by Craig Weatherby

With diabetes threatening to cripple millions while it swamps America's finances and health care system, the need for lifestyle-based prevention has long past the point of urgency.
A diagnosis of metabolic syndrome (MetS) raises your risk of developing type II diabetes and heart disease.

Diabetes drugs amplify
omega-3s' effects… less safely
Omega-3 fats' effects proven on our cell's working genes resemble the beneficial impacts triggered by a leading class of diabetes drugs called glitizars.
Glitizar drugs such as Avandia (rosiglitazone) increase insulin sensitivity through their ability to bind to and activate a gene switch called PPAR-gamma… an effect that improves blood sugar control in diabetics.
Like glitizar drugs, omega-3s serve as “PPAR-gamma activators”. This is no coincidence, because glitizar drugs were designed to mimic the PPAR-gamma activating effects of polyunsaturated fats, including omega-3s.
Compared with omega-3s, glitizars are more effective at activating PPAR-gamma… which explains why, unlike omega-3s, they can lower blood sugar pretty reliably and rapidly.
However, while attempts to improve on nature can yield drugs more effective than natural food factors, they can also produce adverse side effects.
This unfortunate risk is exemplified by the cases of troglitazone, a PPAR-gamma diabetes drug pulled from the market due to proven liver damage, and Avandia, which narrowly escaped banning by an FDA panel earlier this year.
You are considered to have MetS if you show any three of these six signs:
abdominal obesity, hypertension, sticky blood, a poor blood fat/cholesterol profile, inflammation in the blood, or high blood sugar levels (AHA 2010).
University studies provide ample evidence that exercise, balanced whole-food diets, and omega-3 fats from fish tend to deter the risk factors for diabetes, including key components of MetS.
While omega-3s are not clinically proven to lower blood sugar levelsthough they have that effect in some animal studiesomega-3 fish oil supplements are clinically proven to lower blood triglyceride (fat) levels and improve people's blood cholesterol profiles.
And although omega-3s do not lower LDL (“bad”) cholesterol levels, they do something with more proven impact on the risk of heart disease… they raise the HDL/LDL ratio and lower levels of dangerous VLDL cholesterol (Harris WS et al. 1988; Roche HM et al. 1996; Hartwich J et al. 2010; Perez-Martinez P et al. 2010).
Every meal we eat impacts our blood cholesterol and fat (lipid) profile, and your preference for various dietary patternsand your body's reactions to themwill affect your risk of cardiovascular disease and diabetes.
Sharp increases in blood triglyceride (fat) levels following a meal are one of the major abnormalities found in people with MetS.
People with MetS also tend to suffer spikes in blood levels of an undesirable, cholesterol-packed fatty compound called triglyceride-rich lipoprotein.
Spanish researchers decided to measure the immediate impact of diets featuring different amounts and kinds of dietary fat, by testing the blood of MetS patients after eating each kind of meal.
And this intriguing clinical research suggests that supplemental omega-3s can blunt the ill effects that a suboptimal diet exerts in MetS patients.
Omega-3s deter diet-driven rises in blood fat levels
People with or at risk of MetS are sometimes advised to eat a diet low in fat and high in complex carbohydrates (e.g., colorful vegetables and whole grains).
However, prior research has called the wisdom of that approach into question (Garg A et al. 1988; Volek JS et al. 2009).
Sure enough, Spanish researchers report that a low-fat, high-complex carbohydrate diet had “several detrimental effects” in MetS patients, including higher levels of total triglycerides and undesirable triglyceride-rich-lipoproteins.
The new Spanish trial tested the effects of four different diets, all providing about the same number of calories, on blood fat profiles in 164 people with metabolic syndrome:
  1. High in fat, mostly saturated;
  2. High in fat, mostly monounsaturated (e.g., olive oil)
  3. Low in fat, high in complex carbohydrates (whole grains and vegetables)
  4. Low in fat, high in complex carbs plus a daily omega-3 fish oil supplement (1.24 grams a day, or just a bit more than in a standard 1,000mg capsule)
At the outset, all the participants had similar blood fat responses after eating a meal.
But by the end of the three-month trial, those on Diet #4 (low-fat/high-carb plus omega-3s) and Diet #2 (high-fat/monounsaturate-rich) showed healthier blood fat effects.
In fact, participants in the omega-3 fish oil group suffered no ill effects and had lower levels of triglycerides, compared to people eating a high-fat diet rich in saturated fats (Diet #1) or the low-fat/high-carb diet without fish oil (Diet #3).
And we said, there's good evidence that omega-3s exert these beneficial blood fat effects in most dietary contexts.
Interestingly, a diet rich in monounsaturated fats yielded lower blood fat levels than either the test diet or a diet high saturated fats (Monounsaturated fats are most abundant in avocadoes, olives, olive oil, macadamia nut oil, and hi-oleic sunflower oils).
The Spanish team's findings affirm the idea people with metabolic syndrome could benefit from higher omega-3 intake … and support prior research suggesting that olive oil and other foods rich in monounsaturated fats can exert a positive effect on blood lipid profiles.
  • Agren JJ, Hänninen O, Julkunen A, Fogelholm L, Vidgren H, Schwab U, Pynnönen O, Uusitupa M. Fish diet, fish oil and docosahexaenoic acid rich oil lower fasting and postprandial plasma lipid levels. Eur J Clin Nutr. 1996 Nov;50(11):765-71.
  • American Heart Association, Inc. (AHA). What is the metabolic syndrome? Accessed August 23, 2010 at
  • Borkman M, Chisholm DJ, Furler SM, Storlien LH, Kraegen EW, Simons LA, Chesterman CN. Effects of fish oil supplementation on glucose and lipid metabolism in NIDDM. Diabetes. 1989 Oct;38(10):1314-9.
  • Garg A, Bonanome A, Grundy SM, Zhang ZJ, Unger RH. Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1988;319:829–34.
  • Giugliano D, Ceriello A, Esposito K. Are there specific treatments for the metabolic syndrome? Am J Clin Nutr. 2008;87:8–11.
  • Harris WS, Connor WE, Alam N, Illingworth DR. Reduction of postprandial triglyceridemia in humans by dietary n-3 fatty acids. J Lipid Res. 1988 Nov;29(11):1451-60.
  • Hartwich J, Leszczynska-Golabek I, Kiec-Wilk B, Siedlecka D, Pérez-Martinez P, Marin C, López-Miranda J, Tierney A, Monagle JM, Roche HM, Defoort C, Wolkow P, Dembinska-Kiec A. Lipoprotein profile, plasma ischemia modified albumin and LDL density change in the course of postprandial lipemia. Insights from the LIPGENE study. Scand J Clin Lab Invest. 2010 Apr 19;70(3):201-8.
  • Hartwich J, Malec MM, Partyka L, Pérez-Martinez P, Marin C, López-Miranda J, Tierney AC, Mc Monagle J, Roche HM, Defoort C, Wolkow P, Dembinska-Kieć A. The effect of the plasma n-3/n-6 polyunsaturated fatty acid ratio on the dietary LDL phenotype transformation - insights from the LIPGENE study. Clin Nutr. 2009 Oct;28(5):510-5. Epub 2009 May 28.
  • Jiménez-Gómez Y, Marín C, Pérez-Martínez P, Hartwich J, Malczewska-Malec M, Golabek I, Kiec-Wilk B, Cruz-Teno C, Rodríguez F, Gómez P, Gómez-Luna MJ, Defoort C, Gibney MJ, Pérez-Jiménez F, Roche HM, López-Miranda J. A Low-Fat, High-Complex Carbohydrate Diet Supplemented with Long-Chain (n-3) Fatty Acids Alters the Postprandial Lipoprotein Profile in Patients with Metabolic Syndrome. J Nutr. 2010 Jul 14. [Epub ahead of print]
  • Lopez-Miranda J, Williams C, Lairon D. Dietary, physiological, genetic and pathological influences on postprandial lipid metabolism. Br J Nutr. 2007;98:458–73.
  • Perez-Martinez P, Garcia-Quintana JM, Yubero-Serrano EM, Tasset-Cuevas I, Tunez I, Garcia-Rios A, Delgado-Lista J, Marin C, Perez-Jimenez F, Roche HM, Lopez-Miranda J. Postprandial oxidative stress is modified by dietary fat: evidence from a human intervention study. Clin Sci (Lond). 2010 Jun 15;119(6):251-61.
  • Perez-Martinez P, Moreno-Conde M, Cruz-Teno C, Ruano J, Fuentes F, Delgado-Lista J, Garcia-Rios A, Marin C, Gomez-Luna MJ, Perez-Jimenez F, Roche HM, Lopez-Miranda J. Dietary fat differentially influences regulatory endothelial function during the postprandial state in during the postprandial state in patients with metabolic syndrome: from the LIPGENE study. Atherosclerosis. 2010 Apr;209(2):533-8. Epub 2009 Sep 20.
  • Roche HM, Gibney MJ. Postprandial triacylglycerolaemia: the effect of low-fat dietary treatment with and without fish oil supplementation. Eur J Clin Nutr. 1996;50:617–24.
  • Ruotolo G, Howard BV. Dyslipidemia of the metabolic syndrome. Curr Cardiol Rep. 2002;4:494–500.
  • Volek JS, Phinney SD, Forsythe CE, Quann EE, Wood RJ, Puglisi MJ, Kraemer WJ, Bibus DM, Fernandez ML, et al. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids. 2009;44:297–309.