Functional Foods for Reduction of Cardiovascular Risk in Type 2 Diabetic Patients

Metabolic syndrome has become a major health problem which may lead to cardiovascular diseases. In a previous work we have proved the cardiovascular protective effect of two plant food mixtures in rats. So, the present work was established to study the cardiovascular protective effect of consumption of balady bread containing the two plant food mixtures beside dietary advice in type 2 diabetic patients having the main components of metabolic syndrome. Mixture I was thyme herb, wheat germ and dry carrot. Mixture II was celery seeds, rice bran and dry tomato. The dietary intervention study with the two types of balady bread in addition of dietary regimen continued for a month. Different biochemical parameters were assessed before and after bread consumption, these include plasma lipid profile, testosterone, adiponectin, malondialdehye and glucose. Nutritional status was evaluated through anthropometric measurements and dietary intake. Correlation study was carried out between biochemical and anthropometric parameters in the patients before dietary intervention. Proximate composition, rheological properties, sensory attributes and color quality of the balady bread were studied. Results clarified that basal line of patients showed elevation of plasmaT-Ch/HDL-Ch, TG/HDL-Ch and oxidative stresscompared to normal values which reflected risks of CVD. Also, plasma adiponectin and testosterone have significant negative correlation with total cholesterol (T-Ch), triglycerides (TGs), malondialdehyde (MDA), low density lipoprotein-cholesterol (LDL-Ch), body mass index and waist circumference, together with significant positive correlation with high density lipoprotein-cholesterol (HDL-Ch) level. Mean Dietary intake of patient in the beginning of the study revealed that all diabetic patients were normo-caloric. Mean Dietary intake of patient after a month of dietary intervention revealed that all diabetic patients reduced their caloric, saturated fat and cholesterol intake and increased their minerals and vitamins intake as a result of dietary advice. Consumption of the two types of balady bread resulted in significant decrease in fasting and postprandial plasma glucose and MDA level and significant improvement of plasma lipid profile together with significant increase in plasma testosterone and adiponectin. Kidney function tests showed non-significant change. Waist circumference and the ratio of waist circumference to height were reduced significantly. Physicochemical evaluation of bread revealed that addition of plant food mixture I or II to wheat flour elevated all the proximate composition parameters (except for carbohydrate), increased water absorption, arrival time, mixing tolerance index and weakening. Dough development time and dough stability were reduced on adding mixture I or II. Adding mixture I or II produced decrease in sensory scores of balady bread for crust colour, and taste. Conclusion: Dietary intervention with functional balady bread beside dietary advice produced increase in plasma adiponectin and testosterone in type 2 diabetic patients along with reduction of visceral obesity, dyslipidemia and oxidative stress. The observed elevation in plasma adiponectin and testosterone together with reduction of T-Ch/HDL-Ch and TG/HDL-Ch could be taken as good marker of the reduction of cardiovascular risk in diabetic patients.