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Journal of the American College of Nutrition, Vol. 27, No. 1, 65-74 (2008)
Published by the American College of Nutrition

Flaxseed and Cardiovascular Risk Factors: Results from a Double Blind, Randomized, Controlled Clinical Trial

LeAnne T. Bloedon, MS, RD, Shilpa Balikai, BS, Jesse Chittams, MSc, Stephen C. Cunnane, PhD, Jesse A. Berlin, ScD, Daniel J. Rader, MD and Philippe O. Szapary, MD

Division of General Internal Medicine (P.O.S., L.T.B.)
Institute for Translational Medicine and Therapeutics (P.O.S., L.T.B., D.J.R., S.B.)
Center for Clinical Epidemiology and Biostatistics (P.O.S., J.B., J.C.)
General Clinical Research Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, Research Center on Aging, University of Sherbrooke, Quebec, CANADA (S.C.C.)

Address correspondence to: Philippe Szapary MD, MSCE, Cardiovascular Risk Intervention Program, University of Pennsylvania Health System, Philadelphia Heart Institute, 39th and Market streets, suite 2A, Philadelphia, PA 19104. E-mail: philippe.szapary{at}uphs.upenn.edu

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 randomized 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.

Key words: flaxseed, hypercholesterolemia, lipoproteins, insulin resistance, inflammation, oxidative stress






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