HomeHealth Sciences Journalvol. 11 no. 2 (2022)

Effectiveness of chia (Salvia hispanica L.) as an adjuvant therapy for Type 2 diabetes mellitus: A systematic review and meta-analysis

Lorenzo Victor D. Fernandez | Thea Katrina I. Fernandez | Rowena Alysha F. Fider | Bea Steffi C. Flores | Mariah Mae E. Fredeluces | Anthony Joseph M. Fuentes | Pamela Marie G. Fullero | Ma. Cristina J. Gacute | Klarizza V. Galicia | Joseph Francis D. Gallera | April Ann K. Gan | Alyssa Nicole L. Gapuz | Jose Ronilo G. Juangco

 

Abstract:

Introduction Salba-chia (Salvia hispanica L.) is a popular functional food containing high levels of protein, total dietary fiber, and is an excellent source of ?-linolenic acid. Chia seeds significantly decreases weight, suppresses appetite, and has a potential benefit in the management of Type 2 diabetes mellitus (T2DM). This study aimed to determine the effectiveness of chia seeds as an adjuvant treatment for T2DM. Methods Randomized controlled trials from 1990 onwards involving Type 2 diabetic patients given chia seed were included. PubMed, Cochrane, ClinicalKey, Google Scholar, and Hinari were searched systematically using MeSH terms “chia”, “Salvia hispanica”, “dietary supplement”, and “diabetes”. The quality of trials was assessed using the Cochrane Collaboration tool. Data on the study design, blinding status, characteristics of participants, medications taken by participants, chia seed intervention, comparator, duration of intake, and interval of assessment were extracted. The percent change of outcome from baseline was compared between the chia and control groups. Results Four randomized trials with a total of 213 diabetic patients were enrolled in the treatment group using ground salba-chia or the control group using bran. The supplementation of chia resulted in a statistically significant decrease in fasting glucose (-2.90 mmol/L; 95% CI, -3.08, -2.72; p < 0.001), waist circumference (-2.49 cm; 95% CI -2.81, -2.17; p < 0.001), total cholesterol (-2.72 mmol/L; 95% CI -3.68, -1.74; p < 0.001), HDL (-3.69 mmol/L; 95% CI -3.95, -3.42; p < 0.001), LDL (-3.22 mmol/L; 95% CI -4.08, -2.36; p < 0.001); and an increase adiponectin levels (6.50 mg/L; 95% CI 6.25, 6.25; p < 0.001). Conclusion Intake of chia seeds resulted in a statistically significant decrease in fasting blood glucose, waist circumference, total cholesterol levels, HDL and LDL cholesterol levels, and increased adiponectin. Chia seeds are generally safer and have lesser side effects compared to the placebo. Chia is effective as adjunctive treatment for Type 2 diabetic patients.



References:

  1. Melo D, Machado T, Oliveira M. Chia seeds: An ancient grain trending in modern human diets. Food Funct [Internet]. 2019 Jun 19;10(6): 3068-89. doi: 10.1039/c9fo00239a
  2. Marcinek K, Krejpcio Z. Chia seeds (Salvia hispanica): Health promoting properties and therapeutic applications – a review. Rocz Panstw Zakl Hig [Internet]. 2017; 68(2): 123-9.
  3. Teoh SL, Lai NM, Vanichkulpitak P, Vuksan V, Ho H, Chaiyakunapruk N. Clinical evidence on dietary supplementation with chia seed (Salvia hispanica L.): A systematic review and meta-analysis. Nutr Rev [Internet]. 2018 Apr 1; 76(4): 219-42. doi: 10.1093/nutrit/nux071
  4. Ulbricht C, Chao W, Nummy K, et al. Chia (Salvia hispanica): A systematic review by the natural standard research collaboration. Rev Recent Clin Trials [Internet]. 2009 Sep; 4(3): 168-74. doi: 10.2174/157488709789957709
  5. de Souza Ferreira C, de Sousa Fomes LF, Santo da Silva GE. Effect of chia seed (Salvia hispanica L.) consumption on cardiovascular risk factors in humans: a systematic review. Nutr Hosp [Internet]. 2015 Nov 1; 32(5): 1909-18. doi: 10.3305/nh.2015.32.5.9394
  6. Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, Welch V. Editors. Cochrane handbook for systematic review of interventions [Internet]. Version 6.1, 2000 [cited 2020 Oct 11]. Bristol, UK. Available from: http://training.cochrane.org/handbook/current
  7. PRISMA checklist [Inter net]. Prisma Transparent Reporting of Systematic Reviews and Meta-Analysis. [cited 2020 Oct 11]. Available from http://prisma-statement.org/PRISMAStatement/Checklist.aspx
  8. Juangco J, Ramilo-Cruz N, Cruz R, et al. Effectiveness of Saccharomyces boulardii on diarrhea, a systematic review and meta-analysis. Health Sciences J [Internet]. 2021 Jan-Jun; 10(1): 16-24. Available from https://uerm.edu.ph/Forms/research/HSJ%20vol.10no.1%202021.pdf#page=21
  9. Choleva L. The effect of Salvia hispanica L. (Salba) on weight loss in overweight and obese individuals with Type 2 diabetes mellitus [senior research project]. Toronto (ON): University of Toronto. 2011.
  10. Brissette C. The effect of Salvia hispanica L. seeds on weight loss in overweight and obese individuals with Type 2 diabetes mellitus [senior research project]. Toronto (ON): University of Toronto; 2013.
  11. Cardona-Morrell M, Rychetnik L, Morrell SL, Espinel PT, Bauman A. Reduction of diabetes risk in routine clinical practice: Are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis. BMC Public Health [Internet]. 2010 Oct 29; 10: 653. doi: 10.1186/1471-2458-10-653
  12. Vuksan V, Jenkins AL, Brissette C, et al. Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with Type 2 diabetes: A double-blind randomized controlled trial. Nutr Metab Cardiovasc Dis [Internet]. 2017 Feb; 27(2): 38-46. doi: 10.1016/j.numecd.2016.11.124. Epub 2016 Dec 9.
  13. Post RE, Mainous AG III, King DE, Simpson KN. Dietary fiber for the treatment of Type 2 diabetes mellitus: A meta-analysis. J Am Board Fam Med [Internet]. 2012; 12: 16–23. doi: 10.3122/jabfm.2012.01.110148
  14. A n d e r s o n J W, T i e t ye n - C l a r k J. D i e t a r y f i b e r : hyperlipidemia, hypertension, and coronary heart disease. Am J Gastroenterol [Internet]. 1986 Oct; 81(10): 907-19
  15. Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J, Yancy WS Jr. Macronutrients, food groups, and eating patterns in the management of diabetes: A systematic review of the literature, 2010. Diabetes Care [Internet]. 2012; 12: 434–45. doi: 10.2337/dc11-2216
  16. Schwartz SS, Epstein S, Corkey BE, Grant SF, Iii JRG, Aguilar RB, et al. A unified pathophysiological construct of diabetes and its complications. Trends Endocrinol Metab [Internet]. 2017 Sep; 28(9): 645-55. doi: 10.1016/j.tem.2017.05.005
  17. Hotta K, Funahashi T, Arita Y, et al. Plasma concentrations of a novel, adipose-specific protein, adiponectin, in Type 2 diabetic patients. Arterioscler Thromb Vasc Biol [Internet]. 2000 Jun; 20(6): 1595-9. doi: 10.1161/01.atv.20.6.1595
  18. Qi L, Rimm E, Liu S, Rifai N, Hu FB: Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care [Internet]. 2005 May; 28(5): 1022-8. doi: 10.2337/diacare.28.5.1022
  19. Qi L, Meigs JB, Liu S, Manson JE, Mantzoros C, Hu FB. Dietary fibers and glycemic load, obesity, and plasma adiponectin levels in women with Type 2 diabetes. Diabetes Care [Internet]. 2006 Jul; 29(7): 1501-5. doi: 10.2337/dc06-0221
  20. Stefan N, Stumvoll M: Adiponectin: its role in metabolism and beyond. Horm Metab Res [Internet]. 2002 Sep; 34(9): 469-74. doi: 10.1055/s-2002-34785
  21. Lottenberg AMP, Fan PLT, Buonacorso V. Effects of dietary fiber intake on inflammation in chronic diseases. Einstein (Sao Paulo) [Internet]. 2010 Jun; 8(2) :254-8. English, Portuguese. doi: 10.1590/S1679-45082010MD1310