In the UK it is estimated that 1 in 4 adults are at greater risk of heart disease and stroke due to presence of the metabolic syndrome (MetS)^{( 1 )}. The MetS is a term used to describe any combination of at least three of the following conditions: high blood pressure, increased waist circumference, impaired fasting glucose, increased fasting triglycerides, and low HDL cholesterol.

Components of foods that may improve conditions associated with MetS include the omega-3 fatty acid docosahexaenoic acid (DHA) and the soluble plant fibre beta-glucan (BG), which are considered beneficial for maintaining normal blood triglyceride and cholesterol concentrations^{( 2 , 3 )}. There is also clinical evidence that anthocyanins (AC) may improve HDL cholesterol in adults with dyslipidaemia^{(Reference Qin4)}.

In a double-blind, parallel-arm, randomised pilot study, 35 participants (M = 40 %), mean age 45 y, with or at risk of MetS were recruited to consume ready-made pancakes enriched with DHA, BG, or AC alone or in combinations of DHA + BG or DHA + AC every day for 4 weeks. At baseline and endpoint markers of MetS were measured. Mean change, from baseline to endpoint, in biomarkers of the MetS are summarised in Table 1.

Table 1: Mean change in biomarkers of the MetS. HDL-C, HDL cholesterol; SBP, systolic blood pressure; DBP, diastolic blood pressure; SD, standard deviation. Results were not statistically significant.

The objective of this pilot study was to select the enrichment type most effective at improving fasting blood triglycerides and/or HDL cholesterol, to be consumed in the subsequent PATHWAY-27 12-week placebo-controlled, multi-centre trial. Pancakes enriched with DHA and AC alone and in combination appear to be the most effective. DHA + AC enrichment was selected for further study.