Fish oil and the DASH diet in lipid metabolism and inflammation in diabetes



Author: Elmoataz Elmamoun PharmD Candidate, 2022, South College School of Pharmacy

Fish oil consumption plus the DASH diet is associated with partial impairment of lipid metabolism and inflammatory mediators in patients with type 2 diabetes.

With nearly 400 million adults living with diabetes worldwide, the global burden of the disease is expected to reach approximately 600 million by 2035, with an estimated $260 billion cost for diabetes healthcare in America. North and the Caribbean. Therefore, investment in effective prevention and management measures has become essential. Nutritional strategies and lifestyle changes have become an integral part of treating people with diabetes. Total fat intake has been shown to contribute to diabetes by promoting weight gain and insulin resistance. However, several metabolic studies have shown that the consumption of vegetable fats, in particular omega-6 polyunsaturated fatty acids (PUFAs), was associated with a lower risk of developing diabetes.

A recent randomized controlled trial investigated the effects of dietary approaches to arrest hypertension (DASH) and omega-3 fatty acids on lipid metabolism in patients with type 2 diabetes (T2D). The DASH diet was born in 1992 based on funding from several research projects designed for hypertension intervention by the National Institute of Health (NIH). DASH promotes the consumption of minimally processed, fresh foods and includes 2-5 servings per day of fruits, vegetables, carbohydrates, low-fat dairy products, lean meat products, nuts and seeds. For people with T2D, a DASH diet with two sodium restrictions of 400 mg/d has been shown to have beneficial effects on glycemic control and CVD risk factors.

Omega-3 PUFAs are essential dietary elements found in fish such as sardines and salmon and nut oils. They are fatty with more than one carbon-carbon double bond in their backbone and are essential for daily health, especially brain development and other cellular functions. They are an integral part of membrane phospholipids and are involved in many cellular functions. A large body of evidence from experimental, clinical and epidemiological research has reported the role of long chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid [DHA] to mitigate important risk factors for metabolic syndrome, in particular adiposity, dyslipidemia, insulin resistance and diabetes, hypertension, oxidative stress and inflammation.

The study included 32 patients with T2D randomized into two parallel groups; placebo (n=15) and treatment group consuming six 1000 mg EPA/DHA capsules daily (n=17). The results showed significant differences in body weight, body mass index, blood pressure, interleukin-6 and tumor necrosis factor-α in the two groups. However, triglyceride (TG) and VLDL cholesterol levels showed a significant decrease in the fish oil groups (p

The study concluded that fish oil consumption plus the DASH diet is associated with partial impairment of lipid metabolism and inflammatory mediators in patients with T2DM. However, further studies of various dietary considerations in the development and prevention of diabetes are needed to examine the synergistic effects of individual elements of various diets and to understand the physiological mechanisms underlying the observed associations.

Practice Beads:

  • Long-chain omega-3 fatty acids play a vital role in mitigating risk factors associated with metabolic syndrome.
  • Fish oil consumption plus the DASH diet is associated with partial impairment of lipid metabolism and inflammatory mediators in patients with type 2 diabetes.
  • Further studies are needed to investigate the role of various dietary considerations in the development of diabetes.

Ali, F., Saleh, M., and Al-Junaid, A. “Omega-3 fatty acid intervention and DASH diet improve metabolic profiling in patients with type 2 diabetes mellitus.” The Metabolic Institute of America (TMIOA) 2021 World Congress Insulin Resistance Diabetes & Cardiovascular Disease. December 6, 2021

Ley, Sylvia H et al. “Prevention and management of type 2 diabetes: dietary components and nutritional strategies.” Lancet (London, England) vol. 383.9933 (2014): 1999-2007. doi:10.1016/S0140-6736(14)60613-9

Gammone, Maria Alessandra et al. “Omega-3 Polyunsaturated Fatty Acids: Benefits and Parameters in Sport.” Nutrients vol. 11.1 46. 27 Dec. 2018, doi:10.3390/nu11010046

Elmoataz Elmamoun, PharmD candidate, 2022, South College School of Pharmacy

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