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What you need to know about advanced glycation end products


You've probably heard of AGEs, but what precisely are they? Advanced glycation end products (AGEs) are glycotoxins that arise when proteins or lipids mix with sugars. These substances have been linked to increased inflammation and oxidative stress, as well as tissue damage, which can lead to the development of a variety of chronic diseases. Breast cancer has recently been linked to AGEs.


What Are Advanced Glycation End Products (AGEs)?

When proteins and fats interact with sugars during cooking, AGEs, also known as glycotoxins, develop. These chemicals have the potential to harm tissues and contribute to the development of chronic illnesses. AGEs are naturally created by the body, but they can also be produced through cooking procedures such as grilling, frying, and roasting. Processed foods are also rich in AGEs.


Inflammation, oxidative stress, and cell damage have all been associated to AGE exposure. These side effects can result in the development of chronic diseases like diabetes, cardiovascular disease, and Alzheimer's disease.


In the Women's Health Initiative 15-year follow-up trial, postmenopausal women who lowered their exposure to AGEs survived longer after breast cancer and had a lower risk of dying from cardiovascular disease. In the National Institutes of Health-AARP Diet and Health Study, dietary AGEs were shown to play a role in the development of postmenopausal breast cancer.



What types of foods are AGEs?


How Can You Avoid Advanced Glycation End Products?


While the production of AGEs is a normal element of metabolism, excessive levels can be hazardous. There are numerous strategies to avoid AGE exposure.


  1. Cook with moist methods that do not involve high dry heat, such as steaming or boiling.

  2. Reduce your intake of processed foods.

  3. Reduce the cooking time.

  4. Cook food slowly at low heat.

  5. Include acidic elements like lemon juice and vinegar, which prevent the production of AGEs.


Modern diets are frequently high in processed foods with greater levels of AGEs, so it is critical to minimize your consumption of these items. Hot dogs, bacon, sausages, chips, and pizza are some examples of processed foods high in AGEs.


For example, microwaving bacon vs frying bacon, dramatically reduces the formation of AGEs. But bacon has other problems linked to breast cancer.


Bacon has also been associated with triggering dormant breast cancer cells to spread. Erik Nelson, PhD, Professor of Molecular and Integrative Physiology at University of Illinois at Urbana-Champaign has uncovered a cholesterol by-product and foods fried at high temperatures – such as bacon – may lead to breast cancer recurrence. Dr. Nelson showed cured bacon fat increases metastasis compared to lard in a standard diet.


Is it because lard is made using low temperatures compared to bacon, or the curing process of bacon? This is still unknown. This research does not mean bacon causes recurrence and more studies are needed.


Carbohydrate foods and Advanced Glycation End Products


Even after cooking, carbohydrate-rich meals like vegetables, fruits, whole grains, and milk are much lower in AGEs. Foods with reduced AGE levels include:

● whole-grain bread and pasta

● yogurt

● beans and legumes

● fruit

● oatmeal


There is evidence that keeping a healthy gut microbiota may also help to reduce circulating AGE levels. This is due to the ability of gut bacteria to breakdown AGEs during the digestion process. Consuming fermented foods (kimchi, sauerkraut, yogurt, kefir) and taking a probiotic supplement can help maintain a healthy gut microbiota.


Finally, eating a diet high in antioxidants and phytochemicals (antioxidants found in plants) may help reduce cell damage caused by AGEs.



High heat increases AGEs in food


Lowering Intake of Advanced Glycation End Products


According to human studies, a low-AGE diet decreases oxidative stress and inflammation. This research discovered greater insulin sensitivity, which can decrease inflammatory indicators.


So, what exactly is a low-AGE diet? Here are two sample menus featuring some of my favorite meal plan recipes that use AGE-lowering methods:


Menu 1

Breakfast: Orange Cardamom Overnight Oats

Lunch: Kale and Sweet Potato Salad with Walnuts

Snack: Glass soymilk with blueberries

Dinner: Whole-grain Pasta with Beans, Garlic, and Arugula served with Simple Poached Salmon


Menu 2

Breakfast: Chocolate Fudge Smoothie with Hemp Seeds

Lunch: Quinoa Tabbouleh

Snack: Greek yogurt and pomegranate arils

Dinner: African Peanut Stew with Sweet Potatoes and Spinach


Conclusion about Advanced Glycation End Products


Reducing your AGE exposure is an excellent strategy to improve your general health and lower your risk of chronic disease. Simple modifications to your cooking and eating habits can help safeguard your health in the long run by lowering your risk of cardiovascular disease, cancer, diabetes, and Alzheimer's disease.


"The current dAGE database demonstrates that a significantly reduced intake of dAGEs can be achieved by increasing the consumption of fish, legumes, low-fat milk products, vegetables, fruits, and whole grains and by reducing intake of solid fats, fatty meats, full-fat dairy products, and highly processed foods." [PMID: 20497781]


This recommendation is in line with those made by the American Heart Association, the American Institute for Cancer Research, and the American Diabetes Association, so eating a diet low in AGEs reduces the risk of multiple chronic diseases and cancer.


Now that you understand what advanced glycation end products are and how to decrease your exposure to them, you can use them to help manage the impact of these substances.


Yet another reason to eat your fruits and vegetables!


As a registered dietitian nutritionist who works with people experiencing cancer, I’d love to help. I offer clients support to plan, shop, and prepare more nutritious and healthy meals for yourself or your family. Here is my link to book a chat about making sure to meet your nutritional needs.



References:


Dariya B., Nagaraju G.P. Advanced Glycation in Diabetes, Cancer and Phytochemical Therapy. Drug Discov. Today. 2020;25:1614–1623. doi: 10.1016/j.drudis.2020.07.003.


Peterson, L. L., Park, S., Park, Y., Colditz, G. A., Anbardar, N., & Turner, D. P. (2020). Dietary advanced glycation end products and the risk of postmenopausal breast cancer in the National Institutes of Health-AARP Diet and Health Study. Cancer, 126(11), 2648–2657. https://doi.org/10.1002/cncr.32798


Twarda-Clapa A, Olczak A, Białkowska AM, Koziołkiewicz M. Advanced Glycation End-Products (AGEs): Formation, Chemistry, Classification, Receptors, and Diseases Related to AGEs. Cells. 2022 Apr 12;11(8):1312. doi: 10.3390/cells11081312. PMID: 35455991; PMCID: PMC9029922.


Omofuma, O. O., Peterson, L. L., Turner, D. P., Merchant, A. T., Zhang, J., Thomson, C. A., Neuhouser, M. L., Snetselaar, L. G., Caan, B. J., Shadyab, A. H., Saquib, N., Banack, H. R., Uribarri, J., & Steck, S. E. (2021). Dietary Advanced Glycation End-Products and Mortality after Breast Cancer in the Women's Health Initiative. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 30(12), 2217–2226. https://doi.org/10.1158/1055-9965.EPI-21-0610


Uribarri J, Woodruff S, Goodman S, Cai W, Chen X, Pyzik R, Yong A, Striker GE, Vlassara H. Advanced glycation in foods and a practical guide to their reduction in the diet. J Am Diet Assoc. 2010 Jun;110(6):911-16.e12. doi: 10.1016/j.jada.2010.03.018. PMID: 20497781; PMCID: PMC3704564.


Ulrich P, Cerami A. Protein glycation, diabetes, and aging. Recent Prog Horm Res. 2001;56:1-21. doi: 10.1210/rp.56.1.1. PMID: 11237208.


Vlassara H, Cai W, Tripp E, Pyzik R, Yee K, Goldberg L, Tansman L, Chen X, Mani V, Fayad ZA, Nadkarni GN, Striker GE, He JC, Uribarri J. Oral AGE restriction ameliorates insulin resistance in obese individuals with the metabolic syndrome: a randomised controlled trial. Diabetologia. 2016 Oct;59(10):2181-92. doi: 10.1007/s00125-016-4053-x. Epub 2016 Jul 29. PMID: 27468708; PMCID: PMC5129175.


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