Background: Contradictory evidence exist on the impacts of consumption of diets with low advanced glycation end products (LAGE diets) on improving cardiometabolic profile with regards to the participants’ diabetic status and amount of dietary AGEs.
Objective: To determine the effect of low and high AGE diets in reducing cardiometabolic risk.
Methods: Medline, Embase, Scopus, Cochrane, CINHAL and ProQuest databases were searched up to May, 2016. Risk of bias and data extraction was done by two independent reviewers. Meta-analysis using random effects model was employed.
Results: Seventeen RCTs comprising n=560 participants were included. LAGE diets were associated with decreased insulin resistance (MD -1.3 µmol/mU/l, 95% CI -2.3, -0.2) but no change in weight (MD -0.8kg, 95% CI -4.4 to 2.9), fasting glucose (MD -0.4 mg/dl, 95% CI -2.4, 1.7), 2-hour glucose (MD -7.2 mg/dl, 95% CI -16.7, 2.3), HbA1c (MD -0.01%, 95% CI -0.09, 0.08) and 2-hour insulin levels (MD 0.3 µU/ml, 95% CI -1.5, 2.1). Decrease in fasting insulin levels (MD -7, 95% CI -11.5, -2.5) was observed only in patients with type 2 diabetes. Total cholesterol (MD -8.5 mg/dl, 95% CI -9.5, -7.4) and low-density lipoprotein levels (MD -2.4 mg/dl, 95% CI -3.4, -1.3) reduced after consumption of LAGE diets with no change in HDL cholesterol (MD -1.6, 95% CI -6.6, 3.3) and blood pressure. Estimated glomerular filtration rate was improved after a consumption of LAGE diets. Tumour necrosis factor α, vascular cell adhesion protein-1, 8-isoprostane, leptin, and circulating AGEs were reduced in LAGE groups. In addition, adiponectin and sirtuin-1 were increased after a consumption of LAGE diets.
Conclusion: Diets low in AGEs improve cardiometabolic profile by reducing both traditional and non-traditional cardiovascular risk factors in individuals with or without diabetes. Hence restriction in dietary AGE content may be an effective strategy to decrease diabetes and cardiovascular risk.