High consumption of foods that are processed and rich in advanced glycation end products (AGEs) is a primary reason for India’s reputation as the global diabetes epicenter, according to a groundbreaking clinical trial. These foods include items like cakes, biscuits, crackers, fried foods, mayonnaise, margarine, and heavily processed meals.
AGEs are unstable and potentially harmful compounds that emerge when proteins or lipids suffer glycation, i.e., they are modified by aldose sugars (carbohydrates with an aldehyde group).
Researchers from multiple organizations, including the Indian Council of Medical Research (ICMR) and Madras Diabetes Research Foundation (MDRF) held this unique government-funded trial. The trial concluded that consuming foods rich in AGEs could induce inflammation in the body, a root cause of diabetes.
Glycation, a non-enzymatic chemical process where a sugar molecule binds to a protein or lipid molecule, can lead to dangerous reactions in the body. This trial discovered that a low-AGE diet comprising foods low in AGEs, such as fruits, vegetables, whole grains, and low-fat milk, can help overweight and obese individuals lower oxidative stress in their bodies. Here, oxidative stress refers to the severe imbalance between free radicals and antioxidants, leading to inflammation and cell damage.
“This dietary intervention has the potential to lessen the impact of obesity-related type two diabetes,” specified the researchers in the report. It’s important to understand what AGE-rich foods are and the processes that lead to their elevated AGE content. This knowledge is critical in devising India’s strategy to combat the diabetes epidemic, said Dr. V. Mohan, Chairperson, MDRF, who is also one of the paper’s authors.
ICMR and MDRF conducted a study revealing that the prevalence of diabetes in India in 2021 was a staggering 11.4%. This implies that an estimated 10.1 crore Indians suffered from diabetes in 2021.
The study pointed out that previous research from the West indicated a heightened risk for chronic diseases due to high consumption of overly processed foods rich in fats, sugar, salt, and AGEs. The rapid nutrition transition in developing countries like India led to increased consumption of refined carbohydrates, fats, and animal products, leading to increased obesity and diabetes cases.
This new study explored the effects of low and high AGE diets on glucose and lipid metabolism, oxidative stress, inflammatory responses in overweight and obese Indian adults. The clinical trial involved 38 adults who were overweight or obese but non-diabetic. One group adopted a low-AGE diet while the other followed a high-AGE diet for 12 weeks.
The researchers found that after 12 weeks, the insulin oral disposition index (a measure of insulin sensitivity and functional capacity of beta cells that produce insulin), was significantly augmented in the low-AGE diet group compared with the high-AGE diet group. Insulin sensitivity refers to how effectively cells respond to insulin for glucose uptake from the blood.
The study also found that the low-AGE diet group exhibited a substantial reduction in 30-minute postload plasma glucose (PG) levels, which is an indicator of future type 2 diabetes risk, compared with the high-AGE diet group.
The study is significant in that it included routinely consumed Indian foods that were measured for dietary AGE composition before planning the intervention diet menu. According to Dr. Mohan, the results provide evidence in the Indian context that non-processed, healthy foods, like fruits, vegetables, green leafy vegetables, and whole grains have low AGE content.
“In general, fried, grilled and baked foods have the highest AGE content. Other high-AGE foods include dry nuts, roasted walnuts, sunflower seeds, fried chicken, bacon, and beef. Both animal proteins and processed plant foods contain molecules making them susceptible to glycation,” the study authors concluded.
