Omega-3 and plant sterol supplements reduce fasting blood glucose in pre-diabetics: China RCT

By Guan Yu Lim contact

- Last updated on GMT

A combination of omega-3 fatty acids and plant sterols dietary supplements may reduce fasting blood glucose in pre-diabetics. ©Getty Images
A combination of omega-3 fatty acids and plant sterols dietary supplements may reduce fasting blood glucose in pre-diabetics. ©Getty Images

Related tags: omega-3, Plant sterols, Diabetes

A combination of omega-3 fatty acids and plant sterols dietary supplements was found to significantly reduce fasting blood glucose and insulin resistance in people with impaired glucose regulation (IGR) or pre-diabetes, Chinese researchers said.

Published in the journal Lipids in health and disease​, it is one of the first randomised clinical trials focused on the combinations’ potential to alter glucose and lipid metabolism in preventing and/or treating IGR.

The study reported that participants given the combination exhibited significantly decreased triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, and glycosylated haemoglobin.

These findings may provide a scientific basis for the development of nutritional products incorporating plant sterols (PS) and omega-3 fatty acids, and also for the development of nutritional supplement strategies aimed at preventing the development of disease in the IGR population​,” the researchers said.

The clinical trial was conducted in a hospital in China over 12 weeks.

A total of 134 participants with IGR were randomly assigned to four intervention groups: placebo (soybean powder in placebo capsules), omega-3 fatty acids (2g fish oil with 1000mg EPA and 400mg DHA), PS (1.7g plant sterols), and combination of PS and omega-3 (1.7g plant sterols and 2g fish oil with 1000mg EPA and 400mg DHA).

Effect of omega-3

The findings revealed a significant decrease in fasting plasma glucose levels, and insulin resistance in both omega-3 fatty acids treatment group as well as the combination treatment group.

Researchers said, “Omega-3 fatty acids was found to improve glucose metabolism, insulin resistance, and inflammation via decreases in fasting blood glucose, insulin resistance and inflammatory factors​.”

There is evidence from previous clinical trials and animal studies suggesting that omega-3 fatty acids inhibit inflammatory reactions.

They added, “Our results support studies that indicate omega-3 fatty acids may contribute to IGR treatment​.”

However, there was no significant change in fasting insulin amongst the four treatment groups.

These results demonstrate that PS had no effect on glucose metabolism in IGR individuals, while omega-3 fatty acids and the combination of these two interventions did​.”

Effect of plant sterols

Researchers found a significant decrease in triglyceride concentration in both the PS group as well as combination group.

In the combination group, high-density lipoprotein cholesterol levels were also higher, compared to placebo group.

However, there was no significant effect of both interventions on total cholesterol and low-density lipoprotein cholesterol levels.

These findings show that PS and combinatory interventions have positive effects on lipid metabolism in IGR individuals, whereas omega-3 fatty acids alone have no effect​.”

In terms of inflammation factors, both PS group and omega-3 fatty acids group showed a decrease in high-sensitivity C-reactive protein. However, the effect was not seen in the combination group.

These results suggest that a combined intervention cannot reduce inflammation in the IGR population​.”

The researchers said, “We speculate that PS might prevent IGR progression to T2DM via improving lipid metabolism and inflammation​.”

Recommendations

The researchers noted: “The combinatory intervention facilitated a more significant reduction in fasting blood glucose and insulin resistance than either PS or omega-3 fatty acids alone​.”

Although the combined intervention had no synergistic effect on high-density lipoprotein cholesterol, triglyceride, and glycosylated haemoglobin, the findings may still offer a safe and effective therapeutic approach in IGR patients.

There is a need for additional studies to further investigate inflammatory markers and blood pressure in IGR individuals who take PS and omega-3 fatty acids. For example, greater sample size, longer observation period, and detecting more inflammatory factors.

Researchers also suggested collecting n-3 fatty acids levels in future participants, as they are known to decrease cardiometabolic complications in T2DM patients.

The researchers concluded, “This study provides support for a scientific approach to using plant sterols and omega-3 fatty acids for the treatment of IGR, as well as T2DM​.”

Source: Lipids in health and disease

Doi: 10.1186/s12944-019-1048-x

‘‘A combination of omega-3 and plant sterols regulate glucose and lipid metabolism in individuals with impaired glucose regulation: a randomized and controlled clinical trial’’

Authors: Ji-fang Wang, Hai-ming Zhang, et al​.

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