Effects of Different Fish Oil Types on Type 2 Diabetes Risk Factors in High-Risk Adults

Prior treatment

• Prior history of cardiovascular events (e.g. stroke, transient ischemic attack, myocardial infarction, angina, heart failure, arrhythmias, flutter, atrial …)
• Concomitant medications (systemic corticosteroids; hypertension medication; anti-psychotic medications - psycho-active medication that promote weight gain; anticoagulant or anti-aggregates treatment (e.g. aspirin, NSAIDs, warfarin, coumadin..); systemic adrenergic agonists; weight-loss medication (e.g. GLP-1 agonists); lipid lowering medication (e.g. statins, anti-PCSK9); )
• Anticipated surgery or blood transfusion

Other illness

• Elevated risk of cardiovascular disease (≥ 20% of calculated Framingham Risk Score)
• Prior history of cancer within the last 3 years or if lymph nodes were removed
• Thyroid disease - untreated or unstable Synthroid dose
• Bleeding disorders
• Blood coagulation problems (i.e. bleeding predisposition)
• Malabsorptive disease or surgeries (e.g. bariatric surgeries)
• Autoimmune and chronic inflammatory disease (i.e. celiac, inflammatory bowel, Graves, multiple sclerosis, psoriasis, rheumatoid arthritis, and lupus).
• Seizures
• Known history of difficulties accessing a vein
• Known history of vagal shock or loss of consciousness during blood withdrawal
• Allergy to seafood/fish or corn oil
• Allergy to bovine gelatine or glycerine (softgel components)
• Allergy to Xylocaine (anesthesia used during fat tissue biopsy)
• Other conditions deemed inappropriate by the study physician (e.g. difficulties in understanding/communicating in French or English)

Lab values

• Diabetes or HbA1c ≥ 6.5%
• Severe renal dysfunction - eGFR \< 30 mL/min/1.73 m²
• Hepatic dysfunction - AST/ALT \> 3 times normal limit
• Anemia - Hb \< 120 g/L in females and \< 130 in males

Other

• Systolic blood pressure \> 140 mmHg or diastolic blood pressure \> 90 mmHg
• Reactive hypoglycaemia
• Chronic diarrhea
• Cholecystectomy (e.g. removal of gall bladder)
• Sleep apnea
• Known substance abuse
• Very high physical activity (\> 5 hours of aerobic exercise per week)
• Already taking more than 1 gm of EPA and/or DHA supplementation per day
• Lack of compliance to the study requirements (i.e. not being fasting)
• Cancellation of the same scheduled testing visit more than once
• Lack of time to participate in the full length of the study (18-22 weeks)

• Males and post-menopausal females:
• With a body mass index (BMI \>25-40 kg/m2)
• Having confirmed menopausal status (FSH ≥ 30 U/l)
• Non-smokers (tobacco) or have quitted for over a year
• Low-moderate alcohol consumption: \<7 alcoholic servings/ week
• Plasma apoB ≥1.05 g/L