The World Health Organization (WHO) marked its annual World Health Day (7 April) with its first “Global report on diabetes”, where WHO highlights the need to step up prevention and treatment of the disease. WHO has selected diabetes as the theme for World Health Day 2016, to raise awareness of the ways in which diabetes can be prevented or managed effectively to avoid complications (1).
With ‘prevention’ the number one goal of the ‘Beating Diabetes’ campaign, flaxseed is posed to play a huge role as a healthy ingredient in blood glucose management.
Diabetes is a chronic disease that directly impacts more than 350 million people worldwide. This number is likely to be more than double in the next 20 years, which is in great part attributed to the rising levels of obesity and physical inactivity (1). In Canada, 3.2 million people are expected to have the disease in 2016 (2). In the United States, 29.1 million people or 9.3% of the population have diabetes, which resulted in an estimated expenditure of $245 billion in 2012 (3).
Diabetes is characterized by elevated levels of blood glucose (blood sugar). It occurs when the pancreas does not produce enough of the insulin hormone, which regulates blood sugar, or when the body cannot effectively use the insulin it produces.
A recent publication highlighted in the database supports the efficacy of flaxseed for improving glycemic control (4). In a randomized, cross-over study, overweight or obese men and postmenopausal women (n = 25) with pre-diabetes consumed 0, 13, or 26 g ground flaxseed for 12 weeks. Blood glucose decreased on the 13 g intervention compared to the 0 g period [13 g = -2.10 ± 1.66 mg/L (mean ± SEM), 0 g = 9.22 ± 4.44 mg/L, P = .036]. Insulin and HOMA-IR also decreased on the 13 g supplementation. This level of flaxseed represents an intake of about 2 Tbs.
Several reviews are available which provide comprehensive overviews with regard to flaxseed and diabetes. Prasad and Dhar (5) present very compelling evidence which highlight the antioxidant, hypolipidemic and hypoglycemic effects of flax constituents, in particular flax lignan complex and secoisolariciresinol diglucoside (SDG). These nutrients have been shown to improve glycemic control. Dr. Prasad’s research has indicated that SDG treatment reduced the incidence of diabetes using serum glucose levels as the marker by 75% in the streptozotocin model of diabetes and by 72% in the BB rat model of diabetes. These reductions in development of diabetes were associated with decreases in oxidative stress measured by serum and pancreatic malondialdehyde (MDA). Oxidative stress has been implicated in both type 1 and type 2 diabetes.
Another review provides information regarding the role of phytoestrogens such as flaxseed lignans in the prevention and management of type 2 diabetes (6). Phytoestrogens are polyphenols that are structurally similar to endogenous estrogen and have weak estrogenic properties. Emerging evidence from pre-clinical models has suggested that phytoestrogens may have anti-diabetic function via both estrogen-dependent and estrogen-independent pathways. Phytoestrogens, such as flaxseed lignans, have been proposed to protect against diabetes by improving insulin sensitivity and exerting antioxidant effects (7). In addition, flaxseed lignans may help to control blood glucose levels via their effect on enzymes involved in maintaining normoglycemia (8).
In a systematic review and meta-analysis of prospective studies examining the relationship between omega-3 fatty acid intake and diabetes risk, both dietary ALA intake and circulating ALA biomarkers were associated with a trend towards lower risk of diabetes (9). Consumption of fish and or seafood was not significantly associated with diabetes nor were consumption of EPA plus DHA or circulating levels of EPA plus DHA biomarkers. One of the mechanisms by which ALA may act to counter the disease is by increasing insulin sensitivity.
Flaxseed intake appears to decrease glucose and insulin and improve insulin sensitivity. The data suggest that omega 3 ALA as well as lignans and SDG may have great potential for reducing the incidence of type 1 diabetes and delaying the development of type 2 diabetes in humans. Learn more about this research by reviewing the “Diabetes” category.
Other key findings from the “Global report on diabetes” (1)
- The number of people living with diabetes and its prevalence are growing in all regions of the world. In 2014, 422 million adults (or 8.5% of the population) had diabetes, compared with 108 million (4.7%) in 1980.
- The epidemic of diabetes has major health and socioeconomic impacts, especially in developing countries.
- In 2014, more than 1 in 3 adults aged over 18 years were overweight and more than one in 10 were obese.
- The complications of diabetes can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. For example, rates of lower limb amputation are 10 to 20 times higher for people with diabetes.
- Diabetes caused 1.5 million deaths in 2012. Higher-than-optimal blood glucose caused an additional 2.2 million deaths by increasing the risks of cardiovascular and other diseases.
- Many of these deaths (43%) occur prematurely, before the age of 70 years, and are largely preventable through adoption of policies to create supportive environments for healthy lifestyles and better detection and treatment of the disease.
References
- http://www.who.int/campaigns/world-health-day/2016/en/
- Mathers CD, et al. PLoS Med 2006;3:e442.
- Centers for Disease Control and Prevention. 2014. National Diabetes Statistics Report, 2014. http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf
- Hutchins AM, et al. Nutr Res, 2013; 33: 367-375.
- Prasad, K. Dhar, A. Curr Pharm Design, 2016; 22:141 – 144
- Talaei, M. Pan, A. World J Diabetes, 2015; 6(2): 271-283.
- Jungbauer A, et al. J Steroid Biochem Mol Biol 2014;139:277-289.
- Adolphe JL, et al. Br J Nutr 2010;103:929-938.
- Wu JH, et al. Br J Nutr 2012;107 Suppl 2:S214-227.