Abstract 15613: Adherence to the Mediterranean Diet is Inversely Associated with Advanced Glycation Endproduct Carboxymethyllysine among Male Middle-Aged Twins

Abstract

Introduction: Accelerated biological aging is thought to increase the severity of cardiovascular diseases through a network of unifying pathways, including inflammation, oxidative stress, and accumulation of advanced glycation endproducts (AGEs). Adherence to the Mediterranean diet has been inversely linked with markers of inflammation and oxidative stress. However, no previous study has examined whether markers of biological aging, particularly AGEs such as carboxymethyllysine (CML), are associated with the Mediterranean diet.

Hypothesis: Greater adherence to the Mediterranean diet is associated with decreased levels of CML.

Methods: A sample of 426 male middle-aged twins, including 129 monozygotic and 84 dizygotic twin pairs, with no previous history of coronary heart disease, was recruited from the Vietnam Era Twin Registry. All twins completed the Willett food-frequency questionnaire and the Mediterranean diet score (MDS) was calculated. AGEs were measured using commercially available kits. Robust regression analysis was used to examine the association between adherence to the Mediterranean diet and CML within pairs.

Results: The mean age of the twins was 55 years (SD=3.0) and 95.8% were white. Within-pair differences in the MDS were assessed using a continuous scale. A 1-unit within pair absolute difference in the MDS was associated with a 1.7% (P<0.006) lower CML level in the co-twin with a higher MDS after adjustment for total energy intake and other nutritional factors such as egg and potato consumption. After additional adjustment for lifestyle factors (including physical activity), traditional CVD risk factors, and use of supplements and medications, a 1-unit within pair absolute difference in MDS was still associated with a 1.7% (P<0.01) lower CML level in the co-twin with a higher MDS. These within-pair associations did not differ by zygosity.

Conclusions: Adherence to the Mediterranean diet is inversely associated with CML, an advanced glycation endproduct that promotes accelerated biological aging, independent of traditional CVD risk factors and shared familial and genetic factors. Our study supports the importance of a healthy diet for vascular health and for the deceleration of early vascular aging.