Use of Palm Oil in the Dietary Management of Diabetes and Coronary Heart Disease

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1 Use of in the Dietary Management of Diabetes and Coronary Heart Disease Nasser M. Al-Daghri, Ph.D. Assistant Professor, College of Science King Saud University, Riyadh, Kingdom of Saudi Arabia

2 Homocysteine (HCYS) is a sulfur-containing amino acid derived from methionine, following the loss of a methyl group. HCYS accepts a methyl group from the methyltetrahydrofolate to form methionine. Remethylation reaction, catalysed by methionine synthase, requires vitamin B12 as a cofactor and methyltetahydrofolate as substrate.

3 Methylene-tetrahydrofolate reductase (MTHFR) plays an important role in remethylation, by supplying methyl groups as methyltetrahydrofolate for HCYS remethylation. Much of the methionine is activated to form S- adenosylmethionine (SAM), which is the chief donor of methyl groups for methyl transferases

4 Factors that decrease HCYS levels Recent study showed that a 4-wk 4 controlled diet of 500 g/d d fruit and vegetable consumption significantly increased plasma carotenoids,, vitamin C and folate and decreased homocysteine levels versus 100 g/d g of fruits and vegetables In addition, other anti-oxidant intakes from whole grain and legume powder reduces oxidative stress, i.e., decreased plasma HCYS concentration, and spare serum tocopherols and some carotenoids..

5 Supplementation with the B-group B vitamins with or without antioxidants reduced homocysteine in men with mildly elevated concentrations; hence may be effective in reducing cardiovascular risk. Zhang(2003) suggested that red palm oil is a good source of carotenoids and vitamin E when used in Chinese diet preparation, and it can significantly increase plasma concentration of alpha-carotene, beta- carotene, lycopene and alpha-tocopherol tocopherol.

6 Objective The aim of this study is to measure the levels of HCYS in volunteer subjects who are using oil which contains Carotenoids versus subjects using non-carotenoid containing oil which is corn oil.

7 Methodology Measurements of serum cholesterol, HDL, triglycerides, glucose and creatinine were performed using routine laboratory methods. HCYS was measured by high-pressure liquid chromatography (HPLC) with electrochemical gradient detection: - samples were reduced with dithiothreitol to liberate HCYS - protein was precipitated by sulfosalicylic acid - supernatant analysed by HPLC

8 Statistical Analysis Data was analyzed using the Statistical Package for the Social Sciences (SPSS for Windows, version 10.0).

9 Control Diabetic CHD Sex distribution History of Diabetes 150 (72/78) 0 98 (50/48) (69/48) (38/36) (69/61) 0 67(49/1 8) 0 Systolic blood pressure (16.9) (18.0) (20.9) (17.7) (21.6) (19.8) Diastolic blood pressure 77.4 (10.8) 77.8 (13.2) 81.9 (10.5) 81.5 (10.8) 84.2 (11.5) ) BMI (kg/m2) 31.2 (6.7) 28.0 (5.9) 30.3 (7.1) 30.2 (5.5) 30.3 (6.1) 29.4 (5.4)

10 (1.5) (1.5) (1.1) (1.1) (0.5) (0.5) (1.4) (1.4) (1.7) (1.7) Control Control (1.5) (1.5) (1.4) (1.4) (0.4) (0.4) (1.2) (1.2) (1.9) (1.9) (1.6) (1.6) (1.9) (1.9) (1.6) (1.6) (2.1) (2.1) LDL LDL Cholesterol Cholesterol (mmol mmol/l) /L) (1.4) (1.4) (1.6) (1.6) (1.2) (1.2) (2.5) (2.5) Triglyceride Triglyceride (mmol mmol/l) /L) (0.4) (0.4) (0.3) (0.3) (0.3) (0.3) (0.3) (0.3) Cholesterol Cholesterol (mmol mmol/l) /L) (1.4) (1.4) (1.9) (1.9) (1.5) (1.5) (1.8) (1.8) Cholesterol Cholesterol (mmol mmol/l) /L) (4.1) (4.1) (7.2) (7.2) (5.7) (5.7) (5.2) (5.2) FPG ( FPG (mmol mmol/l) /L) CHD CHD Diabetic Diabetic

11 8.7(1.6) 8.7(1.6) 12.8(6.8) 12.8(6.8) 0.4(0.1) 0.4(0.1) 0.9(0.5) 0.9(0.5) Control Control HCYS HCYS p value p value (0.03 ( ) 0.027) Insulin Insulin Lipoproteins Lipoproteins A2 A2 Lipoproteins Lipoproteins A1 A1 8.1(1.4) 8.1(1.4) 10.8(6.7) 10.8(6.7) 0.4(8.2) 0.4(8.2) 0.8(0.2) 0.8(0.2) 8.7(1.6) 8.7(1.6) 8.2(1.6) 8.2(1.6) 7.8(1.8) 7.8(1.8) 8.3(2.01) 8.3(2.01) 17.5(18.4) 17.5(18.4) 16.5(12.3) 16.5(12.3) 14.4(11.6) 14.4(11.6) 15.6(11.0) 15.6(11.0) 0.3(9.9) 0.3(9.9) 0.3(0.1) 0.3(0.1) 0.4(0.2) 0.4(0.2) 0.4(0.1) 0.4(0.1) 0.9(0.5) 0.9(0.5) 0.9(0.5) 0.9(0.5) 0.9(0.5) 0.9(0.5) 1.1(2.0) 1.1(2.0) CHD CHD Diabetic Diabetic

12 Discussion Cardiovascular disease is the major cause of morbidity and mortality in patients with diabetes mellitus. Hyperhomocysteinaemia has only recently been recognized as a risk factor for cardiovascular disease in diabetes mellitus. Patients with Type 2 diabetes mellitus and hyperhomocysteinemia are 1.6 times more likely to develop cardiovascular disease than those patients with normal HCYS concentrations even in the absence of nephropathy

13 Rowely (2001) found that mean plasma homocysteine concentrations decreased by 3 µmol/l L after increasing the density of fresh fruits, vegetables and carotenoids in Australian subjects. Broekmans (2000) showed that a mixed diet of fruits and vegetables with a moderate folate content decreases plasma homocysteine concentrations in humans.

14 The interesting finding in our study is that palm oil,, which contains B-carotenoidsB carotenoids,, reduced the homocysteine levels in all subjects (control, CHD and diabetic) compared to those patients who used corn oil. We also found out that cholesterol and HDL are associated with palm oil.

15 In addition, carotenoids and vitamin D (which is found in palm oil, plays an important role in reducing the HCYST) (Tapola NS 2004) Oleic fatty acid and unsaturated fatty acids in palm oil also reduces the homocysteine levels in blood (Grund 2003)

16 Conclusions oil which contains high amounts of carotenoids,, vitamin D and unsaturated fatty acids play an important role in reducing homocysteine levels in human serum Low HCYS level decreases risk of CHD and diabetes which support the previous study that palm oil reduces risks of having CHD and Diabetes.

17 (Shokran Jazilan)