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The present study showed that a reduction of approximately 56% in CML consumption promoted a 30% reduction in this blood biomarker. This effect was associated with increased fiber intake and reduced consumption of polyunsaturated fatty acids, trans fatty acids, and cholesterol, in addition to a positive linear correlation with lipid peroxidation, body water, and dPFGAs. This represents a potential benefit, given that these factors favor insulin resistance (IR) and vascular endothelial injury, and consequently, the processes of diabetes and atherosclerosis. Thus, reducing the daily consumption of CML in the diet, combined with preparing foods at lower temperatures, constitutes a potentially protective nutritional intervention in the context of diabetes and, especially, vascular health, with a plausible impact on the prevention of cardiometabolic complications. It is worth noting that future research for analyses of total PFGAs, specific PFGAs such as pyrraline and pentosidine, and with dPFGAs, and/or studies involving a table of dietary PFGA composition with foods of Brazilian origin are necessary due to their importance in the public health context in Brazil. Furthermore, the need for long-term studies on restricting PFGA consumption is highlighted.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | Placebo Comparator |
| |
| Intervention group | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| a low-CML diet | Other | Patients were instructed to boil or cook their food, and to avoid frying, grilling, and roasting. The assessment of CML content, as well as adherence to the dietary intervention, was based on the average of the 24-Hour Recalls (R24H) and was calculated based on the previous study conducted by Uribarri and collaborators, who evaluated 549 foods, with results published in 2010. The authors estimated that 1 AGE equals 1,000 KU (kilo-units). Considering that the study was conducted with an American population, certain regional foods were not found in the table; therefore, foods with similar composition were used to quantify CML. |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the effect of the low-CML diet on the percentage reduction of serum CML in patients with T2DM. | Quantification of serum CML was performed using the OxiSelectTM Nε-(carboxymethyl) lysine Competitive ELISA kit (Cell Biolabs®), following the manufacturer's instructions. | Right after the blood collection |
| Measure | Description | Time Frame |
|---|---|---|
| To evaluate the effect of CML reduction on body composition, through anthropometric and bioimpedance measurements. | For the anthropometric assessment, the following variables were used: weight, height, BMI, waist and abdomen circumference. BMI, waist-to-height ratio (WHtR), and abdominal circumference were assessed according to the World Health Organization (WHO). All circumferences were performed in triplicate. Determination of body composition was performed by bioelectrical impedance analysis (BIA) using the Tanita Corporation® (BC601 2018-2020, Maeno-cho Itabashi ku, Tokyo, Japan). |
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Inclusion Criteria: Men and women, aged between 55 and 65 years, diagnosed with T2DM, CAD, and overweight or obesity were included.
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Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Servico de Prevencao, Cardiopatia na Mulher e Reabilitacao Cardiovascular, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, | São Paulo | São Paulo | 05403- 900 | Brazil |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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|
| Control | Other | Patients on their usual diet |
|
| 30 minutes, during the consultation on the first evaluation day and on Day 15 afterward. |
| To evaluate the influence of reduced CML levels on the serum concentrations of glucose, insulin, triglycerides, HDL (High-Density Lipoprotein), and LDL (Low-Density Lipoprotein). | The dosages of glucose,, LDL, HDL, and triglycerides were performed using a colorimetric assay on an automated Alinity C analyzer (Abbott, TX, USA), utilizing specific kits. Insulin dosages were performed by chemiluminescence on an automated Alinity I analyzer (Abbott), utilizing specific kits. | Right after the blood collection |
| D004700 | Endocrine System Diseases |
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |