n-3 polyunsaturated fatty acids increase thermic effect of food in men with metabolic syndrome.

PURPOSE: Effects on energy metabolism of a test meal and a two-week dietary intervention were observed in men with metabolic syndrome (MetS). Both the meal and the intervention included foods containing fish-derived n-3 polyunsaturated fats (PUFA). METHODS: Six men with MetS (46.7 ± 12.1 years, 37.2 ± 5.6 kg/m(2), mean ± standard deviation) completed two test days, separated by a 14-day dietary intervention during which they consumed at least 2.0 g per day of n-3 PUFA from supplied foods. Pre- and post-intervention measurements included body composition, resting metabolic rate (RMR), and the thermic effect of food (TEF) measured for six hours after ingestion of a test meal consisting of 1.43 g of fish-derived n-3 PUFA. RESULTS: Intakes of n-3 PUFA increased over the 14-day intervention, from 0.43 g per day ± 0.48 to 2.92 g per day ± 1.97 (p=0.013), while no changes were observed in total energy intakes, weight, body composition, or RMR (all p>0.05). The TEF increased by 51.3% (p=0.036), and the non-protein respiratory quotient decreased by 36.0% (p=0.700). CONCLUSIONS: Subjects increased their intake of fish-derived n-3 PUFA in an isocaloric manner while maintaining body weight and composition, and increased the TEF. More studies with larger sample sizes and longer intervention periods are required to confirm the use of fish-derived n-3 PUFA as a therapeutic dietary strategy for people with MetS.

Metformin for early comorbid glucose dysregulation and schizophrenia spectrum disorders: a pilot double-blind randomized clinical trial.

Patients with schizophrenia have exceedingly high rates of metabolic comorbidity including type 2 diabetes and lose 15-20 years of life due to cardiovascular diseases, with early accrual of cardiometabolic disease. In this study, thirty overweight or obese (Body Mass Index (BMI) > 25) participants under 40 years old with schizophrenia spectrum disorders and early comorbid prediabetes or type 2 diabetes receiving antipsychotic medications were randomized, in a double-blind fashion, to metformin 1500 mg/day or placebo (2:1 ratio; n = 21 metformin and n = 9 placebo) for 4 months. The primary outcome measures were improvements in glucose homeostasis (HbA1c, fasting glucose) and insulin resistance (Matsuda index-derived from oral glucose tolerance tests and homeostatic model of insulin resistance (HOMA-IR)). Secondary outcome measures included changes in weight, MRI measures of fat mass and distribution, symptom severity, cognition, and hippocampal volume. Twenty-two patients (n = 14 metformin; n = 8 placebo) completed the trial. The metformin group had a significant decrease over time in the HOMA-IR (p = 0.043) and fasting blood glucose (p = 0.007) vs. placebo. There were no differences between treatment groups in the Matsuda index, HbA1c, which could suggest liver-specific effects of metformin. There were no between group differences in other secondary outcome measures, while weight loss in the metformin arm correlated significantly with decreases in subcutaneous, but not visceral or hepatic adipose tissue. Our results show that metformin improved dysglycemia and insulin sensitivity, independent of weight loss, in a young population with prediabetes/diabetes and psychosis spectrum illness, that is at extremely high risk of early cardiovascular mortality. Trial Registration: This protocol was registered with clinicaltrials.gov (NCT02167620).