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Godos J, Scazzina F, Paternò Castello C, Giampieri F, Quiles JL, Briones Urbano M, Battino M, Galvano F, Iacoviello L, de Gaetano G, Bonaccio M, Grosso G. Underrated aspects of a true Mediterranean diet: understanding traditional features for worldwide application of a "Planeterranean" diet. J Transl Med 2024; 22:294. [PMID: 38515140 PMCID: PMC10956348 DOI: 10.1186/s12967-024-05095-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
Over the last decades, the Mediterranean diet gained enormous scientific, social, and commercial attention due to proven positive effects on health and undeniable taste that facilitated a widespread popularity. Researchers have investigated the role of Mediterranean-type dietary patterns on human health all around the world, reporting consistent findings concerning its benefits. However, what does truly define the Mediterranean diet? The myriad of dietary scores synthesizes the nutritional content of a Mediterranean-type diet, but a variety of aspects are generally unexplored when studying the adherence to this dietary pattern. Among dietary factors, the main characteristics of the Mediterranean diet, such as consumption of fruit and vegetables, olive oil, and cereals should be accompanied by other underrated features, such as the following: (i) specific reference to whole-grain consumption; (ii) considering the consumption of legumes, nuts, seeds, herbs and spices often untested when exploring the adherence to the Mediterranean diet; (iii) consumption of eggs and dairy products as common foods consumed in the Mediterranean region (irrespectively of the modern demonization of dietary fat intake). Another main feature of the Mediterranean diet includes (red) wine consumption, but more general patterns of alcohol intake are generally unmeasured, lacking specificity concerning the drinking occasion and intensity (i.e., alcohol drinking during meals). Among other underrated aspects, cooking methods are rather simple and yet extremely varied. Several underrated aspects are related to the quality of food consumed when the Mediterranean diet was first investigated: foods are locally produced, minimally processed, and preserved with more natural methods (i.e., fermentation), strongly connected with the territory with limited and controlled impact on the environment. Dietary habits are also associated with lifestyle behaviors, such as sleeping patterns, and social and cultural values, favoring commensality and frugality. In conclusion, it is rather reductive to consider the Mediterranean diet as just a pattern of food groups to be consumed decontextualized from the social and geographical background of Mediterranean culture. While the methodologies to study the Mediterranean diet have demonstrated to be useful up to date, a more holistic approach should be considered in future studies by considering the aforementioned underrated features and values to be potentially applied globally through the concept of a "Planeterranean" diet.
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Affiliation(s)
- Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Francesca Giampieri
- Department of Clinical Sciences, Università Politecnica Delle Marche, Ancona, Italy
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011, Santander, Spain
| | - José L Quiles
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011, Santander, Spain
- Department of Physiology, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Avda del Conocimiento S/N, Parque Tecnologico de La Salud, Armilla, 18016, Granada, Spain
- Research and Development Functional Food Centre (CIDAF), Health Science Technological Park, Avenida del Conocimiento 37, 18016, Granada, Spain
| | - Mercedes Briones Urbano
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011, Santander, Spain
- Universidad Internacional Iberoamericana, Campeche, 24560, México
- Universidad Internacional Iberoamericana, Arecibo, PR, 00613, USA
| | - Maurizio Battino
- Department of Clinical Sciences, Università Politecnica Delle Marche, Ancona, Italy
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011, Santander, Spain
- International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
- Libera Università Mediterranea (LUM) "Giuseppe Degennaro", Casamassima (Bari), Italy
| | | | | | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
- Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy.
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Rosqvist F, Niinistö S. Fats and oils - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10487. [PMID: 38370114 PMCID: PMC10870979 DOI: 10.29219/fnr.v68.10487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/10/2022] [Accepted: 01/03/2024] [Indexed: 02/20/2024] Open
Abstract
This scoping review for the Nordic Nutrition Recommendations 2023 summarizes the available evidence on fats and oils from a food level perspective. A literature search for systematic reviews (SRs) and meta-analyses was conducted in PubMed. There are few SRs and meta-analyses available that investigate the association between fats and oils (food level) and health outcomes; the majority report associations at the nutrient level (fatty acid classes). All identified SRs and meta-analyses were of low methodological quality, thus the findings and conclusions presented within this scoping review should be interpreted cautiously. Based on this limited evidence, the following results were indicated: the intake of olive oil may be associated with reduced risk of cardiovascular disease (CVD), type 2 diabetes (T2D), and total mortality in prospective cohort studies. The intake of butter was not associated with the risk of CVD but may be related to slightly lower risk of T2D and higher risk of total mortality in prospective cohort studies. For cancer, the evidence is sparse and primarily based on case-control studies. The intake of olive oil may be associated with reduced risk of cancer, whereas the intake of butter may be associated with increased risk of certain cancer types. Butter increases LDL-cholesterol when compared to virtually all other fats and oils. Palm oil may increase LDL-cholesterol when compared to oils rich in MUFA or PUFA but may not have any effect on glucose or insulin. Coconut oil may increase LDL-cholesterol when compared to other plant oils but may decrease LDL-cholesterol when compared to animal fats rich in SFA. Canola/rapeseed oil may decrease LDL-cholesterol compared to olive oil, sunflower oil and sources of SFA and may also reduce body weight compared to other oils. Olive oil may decrease some inflammation markers but may not have a differential effect on LDL-cholesterol compared to other fats and oils. The effect on risk markers likely differs depending on the type/version of oil, for example, due to the presence of polyphenols, phytosterols and other minor components. Taken together, based on the available evidence, oils rich in unsaturated fat (e.g. olive oil, canola oil) are to be preferred over oils and fats rich in saturated fat (e.g. butter, tropical oils).
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Affiliation(s)
- Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Sari Niinistö
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Fadnes LT, Balakrishna R. Nuts and seeds - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10483. [PMID: 38370112 PMCID: PMC10870978 DOI: 10.29219/fnr.v68.10483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 08/29/2022] [Accepted: 01/03/2024] [Indexed: 02/20/2024] Open
Abstract
Background Nuts and seeds have been part of diets in most of the world for millenniums, and they have also been consumed in the Nordic and Baltic countries for centuries. Consumption of nuts and seeds is linked with various health outcomes. Therefore, when updating the Nordic Nutrition Recommendations (NNR), summarizing the best evidence on key health outcomes from the consumption of nuts and seeds is essential. Objectives This study aims to evaluate the updated evidence on the consumption of nuts and seeds and health outcomes regarded relevant for the Nordic and Baltic countries, as well as their dose-response relationship presented in updated systematic reviews and meta-analyses. Method The scoping review is built on a de novo systematic review and an umbrella review published in 2022 on the consumption of nuts and seeds and its various health outcomes, including cardiovascular disease and diabetes. Results Intake of nuts and seeds is associated with a lower risk of cardiovascular diseases, with evidence assessed as probable. This conclusion is mirrored by evidence from trials on biomarkers for chronic diseases. An intake of a serving of nuts of 28-30 g/day compared to not eating nuts is estimated to translate into approximately 20% relative reduction in the risks of cardiovascular disease and premature deaths. For cancers, consumption of a serving of nuts is inversely associated with cancer mortality. However, for type 2 diabetes, there are mixed and inconclusive results. Additionally, there are inverse associations between nut consumption and respiratory and infectious disease mortality. Allergies for nuts are seen among 1-2% of the population. Conclusion Overall, the current evidence supports dietary recommendations to increase nut consumption to a serving of nuts and seeds per day for people without allergies to these foods.
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Affiliation(s)
- Lars T. Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Rajiv Balakrishna
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Yin S, Xu H, Xia J, Lu Y, Xu D, Sun J, Wang Y, Liao W, Sun G. Effect of Alpha-Linolenic Acid Supplementation on Cardiovascular Disease Risk Profile in Individuals with Obesity or Overweight: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:1644-1655. [PMID: 37778442 PMCID: PMC10721518 DOI: 10.1016/j.advnut.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/22/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Overweight and obesity are highly prevalent worldwide and are associated with cardiovascular disease (CVD) risk factors, including systematic inflammation, dyslipidemia, and hypertension. Alpha-linolenic acid (ALA) is a plant-based essential polyunsaturated fatty acid associated with reduced CVD risks. This systematic review and meta-analysis aimed to investigate the effects of supplementation with ALA compared with the placebo on CVD risk factors in people with obesity or overweight (International Prospective Register of Systematic Reviews Registration No. CRD42023429563). This review included studies with adults using oral supplementation or food or combined interventions containing vegetable sources of ALA. All studies were randomly assigned trials with parallel or crossover designs. The Cochrane Collaboration tool was used for assessing the risk of bias (Version 1). PubMed, Web of Science, Embase, and Cochrane library databases were searched from inception to April 2023. Nineteen eligible randomized controlled trials, including 1183 participants, were included in the meta-analysis. Compared with placebo, dietary ALA supplementation significantly reduced C-reactive protein concentration (standardized mean difference [SMD] = -0.38 mg/L; 95% confidence interval [CI]: -0.72, -0.04), tumor necrosis factor-α concentration (SMD = -0.45 pg/mL; 95% CI: -0.73, -0.17), triglyceride in serum (SMD = -4.41 mg/dL; 95% CI: -5.99, -2.82), and systolic blood pressure (SMD = -0.37 mm Hg; 95% CI: -0.66, -0.08); but led to a significant increase in low-density lipoprotein cholesterol concentrations (SMD = 1.32 mg/dL; 95% CI: 0.05, 2.59). ALA supplementation had no significant effect on interleukin-6, diastolic blood pressure, total cholesterol, or high-density lipoprotein cholesterol (all P ≥ 0.05). Subgroup analysis revealed that ALA supplementation at a dose of ≥3 g/d from flaxseed and flaxseed oil had a more prominent effect on improving CVD risk profiles, particularly where the intervention duration was ≥12 wk and where the baseline CVD profile was poor.
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Affiliation(s)
- Shiyu Yin
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Hai Xu
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China; Department of Food Processing and Safety, College of Biology and Food Engineering, Chongqing Three Gorges University, Chongqing, China
| | - Jiayue Xia
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yifei Lu
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Dengfeng Xu
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Jihan Sun
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Yuanyuan Wang
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Wang Liao
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China; China-DRIs Expert Committee on Macronutrients, Chinese Nutrition Society, Beijing, China
| | - Guiju Sun
- Department of Nutrition and Food Hygiene, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China; China-DRIs Expert Committee on Macronutrients, Chinese Nutrition Society, Beijing, China.
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Khandouzi N, Zahedmehr A, Asadian S, Nasrollahzadeh J. Effects of olive oil and flaxseed consumption in a healthy diet on endothelial function, plasma lipids and inflammatory factors of patients with coronary heart disease: a randomized clinical trial. Coron Artery Dis 2023; 34:332-340. [PMID: 37335239 DOI: 10.1097/mca.0000000000001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVES A healthy lifestyle, including a healthy diet has been associated with an improvement in cardiovascular risk factors. The aim of the present study was to assess the effect of olive oil and flaxseed consumption as part of a healthy diet on endothelial function, plasma inflammatory factors, and lipid profile in patients with coronary heart disease (CHD). METHOD This randomized nonblinded trial was performed on CHD patients. In the control group, participants received general heart-healthy dietary recommendations while in the intervention group, in addition to these recommendations, the participants consumed 25 ml of olive oil and 30 g of flaxseeds daily for 3 months. At baseline and after 3 months, changes in brachial flow-mediated dilation (FMD), plasma asymmetric dimethyl arginine, interleukin-6 (IL-6), IL-10, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and lipids and lipoproteins were measured. RESULTS A total of 50 patients finished the trial ( n = 24 in the intervention and n = 26 in the control groups). Compared to the control group, consumption of flaxseed and olive oil significantly improved brachial artery FMD%, and reduced plasma IL-6, TNF-α, MCP-1, total cholesterol, and tended to reduce hs-CRP, and non-HDL-cholesterol but the concentration of other study indices were not different between the two groups. CONCLUSION Inclusion of olive oil and flaxseed in the diet of CHD patients may contribute to secondary prevention by improving endothelial function and plasma inflammatory factors.
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Affiliation(s)
- Nafiseh Khandouzi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
| | | | - Sanaz Asadian
- Department of Radiology, Rajaie Cardiovascular, Medical & Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Nasrollahzadeh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences
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Morshedzadeh N, Rahimlou M, Shahrokh S, Chaleshi V, Mirmiran P, Zali MR. The effects of flaxseed supplementation on concentration of circulating adipokines in patients with ulcerative colitis. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2023; 16:458-467. [PMID: 37070105 PMCID: PMC10105498 DOI: 10.22037/ghfbb.v16i1.2622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/09/2022] [Indexed: 04/19/2023]
Abstract
Aim This study aimed to evaluate the effect of supplementation with ground flaxseed (GF) on the concentrations of adiponectin, resistin, and visfatin in patients with ulcerative colitis (UC). Background Inflammatory bowel disease (IBD) is one of the most common gastrointestinal diseases affecting people of all ages. Adipokines secreted from adipose tissue have been shown to play an essential role in the pathogenesis of UC. Methods This trial is an open-labeled randomized controlled trial conducted on 70 patients with UC. The patients were randomly divided into two groups: flaxseed and control. The patients in the intervention received 30 g/day flaxseed powder for 12 weeks. Patients' anthropometric, nutritional, and biochemical factors were evaluated at the beginning and end of the intervention period. Results Totally, 64 patients (36 men and 28 women) with a mean age of 31.12±9.67 were included in the final analysis. There was no significant difference between the two groups regarding baseline weight and height (P>0.05). After the 12-week intervention, flaxseed supplementation led to a significant reduction in the resistin (-4.85±1.89 vs. -1.10±2.25, P<0.001) and visfatin concentration (-1.33±1.14 vs. -0.53±1.63, P=0.018). Further, we found a significant increase in the adiponectin levels after the GF supplementation (3.49±1.29 vs. -0.35±0.96, P<0.001). Conclusion Flaxseed supplementation could exert beneficial effects on adipokine levels in patients with UC.
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Affiliation(s)
- Nava Morshedzadeh
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Medecine, Zanjan Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shabnam Shahrokh
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Chaleshi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Baldi S, Tristán Asensi M, Pallecchi M, Sofi F, Bartolucci G, Amedei A. Interplay between Lignans and Gut Microbiota: Nutritional, Functional and Methodological Aspects. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28010343. [PMID: 36615537 PMCID: PMC9822457 DOI: 10.3390/molecules28010343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
Lignans are non-flavonoid polyphenols present in a wide range of foods frequently consumed in the Western world, such as seeds, vegetables and fruits, and beverages such as coffee, tea and wine. In particular, the human gut microbiota (GM) can convert dietary lignans into biologically active compounds, especially enterolignans (i.e., enterolactone and enterodiol), which play anti-inflammatory and anti-oxidant roles, act as estrogen receptor activators and modulate gene expression and/or enzyme activity. Interestingly, recent evidence documenting those dietary interventions involving foods enriched in lignans have shown beneficial and protective effects on various human pathologies, including colorectal and breast cancer and cardiovascular diseases. However, considering that more factors (e.g., diet, food transit time and intestinal redox state) can modulate the lignans bioactivation by GM, there are usually remarkable inter-individual differences in urine, fecal and blood concentrations of enterolignans; hence, precise and validated analytical methods, especially gas/liquid chromatography coupled to mass spectrometry, are needed for their accurate quantification. Therefore, this review aims to summarize the beneficial roles of enterolignans, their interaction with GM and the new methodological approaches developed for their evaluation in different biological samples, since they could be considered future promising nutraceuticals for the prevention of human chronic disorders.
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Affiliation(s)
- Simone Baldi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marta Tristán Asensi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marco Pallecchi
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, 50134 Florence, Italy
| | - Gianluca Bartolucci
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50139 Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Interdisciplinary Internal Medicine Unit, Careggi University Hospital, 50134 Florence, Italy
- Correspondence: ; Tel.: +39-055-2758330
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Balakrishna R, Bjørnerud T, Bemanian M, Aune D, Fadnes LT. Consumption of Nuts and Seeds and Health Outcomes Including Cardiovascular Disease, Diabetes and Metabolic Disease, Cancer, and Mortality: An Umbrella Review. Adv Nutr 2022; 13:2136-2148. [PMID: 36041171 PMCID: PMC9776667 DOI: 10.1093/advances/nmac077] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/28/2022] [Accepted: 07/26/2022] [Indexed: 01/29/2023] Open
Abstract
Consumption of nuts and seeds is associated with a range of health outcomes. Summarizing the best evidence on essential health outcomes from the consumption of nuts is essential to provide optimal recommendations. Our objective is to comprehensively assess health outcome associations related to the consumption of nuts and seeds, using a culinary definition including tree nuts and peanuts (registered in PROSPERO: CRD42021258300). Health outcomes of interest include cardiovascular disease, cancer, diabetes, obesity, respiratory disease, mortality, and their disease biomarkers. We present associations for high compared with low consumption, per serving, and dose-response relations. MEDLINE, Embase, Cochrane, and Epistemonikos were searched and screened for systematic reviews and meta-analyses. Evidence was extracted from 89 articles on the consumption of nuts and relevant health outcomes, including 23 articles with meta-analysis on disease and mortality, 66 articles on biomarkers for disease, and 9 articles on allergy/adverse outcomes. Intake of nuts was associated with reduced risk of cardiovascular diseases and related risk factors, with moderate quality of evidence. An intake of 28 g/d nuts compared with not eating nuts was associated with a 21% RR reduction of cardiovascular disease (including coronary heart disease incidence and mortality, atrial fibrillation, and stroke mortality), an 11% risk reduction of cancer deaths, and 22% reduction in all-cause mortality. Nut consumption was also inversely associated with mortality from respiratory diseases, infectious diseases, and diabetes; however, associations between nut consumption and diabetes incidence were mixed. Meta-analyses of trials on biomarkers for disease generally mirrored meta-analyses from observational studies on cardiovascular disease, cancers, and diabetes. Allergy and related adverse reactions to nuts were observed in 1-2% of adult populations, with substantial heterogeneity between studies. Overall, the current evidence supports dietary recommendations to consume a handful of nuts and seeds per day for people without allergies to these foods.
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Affiliation(s)
- Rajiv Balakrishna
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | | | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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Shareghfarid E, Nadjarzadeh A, Heidarzadeh-Esfahani N, Azamian Y, Hajiahmadi S. The Effect of Flaxseed Oil Supplementation on Body Composition and Inflammation Indices in Overweight Adults With Pre-Diabetes. Nutr Metab Insights 2022; 15:11786388221090083. [PMID: 35799617 PMCID: PMC9253991 DOI: 10.1177/11786388221090083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Flaxseed has rich content of alpha linolenic acid for preventing pro
inflammatory process. The aim of present study is exploring the effect of
flaxseed oil supplementation on inflammatory biomarkers and body composition
in overweight adults with pre-diabetes. Material and methods: this double-blind randomized clinical trial conducted with 80 overweight
pre-diabetic patients in 2 clusters (flaxseed oil group (2000-mg daily) and
control group) across a 14-week period. Anthropometric indices, body
composition and inflammatory indices were measured between 2 groups before
and after the treatment. Result: this study found a significant decrease in visceral fat level in the
intervention group (P = .009) and control group
(P = .004) at the end of the survey. However, the mean
change of it (P = .06) was not significant. Also, this
study showed that percentage of body fat (P = .31) and its
mean change (P = .6) did not have significantly different
between the 2 groups at the 14th week. The skeletal muscle% had a
significant rise in the intervention group (P = .005) and
control group (P = .003) by the end of 14th week. However,
the mean change of it (P = .19) was not significant between
the 2 groups. In addition, there was no significant change in the fasting
blood glucose (P = . 7), C reactive protein
(P = .12) and TNF-α (P = .22) between
the 2 groups at the end of study. Conclusion: It showed that flaxseed oil supplementation cannot improve body composition
and inflammation.
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Affiliation(s)
- Elham Shareghfarid
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran
| | - Neda Heidarzadeh-Esfahani
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
| | - Yasaman Azamian
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
| | - Salimeh Hajiahmadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran
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da Silva A, Silveira BKS, Hermsdorff HHM, da Silva W, Bressan J. Effect of omega-3 fatty acid supplementation on telomere length and telomerase activity: A systematic review of clinical trials. Prostaglandins Leukot Essent Fatty Acids 2022; 181:102451. [PMID: 35661999 DOI: 10.1016/j.plefa.2022.102451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/26/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022]
Abstract
Evidence suggests antioxidant and anti-inflammatory properties of omega-3 polyunsaturated fatty acids (n-3 PUFA). However, the effect of supplementation of this fatty acid profile on the telomere length and the telomerase enzyme activity was not revised yet. The PubMed and Embase® databases were used to search for clinical trials. A total of six clinical trials were revised. Omega-3 PUFA supplementation did not statistically affect telomere length in three out of three studies but affected telomerase activity in two out of four studies. The supplementation increased telomerase enzyme activity in subjects with first-episode schizophrenia. Besides, it decreased telomerase enzyme activity without modulating the effects of Pro12Ala polymorphism on the PPARγ gene in type 2 diabetes subjects. The methodological differences between the studies and the limited number of studies on the theme suggest that further studies are needed to elucidate the effects of n-3 PUFA supplementation on telomere length and telomerase enzyme activity in humans.
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Affiliation(s)
- Alessandra da Silva
- Laboratory of Energy Metabolism and Body Composition. Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
| | - Brenda Kelly Souza Silveira
- Laboratory of Energy Metabolism and Body Composition. Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Helen Hermana Miranda Hermsdorff
- Laboratory of Energy Metabolism and Body Composition. Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Walmir da Silva
- Laboratory of Animal Biotechnology. Animal Science Department, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Josefina Bressan
- Laboratory of Energy Metabolism and Body Composition. Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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11
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Khandouzi N, Zahedmehr A, Firoozi A, Nasrollahzadehp J. Effects of flaxseed consumption on plasma lipids, lipoprotein-associated phospholipase A 2 activity and gut microbiota composition in patients with coronary artery disease. Nutr Health 2022:2601060221091016. [PMID: 35382631 DOI: 10.1177/02601060221091016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Clinical studies have demonstrated possible beneficial effects of flaxseed on cardiovascular disease risk factors, but limited studies have evaluated the effects of flaxseed on the plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) and gut microbial composition in patients with coronary artery disease (CAD). Aim: The purpose of the present study was to examine the effect of flaxseed consumption on plasma lipids and lipoproteins, Lp-PLA2 activity, as well as the relative abundance of some gut microbiota in CAD patients. Methods: In a randomized controlled parallel trial, 50 patients with CAD were randomly allocated to 12 weeks of supplementation of flaxseed (30 g/day) or control (usual care). Before and after the intervention, plasma lipids, Lp-PLA2 activity, and some gut microbiota composition (4 different bacterial genera, including Lactobacillus, Bifidobacteria, Bacteroidetes, Firmicutes) were measured. Results: Compared to control, flaxseed consumption was associated with improved Lp-PLA2 activity. After 12 weeks of intervention, no significant changes were observed in plasma lipids and fecal microbial composition in the two study groups. Conclusion: The present study showed that in patients with CAD, flaxseed supplementation reduced plasma Lp-PLA2 activity but had no effect on plasma lipids and the composition of some intestinal bacteria.
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Affiliation(s)
- Nafiseh Khandouzi
- Department of Clinical Nutrition & Dietetics, 226734National Nutrition, and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Hafezi St, Farahzadi Blvd., Qods Town, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, 158776Rajaie Cardiovascular, Medical & Research Center, Iran University of Medical Sciences, Niyayesh Intersection., Valiasr St, Tehran, Iran
| | - Ata Firoozi
- Cardiovascular Intervention Research Center, 158776Rajaie Cardiovascular, Medical & Research Center, Iran University of Medical Sciences, Niyayesh Intersection., Valiasr St, Tehran, Iran
| | - Javad Nasrollahzadehp
- Department of Clinical Nutrition & Dietetics, 226734National Nutrition, and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Hafezi St, Farahzadi Blvd., Qods Town, Tehran, Iran
- Department of Clinical Nutrition & Dietetics, National Nutrition, and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, 48486Shahid Beheshti University of Medical Sciences, No. 7, Hafezi St, Farahzadi Blvd., Qods Town, Tehran, Iran
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12
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Sala-Vila A, Fleming J, Kris-Etherton P, Ros E. Impact of α-Linolenic Acid, the Vegetable ω-3 Fatty Acid, on Cardiovascular Disease and Cognition. Adv Nutr 2022; 13:1584-1602. [PMID: 35170723 PMCID: PMC9526859 DOI: 10.1093/advances/nmac016] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/31/2021] [Accepted: 02/11/2022] [Indexed: 01/28/2023] Open
Abstract
Given the evidence of the health benefits of plant-based diets and long-chain n-3 (ω-3) fatty acids, there is keen interest in better understanding the role of α-linolenic acid (ALA), a plant-derived n-3 fatty acid, on cardiometabolic diseases and cognition. There is increasing evidence for ALA largely based on its major food sources (i.e., walnuts and flaxseed); however, this lags behind our understanding of long-chain n-3 fatty acids. Meta-analyses of observational studies have shown that increasing dietary ALA is associated with a 10% lower risk of total cardiovascular disease and a 20% reduced risk of fatal coronary heart disease. Three randomized controlled trials (RCTs) [AlphaOmega trial, Prevención con Dieta Mediterránea (PREDIMED) trial, and Lyon Diet Heart Study] all showed benefits of diets high in ALA on cardiovascular-related outcomes, but the AlphaOmega trial, designed to specifically evaluate ALA effects, only showed a trend for benefit. RCTs have shown that dietary ALA reduced total cholesterol, LDL cholesterol, triglycerides, and blood pressure, and epidemiologic studies and some trials also have shown an anti-inflammatory effect of ALA, which collectively account for, in part, the cardiovascular benefits of ALA. A meta-analysis reported a trend toward diabetes risk reduction with both dietary and biomarker ALA. For metabolic syndrome and obesity, the evidence for ALA benefits is inconclusive. The role of ALA in cognition is in the early stages but shows promising evidence of counteracting cognitive impairment. Much has been learned about the health benefits of ALA and with additional research we will be better positioned to make strong evidence-based dietary recommendations for the reduction of many chronic diseases.
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Affiliation(s)
| | - Jennifer Fleming
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Penny Kris-Etherton
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Emilio Ros
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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13
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Jamshidi-Naeini Y, Li R, Dickinson S, Vorland CJ, Brown AW. Errors in Analyses and Undisclosed Methods Render Meta-Analysis Irreproducible: A Second Comment on "Effects of Flaxseed Interventions on Circulating Inflammatory Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Adv Nutr 2022; 13:352-354. [PMID: 35100618 PMCID: PMC8803486 DOI: 10.1093/advances/nmab146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Yasaman Jamshidi-Naeini
- From the Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Rui Li
- From the Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Stephanie Dickinson
- From the Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Colby J Vorland
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
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Effects of Sesame Consumption on Inflammatory Biomarkers in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6622981. [PMID: 34760018 PMCID: PMC8575626 DOI: 10.1155/2021/6622981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 12/02/2022]
Abstract
Objectives Existing evidence produces conflicting findings regarding the effect of sesame intake on inflammatory biomarkers; this knowledge gap has yet to be met through systematic review and meta-analysis. This meta-analysis of randomized, controlled clinical trials (RCTs) was conducted to evaluate the effects of sesame consumption on markers of inflammation in humans. Methods PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched through August 2020 to identify relevant papers for inclusion. Using the random-effects model, data were evaluated as weighted mean differences (WMD) with 95% confidence intervals (CI). Cochrane's Q and I-squared (I2) tests were used to identify within-studies heterogeneity. Results Seven RCTs with 310 participants (157 intervention and 153 control) were included in the meta-analysis. Sesame consumption reduced serum level interleukin-6 (IL-6) (WMD − 0.90; 95% CI (−1.71, −0.09), I2 = 80.4%) compared to the control group. However, sesame intake had no significant effects on C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) compared to the control group. Subgroup analysis identified a reduction in serum CRP, TNF-α, and IL-6 concentration among studies with participants who had a higher level of these biomarkers at baseline, those which used sesamin capsules, and those with a bigger sample size, those conducted in Asia, and studies on females. Conclusion Sesame consumption reduced serum levels of IL-6 but did not affect CRP and TNF-α in humans. Additional trials should be conducted utilizing a larger and longer treatment duration, along with studies using different sesame formulations (capsule, oil, and seed) and conducting on participants with varied health conditions.
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15
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Al Za’abi M, Ali H, Ali BH. Effect of flaxseed on systemic inflammation and oxidative stress in diabetic rats with or without chronic kidney disease. PLoS One 2021; 16:e0258800. [PMID: 34665824 PMCID: PMC8525749 DOI: 10.1371/journal.pone.0258800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/05/2021] [Indexed: 12/27/2022] Open
Abstract
Background Diabetes mellitus (DM) and chronic kidney disease (CKD) are common causes of morbidity and mortality. Flaxseed contains several bioactive compounds that have been shown to possess anti-inflammatory and antioxidative properties. The aim of the present study was to investigate the possible effect of flaxseed in diabetic rats with adenine–induced CKD. Methods Male Wister rats (n = 48) were randomly divided into seven equal groups and treated for 33 consecutive days as follows: G1: control. G2 adenine, G3: streptozotocin (STZ), G4: flaxseed, G5: adenine+flaxseed, G6: STZ+flaxseed, G7: adenine+STZ+flaxseed). DM or CKD were experimentally induced by a single intraperitoneal injection of streptozotocin (STZ) or by adenine via oral gavage, respectively. Results Rats fed adenine alone exhibited several changes including decreased body weight, increased food and water intake and urine output, increased urinary albumin/creatinine ratio. They also showed an increase in plasma urea and, creatinine, indoxyl sulfate, neutrophil gelatinase-associated lipocalin and cystatin C, and a decrease in renalase activity. These were associated with significant changes in inflammatory and oxidative biomarkers, e.g., increase in 8-isoprostane, 8 -hydroxy -2-deoxy guanosine and decrease in antioxidant enzymes, as well as increase in interleukins 1β and 6, and NF-κB, and a decrease in interlukin-10. Histopathologically, there was increased tubular necrosis and fibrosis. Concomitant administration of adenine and STZ further worsened the renal damage induced by adenine alone. Flaxseed significantly ameliorated the changes caused by adenine and STZ, given either singly or in combination. Conclusion These findings suggest that flaxseed is a potential therapeutic agent in attenuating the progression of CKD in diabetes.
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Affiliation(s)
- Mohammed Al Za’abi
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
- * E-mail:
| | - Haytham Ali
- Department of Animal and Veterinary Sciences, College of Agricultural and Marine Sciences, Sultan Qaboos University, Muscat, Oman
| | - Badreldin H. Ali
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Yang C, Xia H, Wan M, Lu Y, Xu D, Yang X, Yang L, Sun G. Comparisons of the effects of different flaxseed products consumption on lipid profiles, inflammatory cytokines and anthropometric indices in patients with dyslipidemia related diseases: systematic review and a dose-response meta-analysis of randomized controlled trials. Nutr Metab (Lond) 2021; 18:91. [PMID: 34635132 PMCID: PMC8504108 DOI: 10.1186/s12986-021-00619-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 07/28/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Flaxseed is widely used as a functional food for its rich sources of linolenic acid, lignans and dietary fibers in the world. This systematic review and dose-response meta-analysis on randomized controlled trials (RCTs) is first to evaluate effects of different flaxseed products (whole flaxseed, oil and lignans) on lipid profiles, inflammatory and anthropometric parameters in patients with dyslipidemia related diseases. METHODS Literature search was performed in PubMed, Embase, Cochrane Central, Scopus, and Web of Science from the inception dates to January, 2020. Weighted mean differences with the 95% confidence interval (CI) were pooled using fix or random-effects models. RESULTS Thirty-one RCTs involving 1,698 participants were included. The present meta-analysis revealed that flaxseed consumption had an overall beneficial effect on serum TC, LDL-C, TG, apo B and IL-6 in patients with dyslipidemia related diseases, but not on apo A, HDL-C, hs-CRP, CRP and anthropometric indices. However, different flaxseed products showed obviously different effects. Whole flaxseed supplementation significantly reduced TC (- 11.85 mg/dl, 95% CI - 20.12 to - 3.57, P = 0.005), LDL-C (- 10.51 mg/dl, 95% CI - 14.96 to - 6.06, P < 0.001), TG (- 19.77 mg/dl, 95% CI - 33.61 to - 5.94, P = 0.005), apolipoprotein B (- 5.73 mg/dl, 95% CI - 7.53 to - 3.93, P < 0.001), TC/HDL-C (- 0.10, 95% CI - 0.19 to - 0.003, P = 0.044) and weight (- 0.40 kg, 95% CI - 0.76 to - 0.05, P = 0.027); Lignans supplementation significantly reduced TC (- 17.86 mg/dl, P = 0.004), LDL-C (- 15.47 mg/dl, P < 0.001) and TC/HDL-C (- 0.45, P = 0.04). Although flaxseed oil supplementation had no such lowering-effect on lipid, meta-analysis revealed its lowering-effect on IL-6 (- 0.35 pg/ml, P = 0.033) and hs-CRP (- 1.54 mg/l, P = 0.004). Subgroup analysis revealed that whole flaxseed decreased TC, LDL-C and TG levels irrespective of country and the intervention time prescribed, but was more pronounced when the dose of whole flaxseed was ≤ 30 g/day (TC: WMD - 13.61 mg/mL; LDL-C: WMD - 10.52 mg/mL; TG: WMD - 23.52 mg/mL), rather not a dose > 30 g/day. Moreover, a linear relationship between dose of whole flaxseed and absolute changes in C-reactive protein (P = 0.036) and a nonlinear relationship between with IL-6 (P < 0.001) were detected. CONCLUSIONS Flaxseed intervention suggested the positive effects on lipid profiles, inflammatory cytokines and anthropometric indices in patients with dyslipidemia related diseases. Of these, whole flaxseed and lignans play an important role in reducing blood lipid, while flaxseed oil mainly plays in anti-inflammatory. Lipid- and weight-lowering was significant when whole flaxseed was consumed at doses < 30 mg/d, for lipid status with mixed dyslipidemia and patients with BMI > 25.
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Affiliation(s)
- Chao Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Min Wan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Yifei Lu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Xian Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Ligang Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China.,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, No. 87, Dingjiaqiao, Gulou District, Nanjing, 210009, People's Republic of China. .,Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, People's Republic of China.
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Toulabi T, Yarahmadi M, Goudarzi F, Ebrahimzadeh F, Momenizadeh A, Yarahmadi S. Effects of flaxseed on blood pressure, body mass index, and total cholesterol in hypertensive patients: A randomized clinical trial. Explore (NY) 2021; 18:438-445. [PMID: 34119421 DOI: 10.1016/j.explore.2021.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Given the antioxidant properties of flaxseed and its biologically active ingredients, this study was conducted to determine the effects of flaxseed supplementation on body mass index (BMI), blood pressure, and total cholesterol levels in patients with hypertension. METHODS In this triple-blind clinical trial, 112 patients, with an age range of 35 to 70 years, were randomized to 2 groups receiving 10 g (n = 45) and 30 g (n = 45) of flaxseed supplementation and 1 group receiving placebo (n = 45) for 12 weeks by stratified block randomization. They were evaluated in terms of systolic (SBP) and diastolic blood pressure (DBP), BMI, and total serum cholesterol. Physical activity was measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and food intake was assessed using the Food Frequency Questionnaire (FFQ). The data were analyzed with SPSS, version 22, using the chi-square, Kruskal-Wallis, repeated measures analysis, ANOVA, and ANCOVA tests. RESULTS The interaction effects among the study groups and time on the mean SBP (p = 0.001), DBP (p = 0.001), total cholesterol level (p = 0.032), and BMI (p < 0.001) were significant. During the study, the 30-g group achieved the best results, so that a 13.38-unit decrease in SBP was observed compared to a 1.72 unit increase in the placebo group and a 5.6-unit decrease in DBP was measured compared to a 2.39 unit increase in the placebo group. BMI decreased by 0.86 units compared to 0.06 units in the placebo group. Total cholesterol also decreased by 20.4 units compared to 11.86 units in the placebo group. CONCLUSION The results of this study showed that flaxseed can be effective in reducing blood pressure, total cholesterol, and body mass index in hypertensive patients in a twelve-week period.
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Affiliation(s)
- Tahereh Toulabi
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Masomeh Yarahmadi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fateme Goudarzi
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farzad Ebrahimzadeh
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Amir Momenizadeh
- Cardiovascular Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sajad Yarahmadi
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
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18
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Long-term dietary supplementation with plant-derived omega-3 fatty acid improves outcome in experimental ischemic stroke. Atherosclerosis 2021; 325:89-98. [PMID: 33915355 DOI: 10.1016/j.atherosclerosis.2021.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/26/2021] [Accepted: 04/13/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Early revascularization -the gold standard therapy for ischemic stroke- is often withheld in the elderly population due to high risk of complications. Thus, safe and effective preventive and therapeutic options are needed. The plant-derived omega-3-fatty-acid alpha-linolenic-acid (ALA) has emerged as a novel cardiovascular-protective agent. As of yet, little is known about its potential therapeutic effects on stroke. We hereby aimed to investigate the impact of a clinically relevant long-term dietary intervention with ALA on stroke outcome. METHODS Six month-old C57BL/6 wildtype males were either fed an ALA-rich (high ALA) or a control diet (low ALA) for 12 months. At 18 months, brain ischemia/reperfusion was induced by transient middle cerebral artery occlusion (tMCAO). Stroke size and neurological function were assessed. Functional blood-brain-barrier-(BBB) permeability and protein expression were assessed by immunohistochemistry. Baseline inflammatory markers were measured at 18 months. RESULTS High ALA-fed animals displayed decreased circulating TNF-α levels and Neutrophil-to-Lymphocyte Ratios at 18 months. Stroke size and neurological dysfunction were significantly reduced in high ALA-fed animals. Coherently to the reduced stroke size, functional BBB integrity and occludin endothelial expression were maintained by high ALA supplementation. Additionally, ALA reduced endothelial activation and thus recruitment and activation of macrophages and resident microglia. Finally, high ALA diet reduced the expression of BBB-degrading and neurotoxic MMP-3 and MMP-9. CONCLUSIONS We demonstrate the beneficial effects of a clinically relevant and feasible dietary intervention with a safe and readily available compound in the setting of stroke. The protective effects observed with ALA supplementation may relate to blunting of inflammation and might pave the way for novel stroke treatments.
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Morshedzadeh N, Rahimlou M, Shahrokh S, Karimi S, Mirmiran P, Zali MR. The effects of flaxseed supplementation on metabolic syndrome parameters, insulin resistance and inflammation in ulcerative colitis patients: An open-labeled randomized controlled trial. Phytother Res 2021; 35:3781-3791. [PMID: 33856729 DOI: 10.1002/ptr.7081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
The present study aimed to evaluate the efficacy of flaxseed supplementation in the management of metabolic syndrome (MetS)-related parameters among the patients with mild-to-moderate ulcerative colitis (UC). A randomized controlled clinical trial was conducted on 70 patients with UC. Participants were randomized in the intervention group, which received 30 g/day ground flaxseed powder or control group. Anthropometric and biochemical variables were assessed at the beginning and end of 12 weeks of intervention. Of the 70 patients enrolled in this study, 64 subjects were included in the final analysis. From baseline to 12 weeks' intervention, flaxseed supplementation resulted in a significant reduction in the serum concentration of insulin (p < .001), HOMA-IR (p < .001), triglyceride (p = .001), total cholesterol (p < .001), and significant increase in the serum levels of HDL (p = .008). Also, we found a significant improvement in the SCCAI score (p < .001), TNF-α (p = .03), and CRP (p < .001) following the flaxseed supplementation. However, we not observed any significant differences between two groups regarding the body weight, BMI, waist circumferences, systolic, and diastolic blood pressure (p > .05). Overall, 12 weeks of flaxseed supplementation resulted in greater improvement in the some MetS-related parameters.
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Affiliation(s)
- Nava Morshedzadeh
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Shabnam Shahrokh
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Karimi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alasalvar C, Chang SK, Bolling B, Oh WY, Shahidi F. Specialty seeds: Nutrients, bioactives, bioavailability, and health benefits: A comprehensive review. Compr Rev Food Sci Food Saf 2021; 20:2382-2427. [PMID: 33719194 DOI: 10.1111/1541-4337.12730] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 02/06/2023]
Abstract
Seeds play important roles in human nutrition and health since ancient time. The term "specialty" has recently been applied to seeds to describe high-value and/or uncommon food products. Since then, numerous studies have been conducted to identify various classes of bioactive compounds, including polyphenols in specialty seeds. This review discusses nutrients, fat-soluble bioactives, polyphenols/bioactives, antioxidant activity, bioavailability, health benefits, and safety/toxicology of commonly consumed eight specialty seeds, namely, black cumin, chia, hemp, flax, perilla, pumpkin, quinoa, and sesame. Scientific results from the existing literature published over the last decade have been compiled and discussed. These specialty seeds, having numerous fat-soluble bioactives and polyphenols, together with their corresponding antioxidant activities, have increasingly been consumed. Hence, these specialty seeds can be considered as a valuable source of dietary supplements and functional foods due to their health-promoting bioactive components, polyphenols, and corresponding antioxidant activities. The phytochemicals from these specialty seeds demonstrate bioavailability in humans with promising health benefits. Additional long-term and well-design human intervention trials are required to ascertain the health-promoting properties of these specialty seeds.
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Affiliation(s)
| | - Sui Kiat Chang
- Department of Horticulture, Key Laboratory of South China Agricultural Plant Molecular Analysis and Genetic Improvement, Key Laboratory of Post-Harvest Handling of Fruits, Ministry of Agriculture, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, China
| | - Bradley Bolling
- Department of Food Science, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Won Young Oh
- Department of Biochemistry, Memorial University of Newfoundland, St. John's, Newfoundland, A1B 3X9, Canada
| | - Fereidoon Shahidi
- Department of Biochemistry, Memorial University of Newfoundland, St. John's, Newfoundland, A1B 3X9, Canada
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21
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Wang Q, Liu R, Chang M, Zhang H, Jin Q, Wang X. Dietary oleic acid supplementation and blood inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2020; 62:2508-2525. [PMID: 33305589 DOI: 10.1080/10408398.2020.1854673] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The aim of this systematic review and meta-analysis was to analyze data from randomized controlled trials (RCTs) assessing the effects of oleic acid (OA) supplementation on blood inflammatory markers in adults. PubMed, EMBASE and Cochrane Library databases were systematically searched from 1950 to 2019, with adults and a minimum intervention duration of 4 weeks. The effect size was estimated, adopting standardized mean difference (SMD) and 95% confidence interval (CI). Of the 719 identified studies, thirty-one RCTs involving 1634 subjects were eligible. The results of this study revealed that increasing OA supplementation significantly reduced C-reactive protein (CRP) (SMD: -0.11, 95% CI: -0.21, -0.01, P = 0.038). However, dietary OA consumption did not significantly affect tumor necrosis factor (TNF) (SMD: -0.05, 95% CI: -0.19, 0.10, P = 0.534), interleukin 6 (IL-6) (SMD: 0.01, 95% CI: -0.10, 0.13, P = 0.849), fibrinogen (SMD: 0.08, 95% CI: -0.16, 0.31, P = 0.520), plasminogen activator inhibitor type 1 (PAI-1) activity (SMD: -0.11, 95% CI: -0.34, 0.12, P = 0.355), soluble intercellular adhesion molecule-1 (sICAM-1) (SMD: -0.06, 95% CI: -0.26, 0.13, P = 0.595) or soluble vascular cell adhesion molecule-1 (sVCAM-1) (SMD: -0.04, 95% CI: -0.27, 0.18, P = 0.701). Overall, the meta-analysis demonstrated that dietary OA supplementation significantly reduced CRP, yet did not affect other inflammatory markers including TNF, IL-6, fibrinogen, PAI-1 activity, sICAM-1or sVCAM-1.
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Affiliation(s)
- Qiong Wang
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Ruijie Liu
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Ming Chang
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Hui Zhang
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Qingzhe Jin
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Xingguo Wang
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
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22
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Fatty Acids and Cardiovascular Risk. Evidence, Lack of Evidence, and Diligence. Nutrients 2020; 12:nu12123782. [PMID: 33317164 PMCID: PMC7764656 DOI: 10.3390/nu12123782] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022] Open
Abstract
One of the most controversial areas of nutrition research relates to fats, particularly essential fatty acids, in the context of cardiovascular disease risk. A critical feature of dietary fatty acids is that they incorporate into the plasma membrane, modifying fluidity and key physiological functions. Importantly, they can reshape the bioavailability of eicosanoids and other lipid mediators, which direct cellular responses to external stimuli, such as inflammation and chronic stress conditions. This paper provides an overview of the most recent evidence, as well as historical controversies, linking fat consumption with human health and disease. We underscore current pitfalls in the area of fatty acid research and critically frame fatty acid intake in the larger context of diet and behavior. We conclude that fundamental research on fatty acids and lipids is appropriate in certain areas, but the rigor and reproducibility are lacking in others. The pros and cons are highlighted throughout the review, seeking to guide future research on the important area of nutrition, fat intake, and cardiovascular disease risk.
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23
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Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers-An Overview. Nutrients 2020; 12:nu12103159. [PMID: 33081119 PMCID: PMC7602731 DOI: 10.3390/nu12103159] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/11/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular diseases remain a global challenge, and lipid-associated biomarkers can predict cardiovascular events. Extensive research on cardiovascular benefits of omega-3 polyunsaturated fatty acids (n3-PUFAs) is geared towards fish oil supplementation and fish-rich diets. Nevertheless, vegetarianism and veganism are becoming more popular across all segments of society, due to reasons as varied as personal, ethical and religious values, individual preferences and environment-related principles, amongst others. Due to the essentiality of PUFAs, plant sources of n3-PUFAs warrant further consideration. In this review, we have critically appraised the efficacy of plant-derived n3-PUFAs from foodstuffs and supplements upon lipid profile and selected cardiometabolic markers. Walnuts and flaxseed are the most common plant sources of n3-PUFAs, mainly alpha-linolenic acid (ALA), and feature the strongest scientific rationale for applicability into clinical practice. Furthermore, walnuts and flaxseed are sources of fibre, potassium, magnesium, and non-essential substances, including polyphenols and sterols, which in conjunction are known to ameliorate cardiovascular metabolism. ALA levels in rapeseed and soybean oils are only slight when compared to flaxseed oil. Spirulina and Chlorella, biomasses of cyanobacteria and green algae, are important sources of n3-PUFAs; however, their benefits upon cardiometabolic markers are plausibly driven by their antioxidant potential combined with their n3-PUFA content. In humans, ALA is not sufficiently bioconverted into eicosapentaenoic and docosahexaenoic acids. However, evidence suggests that plant sources of ALA are associated with favourable cardiometabolic status. ALA supplementation, or increased consumption of ALA-rich foodstuffs, combined with reduced omega-6 (n6) PUFAs intake, could improve the n3/n6 ratio and improve cardiometabolic and lipid profile.
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24
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Rahimlou M, Banaie Jahromi N, Hasanyani N, Ramezani Ahmadi A. Reply to M Amiri et al. Adv Nutr 2020; 11:1400-1401. [PMID: 32929446 PMCID: PMC7490210 DOI: 10.1093/advances/nmaa046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Nasrin Banaie Jahromi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nazila Hasanyani
- Emam Reza Hospital affiliated with Social Security Organization, Urmia, Iran
| | - Amirhossein Ramezani Ahmadi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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25
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Amiri M, Raeisi-Dehkordi H, Salehi-Abargouei A. Comment on "Effects of Flaxseed Interventions on Circulating Inflammatory Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Adv Nutr 2020; 11:1399-1400. [PMID: 32929447 PMCID: PMC7490219 DOI: 10.1093/advances/nmaa045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
| | - Hamidreza Raeisi-Dehkordi
- Department of Nutrition, School of Public Health, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Department of Nutrition, School of Public Health, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran
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26
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Flaxseed oil in the context of a weight loss programme ameliorates fatty liver grade in patients with non-alcoholic fatty liver disease: a randomised double-blind controlled trial. Br J Nutr 2020; 123:994-1002. [DOI: 10.1017/s0007114520000318] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractLong-chain n-3 fatty acids have been shown to regulate lipid metabolism and reduce fat accumulation in the liver. This trial investigated the effect of flaxseed oil, as a rich source of α-linolenic acid, on fatty liver and cardiometabolic risk factors in patients with non-alcoholic fatty liver disease (NAFLD). The randomised, double-blind, controlled trial was performed on sixty-eight NAFLD patients who were divided into flaxseed (n 34) and sunflower (n 34) oil groups. Patients were given a hypoenergetic diet (−2092 kJ/d) and 20 g/d of the corresponding oil for 12 weeks. Fatty liver grade, liver enzymes and cardiometabolic parameters were determined. The intention-to-treat approach was used for data analysis. Fatty liver grade significantly decreased in both groups (−0·68 in flaxseed v. −0·29 in sunflower, P = 0·002). Alanine aminotransferase and aspartate aminotransferase decreased in both groups (P < 0·01). Also, significant reduction was observed in blood glucose (P = 0·005) and fat mass (P = 0·01) in the flaxseed and muscle mass (P = 0·01) in the sunflower group. However, none of these alterations was significantly different between the groups. Weight, waist circumference and blood pressure were significantly decreased in both groups but only weight change was significantly different between the groups (P = 0·01). IL-6 did not significantly change in either group but showed a significant between-group difference (P = 0·03). Overall, the results showed that in the context of a low-energy diet and moderate physical activity, flaxseed oil may benefit NAFLD patients to improve fatty liver grade, weight and IL-6 compared with sunflower oil.
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27
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Haidari F, Banaei-Jahromi N, Zakerkish M, Ahmadi K. The effects of flaxseed supplementation on metabolic status in women with polycystic ovary syndrome: a randomized open-labeled controlled clinical trial. Nutr J 2020; 19:8. [PMID: 31980022 PMCID: PMC6982376 DOI: 10.1186/s12937-020-0524-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/16/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is known as the most common endocrine disorder of women in reproductive ages. With the increasing prevalence of PCOS in different countries, the use of herbal medicine as an alternative treatment is growing in these patients. This study aimed to evaluate the effects of flaxseed powder supplementation on metabolic biomarkers of patients with PCOS. METHODS This randomized open-labeled controlled clinical trial was conducted on 41 patients with PCOS. The participants were randomized to take either flaxseed powder (30 g/day) plus lifestyle modification or only lifestyle modification for 12 weeks. Anthropometric and biochemical evaluations were performed for all patients at the beginning and end of the study. RESULTS The flaxseed group showed a significant reduction in body weight, insulin concentration, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Triglycerides (TG), high-sensitivity C-Reactive Protein (hs-CRP), and leptin and an increase in Quantitative Insulin-Sensitivity Check Index (QUICKI), High Density Lipoprotein (HDL), and adiponectin compared to the baseline (p < 0.05). Flaxseed supplementation also led to a significant reduction in insulin concentration, HOMA-IR, TG, hs-CRP, Interleukin 6 (IL- 6), and leptin and an increase in QUICKI, HDL, and adiponectin compared to the control group (p < 0.05). No significant changes were observed in other parameters. CONCLUSIONS Flaxseed supplementation plus lifestyle modification was more effective compared to lifestyle modification alone in biochemical and anthropometric variables in patients with PCOS. TRIAL REGISTRATION The trial protocol was approved by the Ethics Board at Ahvaz Jundishapur University of Medical Sciences and was registered at Iranian Registry of Clinical Trials (code: IRCT20120704010181N11).
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Affiliation(s)
- Fatemeh Haidari
- Department of Nutrition, Nutrition and Metabolic Diseases Research Center, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Nasrin Banaei-Jahromi
- Department of Nutrition, Nutrition and Metabolic Diseases Research Center, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran.
| | - Mehrnoosh Zakerkish
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Ahmadi
- Department of Statistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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