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This study aims to assess the effects of date consumption (three dates daily) on glycemic profile (HbA1c), body mass index (BMI), ... Effects of Daily Low-Dose Date Consumption on Glycemic Control, Lipid Profile, and Quality of Life in Adults with Pre- and Type 2 Diabetes: A Randomized Controlled Trial. Received 2019 Nov 10, Accepted 2019 Dec 2, Collection date 2020 Jan.

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© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). PMCID: PMC7019638 PMID: 31952131. Abstract. Dates have a low glycemic index and are a source of antioxidants but, nevertheless, contain more than 70% sugar. This study aims to assess the effects of date consumption (three dates daily) on glycemic profile (HbA1c), body mass index (BMI), quality of life, and lipid profile, including total cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) in terms of safety for type 2 diabetic mellitus (T2DM) subjects. A randomized controlled trial was conducted with a sample of 100 T2DM subjects (39 male and 61 female) randomly assigned in two groups. The first group received three dates daily for 16 weeks, and the control group avoided date consumption. After a 16-week follow-up period, the study results showed an improvement of lipid profile with a statistically significant decrease in total cholesterol of ∆ = −0.209 mmol/L (confidence interval (CI) 95% −0.358, −0.059, p. Keywords: dates, obesity, diabetes, inflammation, antioxidants. 1. Introduction. Date palm ( Phoenix dactylifera L.) is one of the most important fruit crops in the Middle East and North Africa that produce edible and delicious dates. Date palms are spread across Iraq, Iran, Saudi Arabia, Egypt, Tunisia, Algeria, Libya, United Arab Emirates (UAE), Bahrain, and Oman. All date varieties have four distinct stages of maturity, namely, kimri (immature and inedible), khalal (partially ripe), rutab (soft and ripe), and tamar (ripe and dried) [1]. The date fruit is a traditional delicacy and a seasonal heritage food appreciated mainly for its nutritional and medicinal values, a fact that is well documented in the Holy Quran. The Islamic tradition of breaking a fast with dates during the holy month of Ramadan is observed in all Arab and Islamic countries [2]. Nutritional analysis showed that dates are high in carbohydrates and sugar. Dates consist of more than 70% sugar, consisting mainly of glucose, fructose, and a small amount of sucrose [3]. Dates are also rich in fibers, vitamins, and minerals. Dates contain many nutrients such as calcium, magnesium, amino acids, iron, zinc, potassium, phosphorous, and selenium [4]. Depending on the date variety, there are different levels and patterns of bioactive non-nutrient phytochemicals, including carotenoids, polyphenols, and particularly phenolic acids, along with flavonoids [5,6]. Four free phenolic acids (protocatechuic acid, vanillic acid, syringic acid, and ferulic acid) and nine bound phenolic acids (gallic acid, protocatechuic acid, p -hydroxybenzoic acid, vanillic acid, caffeic acid, syringic acid, p -coumaric acid, ferulic acid, and o -coumaric acid) were identified in Omani date varieties [4]. Recent studies have shown that these constituents of dates act as potent antioxidants, antiglycemics, and anti-inflammatories, providing suitable nutritional therapy for different diseases such as cancer, diabetes, and dyslipidemia [5,6,7,8]. Worldwide, an estimated 425 million adults aged 20–79 years have type 2 diabetes mellitus (T2MD) [9]. As such, there are concerns and expressed reservations in the medical community about the consumption of a certain amount of dates among T2DM patients [5]. To our knowledge, there are no available data showing the association between date consumption and T2DM, obesity, and lipid profile. Dates, because of their high fiber and phenolic contents, could play a potent role in the prevention of chronic diseases such as cardiovascular disease (CVD), atherosclerosis, hypertension and T2DM. Prevention of CVD may be due to the inhibition of platelet aggregation as well as the oxidation of low-density lipoprotein (LDL). Phenolics, because of their anti-inflammatory and antithrombotic effects, may be able to reduce blood pressure [5,10]. Such effects are undoubtedly attributed to the antioxidant properties of phenolic compounds by chelating metal ions and scavenging free radicals, as previously reported in different varieties of dates [11,12,13]. Preliminary data in the literature suggest that date fruit supplementation may exert maximum serum cholesterol, triglyceride, and LDL reduction potential through several mechanisms that modulate cholesterol absorption and metabolism [14,15]. In addition to these animal studies, a recent clinical study with 60 geriatric patients having borderline high LDL (130 to 159 mg/dL) revealed significant reductions of LDL plasma levels after a daily intake of 20–35 g of dates for six months [16]. In addition to these benefits, polyphenolic compounds from dates are able to decrease the postprandial hyperglycemia in T2MD by inhibiting the carbohydrate-hydrolyzing enzymes α-glucosidase and α-amylase [17]. Date fruit extracts can also suppress hypersensitive immune responses because of their anti-inflammatory, antiallergic, and antimodulatory qualities [18]. Moreover, the study by Hussein et al. [19] also confirmed the anti-hyperglycemic effects of date fruit extracts on liver function in diabetic rats. Phytochemicals present in dates could also be used as antiobesetic agents, as demonstrated by the inhibitory effect of pits from various date palm varieties against lipase activity [20]. The effectiveness of the date pit extract against lipase activity strongly suggests that dates through their phytochemical constituents could minimize the absorption of lipids and energy intake from food.













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