Mortality is a crucial endpoint in epidemiological research, offering valuable insights into the effects of diseases and health conditions on a population. It helps in identifying risk factors, understanding the causes and consequences of diseases and health conditions, and informing public health strategies and policy development [1]. Currently, the global mortality rate is about 7.802 deaths per 1000 people [2]. According to the latest estimates by WHO in 2021, ischemic heart diseases were the leading causes of death in the world followed by COVID-19, respiratory diseases, cognitive problems, type 2 diabetes mellitus (T2DM), and finally kidney diseases [3]. An unhealthy diet is considered one of the major factors that can increase the risk of various diseases which ultimately lead to death [4].

Dietary Advanced Glycation End products (dAGEs) are compounds that form in foods or food products when proteins or fats in food react with sugar during cooking or processing of foods [5]. This process is called glycation, and it also occurs naturally in the body although at a slower rate, with AGEs formed in this way being known as endogenous or biological AGEs [5]. It has been suggested that high levels of dAGEs may play a role in the development of chronic diseases and increase the risk of mortality. This is attributed to their pro-inflammatory and oxidative properties, which can lead to cellular and tissue damage, as well as organ dysfunction [6]. According to the recent reports, consumption of a diet high in dAGEs is associated with insulin resistance (IR) and impaired glucose tolerance, which can contribute to the development of chronic diseases such as T2DM, CVDs, and cancer [7], [8].

Also, studies have assessed the possible link between dAGEs and mortality [9], [10], [11], [12], [13], [14], which indicating controversial findings. Omofuma et al.'s study on a US population observed that postmenopausal women diagnosed with breast cancer who consumed more dAGEs post diagnosis had a greater risk of all-cause and CVD mortality [9]. In contrast, a recent study conducted in Iran revealed an inverse relationship between dAGEs intake and the risk of overall and cause-specific mortality [13]. However, a study by Koyama et al.in US found no significant association between dietary dAGEs intake and all-cause mortality among adults with DM [12]. As well as, in a study among participants of EPIC cohort, Mao et al. reported that pre-diagnostic intake of dAGEs was not associated with CRC-specific mortality or overall mortality in CRC patients [11]. Additionally, a study conducted among Japanese population indicated that the intake of Nε-carboxymethyl-lysine (CML), a major dAGEs product, was not associated with total or cause-specific mortality. However, they found a slight negative association between CML consumption and mortality in men, excluding cancer and CVDs. In women, the relationship between CML intake and cause-specific mortality varied depending on individual characteristics [10].

Considering the inconsistent and inconclusive findings from previous studies on the relationship between intake of dAGEs and mortality risk, we aimed to synthesize the available evidence. To achieve this, we conducted a systematic review and meta-analysis of existing studies in this field, with the goal of providing a comprehensive and summarized understanding of the association between dAGEs and risk of all-cause mortality.