Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes

Abstract

BACKGROUND In recent years, American Diabetes Association started to strongly advocate the Mediterranean diet (MD) over other diets in patients with diabetes mellitus (DM) because of its beneficial effects on glycemic control and cardiovascular (CV) risk factors. Tissue levels of advanced glycation endproducts (AGEs) emerged as an indicator of CV risk in DM. Skin biopsy being invasive, the use of AGE Reader has been shown to reflect tissue AGEs reliably. AIM To examine the association between adherence to MD and AGEs in patients with DM type II. METHODS This cross-sectional study was conducted on 273 patients with DM type II. A survey questionnaire was composed of 3 separate sections. The first part of the questionnaire included general data and the habits of the participants. The second part aimed to assess the basic parameters of participants’ diseases and associated conditions. The third part of the questionnaire was the Croatian version of the 14-item MD service score (MDSS). AGEs levels and associated CV risk were measured using AGE Reader (DiagnOptics Technologies BV, Groningen, The Netherlands). RESULTS A total of 27 (9.9%) patients fulfilled criteria for adherence to MD, with a median score of 8.0 (6.0-10.0). Patients with none/limited CV risk had significantly higher percentage of MD adherence in comparison to patients with increased/definite CV risk (15.2% vs 6.9%, P = 0.028), as well as better adherence to guidelines for nuts (23.2% vs 12.6%, P = 0.023) and legumes (40.4% vs 25.9%, P = 0.013) consumption. Higher number of patients with glycated hemoglobin (HbA1c) < 7% adhered to MD when compared to patients with HbA1c > 7% (14.9% vs 7.3%, P = 0.045). Moreover, those patients followed the MDSS guidelines for eggs (33.0% vs 46.8%, P = 0.025) and wine (15.6% vs 29.8%, P = 0.006) consumption more frequently. MDSS score had significant positive correlation with disease duration ( r = 0.179, P = 0.003) and negative correlation with body mass index (BMI) values ( r = -0.159, P = 0.008). In the multiple linear regression model, BMI (β ± SE, -0.09 ± 0.04, P = 0.037) and disease duration (β ± SE, 0.07 ± 0.02, P < 0.001) remained significant independent correlates of the MDSS score. Patients with HbA1c > 7% think that educational programs on nutrition would be useful for patients in significantly more cases than patients with HbA1c < 7% (98.9% vs 92.6%, P = 0.009). ...

The Association between the Level of Advanced Glycation End Products and Objective Skin Quality Parameters

“…Through the multiligand receptor for advanced glycation end products (RAGE) on the vascular cells, AGEs play a key role in the inflammatory process [ 13 ]. It is well established that higher levels of AGEs are linked to diseases such as diabetes, chronic kidney disease, nonalcoholic fatty liver disease, obesity and cardiovascular diseases [ 14 , 15 , 16 , 17 , 18 , 19 ].…”

Obesity, Gut Microbiota, and Metabolome: From Pathophysiology to Nutritional Interventions

“…A high consumption of olive oil, vegetables, fruits, unprocessed cereals, nuts, legumes, fish, and other seafood, moderate consumption of old cheese and red wine, and limited consumption of dairy products and meat are its principal characteristics. Apart from demonstrating benefit in many chronic diseases, a MD’s effects on individuals with obesity is well established, particularly in regard to the gut microbiota composition and the metabolome [ 102 , 103 , 104 ]. Moreover, since a substantial number of RCTs concerning the interrelation between a MD and gut microbiota were performed (unlike with other dietary interventions), inferences about this dietary regime are perhaps the most reliable ones.…”

Can Fasting Curb the Metabolic Syndrome Epidemic?

“…Similar results were obtained in another meta-analysis that also studied the relationship between a posteriori dietary patterns and MetS: a healthy/prudent diet was associated with a lower prevalence of MetS, while an unhealthy/Western pattern was associated with an increased risk of developing MetS [ 64 ]. Another popular dietary pattern, the Mediterranean diet, has also shown benefits regarding MetS [ 65 , 66 ]. In a meta-analysis by Kastorini et al, the combined effect of prospective studies and clinical trials showed that the Mediterranean diet is associated with a reduced risk of MetS (log hazard ratio: −0.69, 95% confidence interval (CI): −1.24 to −1.16) [ 67 ].…”