for chronic diseases and their related mortality. The current systematic review and meta-analysis aimed to synthesize the available evidence and quantify the possible association of dAGEs and risk of all-cause or cause-specific mortality.

METHODS

A comprehensive and systematic search was conducted in online literature databases, including PubMed, Scopus and Web of Science until January 2025 without any language limitation. The hazard ratio (HR) with 95 % confidence interval (CI) for the included studies were extracted and converted into log HR. Also, we used a random-effects model with inverse variance weighting method to compute the pooled effect size.

RESULTS

Six eligible studies (including 18 reports) were included in the current meta-analysis. 111,543 participants, aged 45.6-79 years old, participated in these observational studies, and the duration of follow-up varied from 3.8 to 16 years. According to the pooled results of our analysis, no significant association was observed between dAGEs and its components with the risk of all-cause mortality (HR=1.02; 95 %CI=0.92, 1.13; I2= 73.2 %), cancer mortality (HR=1.00; 95 %CI=0.88, 1.13; I2= 41.0 %) and CVDs mortality (HR=1.16; 95 %CI=0.86, 1.55; I2=86.1 %). Sex, target population, dAGEs components, region, dAGEs assessment method, and dietary data collection methods were the sources of heterogeneity.

CONCLUSIONS

In conclusion, our study suggested that there was no significant association between dAGEs intake and all-cause or cause-specific mortality.

Ultra-processed foods and risk of declined renal function: a dose-response meta-analysis of 786,216 participants

OBJECTIVES

Earlier investigations have documented an association between elevated consumption of Ultra-Processed Foods (UPFs) and adverse renal outcomes. To explore this relationship further, we executed a comprehensive dose-response meta-analysis to examine the link between UPFs intake and the risk of declined renal function.

SETTING

A systematic search was completed utilizing the ISI Web of Science, Scopus, Embase as well as PubMed/MEDLINE databases (without any restrictions), up until September 5, 2024. Effect sizes of declined renal function were recalculated by applying a random effects model. The GRADE tool was adopted to assess the certainty of the evidence, while study quality and potential publication bias were examined via validated methods such as the Newcastle-Ottawa Scale, Egger's regression asymmetry and Begg's rank correlation test.

RESULTS

Thirty-three studies (comprising 786,216 participants) were incorporated in the quantitative analysis. The results demonstrated that a greater UPFs intake was significantly associated with an enhanced risk of declined renal function (RR = 1.16; 95% CI: 1.09, 1.23; I2 = 68.8%; p < 0.001; n = 37). Additionally, we observed that each 1-serving-per-day increase in UPFs consumption was associated to a 5% greater risk of reduced renal function (RR = 1.05; 95% CI: 1.02, 1.09; I2 = 80.9%; p = 0.013; n = 9). A positive, linear association between UPF intake and the risk of declined renal function (Pnonlinearity = 0.107, Pdose-response < 0.001) was further displayed in the non-linear dose-response analysis.

CONCLUSION

Greater exposure to UPFs is positively associated with the risk of declined renal function. The information emphasizes the importance of considering UPFs in the prevention and management of adverse renal outcomes.

The protein paradox, carnivore diet & hypertrophy versus longevity.: Short term nutrition and hypertrophy versus longevity

Meat consumption has been a common food selection for humans for millennia. Meat is rich in amino acids, delivers vast amounts of nutrients and assists in short term health and hypertrophy. However, meat consumption can induce the activation of mTOR and IGF-1, accelerated aging, vascular constriction, atherosclerosis, heart disease, increased risk of diabetes, systemic inflammatory effects, cancers (including colorectal and prostate cancers), advanced glycation end products, impaired immune function / increased susceptibility to infection via downstream advanced glycation end product accumulation, polycyclic aromatic hydrocarbon ingestion, increased homocysteine levels among many other pathophysiologies. Research papers showing health benefits of meat consumption versus other papers showing the detriment of meat have led to confusion as many cohorts such as bodybuilding, health and wellness groups, carnivore diet practitioners, online social media longevity groups and more are interested in data that exists across the peer reviewed literature, however, few papers offer a super wide view where meat consumption benefits and pitfalls are taken into account.BackgroundThe need for such a systematic review is high as health enthusiasts incorrectly often quote single data points from papers showing a single benefit from consuming meat. This often leads to a higher consumption of meat. However, not all meat consumption is the same, and not all meat delivers the same benefits or detriments. Therefore, a systematic review of current literature has been performed to extrapolate the data into whether those interested in hypertrophy, short term nutrition and energy, and longevity should consume meat. Aim: The aim of this research is to dispel myths about meat consumption, such as that meat has a one size fits all benefit to all those that consume it regardless of genetics, or that consuming meat-based protein is the same across all meats.MethodsA deep analysis of almost one hundred peer reviewed papers and surveys spanning decades of cohorts having a meat-based diet compared to those consuming a plant based diet has been performed. Further analysis on specific side effects and disease has also been performed.ResultsThe results of our systematic review show clearly that meat is great for hypertrophy, short term nutrition, short term energy requirements, but a very poor choice when it comes to healthy aging and longevity.ConclusionAnimal protein is great for building muscle, short term energy, maintaining high levels of nutrients, but a carnivore diet holds too many adverse long term side effects to be considered a staple for a longevity-based diet. The evidence is very strong, that subjects interested in longevity and aging should shift their protein intake away from red and processed meats, and either toward white meats or plant-based sources if longevity is the goal.

Genetically proxied therapeutic inhibition of antihypertensive drug targets and risk of pancreatic cancer: a mendelian randomization analysis

BACKGROUND

Conventional epidemiological studies have reported inconsistent results regarding the potential adverse effects of long-term use of antihypertensive drugs on cancer risk. Nevertheless, evidence of their impact on pancreatic cancer risk is limited and deserves further elucidation.

METHODS

We selected genetic variants from the genes encoding the target proteins (angiotensin-converting enzyme, beta-1 adrenergic receptor, and solute carrier family 12 member 3) of the examined antihypertensive drugs as instruments based on expression quantitative trait loci (eQTL) studies. Genetic summary statistics of blood pressure and pancreatic cancer were obtained from genome-wide association studies (GWASs) in Europeans and East Asians. Inverse-variance weight and MR-Egger methods were employed to estimate the effect of genetic variations in the drug targets on pancreatic cancer risk, and meta-analysis was used to combine the results from 3 independent datasets. Positive control analysis was conducted by using Wald ratio test to justify the genetic instruments of the drug by demonstrating the expected effect on the blood pressure which has an established causal relationship with the drug of interest.

RESULTS

Genetically proxied ACEIs were associated with lower pancreatic risk (OR = 0.506, 95% CI: 0.284-0.901, P = 0.021; OR = 0.265, 95% CI: 0.094-0.751, P = 0.012; OR = 0.236, 95% CI:0.078-0.712, P = 0.010, respectively) in 3 independent datasets and the combined results were validated in a meta-analysis using a random effects model (OR = 0.37, 95% CI: 0.22-0.64, P < 0.01) or fixed effects model (OR = 0.39, 95% CI: 0.25-0.62, P < 0.01). Other drug targets did not show consistent significant associations with pancreatic cancer risk in all 3 independent datasets.

CONCLUSIONS

Our study indicated that genetically proxied therapeutic inhibition of ACE was associated with a lower risk of pancreatic cancer, which may have translational potential in clinical practice. However, further long-term randomized controlled trials and observational studies are needed to clarify the effect of ACEIs on the pancreatic cancer risk.

The relationship between advanced glycation end products, metabolic metrics, HbA1c, and diabetic nephropathy

Background

In this cross-sectional study, we aim to investigate the value of non-invasive advanced glycation end products (AGEs) detection in the early screening of diabetic nephropathy(DN) among individuals with type 2 diabetes mellitus and assess whether metabolic parameters and glycated hemoglobin A1c (HbA1c) can moderate this relationship.

Methods

A total of 912 T2DM patients were enrolled. The urinary albumin-to-creatinine ratio (UACR) was measured in morning urine samples to assess DN. AGEs were non-invasively measured through skin autofluorescence. Recognizing the role of age in both AGEs and DN, AGEage was calculated as AGEs × age/100 for related analyses.

Results

The overall prevalence of DN in the present study was 37.2%. Elevated AGEage(χ2 = 61.06) was associated with a higher prevalence of DN. Multivariable linear regression demonstrated that AGEage was positively associated with UACR levels(β = 0.154, 95% CI: 0.126, 0.306, P<0.001). In the moderation analysis, glycated hemoglobin A1c (HbA1c) affected the correlation between AGEage and UACR. Body mass index (BMI) and triglyceride glucose-body mass index (TyG-BMI) also affect the correlation between AGEage and UACR, there were significant interactions between AGEage, HbA1c, BMI, TyG-BMI, and UACR.

Conclusions

Complex associations and interactions were observed between AGEs, metabolic metrics, HbA1c, and DN. Implementing comprehensive interventions can potentially benefit the prevention of DN in T2DM patients.

Targeting ultra-processed foods for prevention of type 2 diabetes: state of the evidence and future directions

The incidence of type 2 diabetes has risen globally, in parallel with the obesity epidemic and environments promoting a sedentary lifestyle and low-quality diet. There has been scrutiny of ultra-processed foods (UPFs) as a driver of type 2 diabetes, underscored by their increasing availability and intake worldwide, across countries of all incomes. This narrative review addresses the accumulated evidence from investigations of the trends in UPF consumption and the relationship with type 2 diabetes incidence. Hypotheses for why UPFs may be causally implicated in the initiation and progression of weight gain and suboptimal blood glucose levels are varied. There is also uncertainty and debate about whether detrimental effects of UPFs could be owing to additives and other features of industrial processing, independent of established dietary risk factors, namely added sugar, sodium, saturated fat and low fibre content. However, these current research gaps are addressable with rigorous research and coordinated efforts across nutrition-science domains; for example, the strengths of longitudinal cohort studies can be leveraged to refine the characterisation of key UPF subcategories within the enormous and diverse category of UPFs and ultra-processed beverages, and to identify high-risk patterns of intake that are related to the development of chronic-disease outcomes. The notable advantages of dietary intervention studies are the critical gains in the reliability of dietary assessments, and isolating the effects of individual UPF additives and features through carefully formulated diets. Research improving our understanding of the modifiable food environment, the diet's causal drivers of weight gain and suboptimal cardiometabolic health, and the interactions among them, can be used to meaningfully shift the food supply for large-scale improvements in health. Thus, although the global market share of UPFs seems to outpace the research on its detrimental health effects, leaving the scientific community with the responsibility of generating proof, there may still be promising opportunities to reduce the burden of type 2 diabetes.

Associations between diet quality indices and psoriasis severity: results from the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study

Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between diet quality indices and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n 257). A 147-item FFQ evaluated adherence to the Mediterranean diet score, the Dietary Approaches to Stop Hypertension score and the Plant-based Diet Index (PDI), including its original (oPDI), healthy (hPDI) and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol overconsumption, energy intake and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to Dietary Approaches to Stop Hypertension (OR = 3·75; 95 % CI 1·313, 10·700; P = 0·01) and hPDI (OR = 4·04; 95 % CI 1·251, 13·064; P = 0·02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0·25; 95 % CI 0·085, 0·716; P = 0·01). With further adjustment for BMI, a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3·46; 95 % CI 1·029, 11·656; P = 0·05). Dietary interventions and assessment should be introduced in the care pathway for psoriasis management.

Systemic immune-inflammation index to albumin (SII/ALB) ratio as a novel dual-dimensional powerful predictor for hip fractures in elderly females with diabetes: a postmenopausal longitudinal cohort study

PURPOSE

Hip fracture is the most dangerous and potentially lethal fracture, described as "the last fracture of life" in older adults. Previous studies have shown that excessive immunoinflammatory response and nutrient deficiency may be involved. Nevertheless, a predictor for hip fracture risk that combines a thorough evaluation of immunoinflammatory with malnutritional conditions in postmenopausal women with type 2 diabetes mellitus (T2DM) remains scarce. This study explored the relationship between the SII/ALB ratio (SAR) and fragility fracture risk in postmenopausal older adults with T2DM.

METHODS

Between January 2014 and January 2021, a total of 509 postmenopausal female participants with T2DM were recruited from the Medical Record Database of the People's Hospital of Guangxi Zhuang Autonomous Region. Finally, 363 participants with an age median of 69.00 (64.00-75.00), were eligible for inclusion in this analysis. According to the statistical tertiles of the SAR, all participants were split into three groups: low-level (≤ 98.24, n = 121), moderate-level (98.24-157.25, n = 121), and high-level (≥ 157.25, n = 121). The participants were followed up for seven years, with a median follow-up time of 45.9 months (1389 person-years). The relationships between the SAR and a real-world fragility fracture event and an individualized future 10-year probability of major osteoporotic fracture (MOF) and hip fracture (HF) calculated by the fracture risk assessment tool (FRAX) were evaluated through Spearman's partial correlation analysis, restricted cubic spline (RCS) model, Cox proportional hazards regression model, and Kaplan-Meier survival analysis. Furthermore, some indicators such as geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and SII were also calculated and compared to their diagnostic efficacy and the clinical application value through the receiver operating characteristic (ROC) curve analysis and the decision curve analysis (DCA), respectively.

RESULTS

Of the 363 participants, 69 suffered a real-world fragility fracture event (19%). Spearman's partial correlation analysis indicated that SAR was negatively related to femoral neck (FN) bone mineral density (BMD) (r = -0.108, P = 0.041) and total hip (TH) BMD (r = -0.118, P = 0.025), but not lumbar spine (LS) BMD (all Models P > 0.05); positively correlated with an individualized future 10-year probability of MOF (r = 0.136, P = 0.010) and HF (r = 0.139, P = 0.008) calculated by FRAX, especially in hip fracture risk. The RCS model demonstrated the relationship between the SAR and a fragility fracture endpoint event in a J-shaped dose-dependent manner (P for overall < 0.001, P for nonlinear = 0.866). Multivariate Cox regression analysis indicated that the SAR was positively associated with fragility fracture risk (P < 0.001). Kaplan-Meier survival analysis showed that patients with higher levels of SAR had a greater probability of fragility fracture risk (log-rank, P < 0.0001). The ROC curve demonstrated an optimal SAR cut-off value of 146.209 with an area under the curve (AUC) of 0.740, a sensitivity of 0.681, and a specificity of 0.701 (P < 0.001). According to the AUC values, the ROC curve analysis combined with the DCA illustrated that the diagnostic efficacy and the clinical application benefit ranked as follows: SAR > SII > PNI > GNRI, respectively.

CONCLUSION

Our findings show the SAR is a novel dual-dimensional powerful predictor for fragility fracture risk, especially hip fracture, and as an effective tool for developing fragility fracture prevention strategies in postmenopausal females with T2DM. Consequently, monitoring SAR levels in usual clinical practice to focus on immunoinflammatory and nutritional status to identify individuals at high risk of hip fracture and implement timely fracture interventions is particularly essential.

CLINICAL TRIAL NUMBER

Not applicable.

The Potential Role of Advanced Glycation End Products in the Development of Kidney Disease

Advanced glycation end products (AGEs) represent a class of toxic and irreversible compounds formed through non-enzymatic reactions between proteins or lipids and carbonyl compounds. AGEs can arise endogenously under normal metabolic conditions and in pathological states such as diabetes, kidney disease, and inflammatory disorders. Additionally, they can be obtained exogenously through dietary intake, particularly from foods high in fat or sugar, as well as grilled and processed items. AGEs accumulate in various organs and have been increasingly recognized as significant contributors to the progression of numerous diseases, particularly kidney disease. As the kidney plays a crucial role in AGE metabolism and excretion, it is highly susceptible to AGE-induced damage. In this review, we provide a comprehensive discussion on the role of AGEs in the onset and progression of various kidney diseases, including diabetic nephropathy, chronic kidney disease, and acute kidney injury. We explore the potential biological mechanisms involved, such as AGE accumulation, the AGEs-RAGE axis, oxidative stress, inflammation, gut microbiota dysbiosis, and AGE-induced DNA damage. Furthermore, we discuss recent findings on the metabolic characteristics of AGEs in vivo and their pathogenic impact on renal function. Additionally, we examine the clinical significance of AGEs in the early diagnosis, treatment, and prognosis of kidney diseases, highlighting their potential as biomarkers and therapeutic targets. By integrating recent advancements in AGE research, this review aims to provide new insights and strategies for mitigating AGE-related renal damage and improving kidney disease management.

Healthful vs. Unhealthful Plant-Based Restaurant Meals

Background: Vegan/vegetarian (VEG) restaurants and VEG options in omnivore (OMNI) restaurants may serve unhealthful plant-based food that may be more harmful than a typical American diet. Methods: A sample of 561 restaurants with online menus were analyzed over a 3-year period. Each plant-based menu entrée was counted, up to a maximum of ten entrées per restaurant, meaning that a restaurant customer could select from ten or more healthful plant-based choices. Entrées containing refined grains (e.g., white rice and refined flour), saturated fat (e.g., palm oil and coconut oil), or deep-fried foods were counted as zero. Results: We evaluated 278 VEG and 283 OMNI restaurants. A full menu (10 or more plant-based entrées) was available in 59% of the VEG, but only 16% of the OMNI (p < 0.0001). Zero healthful options occurred in 27% of OMNI, but only 14% of VEG (p = 0.0002). The mean healthy entrée count for all restaurants was 3.2, meaning that, on average, there were only about three healthful plant-based choices of entrées on the menu, significantly more in VEG (4.0 vs. 2.4 p < 0.0001). The most common entrée reduction was for refined grains (e.g., white flour in veggie-burger buns or white rice in Asian entrées, n = 1408), followed by fried items (n = 768) and saturated fat (n = 318). VEG restaurants had a significantly higher frequency of adequate VEG options (≥7 options, 24% vs. 13%, p = 0.0005). Conclusions: Restaurants listed as VEG have a slightly higher number of healthful entrées than OMNI restaurants, which offer more limited vegan/vegetarian options. Given the published relationship between unhealthful dietary patterns, chronic illness, and mortality, we propose that detailed nutrition facts be publicly available for every restaurant.

Advanced glycation end products and risk of mortality in patients with cirrhosis: a prospective cohort study

The role of diet in reducing the burden of liver disease and mortality attributed to cirrhosis is very imperative. The present study scrutinized the relationship between dietary advanced glycation end products (AGEs) and mortality in patients with cirrhosis. This research was a prospective cohort study on 166 ambulatory cirrhotic patients who had been diagnosed with cirrhosis for a maximum of six months. Follow-up of patients continued for 5 years until May 2024. To determine the incidence of mortality in the quartiles of dietary AGEs, cox regression models were used with the adjustment of potential confounding variables. Although the first model of the analysis by adjusting the results for age and sex failed to show a significant increase in the risk of mortality in patients (HRQ4 vs. Q1 = 2.64; 95% CI = 0.9-7.5, P trend = 0.075), after adjusting the results for further confounders in the second (HRQ4 vs. Q1 = 3.56; 95% CI = 1.1-11.6, P trend = 0.040) and third (HRQ4 vs. Q1 = 3.3; 95% CI = 1.79-13.7, P trend = 0.048) models, the P trend for the risk of mortality during the quartiles of AGEs became significant. In addition, along with increasing trend of dietary AGEs, the number of deaths increased significantly (P = 0.024). Higher mortality risk was generally attributed to higher dietary AGEs in patients with cirrhosis.

Convergent Evolution and Predictability of Gene Copy Numbers Associated with Diets in Mammals

Convergent evolution, the evolution of the same or similar phenotypes in phylogenetically independent lineages, is a widespread phenomenon in nature. If the genetic basis for convergent evolution is predictable to some extent, it may be possible to infer organismic phenotypes and the capability of organisms to utilize new ecological resources based on genome sequence data. While repeated amino acid changes have been studied in association with convergent evolution, relatively little is known about the potential contribution of repeated gene copy number changes. In this study, we explore whether gene copy number changes of particular gene families are linked to diet shifts in mammals and assess whether trophic ecology can be inferred from the copy numbers of a specific set of gene families. Using 86 mammalian genome sequences, we identified 24 gene families with a trend toward higher copy numbers in herbivores, carnivores, and omnivores, even after phylogenetic corrections. We were able to confirm previous findings on genes such as amylase, olfactory receptors, and xenobiotic metabolism genes, and identify novel gene families whose copy numbers correlate with dietary patterns. For example, omnivores exhibited higher copy numbers of genes encoding regulators of translation. We also established a discriminant function based on the copy numbers of 13 gene families that can help predict trophic ecology to some extent. These findings highlight a possible association between convergent evolution and repeated copy number changes in specific gene families, suggesting the potential to develop a method for predicting animal ecology from genome sequence data.

A Mediterranean diet improves glycation markers in healthy people and in those with chronic diseases: a systematic review of clinical trials

CONTEXT

Consumption of the Mediterranean diet (MedDiet) has beneficial effects on cardiometabolic health and aging.

OBJECTIVE

This systematic review aimed to critically investigate the effect of the MedDiet on glycation markers in healthy or overweight individuals with type 2 diabetes or cardiovascular disease.

DATA SOURCES

MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched, using the terms "Mediterranean diet" AND "glycation end products, advanced".

DATA EXTRACTION

Three randomized and 3 nonrandomized clinical trials, containing data on 2935 adult and elderly individuals with normal weight or overweight, were included. All extracted data were compiled, compared, and critically analyzed.

DATA ANALYSIS

The authors of most of the studies demonstrated a reduction in serum concentrations of advanced glycation end products (AGEs), such as εN-carboxymethyllysine and methylglyoxal, and in skin autofluorescence levels after at least 4 weeks of adherence to the MedDiet. The MedDiet also led to positive effects on gene expression of receptors for AGEs, as RAGE and AGER1, and an enzyme involved in detoxification (glyoxalase I). There is no evidence that short-term adherence affects glycation markers.

CONCLUSIONS

Glycation markers improved in response to the MedDiet. The possible mechanisms involved may be related to the low AGE and refined sugars content of the diet, as well as its high monounsaturated fatty acid, phenolic compound, and dietary fiber contents.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42021284006.

Generation of advanced glycation end products from glycated protein or fructose/glyoxal-protein adducts under in vitro simulated gastrointestinal digestion

Advanced glycation end products (AGEs) are a heterogeneous group of compounds formed both endogenously and exogenously through reactions between reducing sugars and amino acids within the proteins. The digestive tract may also serve as a site for endogenous AGEs generation. This study examined whether additional AGEs are formed during the digestion of glycated protein diets and meal-resembling systems (dietary proteins with fructose or glyoxal). The digestion of glycated protein showed that free AGEs were gradually released, but no additional AGEs were generated. In contrast, co-digestion of dietary proteins with fructose or glyoxal resulted in the formation of additional AGEs, and the reaction substrates (fructose or glyoxal) were depleted during digestion. Additionally, the lysine released from proteins decreased, leading to a loss of nutritional value of the food during co-digestion. The formation of AGEs and the depletion of essential amino acids in the gut may have significant implications for human health.

Assessing metal-induced glycation in French fries

Non-enzymatic glycation is the chemical reaction between the amine group of an amino acid and the carbonyl group of a reducing sugar. The final products of this reaction, advanced glycation end-products (AGEs), are known to play a key role in aging and many chronic diseases. The kinetics of the AGE formation reaction depends on several factors, including pH, temperature, and the presence of prooxidant metals, such as iron and copper. In this study, the effect of iron and copper on the rate and outcome of non-enzymatic glycation was examined in the test tube and a food model, using chromatography and spectrometry methods. Binding efficiencies of several chelating agents to selected metals were also assessed. Phytic acid was the most efficient of the tested chelating agents. The effect of phytic acid on AGE formation in French fries was evaluated. While phytic acid treatment increased the amounts of UV-absorbing compounds in fries, a food ingredient rich in phytic acid showed the opposite effect. This study suggests that prooxidant metals can affect the rate, outcome, and yield of the non-enzymatic glycation reaction and that they do so differently when free or chelated. Moreover, despite being an excellent iron chelator, phytic acid can promote AGE formation in fried food potentially via mechanisms other than metal-induced glycation.

Substituting animal protein with black soymilk reduces advanced glycation end product level and improves gut microbiota composition in obese prediabetic individuals: a randomized crossover intervention trial

Prediabetes (PreDM) and obesity increase the risk of type 2 diabetes. Individuals with these conditions often consume diets higher in animal protein than in plant protein, which are associated with elevated levels of dietary advanced glycation end products (dAGEs). Increased dAGE intake has been linked to blood glucose abnormalities, oxidative stress, and dysbiosis of the microbiota, all of which exacerbate metabolic disorders. Black soybeans, as a plant-based protein source, contain substantially lower levels of dAGEs compared with pork. This study aimed to investigate the effects of substituting animal protein with black soybeans on advanced glycation end product (AGE) levels, oxidative stress, and the gut microbiota in individuals with both PreDM and obesity. This study was a randomized crossover intervention trial conducted over 16 weeks. We recruited men and women aged 20-64 years with both prediabetes and obesity. This study had four periods: 0-4 weeks for the run-in period, 4-8 weeks and 12-16 weeks for the pork or black soymilk intervention period, and 8-12 weeks for the wash-out period. During the intervention period, the participants consumed pork or black soymilk with similar protein content as their dietary protein source. The participants maintained 3 day dietary records, and we measured anthropometric items and collected blood and fecal samples for analysis. The results showed that partially substituting pork with black soymilk as a dietary protein source for 4 weeks significantly reduced dAGE intake. The black soymilk group also exhibited significantly lower blood AGE fluorescence intensity, oxidative stress, and levels of glycative stress markers. Furthermore, black soymilk consumption significantly increased the relative abundance of short-chain fatty acid-producing genera compared with pork consumption. In conclusion, partially substituting dietary pork with black soymilk may reduce serum AGE levels, reduce oxidative and glycation stress, and increase the abundance of short-chain fatty acid-producing microbiota in individuals with both PreDM and obesity. Registration number of Clinical Trial: NCT05290519 (ClinicalTrials.gov).

Adherence of Plant-Based Dietary Index in Odds of Diabetic Nephropathy in Women: A Case-Control Study

BACKGROUND & AIMS

Recent research has suggested that adherence to plant-based dietary index (PDI) may reduce the risk of type 2 diabetes and related complications like diabetic nephropathy (DN). Therefore, the aim of this study was to investigate the possible association of PDI with the odds of DN.

METHODS

We enrolled 105 eligible women with DN and 105 controls without DN (30-65 years). A 147-item food frequency questionnaire was used to evaluate an overall PDI, healthy plant-based dietary index (hPDI), and unhealthful PDI. Biochemical variables and anthropometric measurements were assessed for all patients using predefined protocols.

RESULTS

According to our final analyses, after controlling for potential confounders, participants with greater adherence to overall PDI (OR: 0.29; 95% CI: 0.15-0.56; P < .001) and hPDI (OR: 0.30; 95% CI: 0.15-0.56; P < .001) had 71% and 70% lower odds of DN compared to those with a low adherence, respectively. Conversely, subjects with a higher adherence to the unhealthful PDI had a positive association with increased odds of DN in the crude (OR = 5.00; 95% CI = 2.78-8.98; P < .001) and adjusted models (OR = 4.27; 95% CI = 2.24-8.14; P < .001), respectively.

CONCLUSION

The results of this study showed that greater adherence to overall PDI and hPDI was inversely associated with the odds of DN. However, further prospective studies are warranted to confirm these results.

The association of ultra-processed food intake with neurodegenerative disorders: a systematic review and dose-response meta-analysis of large-scale cohorts

OBJECTIVES

Our systematic review and meta-analysis aimed to uncover the relationship between UPFs intake and neurodegenerative disorders, including multiple sclerosis (MS), Parkinson's disease (PD), Alzheimer's disease (AD), cognitive impairment, and dementia.

SETTING

A systematic search was conducted using the Scopus, PubMed/MEDLINE, and ISI Web of Science databases without any limitation until June 24, 2023. Relative risk (RR) and 95% confidence interval (CI) were pooled by using a random-effects model, while validated methods examined quality and publication bias via Newcastle-Ottawa Scale, Egger's regression asymmetry, and Begg's rank correlation tests, respectively.

RESULTS

Analysis from 28 studies indicated that a higher UPFs intake was significantly related to an enhanced risk of MS (RR = 1.15; 95% CI: 1.00, 1.33; I2 = 37.5%; p = 0.050; n = 14), PD (RR = 1.56; 95% CI: 1.21, 2.02; I2 = 64.1%; p = 0.001; n = 15), and cognitive impairment (RR = 1.17; 95% CI: 1.06, 1.30; I2 = 74.1%; p = 0.003; n = 17), although not AD or dementia. We observed that a 25 g increment in UPFs intake was related to a 4% higher risk of MS (RR = 1.04; 95% CI: 1.01, 1.06; I2 = 0.0%; p = 0.013; n = 7), but not PD. The non-linear dose-response relationship indicated a positive non-linear association between UPF intake and the risk of MS (Pnonlinearity = 0.031, Pdose-response = 0.002). This association was not observed for the risk of PD (Pnonlinearity = 0.431, Pdose-response = 0.231).

CONCLUSION

These findings indicate that persistent overconsumption of UPFs may have an adverse impact on neurodegenerative conditions, potentially leading to a decline in quality of life and reduced independence as individuals age.

The Anti-AGEing and RAGEing Potential of Isothiocyanates

Isothiocyanates (ITCs), found in edible plants such as cruciferous vegetables, are a group of reactive organo-sulfur phytochemicals produced by the hydrolysis of precursors known as glucosinolates. ITCs have been studied extensively both in vivo and in vitro to define their therapeutic potential for the treatment of chronic health conditions. Therapeutically, they have shown an intrinsic ability to inhibit oxidative and inflammatory phenotypes to support enhanced health. This review summarizes the current evidence supporting the observation that the antioxidant and anti-inflammatory activities of ITCs temper the pathogenic effects of a group of reactive metabolites called advanced glycation end products (AGEs). AGE exposure has significantly increased across the lifespan due to health risk factors that include dietary intake, a sedentary lifestyle, and comorbid conditions. By contributing to a chronic cycle of inflammatory stress through the aberrant activation of the transmembrane receptor for AGE (RAGE), increased AGE bioavailability is associated with chronic disease onset, progression, and severity. This review debates the potential molecular mechanisms by which ITCs may inhibit AGE bioavailability to reduce RAGE-mediated pro-oxidant and pro-inflammatory phenotypes. Bringing to light the molecular impact that ITCs may have on AGE biogenesis may stimulate novel intervention strategies for reversing or preventing the impact of lifestyle factors on chronic disease risk.

Fructose-mediated AGE-RAGE axis: approaches for mild modulation

Fructose is a valuable and healthy nutrient when consumed at normal levels (≤50 g/day). However, long-term consumption of excessive fructose and elevated endogenous production can have detrimental health impacts. Fructose-initiated nonenzymatic glycation (fructation) is considered as one of the most likely mechanisms leading to the generation of reactive species and the propagation of nonenzymatic processes. In the later stages of glycation, poorly degraded advanced glycation products (AGEs) are irreversibly produced and accumulated in the organism in an age- and disease-dependent manner. Fructose, along with various glycation products-especially AGEs-are present in relatively high concentrations in our daily diet. Both endogenous and exogenous AGEs exhibit a wide range of biological effects, mechanisms of which can be associated with following: (1) AGEs are efficient sources of reactive species in vivo, and therefore can propagate nonenzymatic vicious cycles and amplify glycation; and (2) AGEs contribute to upregulation of the specific receptor for AGEs (RAGE), amplifying RAGE-mediated signaling related to inflammation, metabolic disorders, chronic diseases, and aging. Therefore, downregulation of the AGE-RAGE axis appears to be a promising approach for attenuating disease conditions associated with RAGE-mediated inflammation. Importantly, RAGE is not specific only to AGEs; it can bind multiple ligands, initiating a complex RAGE signaling network that is not fully understood. Maintaining an appropriate balance between various RAGE isoforms with different functions is also crucial. In this context, mild approaches related to lifestyle-such as diet optimization, consuming functional foods, intake of probiotics, and regular moderate physical activity-are valuable due to their beneficial effects and their ability to mildly modulate the fructose-mediated AGE-RAGE axis.

Investigation of Maillard reaction products in plant-based milk alternatives

Over the past decade, plant-based milk alternatives (PBMAs) have gained increasing popularity. Several processing technologies, including heat treatment, are usually employed during their production in order to replicate the properties of cow's milk. These processes can trigger the Maillard reaction, producing Maillard reaction products (MRPs) and amino acid cross-links, which may alter the nutritional profile and digestibility of PBMAs. This study investigates PBMAs available in the Scandinavian market to assess their MRP and amino acid cross-link concentrations, aiming to understand the relationship between the formation of these heat-induced compounds and the specific chemical composition of individual PBMAs. Two types of UHT-treated cow's milk and ten UHT-processed PBMAs from different brands were analyzed. Quantitative analyses included early-stage MRPs (Amadori products detected as furosine), intermediate MRPs (α-dicarbonyl compounds and furans), advanced glycation end products (AGEs), acrylamide, and amino acid cross-links (lanthionine and lysinoalanine). Protein, carbohydrate, and amino acid profiles were also assessed using LC-MS and HPLC methods. PBMAs were found to differ substantially in carbohydrate and protein content, with soy-based drinks containing higher protein and rice and oat drinks having more carbohydrates. Essential amino acid (EAA) levels were found lower in all PBMAs, impacting their nutritional quality. MRP levels, such as furosine and AGEs, varied across PBMAs, indicating different heat-processing intensities. Specific α-dicarbonyl compounds, like 3-deoxyglucosone, were more concentrated in PBMAs than in UHT-treated cow's milk, and compounds like HMF, furfural, and acrylamide were also found in some PBMAs. Finally, correlations were observed between sugar content, α-dicarbonyls, and AGEs, which offer insights into possible chemical transformations in PBMAs during processing.

Advanced Glycation End Products and Health: A Systematic Review

Advanced glycation end products (AGEs) have garnered significant attention due to their association with chronic diseases and the aging process. The prevalence of geriatric diseases among young individuals has witnessed a notable surge in recent years, potentially attributed to the accelerated pace of modern life. The accumulation of AGEs is primarily attributed to their inherent difficulty in metabolism, which makes them promising biomarkers for chronic disease detection. This review aims to provide a comprehensive overview of the recent advancements and findings in AGE research. The discussion is divided into two main sections: endogenous AGEs (formed within the body) and exogenous AGEs (derived from external sources). Various aspects of AGEs are subsequently summarized, including their production pathways, pathogenic mechanisms, and detection methods. Moreover, this review delves into the future research prospects concerning AGEs. Overall, this comprehensive review underscores the importance of AGEs in the detection of chronic diseases and provides a thorough understanding of their significance. It emphasizes the necessity for further research endeavors to deepen our comprehension of AGEs and their implications for human health.

Development and Validation of a Self-Administered Semiquantitative Food Frequency Questionnaire Focused on Gut Microbiota: The Stance4Health-FFQ

Background/Objectives: Diet significantly influences gut microbiota (GM), with variations in GM responses linked to the type and quantity of food consumed. These variations underscore the need for personalized nutrition. The Stance4Health (S4H) project developed the S4H Food Frequency Questionnaire (S4H-FFQ) and the i-Diet S4H app to assess dietary intake of foods affecting GM. This study aimed to validate the S4H-FFQ against the validated I.Family-FFQ and the i-Diet S4H app; Methods: The S4H-FFQ, with 200 food items across 14 food groups, evaluates dietary intake over the past month. Qualitative validation compared food group consumption frequencies from the S4H-FFQ and the I.Family-FFQ, while quantitative validation assessed nutrient and energy intake using the i-Diet S4H app. The S4H-GM score, a measure of GM-relevant food consumption, was evaluated through the S4H-FFQ and i-Diet S4H app; Results: Pearson correlations between the S4H-FFQ and the I.Family-FFQ ranged from 0.3 to 0.7 and were statistically significant across all the food groups. Quantitative validation showed lower but consistent correlations, comparable with other studies, confirming the S4H-FFQ's ability to estimate food intake. A positive correlation was also found between the S4H-GM scores from the S4H-FFQ and the i-Diet S4H app (p < 0.001); Conclusions: The S4H-FFQ is a reliable tool for assessing dietary patterns that influence GM. Its application in nutritional studies can enhance personalized nutrition and support future research aimed at optimizing GM and improving health outcomes.

The association between plant-based diet indices and risk of mortality in patients with cirrhosis: a cohort study

BACKGROUND

Following a plant-based diet is associated with a wide range of health benefits. The current study aimed to investigate the association between plant-based diet indices, specifically the plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) and risk of mortality in cirrhotic patients.

METHODS

This cohort study included a total of 121 patients with cirrhosis, who were followed for four years. Plant-based diet indices were calculated based on a validated semi-quantitative food frequency questionnaire consisting of 168 items. The Hazard ratio (HR) with their corresponding 95% confidence intervals (CIs) were estimated using the Cox proportional risk models.

RESULTS

During 414 person-year of follow-up, 43 deaths (7 women, 36 men) were documented. After adjusting all confounders, it has been found that the PDI (HR T3 vs. T1 = 0.16, 95% CI = 0.03-0.89, P trend = 0.024) and hPDI (HR T3 vs. T1 = 0.04, 95% CI = 0.02-0.61, P trend = 0.020) were inversely associated with the risk of mortality. While uPDI was directly associated with a significant increase in mortality risk (HR T3 vs. T1 = 8.74, 95% CI = 0.33-17.14, P trend = 0.018). The 4-year survival rate among patients showed a significant relationship with all three indices.

CONCLUSIONS

Our findings highlight that higher scores of PDI and hPDI can significantly reduce the risk of mortality in patients with cirrhosis, while a significant increase in mortality risk was found in those with higher uPDI. However, confirmation of these findings requires further studies.

AGE-RAGE Axis and Cardiovascular Diseases: Pathophysiologic Mechanisms and Prospects for Clinical Applications

Advanced glycation end products (AGE), a diverse array of molecules generated through non-enzymatic glycosylation, in conjunction with the receptor of advanced glycation end products (RAGE), play a crucial role in the pathogenesis of diabetes and its associated complications. Recent studies have revealed that the AGE-RAGE axis potentially accelerated the progression of cardiovascular diseases, including heart failure, atherosclerosis, myocarditis, pulmonary hypertension, hypertension, arrhythmia, and other related conditions. The AGE-RAGE axis is intricately involved in the initiation and progression of cardiovascular diseases, independently of its engagement in diabetes. The mechanisms include oxidative stress, inflammation, alterations in autophagy flux, and mitochondrial dysfunction. Conversely, inhibition of AGE production, disruption of the binding between RAGE and its ligands, or silencing of RAGE expression could effectively impair the function of AGE-RAGE axis, thereby delaying or ameliorating the aforementioned diseases. AGE and the soluble receptor for advanced glycation end products (sRAGE) have the potential to be novel predictors of cardiovascular diseases. In this review, we provide an in-depth overview towards the biosynthetic pathway of AGE and elucidate the pathophysiological implications in various cardiovascular diseases. Furthermore, we delve into the profound role of RAGE in cardiovascular diseases, offering novel insights for further exploration of the AGE-RAGE axis and potential strategies for the prevention and management of cardiovascular disorders.

Investigation of formation of AGEs precursors, hydroxymethylfurfural and malondialdehyde in oleogel added cakes using an in vitro simulated gastrointestinal digestive system

The baking process has the potential to generate health-risk compounds, including products from lipid oxidation and Maillard reaction. Pre- and post-digestion levels of hydroxymethylfurfural (HMF), malondialdehyde (MDA), glyoxal (GO), and methylglyoxal (MGO) were studied in cakes formulated with hazelnut and sunflower oil, along with their oleogels as margarine substitutes. The concentration of HMF in oil and oleogel-formulated cakes increased after digestion compared to cakes formulated with margarine. The MDA values were between 82 and 120 μg/100 g in oil and oleogel formulated cakes before digestion and a decrease was observed after digestion. The substitution of margarine with oil and oleogels resulted in the production of high amounts of GO and MGO in cakes. However, the highest bioaccessibility as 318.2% was found in cakes formulated by margarine for GO. Oleogels may not pose a potential health benefit compared to margarines due to the formation of HMF, MDA, GO, and MGO.

Assessment of the Genotoxic Potential of Repeatedly Heated Cooking Oil In Wistar Rats

Repeated heating of edible oils at high temperatures and its use in cooking food generates polycyclic aromatic hydrocarbons (PAHs) that have carcinogenic potential. The use of repeatedly heated cooking oils (RHCO) is a common practice in India. The present investigation in Wistar rats was done to determine the genotoxic potential of consumption of food cooked in sunflower oil that has been repeatedly heated to boiling. The rats were fed a diet cooked-fried in such oil. The biomarkers of genotoxicity, comet assay, micronucleus test, and chromosomal aberrations in peripheral blood lymphocytes (PBL) of Wistar rats were used. Results of the present investigation reveal that rats fed on food cooked in oil that was 5 times repeatedly boiled induced significant Deoxy ribonucleic acid (DNA) damage in PBL and liver homogenate. Increased frequency of micronuclei and chromosomal aberrations in blood and bone marrow of rats were also observed. A similar observation was found in rats that were fed food cooked in oil that was boiled 3 times. However, the results of genotoxicity in rats that ate food cooked in oil heated only once were not statistically significant in comparison to the control rats that fed on food made in heated oil (not boiled). Intake of food cooked in repeatedly heated oil of different heating grades induced significant genotoxicity in rats evident by increased DNA damage and frequency of micronuclei and chromosomal aberrations. The presence of PAHs in heated oils triggers the generation of free radicals which could be the possible causative factor for the induced genetic damage. This study sheds light on the potential link between dietary habits involving the use of degraded oils and long-term health consequences.

Association of dietary intake with pneumothorax: A Mendelian randomization study

Background

An association between dietary habits and lung disease has been demonstrated in previous studies. Employing Mendelian randomization, we aimed to explore how different dietary intakes relate to pneumothorax, shedding light on the interplay among gut flora, the lung-gut axis, and pneumothorax.

Methods

Employing both two-sample and multi-sample Mendelian randomization (MR) analyses, we investigated 24 dietary intake variables to establish a strong association with pneumothorax. Causal inferences were drawn using the inverse variance weighted (IVW) method. To fortify our findings, we employed a diverse array of methodologies, including Weighted Median Estimator (WME), Weighted Mode, Simple Mode, Mendelian Randomization Pleiotropy Residual Sum and Outlier (MR-PRESSO), MR-Egger regression, and LASSO.

Results

Our analysis identified genetic variants reliably predicting dietary intakes, meeting stringent criteria (p < 5 × 10-8) and demonstrating independence (r2 < 0.001). Causal-effect estimates derived from the IVW model unveiled a statistically significant association, indicating a causal correlation between pneumothorax and three dietary intakes. Specifically, heightened consumption of fresh fruit (OR = 0.196, 95%CI: 0.063-0.606, p = 0.004) and dried fruit (OR = 0.323, 95%CI: 0.114-0.911, p = 0.032) correlated with reduced pneumothorax risk, while increased processed meat intake (OR = 2.705, 95%CI: 1.026-7.128, p = 0.044) showed a positive correlation.

Conclusion

In summary, our MR analysis yields robust evidence supporting a causal correlation between dietary elements and pneumothorax. This study significantly advances our comprehension of pneumothorax risk factors, protective agents, and the intricate mechanisms of the lung-gut axis.

Dietary Restriction of Advanced Glycation End-Products (AGEs) in Patients with Diabetes: A Systematic Review of Randomized Controlled Trials

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.

Associations between Cooking Methods and Socio-Demographic, Dietary, and Anthropometric Factors: Results from the Cross-Sectional Swiss National Nutrition Survey

INTRODUCTION

Appropriate cooking methods can improve food safety, decrease contaminants, and increase nutrient bioavailability. Few studies assessed the sociodemographic characterization of their use in European populations. We aimed to characterize the socio-demographic, lifestyle, and anthropometric predictors of cooking methods in the Swiss population.

METHODS

Adults aged 18-75 years (n = 2,050) participating in the cross-sectional national nutrition survey in Switzerland (menuCH) (2014-2015), representing the 7 main regions in the country. We used logistic regressions to assess the probability of the presence or absence of boiled, roasted, microwaved, oven-cooked, gratinated, fried, steamed, and grilled foods by sociodemographic variables.

RESULTS

Among all participants, the most frequently used cooking methods were boiling (46%), stove-cooking (19%), and steaming (8%). Single participants had a higher probability of consuming grilled or fried foods (68%) than their married counterparts and participants with obesity had a higher probability of consuming grilled or fried foods (67% or 135%) compared to those with normal weight. Divorced or separated participants had a 55% lower probability of consuming roasted foods than married participants. Those following a diet had a 57% lower probability of consuming grilled foods compared to those not on a diet.

CONCLUSION

We found differences in the distribution of cooking methods in the Swiss population by sociodemographic variables. Further studies should examine the link between cooking methods and disease risk.

INTRODUCTION

Appropriate cooking methods can improve food safety, decrease contaminants, and increase nutrient bioavailability. Few studies assessed the sociodemographic characterization of their use in European populations. We aimed to characterize the socio-demographic, lifestyle, and anthropometric predictors of cooking methods in the Swiss population.

METHODS

Adults aged 18-75 years (n = 2,050) participating in the cross-sectional national nutrition survey in Switzerland (menuCH) (2014-2015), representing the 7 main regions in the country. We used logistic regressions to assess the probability of the presence or absence of boiled, roasted, microwaved, oven-cooked, gratinated, fried, steamed, and grilled foods by sociodemographic variables.

RESULTS

Among all participants, the most frequently used cooking methods were boiling (46%), stove-cooking (19%), and steaming (8%). Single participants had a higher probability of consuming grilled or fried foods (68%) than their married counterparts and participants with obesity had a higher probability of consuming grilled or fried foods (67% or 135%) compared to those with normal weight. Divorced or separated participants had a 55% lower probability of consuming roasted foods than married participants. Those following a diet had a 57% lower probability of consuming grilled foods compared to those not on a diet.

CONCLUSION

We found differences in the distribution of cooking methods in the Swiss population by sociodemographic variables. Further studies should examine the link between cooking methods and disease risk.

Modulation of circulating levels of advanced glycation end products and its impact on intima-media thickness of both common carotid arteries: CORDIOPREV randomised controlled trial

BACKGROUND

Increasing evidence supports the role of advanced glycation end products (AGEs) in atherosclerosis in both diabetic and non-diabetic patients, suggesting that therapeutic strategies targeting AGEs may offer potential benefits in this population. The Mediterranean diet is associated with improved biomarkers and anthropometric measurements related with atherosclerosis in addition to its ability to modulate AGE metabolism. Our aim was to determine whether the reduction in atherosclerosis progression (measured by changes in intima-media thickness of both common carotid arteries (IMT-CC)), observed after consumption of a Mediterranean diet compared to a low-fat diet, is associated with a modulation of circulating AGE levels in patients with coronary heart disease (CHD).

METHODS

1002 CHD patients were divided in: (1) Non-increased IMT-CC patients, whose IMT-CC was reduced or not changed after dietary intervention and (2) Increased IMT-CC patients, whose IMT-CC was increased after dietary intervention. Serum AGE levels (methylglyoxal-MG and Nε-Carboxymethyllysine-CML) and parameters related to AGE metabolism (AGER1 and GloxI mRNA and sRAGE levels) and reduced glutathione (GSH) levels were measured before and after 5-years of dietary intervention.

RESULTS

The Mediterranean diet did not affect MG levels, whereas the low-fat diet significantly increased them compared to baseline (p = 0.029), leading to lower MG levels following the Mediterranean diet than the low-fat diet (p < 0.001). The Mediterranean diet, but not the low-fat diet, produced an upregulation of AGE metabolism, with increased AGER1 and GloxI gene expression as well as increased GSH and sRAGE levels in Non-increased IMT-CC patients (all p < 0.05). Although the Mediterranean diet increased MG levels in Increased IMT-CC patients, this increment was lower compared to the low-fat diet (all p < 0.05).

CONCLUSIONS

Our results suggest that an improvement in modulation of AGE metabolism, which facilitates better management of circulating AGE levels, may be one of the mechanisms through which the Mediterranean diet, compared to a low-fat diet, reduces the progression of atherosclerosis in patients with CHD. Trial registration https://clinicaltrials.gov/ct2/show/NCT00924937 , Clinicaltrials.gov number, NCT00924937.

Overview of anti-inflammatory diets and their promising effects on non-communicable diseases

An anti-inflammatory diet is characterised by incorporating foods with potential anti-inflammatory properties, including fruits, vegetables, whole grains, nuts, legumes, spices, herbs and plant-based protein. Concurrently, pro-inflammatory red and processed meat, refined carbohydrates and saturated fats are limited. This article explores the effects of an anti-inflammatory diet on non-communicable diseases (NCD), concentrating on the underlying mechanisms that connect systemic chronic inflammation, dietary choices and disease outcomes. Chronic inflammation is a pivotal contributor to the initiation and progression of NCD. This review provides an overview of the intricate pathways through which chronic inflammation influences the pathogenesis of conditions including obesity, type II diabetes mellitus, CVD, autoinflammatory diseases, cancer and cognitive disorders. Through a comprehensive synthesis of existing research, we aim to identify some bioactive compounds present in foods deemed anti-inflammatory, explore their capacity to modulate inflammatory pathways and, consequently, to prevent or manage NCD. The findings demonstrated herein contribute to an understanding of the interplay between nutrition, inflammation and chronic diseases, paving a way for future dietary recommendations and research regarding preventive or therapeutic strategies.

Suppression of the postprandial hyperglycemia in patients with type 2 diabetes by a raw medicinal herb powder is weakened when consumed in ordinary hard gelatin capsules: A randomized crossover clinical trial

INTRODUCTION

Contradictory claims about the efficacy of several medicinal plants to promote glycemic control in patients with type 2 diabetes mellitus (T2DM) have been explained by divergences in the administration form and by extrapolation of data obtained from healthy individuals. It is not known whether the antidiabetic effects of traditional herbal medicines are influenced by gelatin capsules. This randomized crossover trial aimed to evaluate the acute effect of a single dose of raw cinnamon consumed orally either dissolved in water as a beverage or as ordinary hard gelatin capsules on postprandial hyperglycemia (>140 mg/dL; >7.8 mmol/L) in T2DM patients elicited by a nutritionally-balanced meal providing 50 g of complex carbohydrates.

METHODS

Fasting T2DM patients (n = 19) randomly ingested a standardized meal in five experimental sessions, one alone (Control) and the other after prior intake of 3 or 6 g of crude cinnamon in the form of hard gelatin capsules or powder dissolved in water. Blood glucose was measured at fasting and at 0.25, 0.5, 0.75, 1, 1.5 and 2 hours postprandially. After each breakfast, its palatability scores for visual appeal, smell and pleasantness of taste were assessed, as well as the taste intensity sweetness, saltiness, bitterness, sourness and creaminess.

RESULTS

The intake of raw cinnamon dissolved in water, independently of the dose, decreased the meal-induced large glucose spike (peak-rise of +87 mg/dL and Δ1-hour glycemia of +79 mg/dL) and the hyperglycemic blood glucose peak. When cinnamon was taken as capsules, these anti-hyperglycemic effects were lost or significantly diminished. Raw cinnamon intake did not change time-to-peak or the 2-h post-meal glycaemia, but flattened the glycemic curve (lower iAUC) without changing the shape that is typical of T2DM patients.

CONCLUSIONS

This cinnamon's antihyperglycemic action confirms its acarbose-like property to inhibit the activities of the carbohydrate-digesting enzymes α-amylases/α-glucosidases, which is in accordance with its exceptionally high content of raw insoluble fiber. The efficacy of using raw cinnamon as a diabetes treatment strategy seems to require its intake at a specific time before/concomitantly the main hyperglycemic daily meals. Trial registration: Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-98tx28b.

Ultra-processed foods and type 2 diabetes mellitus incidence in RaNCD project: a prospective cohort study

BACKGROUND

Following rapid population growth and urbanization, global ultra-processed food consumption levels have increased. Additionally, type 2 diabetes mellitus, a non-communicable disease, is affecting one-tenth of the people worldwide. In this study, we aimed to investigate the association between ultra-processed food consumption and the risk of type 2 diabetes mellitus in different scenarios in a prospective cohort study in the western part of Iran.

METHODS

The RaNCD cohort includes 10,047 participants aged 35 to 65; we included participants susceptible to diabetes at enrolment with follow-up data. We used the widely accepted Nova classification to define ultra-processed foods. A multivariable Cox proportional hazards regression model was used as the main model; furthermore, the Cox model with different adjustments and the logistic regression model were used as sensitive analysis to evaluate the association between ultra-processed foods consumption and type 2 diabetes mellitus.

RESULTS

A total of 8827 participants with a mean age of 46.92y, a mean follow-up time of 7.1y, and a mean daily ultra-processed food intake of 87.69 g were included. During the follow-up phases, we included 255 incidences of type 2 diabetes mellitus cases. After adjusting for confounders in the primary model, including age, gender, residence type, socioeconomic status, physical activity, body mass index, and familial history of diabetes despite the elevated hazard ratio of 1.08 (0.75, 1.55) in the fourth quartile compared to the first quartile, the P-value was insignificant (p-value = 0.665); p for trend in the UPF quartiles was also insignificant.

CONCLUSION

Our study has shed light on the association between ultra-processed food consumption and the risk of type 2 diabetes mellitus. However, further investigations are necessary to confirm or refute the UPFs/T2DM association.

Dietary advanced glycation end-products (dAGEs) are not associated with the risk of cancer incidence. A systematic review and meta-analysis of prospective cohort studies

A growing body of evidence indicates the association of dietary advanced glycation end-products (dAGEs) with the risk of cancer. This systematic review and meta-analysis aimed to assess the overall association between dAGEs and cancer incidence. An extensive search was carried out through online databases including PubMed, Scopus, and Web of Science up to June 2024. All reported HRs and their 95% CIs for risk of cancer were used to estimate log HRs and their standard errors (SEs). The overall risk estimate was obtained using a random effects model. Inter-study heterogeneity was determined using Cochrane's Q test and I-squared. Five prospective cohort studies with a total of 1,220,096 participants and 23,229 incident cancer cases (2193 pancreatic cancers, 11,443 breast cancers, 6162 colorectal cancers, and 3431 total cancers) were included in this meta-analysis. Compared with the lowest category of dAGEs, the pooled hazard ratio (HR) for overall cancers was 1.04 (95% CI: 0.94, 1.15; I 2 = 67.9%) for the highest category of dAGEs. Pooled estimates for different types of cancer showed no significant relationship between dAGEs and risk of breast cancer (HR: 1.119; 95% CI: 0.868, 1.444; I 2 = 77.6%; N = 2 studies), pancreatic cancer (HR: 1.242; 95% CI: 0.971, 1.588; I 2 = 0.0%; N = 2 studies), colon cancer (HR: 10.985; 95% CI: 0.887, 1.094; I 2 = 0.0%; N = 2 studies) and rectal cancer (HR: 0.940; 95% CI: 0.616, 1.433; I 2 = 57.7%; N = 2 studies). Dietary AGEs had no significant link with cancer risk. More well-designed prospective studies are required.