Annatto Tocotrienols:

Their Significant Role in Blood Sugar Control

By John Raimo, MS, RD

The rate and prevalence of type 2 diabetes, especially in adults, is increasing at an alarming rate.1 Many factors are involved in the development of type 2 diabetes, and some have been more extensively studied than others. Recently, medical interest has turned to a pre-diabetes condition called metabolic syndrome, also called syndrome X or insulin resistance syndrome. The prevalence of metabolic syndrome, a major causative factor both in the early development of type 2 diabetes and cardiovascular disease, is becoming alarmingly widespread.2-4 According to the American Diabetes Association about 41 million people in the United States, ages 40 to 74, have pre-diabetes.5 In addition, there is the increasing prevalence of childhood obesity,6 which contributes to the subsequent development of metabolic syndrome and type 2 diabetes. Thus, there is an urgency to identify cost-effective solutions for metabolic syndrome and insulin resistance that are safe, efficacious and complimentary to current treatments.

Recent research has shown that early, presymptomatic but persisting damage to the body—especially the heart and circulatory system, kidneys and retinas—may already be occurring during pre-diabetes. By taking action to control blood glucose during the pre-diabetes stage, individuals can delay or prevent type 2 diabetes from developing.5

As presented last month, delta-tocotrienols found in annatto oil is the second generation form of vitamin E that has powerful effects on the reduction of triglycerides, blood glucose levels and levels of glycosylated hemoglobin (HbA1c), an indicator of long term blood sugar control. This article will further explore the ways in which annatto tocotrienols help support healthy blood sugar levels as well as address lifestyle modifications used to control metabolic syndrome.

 What is Metabolic Syndrome?

The American Medical Association defines metabolic syndrome as a collection of unhealthy body measurements and abnormal laboratory test results.7 These include: a) abdominal (waist) circumference greater than 40 inches for men or 35 inches for women; b) presence of high blood pressure (hypertension); c) hyperglycemia (fasting blood sugar more than 110 mg/dl); d) elevated triglycerides; and e) low levels of high-density lipoprotein (also known as HDL). If a person presents with at least three of these, that person is said to have metabolic syndrome and is at risk for developing type 2 diabetes, coronary artery disease, heart attacks or a stroke.

Because these problems are often linked, reducing one measurement may help the other issues. For example, regular exercise can help an individual lose weight, and also help reduce blood pressure and manage hyperglycemia and insulin resistance. Combining regular exercise with healthful eating is the cornerstone of controlling metabolic syndrome.7 Losing just 10 percent of excess body weight lowers blood pressure and improves insulin resistance. In many individuals, lifestyle modification alone is not enough; they may have to turn to nutraceuticals and dietary supplements to aid in managing this syndrome.

Lifestyle Modifications

Dietary tocotrienols and supplements of delta-tocotrienol have effective lipid lowering properties with no known side effects. The Diabetes Prevention Program study conclusively showed that people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity.8 They may even be able to return their blood glucose levels to the normal range. While the Diabetes Prevention Program also showed that some medications may delay the development of diabetes, diet and exercise worked better. Just 30 minutes a day of moderate physical activity, coupled with a 5-10 percent reduction in body weight, produced a 58 percent reduction in diabetes.8

Reduction in Metabolic Syndrome Parameters

In type 2 diabetics, the progression of cardiovascular-related complications is much more rapid than in the general population, and as many as 80 percent of these people with type 2 diabetes will die of a cardiovascular event.9 In a study by Baliarsingh, et al. the therapeutic impact of tocotrienols in type 2 diabetic patients with hyperlipidemia was tested. This well-designed study investigated the therapeutic impact of tocotrienols on serum and lipoprotein lipid levels, elevated blood glucose and glycosylated hemoglobin (HbA1c). A randomized, double blind, placebo-controlled design involving 19 type 2 diabetic subjects was used. After 60 days the subjects showed an average decline of 23 percent in total serum lipids, a 30 percent reduction in triglycerides and a 42 percent reduction in LDL cholesterol. The authors concluded that “daily intake of dietary tocotrienols by type 2 diabetics will be useful in the prevention and treatment of hyperlipidemia and atherogenesis.”9

Another study done with type 2 diabetic rats showed that a rice bran diet containing gamma-tocotrienol suppressed hyperlipidemic and hyperinsulinemic responses.10  Diabetic rats were divided into control and experimental groups. The experimental group were fed a rice bran diet containing a high amount of gamma-tocotrienol for 4 weeks. The study demonstrated that diabetic rats fed the special gamma-tocotrienol-

fortified diet had greater insulin sensitivity, which was statistically significant compared to the control group. These rats also had lower plasma triglycerides and LDL cholesterol.

Researchers in Malaysia published a study that determined the effects of a tocotrienols-rich diet on the levels of blood glucose, glycated hemoglobin (HA1c), serum advanced glycosylation end-products (AGE) and malondialdehyde (MDA) of diabetic rats.11 The control rats received a normal diet or a vitamin C diet (that was tocotrienols deficient), and the rats in the experimental group received a tocotrienols rich diet. The rats were maintained on their respective diets for 4 weeks, then made diabetic. The rats were then followed-up after 8 weeks. Levels of blood glucose, a measure of blood sugar control called glycated hemoglobin (HA1c), serum advanced glycosylation end-products (AGEs) and a marker of free radical/oxidation damage known as malondialdehyde (MDA) were measured at 4 weeks and at 8 weeks. This study showed that a tocotrienols-rich diet effectively prevented an increase in advanced glycation end products (AGEs) in normal rats, and produced a decrease in blood glucose and HA1c in diabetic rats. (To learn more about AGEs, please read the article explaining these destructive compounds in this newsletter).

Conclusion

Metabolic syndrome is one of the most common health concerns of our time. By consuming a healthy diet, exercising and giving the body proper supplemental nutrition, the incidence of this syndrome can be substantially reduced. Annatto tocotrienols may be used together with lifestyle modifications to establish healthy blood sugar levels in the body and to reduce markers of impaired blood sugar control.

References:

1. Zimmet P, ALberti, KG, Shaw, J. Global and societal implications of the diabetes epidemic. Nature. 2001; 414: 782-87.

2. Reaven GM. Insulin resistance and its consequences: type 2 diabetes mellitus and coronary heart disease. Diabetes Mellitus: A Fundamental and Clinical Text. LeRoth D, Taylor SI, Olefsky, JM, Eds.Philadelphia, Lippincott Williams & Wilkins, 2000; 604-15.

3. Reaven, GM. Role of insulin resistance in human disease. Diabetes. 1988; 37: 1595-1607.

4. DeFronzo, RA. Pathogenesis of type 2 diabetes: metabolic and molecular implications for identifying diabetes genes. Diabetes Review. 1997; 5: 177-269.

5. American Diabetes Association. www.diabetes.org.

6. Kimm, SY, Obarzanek, E. Childhood obesity: an new pandemic if the new millennium. Pediatrics. 2002; 110: 1003-7.

7. Torpy, JM, Lynm, C, Glass, R. The metabolic syndrome. JAMA. 2006; 295(7): 850.

8. Knowler, WC, Barrett-Connor E, Fowler S, Hamman RF, Lachin JM, Walker EA, and Nathan DM. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin: Diabetes Prevention Program Research Group. New England Journal of Medicine. 2002; 346(6): 393-403.

9. Baliarsingh S, Beg ZH, Ahmad J. The therapeutic impacts of tocotrienols in type 2 diabetic patients with hyperlipidemia. Atherosclerosis. 2005; 182(2): 367-74.

10. Chen CW, Cheng HH. A rice bran oil diet increases LDL-receptor and HMG-CoA reductase mRNA expressions and insulin sensitivity in rates with streptozotocin/nicotinamide type 2 diabetes. Journal of Nutrition. 2006; 136(6): 1472-76.

11. Wan-Nazaimoon WM, Khalid BA. Tocotrienols-rich diet decreases advanced glycosylation end-products in non-diabetic rats and improves glycemic control in streptozotocin-induced diabetic rats. Malaysia Journal of Pathology. 2002; 24(2): 77-82.