The Maillard reaction is at the crossroads of food and biomedical sciences in both normal aging of tissues and pathologic conditions including arthritis, atherosclerosis, diabetes, and neurodegenerative diseases. The role of the Maillard reaction in diabetic complications, for example, has become a major focus of recent research, leading to a better understanding of the importance of hyperglycemia, oxidative stress, and lipid peroxidation in the pathogenesis of complications, including nephropathy, retinopathy, neuropathy, and macrovascular complications. Chemical damage to protein by glycoxidation and lipoxidation reactions are two sides of the same coin, one side representing the damage to tissue proteins by sugar, the other side by lipids. In both cases, the chemical modification of tissue proteins by oxidative chemical reactions, and underlying damage to DNA, contributes to loss of function and development of disease. The final sections of the volume are devoted to recent research on AGE/ALE inhibitors in animal models and clinical trials, and assess the current status of pharmaceutical interventions for retarding the Maillard reaction and the pathophysiology associated with aging and age-related disease.