In my preventive clinic, the focus is long-term cardiac but cancer, diabetes, and dementia risk is reviewed. A largely ignored pathway of disease known as advanced glycation end-product (AGEs) accumulation is a focus as the Kahn Center as it leads to all major chronic diseases.
We now measure AGEs at the Kahn Center, unique in Michigan, using skin autofluorescence (SAF). Changes in blood sugar, changes in cooking methods (stopping high heat and dry cooking of meats like bacon, chicken, and steak in particular), and a vitamin called benfotiamine, can reduce AGEs over time. Benfotiamine is a byproduct of the B -vitamin thiamine.
In preclinical models, benfotiamine efficiently ameliorates the clinical and biological pathologies that define Alzheimer’s disease (AD) including impaired cognition, amyloid-β plaques, neurofibrillary tangles, diminished glucose metabolism, oxidative stress, increased AGEs, and inflammation.
Now a study has examined if benfotiamine can improve cognitive function in adults with cognitive defecits.
To collect preliminary data on feasibility, safety, and efficacy in individuals with amnestic mild cognitive impairment (aMCI) or mild dementia due to AD in a placebo-controlled trial of benfotiamine.
A twelve-month treatment with benfotiamine (300 mg twice a day) was tested to see whether clinical decline would be delayed in the benfotiamine group compared to the placebo group. The primary clinical outcome was the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). Secondary outcomes were the clinical dementia rating (CDR) score and fluorodeoxyglucose (FDG) uptake, measured with brain positron emission tomography (PET). Blood AGE were examined as an exploratory outcome.
Participants were treated with benfotiamine (34) or placebo (36). Benfotiamine treatment was safe.
The increase in ADAS-Cog was 43% lower in the benfotiamine group than in the placebo group, indicating less cognitive decline.
Worsening in CDR was 77% lower (p = 0.034) in the benfotiamine group compared to the placebo group, and this effect was stronger in the APOE ε4 non-carriers.
Benfotiamine significantly reduced increases in AGE (p = 0.044), and this effect was stronger in the APOE ε4 non-carriers.
Oral benfotiamine is safe and potentially efficacious in improving cognitive outcomes among persons with MCI and mild AD. It is an inexpensive and widely available supplement (https://shop.drjoelkahn.com/mega-benfotiamine-120-vegetarian-capsules.html).
Now that AGEs can be measured easily, and repeat measurements performed, using SAF, higher risk patients for AD and other chronic conditions like coronary disease, diabetes, neuropathy, and possibly cancers, can be measured. At the Kahn Center, we advise avoiding the cooking of foods at high temperature and in dry conditions. Stews, curries, and crock pots are preferred. Animal foods are highest in AGEs and further suggest a plant diet is superior. Bacon is the single food highest in AGEs and is to be avoided.
Benfotiamine has been studied in dozens of studies and there is growing evidence for its efficacy. It is used at the Kahn Center as another preventive strategy along with lifestyle. Attention to blood sugar by testing fasting glucose, insulin, and HgbA1C is routine. The use of a continuous glucose monitor is a consideration in some.
