Lifestyle biomarkers investigated in prostate cancer survivors

January 11, 2018
Dr. David Turner sits outside
Dr. David Turner co-leads a new study testing the impact of dietary and exercise interventions on advanced glycation end products, or AGEs. Photos by Sarah Pack

When it comes to cancer, lifestyle factors can impact cancer recurrence.

Just how much is what Hollings Cancer Center researchers want to find out. A clinical trial is looking into whether dietary and exercise interventions can decrease advanced glycation end products (AGEs) — metabolites formed during regular metabolism of sugars in the diet — that have been linked to cancer. 

Hollings Cancer Center at the Medical University of South Carolina in collaboration with South Carolina State University will be enrolling prostate cancer survivors to see whether a decrease in advanced glycation end products through dietary and exercise intervention can improve quality of life and decrease tumor recurrence in these patients.

AGEs have been linked to many chronic diseases, including diabetes, cardiovascular disease and cancer. They build up in the body from birth due to normal metabolism but are often higher in those eating the high-fat, high-sugar, highly processed foods characteristic of the Western diet. AGE levels have been linked to lifestyle, such as diet and exercise, and previous studies at MUSC have shown that lifestyle changes can drive a reduction in AGEs in breast cancer patients.

AGEs also may yield insight into health care disparities. For example, black men are three times more likely to develop prostate cancer than white men and may have higher AGE levels due to low income, poor diet and obesity. 

David Turner, Ph.D., assistant professor in the Department of Pathology and Laboratory Medicine at MUSC, in collaboration with Mahtabbuddin Ahmed, Ph.D., at South Carolina State University (SCSU), are co-principal investigators for the clinical trial that just opened. Although AGEs have been studied in other chronic diseases, such as diabetes, this is among the first trials to look at AGEs in cancer survivors.

The trial aims to determine whether a decrease in AGEs through dietary and exercise intervention can improve quality of life and decrease tumor recurrence in both African American and European American patients. Funding for the trial was awarded to Turner and Ahmed through a National Institutes of Health/National Cancer Institute U54 study led by Judith Salley-Guydon, Ph.D., at SCSU and Marvella Ford, Ph.D., at MUSC.

Each institution is recruiting 60 prostate cancer survivors for a 12-week dietary and physical activity intervention based on cardiovascular disease rehabilitation. The physical activity intervention will be supervised and individualized for 12 weeks, with unsupervised follow-ups that continue throughout the year. Fitness trackers will be given to each study participant to track exercises for the entirety of the trial. Participants will complete dietary questionnaires to track diet and document how many AGEs are consumed.

To determine whether these lifestyle changes have had an effect on the immune system, biomarkers such as interleukin-6 (IL-6) and C-reactive protein (CRP) and AGE levels will be measured. Preliminary data from the breast cancer patients studied earlier show a reduction in AGEs without a change in IL-6 or CRP, which indicates AGEs could be a better biomarker of lifestyle changes than previously used biomarkers. The current trial in prostate cancer survivors will enable further analysis of AGEs as a biomarker of lifestyle.

“This could be a real landmark study, especially if it turns out that AGEs are a better biomarker than what is available,” says Turner. To learn more about this and other trials at MUSC Hollings Cancer Center, the only NCI-designated Cancer Center in South Carolina, call 843-792-9321.

What you need to know about AGEs

As our bodies use the sugars that we consume for energy, they generate waste chemicals known as Advanced Glycation End Products or AGEs for short. AGEs accumulate in the body as we grow older, which damages our tissues and organs and contributes to chronic diseases, such as diabetes, Alzheimer’s, cardiovascular disease, arthritis and cancer.

* The Western Way of Life has Increased the Levels of AGEs in our Bodies.

  • Consuming foods that are high in sugar/fat or are highly processed substantially increases the levels of AGEs in our bodies. AGEs are naturally present in raw, animal-derived foods, but grilling, broiling, roasting, searing, and frying greatly increase the levels.
  • Alcohol and smoking also increase AGE accumulation as do a sedentary lifestyle and/or a lack of exercise.
  • The increased levels of AGEs brought about by a Western lifestyle coincide with the epidemic rise in chronic diseases.

* Even small changes in our daily lives can reduce AGE accumulation.

By being aware of what AGEs are and how they contribute to chronic disease, we can make small changes to our daily lives that will reduce the amount of AGEs we accumulate. If our children ate 3 or 4 meals a week that were lower in AGEs, over a lifetime this might have a significant effect on their overall health and delay or even prevent the onset of chronic disease.

Simple Tips to Lower AGE Accumulation

  • Avoid foods high in protein, sugar and fat, as well as processed foods.
  • Substitute unhealthy marinades with acidic ones, such as lemon juice and vinegar to inhibit AGE formation.

    Change how you cook your foods:

  • Cook foods at lower temperatures for longer (slow cookers are great for lowering AGEs in foods). Use moist heat.
  • Cook over ceramic surfaces instead of metal. This will reduce AGE formation as you cook.
  • Use a food thermometer to make sure you do not overcook meats to keep AGEs to a minimum.
  • Skip the browning step when preparing dishes such as stews or roasts. Cut meat in smaller pieces to reduce cooking time.
  • Exercise regularly, as this lowers the levels of AGEs in the bloodstream, which helps prevent accumulation.