The Effect of Flax Seed Cultivars with Differing Content of α-Linolenic Acid and Lignans on Responses to Mental Stress

Negative Association of Lignan and Phytosterol Intake with Stress Perception during the COVID-19 Pandemic-A Polish Study on Young Adults

BACKGROUND

There has been an increasing global prevalence of depression and other psychiatric diseases in recent years. Perceived stress has been proven to be associated with psychiatric and somatic symptoms. Some animal and human studies have suggested that consuming foods abundant in lignans and phytosterols may be associated with lower levels of stress, depression, and anxiety. Still, the evidence is not yet strong enough to draw firm conclusions. Thus, we investigated the association between dietary intake of these phytochemicals and the level of stress experienced by adult individuals.

METHODS

Diet was assessed using self-reported 7-day dietary records. The intakes of lignans and phytosterols were estimated using databases with their content in various food products. The Perceived Stress Scale (PSS) was implemented to measure the level of perceived stress. A logistic regression analysis was used to test for associations.

RESULTS

The odds of elevated PSS were negatively associated with dietary intake of total phytosterols, stigmasterol, and β-sitosterol, with evidence of a decreasing trend across tertiles of phytochemicals. The analysis for doubling the intake reinforced the aforementioned relationships and found protective effects against PSS for total lignans, pinoresinol, and campesterol.

CONCLUSIONS

Habitual inclusion of lignans and phytosterols in the diet may play a role in psychological health. To address the global outbreak of depression and other mental health issues triggered by stress, it is important to take a holistic approach. There is a need to develop effective strategies for prevention and treatment, among which certain dietary interventions such as consumption of products abundant in lignans and phytosterols may play a substantial role.

Availability of bioactive flax lignan from foods and supplements

Hyperlipidemia, high levels of blood lipids including cholesterol and triglycerides, is a major risk factor for cardiovascular disease. Traditional treatments of hyperlipidemia often include lifestyle changes and pharmacotherapy. Recently, flaxseed has been approved as a nutrient that lowers blood lipids. Several metabolites of flaxseed lignan secoisolariciresinol diglucoside (SDG), have been identified that reduce blood lipids. SDG is present in flaxseed hull as an ester-linked copolymer with 3-hydroxy-3-methylglutaric acid (HMGA). However, purification processes involved in hydrolysis of the copolymer and enriching SDG are often expensive. The natural copolymer of SDG with HMGA (SDG polymer) is a source of bioactive compounds useful in prophylaxis of hypercholesterolemia. After consumption of the lignan copolymer, SDG and HMGA are released in the stomach and small intestines. SDG is metabolized to secoisolariciresinol, enterolactone and enterodiol, the bioactive forms of mammalian lignans. These metabolites are then distributed throughout the body where they accumulate in the liver, kidney, skin, other tissues, and organs. Successively, these metabolites reduce blood lipids including cholesterol, triglycerides, low density lipoprotein cholesterol, and lipid peroxidation products. In this review, the metabolism and efficacies of flaxseed-derived enriched SDG and SDG polymer will be discussed.

Therapeutic implications of hypothalamic-pituitaryadrenal-axis modulation in Alzheimer's disease: A narrative review of pharmacological and lifestyle interventions

With disease-modifying treatments for Alzheimer's disease (AD) still elusive, the search for alternative intervention strategies has intensified. Growing evidence suggests that dysfunction in hypothalamic-pituitaryadrenal-axis (HPAA) activity may contribute to the development of AD pathology. The HPAA, may therefore offer a novel target for therapeutic action. This review summarises and critically evaluates animal and human studies investigating the effects of pharmacological and non-pharmacological intervention on HPAA modulation alongside cognitive performance. The interventions discussed include glucocorticoid receptor antagonists and 11β-hydroxysteroid dehydrogenase inhibitors as well as lifestyle treatments such as physical activity, diet, sleep and contemplative practices. Pharmacological HPAA modulators improve pathology and cognitive deficit in animal AD models, but human pharmacological trials are yet to provide definitive support for such benefits. Lifestyle interventions may offer promising strategies for HPAA modification and cognitive health, but several methodological caveats across these studies were identified. Directions for future research in AD studies are proposed.

Flaxseed for Health and Disease: Review of Clinical Trials

BACKGROUND

Flaxseed (Linum usitatissimum) is an oil-based seed that contains high amounts of alpha-linolenic acid, linoleic acid, lignans, fiber and many other bioactive components which is suggested for a healthier life. Nowadays, flaxseed is known as a remarkable functional food with different health benefits for humans and protects against cardiovascular disease, diabetes, dyslipidemia, obesity and altogether metabolic syndrome.

METHODS

To review the bioactive components of flaxseed and their potential health effects, PubMed and Scopus were searched from commencement to July 2019. Keywords including: "flaxseed", "Linum usitatissimum", "metabolic syndrome", "obesity", "inflammation", "insulin resistance", "diabetes", "hyperlipidemia" and "menopause" were searched in the databases with varying combinations.

CONCLUSION

Consumption of flaxseed in different forms has valuable effects and protects against cardiovascular disease, hypertension, diabetes, dyslipidemia, inflammation and some other complications. Flaxseed can serve as a promising candidate for the management of metabolic syndrome to control blood lipid levels, fasting blood sugar, insulin resistance, body weight, waist circumference, body mass and blood pressure.

Polyunsaturated Fatty Acids: What is Their Role in Treatment of Psychiatric Disorders?

In the central nervous system omega-3 fatty acids modulate cell signaling and affect dopaminergic and serotonergic pathways. On this basis, a new application for omega-3 fatty acids has been proposed, concerning the treatment of several psychiatric disorders. The present article is an update of a previous systematic review and is aimed to provide a complete report of data published in the period between 1980 and 2019 on efficacy and tolerability of omega-3 fatty acids in psychiatric disorders. In July 2019, an electronic search on PUBMED, Medline and PsychINFO of all RCTs, systematic reviews and meta-analyses on omega-3 fatty acids and psychiatric disorders without any filter or MESH restriction was performed. After eligibility processes, the final number of records included in this review was 126. One hundred and two of these studies were RCTs, while 24 were reviews and meta-analyses. The role of omega-3 fatty acids was studied in schizophrenia, major depression, bipolar disorder, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, eating disorders, substance use disorder and borderline personality disorder. The main evidence of the efficacy of omega-3 fatty acids has been obtained in treating depressive symptoms in patients with major depression and, to a lesser degree, bipolar depression. Some efficacy was also found in early phases of schizophrenia in addition to antipsychotic treatment, but not in the chronic phases of psychosis. Small beneficial effects of omega-3 fatty acids were observed in ADHD and positive results were reported in a few trials on core symptoms of borderline personality disorder. For other psychiatric disorders results are inconsistent.

Flaxseed Lignans as Important Dietary Polyphenols for Cancer Prevention and Treatment: Chemistry, Pharmacokinetics, and Molecular Targets

Cancer causes considerable morbidity and mortality across the world. Socioeconomic, environmental, and lifestyle factors contribute to the increasing cancer prevalence, bespeaking a need for effective prevention and treatment strategies. Phytochemicals like plant polyphenols are generally considered to have anticancer, anti-inflammatory, antiviral, antimicrobial, and immunomodulatory effects, which explain their promotion for human health. The past several decades have contributed to a growing evidence base in the literature that demonstrate ability of polyphenols to modulate multiple targets of carcinogenesis linking models of cancer characteristics (i.e., hallmarks and nutraceutical-based targeting of cancer) via direct or indirect interaction or modulation of cellular and molecular targets. This evidence is particularly relevant for the lignans, an ubiquitous, important class of dietary polyphenols present in high levels in food sources such as flaxseed. Literature evidence on lignans suggests potential benefit in cancer prevention and treatment. This review summarizes the relevant chemical and pharmacokinetic properties of dietary polyphenols and specifically focuses on the biological targets of flaxseed lignans. The consolidation of the considerable body of data on the diverse targets of the lignans will aid continued research into their potential for use in combination with other cancer chemotherapies, utilizing flaxseed lignan-enriched natural products.

Secoisolariciresinol Diglucoside of Flaxseed and Its Metabolites: Biosynthesis and Potential for Nutraceuticals

Secoisolariciresinol diglucoside (SDG), found mainly in flaxseed, is one of the essential lignans. SDG, as well as the beneficial fatty acid composition and high fiber content, has made flaxseed an important source of functional food or nutraceutical ingredients. Various studies have shown that SDG offers several health benefits, including protective effects against cardiovascular diseases, diabetes, cancer, and mental stress. These health benefits have been attributed to the antioxidant properties of SDG. Additionally, SDG metabolites, namely mammalian lignans, enterodiol and enterolactone, have shown promising effects against cancer. Therefore, understanding the biosynthetic pathway of SDG and its molecular mechanisms is a key to enable the production of new flaxseed cultivars rich in nutraceutical content. The present review highlights studies on the different health benefits of SDG, as well as lignan biosynthesis in flaxseed and genes involved in the biosynthetic pathway. Since SDG, the predominant lignan in flaxseed, is a glycosylated lignan, we also focus on studies investigating the genes involved in secoisolariciresinol glycosylation. These genes can be used to produce new cultivars with a novel level of glycosylation or lignan composition to maximize the yields of lignans with a therapeutic or protective potential.

Variation of fatty acid composition in seed oil in the collection of induced oil flax (Linum humile Mill.) mutants

A wide variety of application fields for flax seeds requires for breeders to develop new varieties with different characteristics, corresponding to the intended final product. The method of experimental mutagenesis is one of the ways to solve this problem. This method allows mutant lines with an array of morphometric and biochemical traits to be created from a single species and within a relatively short period of time. The article demonstrates that treatment of Linum humile Mill. seeds of the cultivars Iceberg and Solnech-ny with the new chemical mutagens DG-2, DG-6, DG-7, DG-9 (derivatives of dimethyl sulfate (DMS)) as well as with the mutagens DMS and EMS resulted in the production of mutant lines and accessions with altered morphometric and biochemical parameters. Seeds of the initial cultivars were treated with 0.5 and 0.05 % aqueous solutions of the above mentioned substances and planted in the field to raise M1, M2, and M3generations. Ultimately, 27 types of mutations were identified and subdivided into five groups by morphometric characteristics. The fatty acid composition of seed oil for the isolated mutant specimens was studied: the content of palmitic, stearic, oleic, linoleic (w6) and lino-lenic (w3) acids, as well as the w6/w3 ratio. The statistical analysis showed significant distinctions between the mutant lines in the biochemical composition of the oil. A strong negative correlation between the content of linoleic and linolenic acids was demonstrated, as well as a positive relationship of average strength between the content of stearic and oleic acids for the both varieties. The mutant accessions obtained can be used as donor material for conducting breeding work on flax in various directions.

Effects of omega-3 polyunsaturated fatty acids on psychophysiological symptoms of post-traumatic stress disorder in accident survivors: A randomized, double-blind, placebo-controlled trial

BACKGROUND

Psychophysiological symptoms (e.g., pounding heart) are known to be a prominent feature of post-traumatic stress disorder (PTSD). Although omega-3 polyunsaturated fatty acids (PUFAs) have a beneficial potential pharmacological effect of preventing these psychophysiological symptoms, no clinical data is yet available. Therefore, we conducted a randomized, double-blind, placebo-controlled trial of Japanese accident survivors.

METHODS

A total of 83 participants received either omega-3 PUFAs (1470mg docosahexaenoic acid and 147mg eicosapentaenoic acid per day) or placebo within 10 days of the accidental injury. After 12-week supplementation, participants performed script-driven imagery of their traumatic event during monitoring of their heart rate and skin conductance.

RESULTS

Analysis revealed that heart rate during both rest and script-driven imagery was significantly lower in the omega-3 group than the placebo group, whereas baseline heart rate was comparable between the two groups.

LIMITATIONS

The present trial was conducted at a single-center in Japan and psychophysiological symptoms of PTSD in most participants were not serious.

CONCLUSION

These findings suggest that post-trauma supplementation of omega-3 PUFAs might be effective for the secondary prevention of psychophysiological symptoms of PTSD.

Associations between Sleep, Cortisol Regulation, and Diet: Possible Implications for the Risk of Alzheimer Disease

Accumulation of proteinaceous amyloid β plaques and tau oligomers may occur several years before the onset of Alzheimer disease (AD). Under normal circumstances, misfolded proteins get cleared by proteasome degradation, autophagy, and the recently discovered brain glymphatic system, an astroglial-mediated interstitial fluid bulk flow. It has been shown that the activity of the glymphatic system is higher during sleep and disengaged or low during wakefulness. As a consequence, poor sleep quality, which is associated with dementia, might negatively affect glymphatic system activity, thus contributing to amyloid accumulation. The diet is another important factor to consider in the regulation of this complex network. Diets characterized by high intakes of refined sugars, salt, animal-derived proteins and fats and by low intakes of fruit and vegetables are associated with a higher risk of AD and can perturb the circadian modulation of cortisol secretion, which is associated with poor sleep quality. For this reason, diets and nutritional interventions aimed at restoring cortisol concentrations may ease sleep disorders and may facilitate brain clearance, consequentially reducing the risk of cognitive impairment and dementia. Here, we describe the associations that exist between sleep, cortisol regulation, and diet and their possible implications for the risk of cognitive impairment and AD.

Potential protective properties of flax lignan secoisolariciresinol diglucoside

Lignans are a group of phytonutrients which are widely distributed in the plant kingdom. Flaxseed is the richest source of providing lignan precursor such as secoisolariciresinol diglucoside (SDG). This article reviews the studies relevant to experimental models in animals and humans demonstrating the possible nutraceutical actions of SDG to prevent and alleviate lifestyle-related diseases. A local and international web-based literature review for this project was carried out to provide information relating to the study. The major key word "SDG" was selected to gather information using the electronic databases pertaining to the current state of flaxseed lignans composition, bioactive compounds, metabolism and to find out their role in terms of chemopreventive action. The extraction methods vary from simple to complex depending on separation, fractionation, identification and detection of the analytes. The majority of studies demonstrate that SDG interferes with the development of different types of diseases like cardiovascular, diabetic, lupus nephritis, bone, kidney, menopause, reproduction, mental stress, immunity, atherosclerosis, hemopoietic, liver necrosis and urinary disorders due to its various biological properties including anti-inflammatory, antioxidant, antimutagenic, antimicrobial, antiobesity, antihypolipidemic and neuroprotective effects. Moreover, SDG has a defending mediator against various cancers by modulating multiple cell signaling pathways. As discussed in this review, SDG has shown therapeutic potential against a number of human diseases and can be recommended for discerning consumers.

Effect of chemical pretreatment on dehulling parameters of flaxseed (cv. Garima)

In the present study, effects of chemical (ethanol, HCl and sulphuric acid) pretreatment on various dehulling parameters of flaxseed (cv. Garima) including yield, hull, hullability, extraction rate and embryo (dehulled flaxseed) recovery were studied. Pretreated flaxseed, at 3.1 to 3.6 % moisture range (p > 0.05) were dehulled for 60 s in a laboratory model rice polisher/dehulling machine at 2,000 rpm followed by aspiration (hull separation) using a laboratory model aspirator. The study revealed that chemical pre-dehulling treatment of flaxseed plays a significant role in the embryo recovery of flaxseed. Both ethanol and HCl pre-dehulling treatment enhanced but sulphuric acid pretreatment reduced the embryo recovery of flaxseed. Moreover, HCL and Sulphuric acid deteriorated the quality of hull obtained during dehulling, hence may not be considered for flaxseed dehulling. The study showed the maximum embryo recovery from ethanol pretreated flaxseed, hence ethanol pre-dehulling treatment with 2 h tempering time may be considered for effective flaxseed dehulling.

Screw pressing performance of whole and dehulled flaxseed and some physico-chemical characteristics of flaxseed oil

Screw pressing performance of whole and dehulled flaxseed at different seed moisture (6.4 to 11.1 % d.b.) and press head temperature (80-120 °C) was investigated. Oil recovery, residual oil, press rate and sediment content and some important physico-chemical characteristics were determined at six different levels (50, 60, 70, 80, 90 and 100 %) of dehulled flaxseed. Oil recovery decreased with increasing moisture content as well as press head temperature. Press rate was found maximum for 100 % dehulled flaxseed while minimum for 50 % dehulled flaxseed at 6.4 % moisture content. Colour of oil samples was found affected both with the level of dehulled flaxseed and press head temperature. Free fatty acids content of oil ranged from 1.07 % to 2.70 % and lower at 80 °C press head temperature. Oil and cake temperatures ranged from 53.10 °C to 65.95 °C and 69.15 to 103.75 °C, respectively. The α-linolenic acid content of different oil samples obtained at 80 °C was in the range of 53.34 ± 0.95 to 54.21 ± 1.04 %. In view of maximum oil recovery (82.9 % d.b.), lower FFA content, and oil and cake temperature, 7:3 ratio of dehulled and whole flaxseed having 6.4 % d.b. moisture content and 80 °C press head temperature may be considered for screw pressing of flaxseed.

Fish consumption and cardiovascular response during mental stress

BACKGROUND

Frequent fish consumption is related to a lower risk of coronary heart disease. However, the physiological mechanisms underlying this cardioprotective effect are as yet unknown. We therefore examined certain cardiovascular physiological variables of fish eaters during rest, whilst conducting mental arithmetic, and during recovery.

FINDINGS

The participants were 12 fish eaters (eating baked fish more than 3-4 times/week) and 13 controls (eating fish less than 1-2 times/week). Analysis of the collected data revealed that heart rate, blood pressure, and pulse wave velocity were significantly lower and pre-ejection period and baroreflex sensitivity were significantly higher in the fish eaters than in the controls during both rest and mental arithmetic, and that systolic and mean blood pressure recovery from mental arithmetic were faster in the fish eaters than in the controls.

CONCLUSIONS

These findings suggest a possible physiological mechanism that may explain why frequent fish consumption reduces coronary heart disease risk.

The effect of omega-3 fatty acids on psychophysiological assessment for the secondary prevention of posttraumatic stress disorder: an open-label pilot study

Our recent pilot study has shown that the supplementation of omega-3 fatty acids (fish oil) immediately after a traumatic event may be effective toward the secondary prevention of post-traumatic disorder (PTSD). To lay the groundwork for addressing the mechanism by which omega-3 fatty acids can prevent PTSD, we analyzed its psychophysiological data. The psychophysiological data included heart rate, skin conductance, and continuous blood pressure during patient subjection to startling tones and idiographic trauma-related cues. Of the 8 patients, 1 met the diagnostic criteria for PTSD. Compared to the seven patients without PTSD, one patient with PTSD showed relatively large reactivity to the startle tones. In contrast, this patient did not show large reactivity to the trauma-related cue during script-driven imagery. The combination of psychophysiological measurements in our randomized control trial should shed light on the underlying mechanisms by which omega-3 fatty acids can prevent PTSD.

Estrogenic botanical supplements, health-related quality of life, fatigue, and hormone-related symptoms in breast cancer survivors: a HEAL study report

BACKGROUND

It remains unclear whether estrogenic botanical supplement (EBS) use influences breast cancer survivors' health-related outcomes.

METHODS

We examined the associations of EBS use with health-related quality of life (HRQOL), with fatigue, and with 15 hormone-related symptoms such as hot flashes and night sweats among 767 breast cancer survivors participating in the Health, Eating, Activity, and Lifestyle (HEAL) Study. HRQOL was measured by the Medical Outcomes Study short form-36 physical and mental component scale summary score. Fatigue was measured by the Revised-Piper Fatigue Scale score.

RESULTS

Neither overall EBS use nor the number of EBS types used was associated with HRQOL, fatigue, or hormone-related symptoms. However, comparisons of those using each specific type of EBS with non-EBS users revealed the following associations. Soy supplements users were more likely to have a better physical health summary score (odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.02-2.70). Flaxseed oil users were more likely to have a better mental health summary score (OR = 1.76, 95% CI = 1.05-2.94). Ginseng users were more likely to report severe fatigue and several hormone-related symptoms (all ORs ≥ 1.7 and all 95% CIs exclude 1). Red clover users were less likely to report weight gain, night sweats, and difficulty concentrating (all OR approximately 0.4 and all 95% CIs exclude 1). Alfalfa users were less likely to experience sleep interruption (OR = 0.28, 95% CI = 0.12-0.68). Dehydroepiandrosterone users were less likely to have hot flashes (OR = 0.33, 95% CI = 0.14-0.82).

CONCLUSIONS

Our findings indicate that several specific types of EBS might have important influences on a woman's various aspects of quality of life, but further verification is necessary.

Effects of diets high in walnuts and flax oil on hemodynamic responses to stress and vascular endothelial function

BACKGROUND

Polyunsaturated fatty acids (PUFA) have beneficial effects on cardiovascular risk, although the mechanisms are incompletely understood. In a previous article, we showed significant reductions in low-density lipoprotein cholesterol and several markers of inflammation with increasing intake of alpha-linolenic acid (ALA) from walnuts and flax.

OBJECTIVE

To examine effects of ALA on cardiovascular responses to acute stress, flow-mediated dilation (FMD) of the brachial artery, and blood concentrations of endothelin-1 and arginine-vasopressin (AVP).

DESIGN

Using a randomized, crossover study design, cardiovascular responses to acute stress were assessed in 20 hypercholesterolemic subjects, a subset of whom also underwent FMD testing (n  =  12). Participants were fed an average American diet (AAD) and 2 experimental diets that varied in the amount of ALA and linoleic acid (LA) that they contained. The AAD provided 8.7% energy from PUFA (7.7% LA, 0.8% ALA). On the LA diet, saturated fat was reduced, and PUFA from walnuts and walnut oil provided 16.4% of energy (12.6% LA, 3.6% ALA). On the ALA diet, walnuts, walnut oil, and flax oil provided 17% energy from PUFA (10.5% LA, 6.5% ALA).

RESULTS

The ALA and LA diets significantly reduced diastolic blood pressure (-2 to -3 mm Hg) and total peripheral resistance (-4%), and this effect was evident at rest and during stress (main effect of diet, p < 0.02). FMD increased (+34%) on the diet containing additional ALA. AVP also increased by 20%, and endothelin-1 was unchanged.

CONCLUSIONS

These results suggest novel mechanisms for the cardioprotective effects of walnuts and flax, and further work is needed to identify the bioactives responsible for these effects.

A 1H NMR study of the fatty acid distribution in developing flax bolls before and after a cooking treatment

Flax is an important Canadian crop that contains a large percentage of fatty acids (FAs) by seed weight. Gas chromatography (GC) methods have traditionally been used to study FA distributions in oil seed crops. These methods, however, require sample preparation involving saponification and methyl ester formation. Recently, 1H NMR has been shown to be an excellent way to directly measure FA distributions in edible oils using a nondestructive and experimentally faster methodology. As such, we have examined the FA profiles in developing bolls of flax cultivar AC McDuff using 1H NMR and assessed the effect of cooking on FA stability and distribution. The data confirmed the high percentage of linolenic acid in mature AC McDuff flax seed compared to early stages of development and showed that FAs at early stages of boll development are more prone to thermal degradation. Triacylglycerol was found to be important to FA stability to heat. It was also observed that the FAs did not convert from cis to trans under the cooking process used herein. The usefulness of 1H NMR spectroscopy in oils chemistry is highlighted.

Flaxseed: a potential source of food, feed and fiber

Flaxseed is one of the most important oilseed crops for industrial as well as food, feed, and fiber purposes. Almost every part of the flaxseed plant is utilized commercially, either directly or after processing. The stem yields good quality fiber having high strength and durability. The seed provides oil rich in omega-3, digestible proteins, and lignans. In addition to being one of the richest sources of α-linolenic acid oil and lignans, flaxseed is an essential source of high quality protein and soluble fiber and has considerable potential as a source of phenolic compounds. Flaxseed is emerging as an important functional food ingredient because of its rich contents of α-linolenic acid (ALA), lignans, and fiber. Lignans appear to be anti-carcinogenic compounds. The omega-3s and lignan phytoestrogens of flaxseed are in focus for their benefits for a wide range of health conditions and may possess chemo-protective properties in animals and humans. This paper presents a review of literature on the nutritional composition of flaxseed, its health benefits, and disease-prevention qualities, utilization of flaxseed for food, feed, and fiber, and processing of flaxseed.

The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid

Preventing the occurrence of cardiovascular disease (CVD) with nutritional interventions is a therapeutic strategy that may warrant greater research attention. The increased use of omega (&omega;)-3 fatty acids is a powerful example of one such nutritional strategy that may produce significant cardiovascular benefits. Marine food products have provided the traditional dietary sources of &omega;-3 fatty acids. Flaxseed is an alternative to marine products. It is one of the richest sources of the plant-based &omega;-3 fatty acid, alpha-linolenic acid (ALA). Based on the results of clinical trials, epidemiological investigations and experimental studies, ingestion of ALA has been suggested to have a positive impact on CVD. Because of its high ALA content, the use of flaxseed has been advocated to combat CVD. The purpose of the present review was to identify the known cardiovascular effects of flaxseed and ALA and, just as importantly, what is presently unknown.

The quality of commercially available nutraceutical supplements and food sources

OBJECTIVES

Nutraceuticals are components of dietary origin, with claimed beneficial therapeutic activities. The quality of nutraceuticals is paramount for efficacy and safety, and it includes quality of raw materials, different available chemical forms, complex products, lack of substitution of inappropriate materials, and the absence of contaminants. The aim of this review is to investigate the extent of substandard formulated and raw material nutraceuticals, and to highlight any consequent health concern.

KEY FINDINGS

Reports of the quality of raw materials have revealed wide variations, often as a result of lack of clear regulatory definitions with respect to size of polymeric entities and also presence of glycosidic and salt forms. Published evaluations of over 70 formulations of 25 different nutraceuticals revealed variable quality; no nutraceutical showed consistent high quality, but a number revealed consistent low quality, thereby making the case for closer regulation of manufacturers. Whole food sources have also been shown to be widely variable in constituent levels. The effect of different formulations requires consideration, as the different types have been shown to have marked effects on bioavailability.

SUMMARY

The poor quality of commercially available nutraceuticals has been highlighted. In addition, incidences of side effects and drug interactions are increasing, as consumption of nutraceuticals rises. Pharmacists and health practitioners need to be aware of the scientific literature to advise accordingly.

Adrenocorticotrophic hormone-stimulated cortisol release by the head kidney inter-renal tissue from sea bream (Sparus aurata) fed with linseed oil and soyabean oil

The mode of action of highly unsaturated fatty acids (HUFA) in regulating gilthead sea bream (Sparus aurata) head kidney (HK) cortisol production was studied through in vitro trials using a dynamic superfusion system. Fish were previously fed with different diets containing several inclusion levels of linseed oil (LO) or soyabean oil (SO) for 26 weeks. Five diets were tested; anchovy oil was the only lipid source for the control diet (fish oil, FO) and two different substitution levels (70 and 100 %) were tested using either LO or SO (70LO, 70SO, 100LO and 100SO). Fatty acid compositions of the HK reflected the dietary input, thus EPA, DHA, arachidonic acid and n-3 HUFA were significantly (P < 0·05) reduced in fish fed vegetable oils compared with fish fed the FO diet. Feeding 70 or 100 % LO increased significantly (P < 0·05) cortisol release in HK after stimulation with adrenocorticotrophic hormone (ACTH), while feeding SO had no effect on this response. Cortisol stimulation factor (SF) was increased in fish fed the 70LO and 100LO diets compared with fish fed the control diet. Moreover, eicosanoid inhibition by incubating the HK tissue with indomethacin (INDO) as a cyclo-oxygenase (COX) inhibitor, or nordihydroguaiaretic acid (NDGA) as a lipoxygenase (LOX) inhibitor, significantly reduced (P < 0·05) the cortisol release after ACTH stimulation in the 70LO and 100LO diets. Cortisol SF was reduced in the FO, 70LO and 100LO diets when incubating the HK with INDO or NDGA, while it was increased in the 70SO diet. The present results indicate that changing the fatty acid profile of gilthead sea bream HK by including LO and/or SO in the fish diet affected the in vitro cortisol release, and this effect is partly mediated by COX and/or LOX metabolites.

Health effects with consumption of the flax lignan secoisolariciresinol diglucoside

Flaxseed is the richest source of the lignan secoisolariciresinol diglucoside (SDG). After ingestion, SDG is converted to secoisolariciresinol, which is further metabolised to the mammalian lignans enterodiol and enterolactone. A growing body of evidence suggests that SDG metabolites may provide health benefits due to their weak oestrogenic or anti-oestrogenic effects, antioxidant activity, ability to induce phase 2 proteins and/or inhibit the activity of certain enzymes, or by mechanisms yet unidentified. Human and animal studies identify the benefits of SDG consumption. SDG metabolites may protect against CVD and the metabolic syndrome by reducing lipid and glucose concentrations, lowering blood pressure, and decreasing oxidative stress and inflammation. Flax lignans may also reduce cancer risk by preventing pre-cancerous cellular changes and by reducing angiogenesis and metastasis. Thus, dietary SDG has the potential to decrease the incidence of several chronic diseases that result in significant morbidity and mortality in industrialised countries. The available literature, though, makes it difficult to clearly identify SDG health effects because of the wide variability in study methods. However, the current evidence suggests that a dose of at least 500 mg SDG/d for approximately 8 weeks is needed to observe positive effects on cardiovascular risk factors in human patients. Flaxseed and its lignan extracts appear to be safe for most adult populations, though animal studies suggest that pregnant women should limit their exposure. The present review discusses the potential health benefits of SDG in humans, with supporting evidence from animal studies, and offers suggestions for future research.

Nutrition and Stroke Prevention

Nutrition is much more important in prevention of stroke than is appreciated by most physicians. The powerful effects of statin drugs in lowering the levels of fasting cholesterol, combined with an unbalanced focus on fasting lipids (as opposed to postprandial fat and oxidative stress), have led many physicians and patients to believe that diet is relatively unimportant. Because the statins can lower fasting lipids by &50% to 60%, and a low-fat diet only lowers fasting cholesterol by &5% to 10%, this error is perhaps understandable. However, a Cretan Mediterranean diet, which is high in beneficial oils, whole grains, fruits, and vegetables and low in cholesterol and animal fat, has been shown to reduce stroke and myocardial infarction by 60% in 4 years compared with the American Heart Association diet. This effect is twice that of simvastatin in the Scandinavian Simvastatin Survival Study: a reduction of myocardial infarction by 40% in 6 years. Vitamins for lowering of homocysteine may yet be shown to be beneficial for reduction of stroke; a key issue is the high prevalence of unrecognized deficiency of vitamin B(12), requiring higher doses of vitamin B(12) than have been used in clinical trials to date. Efforts to duplicate with supplementation the evidence of benefit for vitamins E, C, and beta carotene have been largely fruitless. This may be related to the broad combination of antioxidants included in a healthy diet. A Cretan Mediterranean diet is probably more effective because it provides a wide range of antioxidants from fruits and vegetables of all colors.

Dietary phytoestrogens and vascular function in postmenopausal women

OBJECTIVE

To investigate the effects of low levels of intake of phytoestrogens in Western habitual diet on vascular function.

DESIGN

A cross-sectional study.

SETTING

A population-based study.

PARTICIPANTS

A total of 301 postmenopausal women aged 60-75 years living in The Netherlands. DETERMINANT: Dietary phytoestrogen intake as assessed using a food frequency questionnaire covering the year prior to enrollment.

MAIN OUTCOME MEASURES

Blood pressure, hypertension, endothelial function and ankle brachial index.

RESULTS

The median isoflavone intake was 0.2 mg in the lowest tertile and 11.4 mg in the highest tertile. Median lignan intake was 0.8 and 2.2 mg, respectively. No associations were found for higher intake of isoflavones, systolic and diastolic blood pressures, ankle-arm blood pressure index, endothelial function or hypertension. For lignans no association was found for ankle-arm blood pressure index or endothelial function, but we did observe lower systolic and diastolic blood pressures and a lower prevalence of hypertension (systolic blood pressure difference T3-T1, -11.2 mmHg, 95% confidence interval = -17.8 to -4.5, P for trend = 0.001; diastolic blood pressure difference T3-T1, -3.6 mmHg, 95% confidence interval = -7.8 to 0.6, P for trend = 0,08; and prevalence of hypertension, odds ratio T3 versus T1 = 0.41, 95% confidence interval = 0.22-0.76, P for trend over tertiles = 0.004).

CONCLUSION

The results of this study suggest a protective effect of dietary lignan intake on blood pressure and hypertension, even at low levels.