title: The effect of flaxseed powder on insulin resistance indices and blood pressure in prediabetic individuals: A randomized controlled clinical trial Daily flaxseed consumption improves glycemic control in obese men and women with pre-diabetes: a randomized study. Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study Decreasing the Linoleic Acid to α-Linolenic Acid Diet Ratio Increases Eicosapentaenoic Acid in Erythrocytes in Adults The effects of flaxseed dietary supplement on lipid profile, bone mineral density, and symptoms in menopausal women: a randomized, double-blind, wheat germ placebo-controlled clinical trial. Flaxseed supplementation improved insulin resistance in obese glucose intolerant people: a randomized crossover design An Open-Label Study on the Effect of Flax Seed Powder (Linum usitatissimum) Supplementation in the Management of Diabetes Mellitus No evidence of hypoglycemia or hypotension in older adults during 6 months of flax lignan supplementation in a randomized controlled trial: A safety evaluation Lignan Content of the Flaxseed Influences Its Biological Effects in Healthy Men and Women A Comparison of the Effects of n-3 Fatty Acids From Linseed Oil and Fish Oil in Well-Controlled Type II Diabetes Effect of Protein Ingestion on the Glucose and Insulin Response to a Standardized Oral Glucose Load Dietary flaxseed lignan extract lowers plasma cholesterol and glucose concentrations in hypercholesterolaemic subjects. Dietary modulation of the gut microbiota – a randomised controlled trial in obese postmenopausal women Flaxseed Lignan Complex Administration in Older Human Type 2 Diabetics Manages Central Obesity and Prothrombosis—An Invitation to Further Investigation into Polypharmacy Reduction Effects of a Flaxseed-Derived Lignan Supplement in Type 2 Diabetic Patients: A Randomized, Double-Blind, Cross-Over Trial High dose flaxseed oil supplementation may affect fasting blood serum glucose management in human type 2 diabetics. Dietary Milled Flaxseed and Flaxseed Oil Improve N-3 Fatty Acid Status and Do Not Affect Glycemic Control in Individuals with Well-Controlled Type 2 Diabetes Flaxseed and Cardiovascular Risk Factors: Results from a Double Blind, Randomized, Controlled Clinical Trial Flaxseed on cardiovascular disease markers in healthy menopausal women: a randomized, double-blind, placebo-controlled trial. Effects of hempseed and flaxseed oils on the profile of serum lipids, serum total and lipoprotein lipid concentrations and haemostatic factors Flaxseed oil does not affect inflammatory markers and lipid profile compared to olive oil, in young, healthy, normal weight adults. Effects of brown and golden flaxseed on the lipid profile, glycemia, inflammatory biomarkers, blood pressure and body composition in overweight adolescents. Flaxseed supplementation in non-alcoholic fatty liver disease: a pilot randomized, open labeled, controlled study Systemic Inflammation in Morbidly Obese Subjects: Response to Oral Supplementation with Alpha-Linolenic Acid The effect of a lignan complex isolated from flaxseed on inflammation markers in healthy postmenopausal women. Effects of Soy-Soluble Fiber and Flaxseed Gum on the Glycemic and Insulinemic Responses to Glucose Solutions and Dairy Products in Healthy Adult Males Effects of n-3 fatty acid supplements on glycemic traits in Chinese type 2 diabetic patients: A double-blind randomized controlled trial.
abstract: Background : Design ing the effective and early interventions can prevent progression of prediabetes to diabetes . Few studies have shown the effect of flaxseed on glycemic control . This study aim ed to assess the effect of flaxseed powder on insulin resistance ( IR ) indices and blood pressure in prediabetic individuals . Material s and Methods : In a r and omized clinical trial , 99 prediabetic individuals were r and omly divided into three groups : two groups received 40 g ( FG40 ) and 20 g ( FG20 ) flaxseed powder daily for 12 weeks and the third group was the control ( CG ) . Before and after the intervention , anthropometric measurements , blood pressure , fasting serum glucose ( FSG ) , insulin , homeostasis model assessment IR index ( HOMA-IR ) , beta-cell function , and insulin sensitivity were measured . Results : FSG significantly declined overall in all groups compared to the baseline ( P = 0.002 in CG and FG20 groups and P = 0.001 in FG40 ) . In contrast , mean of the changes in FSG was not significantly different between groups . Insulin concentration did not change significantly within and between the investigated groups . Although HOMA-IR reduced in FG20 ( P = 0.033 ) , the mean of changes was not significant between the three groups . Mean of beta-cell function increased in CG and FG40 groups compared to the baseline ( P = 0.044 and P = 0.018 , respectively ) , but mean of its changes did not show any difference between the three groups . The mean of changes in IR indices was not significant between the three groups . FG40 group had significantly lowered systolic blood pressure after the intervention ( P = 0.005 ) . Conclusion : Daily intake of flaxseed powder lowered blood pressure in prediabetes but did not improve glycemic and IR indices The study hypothesis was that fasting glucose , insulin , fructosamine , C-reactive protein , and interleukin-6 decrease and adiponectin increases with daily flaxseed consumption in overweight or obese individuals with pre-diabetes . In this r and omized , cross-over study overweight or obese men and postmenopausal women ( n = 25 ) with pre-diabetes consumed 0 , 13 , or 26 g ground flaxseed for 12 weeks . Glucose , insulin , homeostatic model assessment ( HOMA-IR ) , and normalized percent of α-linolenic fatty acid ( ALA ) were significantly different by treatment ( multiple analysis of variance , P = .036 , P = .013 , P = .008 , P = .024 respectively ) . Paired t tests showed glucose decreased on the 13 g intervention compared to the 0 g period [ 13 g = -2.10 ± 1.66 mg/L ( mean ± SEM ) , 0 g = 9.22 ± 4.44 mg/L , P = .036 ] . Insulin decreased on the 13 g intervention but not the 26 g ( P = .021 ) and 0 g ( P = .013 ) periods ( 13 g = -2.12 ± 1.00 mU/L , 26 g = 0.67 ± 0.84 mU/L , 0 g = 1.20 ± 1.16 mU/L ) . HOMA-IR decreased on the 13 g period but not on the 26 g ( P = .012 ) and 0 g ( P = .008 ) periods ( 13 g = -0.71 ± 0.31 , 26 g = 0.27 ± 0.24 , 0 g = 0.51 ± 0.35 ) . The α-linolenic fatty acid decrease for the 0 g period was different than the 13 g ( P = .024 ) and 26 g ( P = .000 ) periods ( 13 g = 0.20 ± 0.04 , 26 g = 0.35 ± 0.07 , 0 g = -0.01 ± 0.07 ) . Fructosamine , high sensitivity C-reactive protein , adiponectin , and high-sensitivity interleukin-6 had no significant  differences . Flaxseed intake  decreased glucose and insulin and improved insulin sensitivity as part of a habitual diet in overweight or obese individuals with pre-diabetes Background Flaxseed has received attention for its anti-inflammatory and antioxidant role . The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease . Methods In a prospect i ve , single blinded 42 days protocol , subjects were allocated into two groups with low carbohydrates intake : GriceLC ( 35 % of carbohydrate and 60 g of raw rice powder per day ) and GflaxLC ( 32 % of carbohydrate and 60 g of flaxseed powder per day ) . Blood pressure , anthropometric measures and serum levels of isoprostane , C-reactive protein , Tumor Necrosis Factor-alpha , glucose , lipidic profile , uric acid , adiponectin , leptin and insulin were measured at baseline and at the end of interventions . Serum and urinary enterodiol and enterolactione were also measured . Results A total of 27 men with cardiovascular risk factors were evaluated , with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC . Both groups experienced weight loss and systolic blood pressure reduction . A decrease in inflammatory markers ( CRP and TNF-α ) was observed after flaxseed intake ( mean decrease of 25 % and 46 % for GflaxLC respectively ) . All groups also showed improvement in levels of total cholesterol , LDL-c , uric acid and adiponectin . Only GflaxLC group showed a decrease in triglyceride levels . Conclusion This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α . Trial registration Clinical Trials.gov NCT02132728 The n-6/n-3 fatty acid ( FA ) ratio has increased in the Western-style diet to ~10–15:1 during the last century , which may have contributed to the rise in cardiovascular disease ( CVD ) . Prior studies have evaluated the effects on CVD risk factors of manipulating the levels of n-6 and n-3 FA using food and supplements or investigated the metabolic fate of linoleic acid ( LNA ) and α-linolenic acid ( ALA ) by varying the n-6/n-3 ratios . However , no previous studies have investigated the potential interaction between diet ratios and supplementation with eicosapentaenoic acid ( EPA , 20:5n-3 ) and docosahexaenoic acid ( DHA , 22:6n-3 ) . We used a factorial design approach with adults ( n = 24 ) in a controlled feeding trial to compare the accretion of EPA and DHA into red blood cell membranes ( RBC ) by adding a direct source ( algal oil supplement ) of EPA and DHA in a diet with a 10:1 versus 2:1 ratio of n-6/n-3 FA . Subjects were r and omized into 8-week crossover diet sequences and each subject consumed three of four diets [ 10:1 , 10:1 plus supplement ( 10:1 + S ) , 2:1 and 2:1 + S ] . LNA and ALA intakes were 9.4 and 7.7 % , and 1.0 and 3.0 % during the low and high ALA diets , respectively . Compared to the Western-style 10:1 diet , the 2:1 diet increased EPA by 60 % ( P < 0.0001 ) in RBC membranes without the direct EPA source and a 34 % increase ( P = 0.027 ) was observed with the 10:1 + S diet ; however , DHA levels increased in both diet ratios only with a direct DHA source . Shifting towards a 2:1 diet is a valid alternative to taking EPA-containing supplements Phytoestrogens are increasingly incorporated into the diet of menopausal women . However , there are limited data on the efficacy of flaxseed on the consequences of estrogen deficiency in menopausal women . The purpose of the study was to assess the effects of flaxseed incorporation into the diet of healthy menopausal women . One hundred and ninety-nine menopausal women were r and omly assigned to consume 40 g flaxseed/d ( n = 101 ) or wheat germ placebo ( n = 98 ) for 12 months . At baseline and at month 12 , serum levels of lipids , bone mineral density ( BMD ) , and menopausal symptoms were evaluated . Statistical analysis was performed under the intention to treat principle . Flaxseed reduced serum total ( -0.20 + /- 0.51 mmol/liter ; P = 0.012 ) and high-density lipoprotein ( -0.08 + /- 0.24 mmol/liter ; P = 0.031 ) cholesterol concentrations compared with wheat germ placebo .  BMD did not differ significantly between the two arms . Both flaxseed and wheat germ reduced ( P < 0.0001 ) the severity scores of menopausal symptoms , but no statistical difference was found between the two arms . Our findings suggest that 1-yr incorporation of flaxseed into the diet produced a favorable , but not clinical ly significant , effect on blood cholesterol and caused no significant change in BMD or symptoms in healthy menopausal women Background Obesity leads to an increase in inflammation and insulin resistance . This study determined antioxidant activity of flaxseed and its role in inflammation and insulin resistance in obese glucose intolerant people . Methods Using a r and omized crossover design , nine obese glucose intolerant people consumed 40 g ground flaxseed or 40 g wheat bran daily for 12 weeks with a 4-week washout period . Plasma inflammation biomarkers ( CRP , TNF-α , and IL-6 ) , glucose , insulin , and thiobaribituric acid reactive substance ( TBARS ) were measured before and after of each supplementation . Results Flaxseed supplementation  decreased TBARS ( p = 0.0215 ) and HOMA-IR ( p = 0.0382 ) . Flaxseed or wheat bran supplementation did not change plasma inflammatory biomarkers . A positive relationship was found between TBARS and HOMA-IR ( r = 0.62 , p = 0.0003 ) . Conclusions The results of the study weakly support that decreased insulin resistance might have been secondary to antioxidant activity of flaxseed . However , the mechanism(s ) of decreased insulin resistance by flaxseed should be further determined using flaxseed lignan ABSTRACT Diabetes mellitus is characterized by hyperglycemia and associated with aberrations in the metabolism of carbohydrate , protein , and lipid that result in development of secondary complications . Extensive studies have indicated that nutritional therapy plays a pivotal role in the controlling or postponing of development of these secondary complications . Several functional foods have been shown to possess hypoglycemic and hypolipidemic properties . Flax seed ( FS ) is a functional food that is rich in omega 3 fatty acids and antioxidants and is low in carbohydrates . In exploratory studies , FS was incorporated in recipes , which result ed in a reduction in the glycemic index of the food items . These observations prompted us to investigate the efficacy of FS supplementation in type 2 diabetics ( n = 29 ) . Subjects were assigned to the experimental ( n = 18 ) or the control group ( n = 11 ) on the basis of their desire to participate in the study . The experimental group 's diet was supplemented daily with 10 g of FS powder for a period of 1 month . The control group received no supplementation or placebo . During the study , diet and drug intake of the subjects remained unaltered . The efficacy of supplementation with FS was evaluated through a battery of clinico-biochemical parameters . Supplementation with FS  reduced fasting blood glucose by 19.7 % and glycated hemoglobin by 15.6 % . A favorable reduction in total cholesterol ( 14.3 % ) , triglycerides ( 17.5 % ) , low-density lipoprotein cholesterol ( 21.8 % ) , and apolipoprotein B and an increase in high-density lipoprotein cholesterol ( 11.9 % ) were also noticed . These observations suggest the therapeutic potential of FS in the management of diabetes mellitus Abstract Context : The natural health product , BeneFlax , is a st and ardized flaxseed [ Linum usitatissimum L. ( Linaceae ) ] lignan enriched product with evidence of product quality and known quantity of the bioactive component , lignan . The acceptance of this natural health product for its various health benefits requires greater evidence of its safety in the general population . Objective : We determined whether flaxseed lignan causes clinical hypoglycemia or hypotension in healthy older adults as an important aspect of safety . Material s and methods : Participants aged 49–87 years were r and omized in a double-blind trial to receive flaxseed lignan ( 543 mg/day in BeneFlax ) or placebo while completing a 6-month walking program . The 94 participants who completed the study were stratified by age ( < 65 years versus ≥65 years ) and treatment category to determine whether older adults were more susceptible to adverse effects . Results : After 6 months of treatment , average plasma glucose level ( 5.4 ± 0.6 mmol/L ) , systolic blood pressure ( 127 ± 14 mm Hg ) , and diastolic blood pressure ( 80 ± 9 mm Hg ) were within normal clinical range . Controlling for sex and body mass index covariates result ed in no observed differences between plasma glucose or blood pressure measurements between treatment or age groups ( p > 0.05 ) . No incidents of hypoglycemia or hypotension were observed during BeneFlax treatment , suggesting that 543 mg falls at or below the no observable adverse effect level ( NOAEL ) . Discussion and conclusion : These data suggest the flaxseed lignan product BeneFlax does not pose a risk of hypoglycemia or hypotension in healthy adults aged 49–87 years Objective : The omega-3 polyunsaturated fatty acid ( n-3 PUFA ) as well as lignan components of flaxseed ( FLX ) can have beneficial effects . In this 6-week-long , r and omized , double-blinded , placebo-controlled study , we investigated the effects of FLX lignans on cardiovascular risk factors . Methods : Thirty-seven subjects ( 13 men and 24 women , age : 54 ± 7 years , body mass index [ BMI ] : 29.7 ± 1 kg/m2 ) consumed nutrition bars  with similar macronutrient contents . The fatty acid composition and the lignan contents of the bars differed significantly . Two FLX bars both contained 3.0 g of alpha linolenic acid ( ALA : 18:3 n-3 ) but different amount of lignans ( 0.15 g vs. 0.41 g ) . Results : High-lignan FLX  decreased total cholesterol ( C ) by 12 % ( p = 0.044 ) , LDL-C by 15 % ( p = 0.022 ) , and oxidized (Ox)-LDL by 25 % ( p = 0.035 ) . Regular FLX tended to increase Ox-LDL by 13 % ( p = 0.051 ) . The difference between the effects of high-lignan vs. regular lignan FLX  on Ox-LDL was highly significant ( p = 0.004 ) . Conclusion : High-lignan FLX has the unique property of decreasing Ox-LDL , which is an independent risk factor for cardiovascular disease OBJECTIVE Supplementation of type II diabetic diets with n-3 fatty acids ( FAs ) from fish oil ( FO ) has been associated with lowered triglyceride and VLDL levels , although reports of impaired glycemic control have limited their use . Effects of n-3FAs from nonmarine sources are less well documented . Therefore , an investigation comparing the effects of linseed oil ( LO ) with FO supplementation was undertaken in subjects with type II diabetes . RESEARCH DESIGN AND METHODS Eleven subjects with type II diabetes were given supplements with LO and FO for 3 months each in a r and omized double-blind crossover fashion after 3 months of olive oil placebo . Oils were given as 35 mg FA · kg body wt−1 · day−1 . After each 3-month period , fasting glucose and insulin levels , HbA1c , lipid profiles , insulin sensitivity ( SI ) , glucose effectiveness ( SG ) , and acute insulin response to glucose ( AIRG ) were evaluated . RESULTS HbA1c and lipid values were within the normal range at r and omization . Repeated measures analysis of variance testing found no significant differences in weight ; fasting glucose and insulin levels ; HbA1c ; total , LDL , and HDL cholesterol levels ; SI ; SG ; or AIRG with either active oil . FO was associated with significant reductions in triglycerides and a trend toward decreased SI . CONCLUSIONS In a population with well-controlled type II diabetes , 3 months of FO but not LO result ed in lowered triglyceride levels . Neither LO nor FO significantly affected glycemic control , cholesterol values , SG , or insulin secretion , while a nonsignificant trend toward decreased insulin sensitivity was found with FO Type II diabetic subjects were given 50 g protein , 50 g glucose , or 50 g glucose with 50 g protein as a single meal in r and om sequence . The plasma glucose and insulin response was determined over the subsequent 5 h. The plasma glucose area above the baseline following a glucose meal was reduced 34 % when protein was given with the glucose . When protein was given alone , the glucose concentration remained stable for 2 h and then declined . The insulin area following glucose was only modestly greater than with a protein meal ( 97 ± 35 , 83 ± 19 µU · h/ml , respectively ) . When glucose was given with protein , the mean insulin area was considerably greater than when glucose or protein was given alone ( 247 ± 33 µU · h/ml ) . When various amounts of protein were given with 50 g glucose , the insulin area response was essentially first order . Subsequently , subjects were given 50 g glucose or 50 g glucose with 50 g protein as two meals 4 h apart in r and om sequence . The insulin areas were not significantly different for each meal but were higher when protein + glucose was given . After the second glucose meal the plasma glucose area was 33 % less than after the first meal . Following the second glucose + protein meal the plasma glucose area was markedly reduced , being only 7 % as large as after the first meal . These data indicate that protein given with glucose will increase insulin secretion and reduce the plasma glucose rise in at least some type II diabetic persons Lignans , derived from flaxseed , are phyto-oestrogens being increasingly studied for their health benefits . An 8-week , r and omised , double-blind , placebo-controlled study was conducted in fifty-five hypercholesterolaemic subjects , using treatments of 0 ( placebo ) , 300 or 600 mg/d of dietary secoisolariciresinol diglucoside ( SDG ) from flaxseed extract to determine the effect on plasma lipids and fasting glucose levels . Significant treatment effects were achieved ( P < 0.05 to < 0.001 ) for the decrease of total cholesterol ( TC ) , LDL-cholesterol ( LDL-C ) and glucose concentrations , as well as their percentage decrease from baseline . At weeks 6 and 8 in the 600 mg SDG group , the decreases of TC and LDL-C concentrations were in the range from 22.0 to 24.38 % respectively ( all P < 0.005 compared with placebo ) . For the 300 mg SDG group , only significant differences from baseline were observed for decreases of TC and LDL-C. A substantial effect on lowering concentrations of fasting plasma glucose was also noted in the 600 mg SDG group at weeks 6 and 8 , especially in the subjects with baseline glucose concentrations > or = 5.83 mmol/l ( lowered 25.56 and 24.96 % ; P = 0.015 and P = 0.012 compared with placebo , respectively ) . Plasma concentrations of secoisolariciresinol ( SECO ) , enterodiol ( ED ) and enterolactone were all significantly raised in the groups supplemented with flaxseed lignan . The observed cholesterol-lowering values were correlated with the concentrations of plasma SECO and ED ( r 0.128 - 0.302 ; P < 0.05 to < 0.001 ) . In conclusion , dietary flaxseed lignan extract decreased plasma cholesterol and glucose concentrations in a dose-dependent manner The gut microbiota has been implicated in obesity and its progression towards metabolic disease . Dietary interventions that target the gut microbiota have been suggested to improve metabolic health . The aim of the present study was to investigate the effect of interventions with Lactobacillus paracasei F19 or flaxseed mucilage on the gut microbiota and metabolic risk markers in obesity . A total of fifty-eight obese postmenopausal women were r and omised to a single-blinded , parallel-group intervention of 6-week duration , with a daily intake of either L. paracasei F19 ( 9·4 × 1010 colony-forming units ) , flaxseed mucilage ( 10 g ) or placebo . Quantitative metagenomic analysis of faecal DNA was performed to identify the changes in the gut microbiota . Diet-induced changes in metabolic markers were explored using adjusted linear regression models . The intake of flaxseed mucilage over 6 weeks led to a reduction in serum C-peptide and insulin release during an oral glucose tolerance test ( P < 0·05 ) and improved insulin sensitivity measured by Matsuda index ( P < 0·05 ) . Comparison of gut microbiota composition at baseline and after 6 weeks of intervention with flaxseed mucilage  showed alterations in abundance of thirty-three metagenomic species ( P < 0·01 ) , including decreased relative abundance of eight Faecalibacterium species . These changes in the microbiota could not explain the effect of flaxseed mucilage on insulin sensitivity . The intake of L. paracasei F19 did not modulate metabolic markers compared with placebo . In conclusion , flaxseed mucilage  improves insulin sensitivity and alters the gut microbiota ; however , the improvement in insulin sensitivity was not mediated by the observed changes in relative abundance of bacterial species Aim . Animal and human study evidence supports the hypothesis that flaxseed lignan complex ( FLC ) at a dose of 600 mg secoisolariciresinol diglucoside (SDG)/day for three months would combat hyperglycaemia , dyslipidemia , blood pressure , central obesity , prothrombotic state , inflammation , and low density lipoprotein ( LDL ) oxidation . Methods . Sixteen type 2 diabetic patients completed this double-blind , r and omised crossover placebo-controlled study . A univariate repeated measures analysis of covariance ( significance P < 0.05 ) was followed by a mixed linear model effects analysis corrected for multiple comparisons ( MCC ) . Results . Prior to MCC , FLC caused decreased fasting plasma glucose , A1c , inflammation ( c-reactive protein ( CRP ) and interleukin-6 ( IL-6 ) ) , and increased bleeding time . After correction for multiple comparisons , FLC induced a statistically significant increase in bleeding time and smaller waist circumference gain . No treatment effect occurred in the other variables before or after adjustment . Conclusions . It is concluded that FLC significantly increased bleeding time thus reducing the prothrombotic state , reduced central obesity gain as measured by waist circumference , and did not affect significantly the other dependent variables measured after adjustment for multiple comparisons . These findings , not yet published in human type 2 diabetes , suggest that this FLC dose over at least three months , may , subject to further investigation , reduce polypharmacy Background Flaxseed consumption has been shown to improve blood lipids in humans and flaxseed-derived lignan has been shown to enhance glycemic control in animals . The study aim ed to investigate the effect of a flaxseed-derived lignan supplement on glycemic control , lipid profiles and insulin sensitivity in type 2 diabetic patients . Methodology /Principal Findings This was a r and omized , double-blind , placebo-controlled , cross-over trial and it was conducted between April and December 2006 in Shanghai , China . Seventy-three type 2 diabetic patients with mild hypercholesterolemia were enrolled into the study . Patients were r and omized to supplementation with flaxseed-derived lignan capsules ( 360 mg lignan per day ) or placebo for 12 weeks , separated by an 8-week wash-out period . HbA1c , lipid profiles , insulin resistance index and inflammatory factors were measured . Sixty-eight completed the study and were included in the analyses . The lignan supplement significantly improved glycemic control as measured by HbA1c ( -0.10±0.65 % vs. 0.09±0.52 % , P = 0.001 ) compared to placebo ; however , no significant changes were observed in fasting glucose and insulin concentrations , insulin resistance and blood lipid profiles . Urinary excretion of lignan metabolites ( enterodiol and enterolactone ) was significantly higher after the lignan supplement intervention compared to baseline ( 14.2±18.1 vs. 1.2±2.4 µg/mL , P<0.001 ) . Data also suggested minimal competition between lignan and isoflavones for bioavailability when measured by the excretion concentrations . Conclusions / Significance Daily lignan supplementation result ed in modest , yet statistically significant improvements in glycemic control in type 2 diabetic patients without apparently affecting fasting glucose , lipid profiles and insulin sensitivity . Further studies are needed to vali date these findings and explore the efficacy of lignans on type 2 diabetes . Trial Registration Clinical Trials.gov Type 2 diabetes is characterized partially by elevated fasting blood serum glucose and insulin concentrations and the percentage of hemoglobin as HbA1c . It was hypothesized that each of blood glucose and its co-factors insulin and HbA1c and would show a more favorable profile as the result of flaxseed oil supplementation .  Patients were recruited at r and om from a population pool responding to a recruitment advertisement in the local newspaper and 2 area physicians . Completing the trial were 10 flaxseed oil males , 8 flaxseed oil females , 8 safflower ( placebo ) oil males and 6 safflower oil females . Patients visited on two pre-treatment occasions each three months apart ( visits 1 and 2 ) . At visit 2 subjects were r and omly assigned in double blind fashion and in equal gender numbers to take flaxseed oil or safflower oil for three further months until visit 3 . Oil consumption in both groups was approximately 10 g/d . ALA intake in the intervention group was approximately 5.5 g/d . Power was 0.80 to see a difference of 1 mmol of glucose /L using 12 subjects per group with a p < 0.05 . Flaxseed oil had no impact on fasting blood serum glucose , insulin or HbA1c levels . It is concluded that high doses of flaxseed oil have no effect on glycemic control in type 2 diabetics Objective : To determine the effects of dietary consumption of milled flaxseed or flaxseed oil on glycemic control , n-3 fatty acid status , anthropometrics , and adipokines in individuals with type 2 diabetes . Design : Thirty-four participants were r and omized into a parallel , controlled trial . Subjects : The participants were adults with type 2 diabetes ( age 52.4 ± 1.5 years , body mass index 32.4 ± 1.0 kg/m2 , n = 17 men and 17 women ) . Interventions : Participants consumed a selection of bakery products containing no flax ( control group [ CTL ] , n = 9 ) , milled flaxseed ( FXS , n = 13 ; 32 g/d ) , or flaxseed oil ( FXO , n = 12 ; 13 g/d ) daily for 12 weeks . The FXS and FXO groups received equivalent amounts of alpha-linolenic acid ( ALA ; 7.4 g/day ) . Measures of Outcome : The primary outcome measures were fasting plasma hemoglobin A1c , glucose , insulin , and phospholipid fatty acid composition . The secondary outcome measures were fasting circulating leptin and adiponectin , as well as body weight , body mass index , and waist circumference . Dietary intake assessment and calculations for homeostasis model assessment for insulin resistance and quantified insulin sensitivity check were also completed . Results : The FXS and FXO groups had increases in plasma phospholipid n-3 fatty acids ( ALA , eicosapentaenoic acid [ EPA ] , or decosapentaenoic acid [ DPA ] , but not docosahexaenoic acid ) , and the FXO group had more EPA and DPA in plasma phospholipids compared to the FXS group . All groups had similar caloric intakes ; however , the CTL group experienced a 4 % weight gain compared to baseline ( p < 0.05 ) , while both flax groups had constant body weights during the study period . All other parameters , including glycemic control , were unchanged by dietary treatment . Conclusions : Milled FXS and FXO intake does not affect glycemic control in adults with well-controlled type 2 diabetes . Possible prevention of weight gain by flax consumption warrants further investigation Objective : Flaxseed is a rich source of alpha linolenic acid ( ALA ) , fiber and lignans , making it a potentially attractive functional food for modulating cardiovascular risk . We studied the effects of flaxseed on markers of cardiovascular risk in hypercholesterolemic adults . Methods : Sixty-two men and post-menopausal women with pre- study low density lipoprotein cholesterol ( LDL-C ) between 130 and 200 mg/dl were r and omized to 40g/day of ground flaxseed-containing baked products or matching wheat bran products for 10 weeks while following a low fat , low cholesterol diet .  Fasting lipoproteins , measures of insulin resistance , inflammation , oxidative stress , and safety were assessed at 0 , 5 and 10 weeks . Results : Flaxseed was well-tolerated , and increased serum levels of ALA ( p < 0.001 ) . Compared to wheat , flaxseed significantly reduced LDL-C at 5 weeks ( −13 % , p < 0.005 ) , but not at 10 weeks ( −7 % , p = 0.07 ) . Flaxseed  reduced lipoprotein a ( Lp[a ] ) by a net of 14 % ( p = 0.02 ) , and reduced the homeostatic model assessment of insulin resistance ( HOMA-IR ) index by 23.7 % ( p = 0.03 ) compared to wheat at 10 weeks , but did not affect markers of inflammation ( IL-6 , Hs-CRP ) or oxidative stress ( ox LDL , urinary isoprostanes ) at any time points . In men , flaxseed  reduced HDL-C concentrations by a net of 16 % ( p = 0.03 ) and 9 % ( p = 0.05 ) at 5 and 10 weeks , respectively . Conclusions : Ground flaxseed has a modest but short lived LDL-C lowering effect , yet reduces Lp(a ) and improves insulin sensitivity in hyperlipidemic adults . The HDL-C lowering effect of flaxseed in men warrants additional study OBJECTIVE Due to its high content of lignans , alpha-linolenic acid and fiber , flaxseed may reduce cardiovascular disease risk in humans . The present study evaluated the effect of flaxseed on markers of cardiovascular disease risk in healthy menopausal women . METHODS One hundred ninety-nine women were r and omly assigned to consume 40 g daily of flaxseed or wheat germ placebo for 12 mo . Fatty acids , apolipoproteins A-1 and B , lipoprotein(a ) , low-density lipoprotein particle size , fibrinogen , C-reactive protein , insulin , and glucose were measured at baseline and at 12 mo . RESULTS In total 179 women were available for the intention-to-treat analysis .  Flaxseed increased plasma alpha-linolenic ( P < 0.0001 ) , docosapentaenoic ( P = 0.001 ) , and total omega-3 fatty ( P = 0.0004 ) acids . Differences between flaxseed and wheat germ were observed for apolipoprotein A-1 ( -0.10 + /- 0.26 g/L , P = 0.011 ) and apolipoprotein B ( -0.05 + /- 0.16 g/L , P = 0.047 ) . From baseline , flaxseed raised apolipoproteins A-1 and B by 4.4 % ( P = 0.006 ) and 3 % ( P = 0.054 ) , whereas wheat germ increased these apolipoproteins by 11.6 % ( P < 0.0001 ) and 7 % ( P = 0.0001 ) , respectively . Both treatments increased lipoprotein(a ) ( P < 0.0001 ) and decreased low-density lipoprotein peak particle size ( P < 0.0001 ) . CONCLUSION In this large , long-term , placebo-controlled trial in healthy menopausal women , flaxseed increased some omega-3 fatty acids in plasma and had a limited effect on apolipoprotein metabolism Summary Background Both hempseed oil ( HO ) and flaxseed oil ( FO ) contain high amounts of essential fatty acids ( FAs ) ; i.e. linoleic acid ( LA , 18:2n-6 ) and alpha-linolenic acid ( ALA , 18:3n-3 ) , but almost in opposite ratios . An excessive intake of one essential FA over the other may interfere with the metabolism of the other while the metabolisms of LA and ALA compete for the same enzymes . It is not known whether there is a difference between n-3 and n-6 FA of plant origin in the effects on serum lipid profile . Aim of the study To compare the effects of HO and FO on the profile of serum lipids and fasting concentrations of serum total and lipoprotein lipids , plasma glucose and insulin , and haemostatic factors in healthy humans . Methods Fourteen healthy volunteers participated in the study . A r and omised , double-blind crossover design was used . The volunteers consumed HO and FO ( 30 ml/day ) for 4 weeks each . The periods were separated by a 4-week washout period . Results The HO period result ed in higher proportions of both LA and gamma-linolenic acid in serum cholesteryl esters ( CE ) and triglycerides ( TG ) as compared with the FO period ( P < 0.001 ) , whereas the FO period result ed in a higher proportion of ALA in both serum CE and TG as compared with the HO period ( P < 0.001 ) . The proportion of arachidonic acid in CE was lower after the FO period than after the HO period ( P < 0.05 ) . The HO period result ed in a lower total-to-HDL cholesterol ratio compared with the FO period ( P = 0.065 ) . No significant differences were found between the periods in measured values of fasting serum total or lipoprotein lipids , plasma glucose , insulin or hemostatic factors . Conclusions The effects of HO and FO on the profile of serum lipids differed significantly , with only minor effects on concentrations of fasting serum total or lipoprotein lipids , and no significant changes in concentrations of plasma glucose or insulin or in haemostatic factors OBJECTIVE Olive oil ( OO ) is a rich source of monounsaturated fat and bioactive components that exert strong anti-oxidant and anti-inflammatory properties . Flaxseed oil ( FO ) is rich in α-linolenic n-3 fatty acid ( ALA ) , which also exhibits anti-inflammatory effects . This r and omized , cross-over study aim ed at exploring whether diet 's enrichment with FO could beneficially alter inflammatory markers and lipid profile , compared to OO , in a sample of normal weight , apparently healthy young adults . MATERIAL S AND METHODS Participants were supplied with 15 mL/day of either FO or OO . Each intervention and the wash-out period lasted 6 weeks . Dietary , anthropometric and physical activity variables were recorded at the beginning and the end of each intervention . Serum biochemical and inflammatory markers were measured . Compliance to the intervention was evaluated by fatty acid analysis in erythrocytes . Repeated Measures ANOVA was used to assess the effect of the treatment . RESULTS Thirty seven participants completed the study . No difference between the two interventions was observed in adiponectin , TNF-α , high sensitivity-CRP or glucose levels and lipid profile . At the end of the FO period , participants exhibited significant reductions in total ( -5.0 % ) and LDL-cholesterol ( -6.7 % ) levels ( all P<0.01 ) . During the FO and the OO period serum adiponectin changes were significantly correlated with changes in erythrocyte % ALA ( rs=0.34 , P=0.007 ) and in erythrocyte % EPA ( r(s)=0.47 , P=0.01 ) , respectively . CONCLUSIONS Daily consumption of FO did not confer any benefit in inflammatory or biochemical markers in normal weight young adults , who traditionally use olive oil as the main edible oil BACKGROUND Flaxseed is a promising alternative to reduce the risk of diseases associated with body weight excess because it is rich in a-linolenic acid , lignans , and dietary fiber . Flaxseed ( Linum usitatissimum ) can be found in brown and golden varieties ; however , questions have arisen as to whether the variety may influence the health effects . OBJECTIVE The objective of this study was to compare the effects of brown and golden flaxseeds on lipid profile , glycemia , blood pressure , inflammatory status , body weight , and body composition in overweight adolescents . METHODS Seventy-five overweight adolescents ( 33 boys , 42 girls ; age 13.7 ! 2.1 y ) , from Alegre-ES , Brazil , were r and omized to one of the three groups ( n ¼ 25 ) on a parallel , single-blind clinical trial . They received 28 g/d of brown flaxseed ( BF ) , golden flaxseed ( GF ) , or the equivalent amount of wheat bran ( Control , CG ) in different preparations at school from Monday to Friday for 11 wk . Blood pressure , anthropometric evaluation , and the analyses of blood total cholesterol , lipoproteins , glucose , and inflammatory markers were performed at the beginning and at the end of the intervention . The data were analyzed by ANCOVA at 5 % significance . RESULTS The groups who consumed brown and golden flaxseed showed significant reduction in diastolic blood pressure . Brown and golden flaxseed did not differentially affect plasma lipid responses , plasma glucose and inflammatory profile , although all groups ( BF , GF , and CG ) showed increased levels of TNF-a . CONCLUSIONS The adolescents consumed about half the daily amount provided , which may not have been sufficient to exert the health benefits of flaxseed reported in the literature , concerning the lipid profile , inflammation biomarkers and body composition Abstract A two-arm r and omized open labeled controlled clinical trial was conducted on 50 patients with non-alcoholic fatty liver disease ( NAFLD ) . Participants were assigned to take either a lifestyle modification ( LM ) , or LM + 30 g/day brown milled flaxseed for 12 weeks . At the end of the study , body weight , liver enzymes , insulin resistance and hepatic fibrosis and steatosis decreased significantly in both groups ( p < 0.05 ) ; however , this reduction was significantly greater in those who took flaxseed supplementation ( p < 0.05 ) . The significant mean differences were reached in hepatic markers  between flaxseed and control group , respectively : ALT [ −11.12 compared with −3.7 U/L ; P < 0.001 ] , AST [ −8.29 compared with −4 U/L ; p < 0.001 ] , GGT [ −15.7 compared with −2.62 U/L ; p < 0.001 ] , fibrosis score [ −1.26 compared with −0.77 kPa ; p = 0.013 ] and steatosis score [ −47 compared with −15.45 dB/m ; p = 0.022 ] . In conclusion , flaxseed supplementation plus lifestyle modification  is more effective than lifestyle modification alone for NAFLD management Background Morbidly obese patients frequently display asymptomatic chronic activation of acute phase response , with potentially adverse metabolic and cardiovascular consequences . Nutritional preparations to improve this phenomenon have rarely been administered . Aim ing to investigate the supplementation of flaxseed flour , a source of omega-3 fatty acids , a prospect i ve r and omized double-blind cross-over study was design ed . Methods Outpatient obese subjects ( n = 41 ) were clinical ly and biochemically screened , and results for 24 r and omized subjects are shown . Age was 40.8 ± 11.6 years ( 83.3 % females ) and body mass index ( BMI ) was 47.1 ± 7.2 kg/m2 . Flaxseed flour ( Farinha de Linhaca Dourada LinoLive , Cisbra , Brazil ) in the amount of 30 g/day ( 5 g of alpha-linolenic acid – omega-3 ) and an equal mass of placebo ( manioc flour ) were administered for 2 weeks each . Variables included general biochemical investigation , white blood cell count ( WBC ) , C-reactive protein ( CRP ) , serum amyloid A ( SAA ) and fibronectin . Results No intolerance was registered . Body weight and general biochemical indices remained stable . Initial CRP and SAA were elevated ( 13.7 ± 9.9 and 17.4 ± 8.0 ) . WBC ( 8100 ± 2100/mm3 ) and fibronectin ( 463.2 ± 61.3 mg/dL ) were acceptable but in the upper normal range . Corresponding findings after supplementation of flaxseed were 10.6 ± 6.2 mg/L , 14.3 ± 9.2 mg/L , 7300 ± 1800/mm3 and 412.8 ± 38.6 respectively ( P < 0.05 ) . No change during the control period regarding baseline occurred when placebo was r and omized to be given first ; however , when it followed omega-3 supplementation , CRP and SAA recovered , whereas WBC and fibronection remained depressed during those 2 weeks ( 7500 ± 2100/mm3 and 393.2 ± 75.8 mg/dL , P < 0.05 ) . Conclusions 1 ) Various inflammatory markers were elevated in the studied population , although not necessarily exceeding the normal range ; 2 ) Significant reduction could be demonstrated ; 3 ) Some persistent effects of flaxseed supplement 2 weeks after discontinuation were observed BACKGROUND AND AIM Plant lignans are metabolised by the colonic micro-flora to the mammalian lignans enterodiol and enterolactone , which are hypothesized to be cardioprotective . The aim of this study was to investigate the effects of a plant lignan complex isolated from flaxseed , providing 500 mg/d of secoisolariciresinol diglucoside , on inflammatory markers . METHODS AND RESULTS Healthy postmenopausal women ( n=22 ) completed a r and omised double-blind , placebo-controlled crossover study . Women consumed daily a low-fat muffin , with or without a lignan complex , for 6 weeks , separated by a 6-week washout period . A significant difference of approximately 15 % ( P=0.028 ) was observed for C-reactive protein ( CRP ) concentration between the lignan complex intervention period and placebo period . CRP concentrations ( median ; 25th , 75th percentiles ) were 0.88 ( 0.63 , 2.05 ) mg/L at baseline and 0.92 ( 0.59 , 1.49 ) mg/L after the lignan complex intervention period compared with 0.80 ( 0.62 , 1.62 ) mg/L at baseline and 1.10 ( 0.72 , 1.62 ) mg/L after placebo . No significant differences in interleukin-6 , tumor necrosis factor-alpha , soluble intracellular adhesion molecule-1 , soluble vascular cell adhesion molecule-1 , and monocyte chemoattractant protein-1 were found between the lignan complex intervention period and placebo period . CONCLUSION Daily consumption for 6 week of a low-fat muffin enriched with a lignan complex may reduce CRP concentrations compared to a low-fat muffin with no lignans added Objective : Soy-soluble polysaccharides and flaxseed gum are underutilized dietary fibers of interest to the food industry . However , because the ability of soluble fibers to modulate postpr and ial glucose and insulin metabolism has been related to their viscous effects , the utility of these and other low-viscosity soluble fibers remains unproven . The objective of this study was to examine the associations between soy-soluble polysaccharides and flaxseed gum concentration , product viscosity , and the postpr and ial glycemic and insulinemic responses in the context of glucose solutions as well as fluid and gelled dairy products . Methods : Twelve healthy males participated in a r and omized crossover postpr and ial study in which they visited the laboratory following overnight fasts on 11 occasions to consume one of 11 study treatments , each consisting of 50 g available carbohydrates . The study treatments included a glucose reference ( in duplicate ) , glucose solutions containing soy-soluble polysaccharides ( 6 % ) , flaxseed gum ( 0.7 % ) , or guar gum ( 0.23 % ) , all matched for an apparent viscosity of 61 mPa·s at 50 s−1 , as well as dairy-based beverages and puddings with 0 % or 1 % soluble fiber added . Blood sample s were collected at fasting and up to 2 hours postpr and ially for determination of glucose and insulin concentrations . Area under the curve ( AUC ) , peak concentration , and time-to-peak values as well as glycemic index ( GI ) and insulinemic index ( II ) were calculated . Results : Fiber fortification of a 50 g glucose solution had no effect on postpr and ial blood glucose or insulin levels , even at a high concentration ( i.e. , 6 % soy-soluble polysaccharides ) . Glucose AUC and GI values for the dairy-based beverage ( p < 0.05 ) and pudding ( p < 0.01 ) controls were significantly lower than the glucose reference . Glucose AUC and GI values for the soy-soluble polysaccharide-fortified dairy products ( p < 0.01 ) and flaxseed gum – fortified dairy products ( p < 0.001 ) were significantly lower than the glucose reference . No significant differences were observed between the fiber-fortified fluid and gelled dairy-based study treatments and no significant differences were observed in terms of the insulin AUC , II , and peak insulin concentration between any of the dairy products . Conclusions : All dairy products had lower glycemic responses relative to the reference , with no effect of beverage versus pudding matrix observed and minimal impact of 1 % flaxseed gum or soy-soluble polysaccharides . Product apparent viscosity , but not fiber concentration , was significantly and inversely correlated with glucose AUC and GI SCOPE To investigate the effects of n-3 fatty acid supplements , both marine and plant-based , on glycemic traits in Chinese type 2 diabetes patients . METHOD AND RESULTS In a double-blind r and omized controlled trial , 185 recruited Chinese type 2 diabetes patients were r and omized to either fish oil ( FO , n = 63 ) , flaxseed oil ( FSO , n = 61 ) , or corn oil group ( served as control group , n = 61 ) for 180 days . The patients were asked to take corresponding oil capsules ( four capsules/day ) , which totally provided 2 g/day of eicosapentaenoic acid + docosahexaenoic acid in FO group and 2.5 g/day of alpha-linolenic acid in FSO group . No group × time interaction was observed for homeostatic model assessment of insulin resistance , fasting insulin , or glucose . Significant group × time interaction ( P = 0.035 ) was observed for glycated hemoglobin A1c ( HbA1c ) , with HbA1c decreased in FO group compared with corn oil group ( P = 0.037 ) . We also found significant group × time interactions for lipid traits , including LDL cholesterol ( P = 0.043 ) , total cholesterol ( P = 0.021 ) , total cholesterol/HDL cholesterol ( P = 0.009 ) , and triacylglycerol ( P = 0.003 ) , with the lipid profiles improved in FO group . No significant effects of FSO on glycemic traits or blood lipids were observed . CONCLUSIONS Marine n-3 PUFA supplements may improve glycemic control and lipid profiles among Chinese type 2 diabetic patients
target: Conclusions Whole flaxseed , but not flaxseed oil and lignan extract , has significant effects on improving glycemic control .
background: Context The results of human clinical trials investigating the effects of flaxseed on glucose control and insulin sensitivity are inconsistent .
  Objective The present study aim ed to systematic ally review and analyze r and omized controlled trials assessing the effects of flaxseed consumption on glycemic control .