Abstract
Purpose: The aim of the present study was to compare the clinical effect of flaxseed and hesperidin alone and with combination in patients with metabolic syndrome. Number of participants with treated metabolic syndrome was assessed as a primary end point. Methods: In this 12-week randomized controlled trial, ninety-eight patients with metabolic syndrome randomly assigned to receive either whole flaxseed powder (30 g/day), or hesperidin (1 g/day), or combination of 30 g flaxseed and 1 g hesperidin or no supplement while adhering a lifestyle modification program. Results: In comparison to control group, systolic blood pressure (− 5.68 vs. − 2.91 mmHg, P = 0.041) and serum concentrations of triglyceride (− 50.06 vs. 3.87 mg/dL, P = 0.033) in hesperidin group showed a significant reduction over 12 weeks of intervention. Comparison of the results of flaxseed group with the control group showed a significant improvement in serum concentrations of triglyceride (− 66 vs. 3.87 mg/dL, P = 0.028), insulin (− 4.27 vs. − 2.51 mU/L, P = 0.003) and accordingly insulin resistance (− 1.19 vs. − 0.76, P = 0.005) and sensitivity (0.03 vs. 0.01, P = 0.022) indices in flaxseed group. Combination of flaxseed and hesperidin improved three of five metabolic syndrome components including serum concentrations of triglyceride, glucose and systolic blood pressure as compared to placebo. Interestingly, co-administration of flaxseed and hesperidin with 77.3% reduction in the prevalence of defined metabolic syndrome was revealed to be most effective in controlling the metabolic syndrome, after which the group of flaxseed with 76% reduction and hesperidin group with 54.5% reduction were ranked second and third, respectively. Conclusions: It can be concluded that co-administration of flaxseed and hesperidin appears to be superior to either supplementation alone on metabolic syndrome treatment, while the effects of flaxseed are stronger than hesperidin supplementation.
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Key Points
Hesperidin is reported to be the most abundant polyphenolic compound found in citrus fruits that exerts many health benefits. Fiber and omega-3 fatty acids consumption can contribute to reducing the risk of metabolic abnormalities. The current study was carried out to investigate whether the co-administration of hesperidin and flaxseed would enhance the management of MetS components compared to either compound alone or lifestyle modification. This four-grouped randomized controlled intervention revealed that co-administration of flaxseed and hesperidin followed by flaxseed alone supplementation are superior to hesperidin supplementation in MetS treatment. The significant improvement in three MetS components including serum concentrations of triglyceride, glucose and systolic blood pressure resulted from 12 weeks of co-supplementation with flaxseed and hesperidin. These findings provide strong support to recommend flaxseed and hesperidin, as an adjunct to a comprehensive program of lifestyle modification in MetS treatment. The present study results revealed significant reductions in serum triglyceride level after treatment with flaxseed either alone or in combination with hesperidin. Glucose homeostasis parameters are other determinants of MetS. Patients treated by lifestyle modification along with flaxseed and hesperidin combination had significantly greater improvement in FBS, insulin, insulin resistance and sensitivity indices than those who received lifestyle modification program alone during the study period. HOMA-β index significantly decreased in all groups except for the control group. In conclusion, the present study revealed significant alleviation in MetS by flaxseed–hesperidin co-administration. Despite the proven effects of flaxseed and hesperidin on improving the lipid metabolism, glycemic control and blood pressure, this combination can also be beneficial in improving metabolic syndrome by the antioxidant system enhancement and possessing anti-inflammatory properties.