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Welcome to the Exam Room podcast brought to you by the Physicians Committee. Hi.
I am the weight loss champion, Chuck Carroll, and today we are going to learn
what is probably a new term for you.
It's called Advanced Glycation End Products.
What are they?
Well, a new study sheds a whole lot of light on that.
And it turns out, spoiler alert, the fewer
you have in your diet, probably you're going to lose some weight.
You're going to get your diabetes under control.
You may even get a little bit of help with your heart.
But I'm not the expert on it.
The person who is is someone who just led some extraordinary research
all about ages.
Dr. Hamid Khalifa is with us once again here on the exam room. Dr.
Colley, over. Good to see you again.
Thanks for having me, Chuck.
This is a pretty exciting paper, a study that you published here.
I had no idea what age these were until you sent the study my way.
So I'm excited to share it with the Exam Room is today.
So let's start by talking about what in the world
is an advanced glycation end product?
Yeah, I'm glad you asked, Chuck.
There are so many reasons why
a plant based diet is good for your health.
It's low in saturated fat and cholesterol
and rich in fiber, high in antioxidants.
It's low in heme iron
and now we're talking about advanced glycation end products,
which are molecules that cause
inflammation and damage in your body.
So let me share my screen and let's let's dove into this.
The less of advanced glycation and products
you have in your body, the better.
And we looked into the effect of a plant based diet
on advanced glycation end products and its association with body weight,
body composition and insulin sensitivity.
So what are the advanced glycation
end products or the ages, as we call them?
These are proteins in our body that have been changed through
an extended exposure with sugar or fat.
First, they form the early glycation end products.
That happens fast within within a few days.
And then it's the exposure to sugar
and fat in your bloodstream continues.
Then the proteins grow to form the advanced glycation end products
or the ages, and we can measure them in your bloodstream,
we can measured them and they're in your skin.
And these compounds
increase the oxidative stress.
You've probably heard the term before.
That means the oxidative damage that that happens in our body
and that they also increase chronic inflammation,
immune system imbalance and tissue injury.
And they are the molecules that are behind
the development of cardiovascular disease and kidney disease.
And liver disease and metabolic disease, such as diabetes and cancer and neuro
neuro degeneration such as Alzheimer's
disease, immune problems.
In other words,
you don't want these in everybody.
So the lower their level in your body, the better.
Now, how do we get the eggs in our body?
Some of them are being formed during metabolism.
As we eat food, they're being formed and released into our bloodstream.
But some of them are being consumed in the diet.
The foods that are particularly high
in ages are the processed meats and cheese,
but they're also contained in processed grains.
And, for example, chocolate, the you know, the sugar and the sugar
the sugar sweetened beverages and sugary foods.
So in other words,
we consume them in our diet.
And you've probably heard
that when you grill meat,
the ages are being formed,
especially when you when
when the food gets good,
like dark brown and almost, almost black.
And the consumption of dietary ages has been shown to increase body weight.
Also visceral fat and insulin resistance
independent of caloric intake.
A lot of attention
has been directed toward cooking methods.
So when you, for example, microwave chicken,
the amount of ages will double.
But when you grilled chicken,
then the eggs will go up six times.
Well, that's true for meat.
But what about other other foods?
What about plant foods?
It turns out that, for example,
boiled potatoes or apples are much, much lower in ages
compared with chicken and with other meats.
So that Lee, that led us to ask the question,
what if we put people on a vegan diet?
What what will happen to their eggs?
So that's exactly what we did.
We had 240 overweight people
who were endemically assigned
to follow either a low fat vegan diet that consisted of fruits and vegetables
and whole grains and legumes or
to stay on their usual diet for 16 weeks.
Now, we were tracking their body
weight, their body composition,
using a DEXA scan.
We were tracking their insulin resistance,
and they gave us detailed
diet records at the beginning and at the end of the study.
And based on that, we ran all the foods
in from from the database, and we looked at
how many eggs they were consuming.
Now, over the course of 16 weeks,
people lost about £14 on a vegan diet.
That's about £1 a week.
That's very consistent with our previous findings.
About two thirds of the weight loss was due to fat loss.
They also lost a lot of visceral fat around the in their organs.
That's the metabolically most dangerous fat.
Also, insulin resistance was decreased, which is a good finding.
Now, the dietary changes were reduced
by 80% on the on the vegan diet, which is just mind blowing.
Now, where did all the old,
old, older eduction of the ages come from?
55% of the
reduction came from meat, obviously, on a vegan diet.
You don't eat any meat.
So the age is coming from meat.
We're decreased by 50, 55% of the reduction
came from the fact that people were not eating any meat.
So that was the majority,
not eating any dairy was responsible
for 26% decrease in the total ages.
And what also helped is, is that the vegan diet was low fat.
We minimized the consumption of oils.
And also, obviously on a vegan diet,
you don't use any animal fats.
And that was responsible for 15% of the eggs reduction.
We found significant correlations.
One thing is to reduce the eggs in the diet.
But was it was it somehow a associated with weight loss
and the improvements in metabolism?
And the answer is yes.
The reduction in dietary eggs
was also associated with weight loss, improved body composition.
That means lower fat mass, lower risk of fat
and increased insulin sensitivity
independent of caloric intake.
Because some of you may be asking, you know, is it because people
are eating less calories on a plant based diet?
Now, that was completely independent of caloric intake.
So in summary, a plant based diet
reduced dietary changes significantly,
and this was also associated with weight loss, improved body composition
and improved insulin sensitivity independent of energy intake.
So our advanced glycation
end products aging, you
don't let them.
This is what I have, Chuck, and I'm ready for your questions.
Oh, good.
Because I have some that that is a fascinating study.
You always bring such great research to the show.
The first question I have for you is you were talking about
how plant based foods tend to have far fewer ease.
And the examples that you cited there in your slides
were boiled potatoes and an apple.
But what about
foods that are cooked in a drier way?
Say, I really like roasted Brussels sprouts.
So those are going to go in the oven.
That's a dry heat, possibly even a higher heat.
Are they likely to have more energy ease because they've been roasted?
Possibly.
Even if you have a gas stove
exposed to a little bit of flame than, say, the boiled potatoes?
That's a great question.
If you toast bread or if you toast
or if you grill something in the oven,
if you bake something in the oven,
generally speaking, the dry heat
will increase the amount of energy in your food,
regardless of the origin of the foods.
But what do you need to keep in mind?
Is that all the plan to are much lower
in age to start with.
So let's say, you know, a slice of bread
would have 50 kilo units of ages, 100 grams.
And by toasting the bread, you would increase
the amount of egg used, 75 or even a hundred.
That would be still super low compared to the animal product.
So is it is it better to boil
the potatoes, for example, than bake them in terms of eggs?
Yes, absolutely.
But at the same time,
if you are sticking to a plant based diet,
then your diet will be automatically much lower in eggs
compared with someone who eats animal products.
For the people that were participating in the study,
did you talk about cooking methods with them and suggest.
Not at all. Yeah, that's a good point.
Not at all.
The participants in the study were not instructed in
any in any way on which cooking methods they should be using.
So even without any instructions,
their amount of ages went down by 80%.
All right.
Now, there was a quote in the study that stood out to me, and it made me
wonder how much meat were the participants eating prior to the study?
Because verbatim.
Now you wrote that their consumption
of animal derived foods was significant.
So are we talking about meat for breakfast, lunch and dinner?
Exactly.
It's a standard American diet.
So, of course, we're talking about daily consumption of meat.
One finding that's really surprising for me personally.
You know, we know from from the nutritional
tables and the content of ages
that processed meat are the highest in ages.
And so I was looking at which which foods
and which meat contributed most to the reduction of eggs.
So I was expecting that the processed meat
would be the biggest driver, but that was not the case.
It was white meat that was the biggest contributor.
So when people stopped eating meat,
most people already know that processed meat and red meat,
they're kind of, you know, risky and they increase
your risk of colon cancer and so many, so many other issues.
So most of peop most people
think that they're eating healthy
when they eat the majority of meat in the form of white meat.
And but getting away from all meat,
you know, reduce the age is the most.
And specifically, the majority was coming from white meat
because people were consuming white meat as healthy food.
You know, it's not just that group.
That's that's the common perception, I think, almost universally
around the world that your poultry is probably going
to be thought of as being healthy.
When we've seen time and time and time again, it's not.
That's just a misnomer.
One of the other interesting things that I found in the study was
there was a pretty big caloric drop for the vegan group versus
the control group here who did not make any changes to their diet.
So we're talking about with the vegan group that went from around
1800 to a little over 1300, the control group down just to a hair
like maybe 1800 to 1650, somewhere in that ballpark.
My question is, could the caloric
drop explain some of this or
basically what the results of health study,
if they were still eating 1800 calories worth of low fat,
100% plant based foods, would that
drop still exist?
You tell me.
That's an excellent question.
And in fact, this is one of the strengths
of the look of a vegan diet.
When people start eating a vegan diet,
the fiber just fills them up and they feel satiated.
They don't need to eat more.
And if you want to lose weight, this is a great advantage
because you are satisfied with less calories.
And as a result, you will you will start losing weight.
But that's not the only mechanism behind weight loss on the plant based diet.
We also showed that vegan diet increases metabolism.
It increases the thermic effect of food, which is the amount of calories
that are being released once we eat a meal in the form of heat.
So wouldn't that be nice if we could just burn
all the extra calories in the form of heat whenever we eat?
And that's exactly what started happening in this particular study.
So reducing the calories
is just one, one part of the picture.
Another one is increasing the metabolism, which is another mechanism
behind weight loss in this particular study.
And you asked an important question is the reduction in age
is driven by the reduction in calories?
And the answer is no.
It's completely independent.
It's it's based on the foods that are that you're
eating, the types of foods.
Also, the associations with weight loss
and improve body composition and improved insulin sensitivity.
These associations remain significant
after adjustment for caloric intake.
So it's not about how many calories you're eating.
It's about what kind of foods you're eating.
A couple more before I let you go.
When I was going through it, I was looking at you guys,
did a really good job of breaking down or measuring the ages by food group.
And what we saw was that there was actually a rise
in the amount of ages in the vegan groups diet
from legumes and whole grains.
Is that simply because they weren't eating a lot of them
before they started eating the low fat vegan diet?
That's exactly right.
And you just nailed it. Yeah.
People were eating more ages from legumes, for example,
because they were not eating many beans to start with.
And yet its beans are not a significant source
of eggs compared with meat or dairy or added fat.
So even with the increase of veggies
from legumes, their overall ages
just plummeted over the course of six weeks.
And we also saw a rise in ages with
the meat alternatives as they were categorized.
So a lot of the plant based meats that we see right now in stores,
are they a little bit higher in ages than whole plant foods?
That's correct.
Processed foods in general tend to be higher in ages
compared with fresh produce.
So the more minimally processed foods
you consume, the better off you are in terms of ages.
But at the same time, this is not a reason to exclude them
completely from the diet, because still, you know, even
when including all the soy milk and all the roasted bread
and all the roasted potatoes and all the baked goods,
people are still reducing their total eggs by 80%.
That's pretty significant.
And were there any other changes to the diet?
Was fasting included in any of this or was it just eat
the low fat plant based diet and we'll see what happens?
It was the latter.
It was just go vegan.
Keep keep the fat content low.
The the upper limit for fat intake was 30 grams per day.
We instructed the participants to minimize the consumption of oils,
the sauteed, their onions and vegetables in vegetable
broth or soy sauce or water,
instead of oil, and also minimize
other fatty foods such as nuts and avocados.
And obviously, most of the packaged foods are out because of the high fat content.
There you go.
That's your new word for the day.
Well, new phrase for the day, advanced glycation end products.
And you want to minimize them in your diet as well
to live a longer and healthier life.
Dr. Hannah Kali over. Thank you again.
Brilliant research. Thanks for sharing it with us.
Thanks, Jack.
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