Abstract
Background: Regarding the increasing prevalence of cardiometabolic abnormalities, and its association with non-communicable chronic diseases, providing preventive and therapeutic strategies is a priority. A randomized placebo-controlled study was conducted to assess the effects of combination therapy of milled brown flaxseed and hesperidin during lifestyle intervention on controlling cardiovascular risk in prediabetes. Methods: A total of forty-eight subjects were randomly assigned to receive lifestyle intervention plus combination therapy of brown flaxseed (30 g milled) and hesperidin (two 500 mg capsules) or lifestyle modification alone for 12 weeks. Changes from baseline in anthropometric measures, lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers was assessed as a primary end point. Results: Anthropometric data comparison between the two groups showed a significant reduction in weight (p = 0.048). Waist circumference reduction was about twice that of the control group (- 6.75 cm vs – 3.57 cm), but this difference was not statistically significant. Comparison of blood pressure changes throughout the study indicated a greater reduction in blood pressure in the intervention group rather than control group (- 5.66 vs. – 1.56 mmHg, P = 0.049). Improvements of lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers in flaxseed-hesperidin group was significantly more than the control group after 12 weeks of intervention (p < 0.05). Conclusion: Our results indicate that co-administration of flaxseed and hesperidin as an adjunct to lifestyle modification program is more effective than lifestyle modification alone in the metabolic abnormalities remission of prediabetic patients.
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Key Points
Although the beneficial effects of flaxseed and hesperidin on cardiometabolic risk factors have been shown previously, no study has evaluated the effects of their combinations on pre-diabetic patients. This study found that including daily intake of 30 g of whole flaxseed and one gram of hesperidin can modulate cardiometabolic risk factors in patients with prediabetes. The combination of hesperidin, as a flavonoid, and flaxseed, as a functional food, can exhibit a great potency in preventing and controlling cardiometabolic abnormalities through their combined anti-inflammatory and anti-oxidant properties as well as high fiber content. Reducing the risk of cardiometabolic complications has been stem from increasing insulin sensitivity, improving dyslipidemia and lowering blood pressure succeeding consumption of flaxseed and hesperidin.
In the present study, although the concentration of HDL did not change, a decline in the concentration of triglyceride and LDL was observed in response to hes-flax supplementation.
A significant finding of the present study was the improvement of glycemic parameters, including fasting plasma glucose, insulin, HOMA-IR and QUICKI after 12 weeks treatment with combination of hesperidin and flaxseed.
In conclusion, incorporating 30 g of brown flaxseed and one-gram hesperidin into a healthy diet along with increasing physical activity seems reasonable and valuable to reduce risk of cardiometabolic abnormalities through ameliorating insulin resistance, lowering blood pressure, improving glycemic control, modifying lipid profile, and reduction of inflammation.