Flaxseed, a small seed of brown or gold hue, does not look like a superhero of nutrition but it is indeed a superlative source of some very healthful nutrients. Emerging evidence is showing that flaxseed can protect us from dozens of life-threatening health conditions including cardiovascular disease, atherosclerosis, diabetes, cancer, arthritis, osteoporosis, autoimmune diseases and neurological disorders (1).
Flax is considered a functional food because, over and above its basic nutritional offerings, it has proven health benefits in the reduction of cancer and cardiovascular disease and in its ability to lower levels of LDL-cholesterol (1).
Canada is one of the top producers of flaxseed in the world, responsible for about 40% of world production. China, India, the United States, Germany, the United Kingdom and France are other major producers of this crop (2).
WHAT MAKES FLAXSEED SO HEALTHY?
Omega-3 fatty acids – Alpha Linolenic Acid (ALA)
Flaxseed is one of the richest plant sources of the omega-3 fatty acid, alpha-linolenic acid (ALA). ALA is a short-chain omega-3 fatty acid which can be converted within the human body into the longer chain omega-3s, DHA and EPA. Though it was once believed that ALA itself did not have health benefits, recent research is changing minds about that idea. It is now evident that ALA can lower cardiovascular risk with comparable benefits between plant-sourced ALA and marine-derived DHA and EPA (3). A large review of twenty-seven studies encompassing more than 250,000 participants found that ingestion of ALA was linked to a 14% lower risk of heart disease (4).
In modern Western diets, intake of omega-3 fatty acids is very low compared to that of omega-6 fatty acids, with a ratio of 16:1 to 20:1 omega-6 to omega-3. This is in sharp contrast to the ratio of 1:1 in diets that were eaten by our ancestors over our millions of years of evolution (5). The ideal ratio of omega-6 to omega-3 for health is between 1:1 and 4:1 (5,6). Flaxseeds have one of the lowest omega-6 to omega-3 ratios of all foods at 1:4. This ratio is important because omega-6 fatty acids cause inflammation while omega-3s reduce it. Additionally, when dietary omega-6s are high, the enzyme that is crucial for the metabolism of both of these fatty acid types can be overwhelmed by the excess omega-6s resulting in less availability of omega-3 fatty acids. Chronic inflammation caused by a high omega-6 to omega-3 ratio is linked to many of our most common diseases including cardiovascular disease, diabetes, cancer and autoimmune disease (7).
Lignans are phenolic compounds that act as antioxidants and phytoestrogens and they are abundant in fiber-rich plants such as grains, legumes, vegetables, fruits, berries, tea and alcoholic beverages. Flax is the richest source of lignans among plants, containing from 75 to 800 times more lignans than other plant foods (8).
Though lignans and other phenolic compounds in flax are antioxidants, protecting tissues from the damaging effects of free radicals, this is not their most important contribution to health (1,8,9). Lignans are also phytoestrogens that can bind to estrogen receptors. Phytoestrogens have only weak estrogenic activity and they can also block the physiological effects of estrogens in tissues. Increasing evidence illustrates that lignans from flax can reduce growth of cancers, especially hormone-sensitive cancers such as breast, endometrial and prostate cancer as well as lower the risk of heart disease.
Flax is high in fiber and contains both soluble and insoluble types of fiber in proportions varying from 20:80 to 40:60 soluble:insoluble. Eating 10 gm of flaxseed provides 1 gm of soluble fiber and 3 gm of insoluble fiber (1). The major insoluble fibers in flax are cellulose and lignin while its soluble fibers are mucilage gums (polysaccharides that thicken when mixed with water or other fluids) (1). Insoluble fiber prevents constipation and promotes a healthy gut microbiome. Soluble fiber helps to maintain healthy blood glucose levels and lowers blood cholesterol levels (1).
Flax is also a good source of minerals. A 30 gm (2 tablespoonful) serving of flaxseed provides up to 30% of the recommended daily allowances of calcium, magnesium and phosphorus. Flax is also high in potassium. Higher potassium intake is related to lower incidence of strokes, less tendency of blood to clot and reduced levels of free radicals in the blood (1,8).
Flaxseed contains the so called “anti-nutrient” phytic acid which can reduce the bioavailability of some micronutrients. However, recent research has revealed that phytic acid, far from presenting a problem, has antioxidant, anticancer and cholesterol-lowering benefits (1,10).
Flaxseeds, like many other seeds, also contain cyanide, present as a defense against plant-eating predators. In 2016, several foods were examined to see if their cyanide content reached toxic levels and flaxseeds were among the foods tested. A variety of flaxseed products were procured. The one with the highest cyanide content was identified then finely ground, mixed with tap water (a method previously determined to result in the highest blood levels of cyanide) and consumed on an empty stomach by test subjects (11). Results showed that….
- Cyanide is released relatively slowly from flaxseed.
- A very high amount of flaxseed, around 100 gm, is required to produce a level even nearing toxicity and no symptoms were seen in any participants of this study.
- Doses of up to 15 gm of flaxseed three times a day are deemed to be low enough in cyanide to prevent problems. Such doses are much higher than those recommended to reap the benefits provided by eating flaxseeds (11).
BENEFITS OF EATING FLAXSEED
BENEFITS OF FLAXSEED ON CANCER
Plant-sourced foods in general are good sources of lignans, so much so that vegetarians have been found to have eight times the lignan consumption of omnivores (12). Flaxseeds especially are very rich in lignans. Evidence is accumulating that eating flaxseeds can both prevent and treat some types of cancer.
What are possible mechanisms for the effect of flaxseeds on incidence and outcome of cancers?
Lignans have been shown to reduce the development of tumours in at least three ways (1);
- They can decrease angiogenesis (development of the new blood vessels necessary to feed a tumour)
- They can reduce the proliferation (spread) of cancer cells
- They can increase apoptosis (programmed cell death) in tumour cells
How do they do this?
Lignans are structurally similar to human estrogens and can bind to estrogen receptors, reducing the cancer- promoting effects of estrogen (1).
Flaxseeds may help our body fight against interleukin-1, a molecule that encourages the growth and spread of tumours. The human body produces an interleukin-1 receptor antagonist that binds to the interleukin-1 receptor to block the action of interleukin-1. Eating flax seeds can boost the activity of the interleukin-1 receptor antagonist (13).
Consumption of flaxseed can prevent breast cancer
A Canadian study involving over 6000 women found that those who eat flaxseeds or flax bread were associated with an 18% to 23% lower risk of breast cancer development (14).
A 2013 systematic review of ten studies concluded that current evidence shows that flax consumption in doses of 25 gm of ground flax daily may prevent breast cancer and may also increase cancer cell death and decrease cancer cell proliferation in women who already have breast cancer (15).
Postmenopausal women who eat lots of grains, fruits, vegetables, flaxseeds and sesame seeds are getting plenty of lignans in their diet. Researchers reviewed twenty-one studies and concluded that eating lignans can reduce the risk of breast cancer by 14% (16).
Consumption of flaxseed can reduce the growth and spread of breast cancer
In a randomized double-blind placebo-controlled clinical trial from the University Health Network in Toronto, patients diagnosed with breast cancer through biopsy were placed into two groups for about a month before their surgery. The first group ate a flaxseed-containing muffin daily and the second group ate a placebo muffin. Both muffins were similar in fiber content. The muffins were apparently popular among all the subjects but only the flaxseed muffins resulted in a significant increase in lignan levels. The flaxseed muffin-eating group experienced 34% less multiplication of tumour cells and 30% higher death of tumour cells. Also, expression of the cancer was decreased by 71% in the flaxseed group but not in the placebo group. Higher cancer expression is linked to more aggressive breast cancer with increased metastases. This study suggests that flaxseed ingestion has the potential to reduce the growth and invasiveness of breast cancer in a surprisingly short period of time (17).
Consumption of flaxseed is linked with longer life in women with breast cancer
Postmenopausal women with breast cancer who ingest the most lignans have a statistically significant reduced risk of death from breast cancer compared to women eating lower amounts of lignan (18).
Another study followed 2653 postmenopausal breast cancer patients and found that higher lignan intake was associated with significantly longer survival (16).
A 2012 investigation agreed, finding that breast cancer-related mortality risk was consistently lower years after breast cancer surgery in patients who had higher lignan levels in their bloodstream at the time of the operation (19).
And yet another one…. A team from Germany followed over 1100 postmenopausal patients with breast cancer and discovered that the women with the highest lignan levels lived the longest (20).
Consumption of flaxseed shows benefits in prostate cancer
In 2004 a pilot study placed fifteen men waiting for a repeat biopsy for prostate cancer onto a fat-restricted diet supplemented with 30 gm of flaxseeds daily for six months. Results showed significant decreases in cholesterol and PSA (a marker of prostate cell growth that is elevated in prostate cancer). Additionally, proliferation of their cancer cells decreased significantly. These outcomes suggest that flaxseed may be able to control prostatic cancer growth (21).
BENEFITS OF FLAXSEED ON CARDIOVASCULAR DISEASE
Consumption of flaxseed reduces blood pressure
A 2013 prospective, randomized, double-blind, placebo-controlled study in Canada discovered that ingesting flaxseed significantly lowered systolic blood pressure by 10 mmHg and diastolic blood pressure by 7 mmHg in patients with high blood pressure. Participants that began the study with a systolic blood pressure of over 140 mmHg had larger blood pressure drops, about 15 mmHg. This study illustrates that flaxseed is capable of inducing a very potent drop in hypertension through diet alone (22).
Though the blood pressure falls achieved in this study may seem small at first glance, in practice they are significant. Such drops in blood pressure have the potential to cut the risk of stroke and heart disease by large amounts. It has been shown that for every 10 mmHg reduction in systolic blood pressure, major cardiovascular events are decreased by 20%; coronary heart disease falls by 17%; stroke risk is lowered by 27%; heart failure drops by 28%; and there is a 13% reduction in death from all causes (23).
In addition, the blood pressure reductions brought about by the regularly used blood pressure medications are no larger than the blood pressure decreases induced by eating flaxseed. A review of trials examining ACE inhibitors found that they lower systolic blood pressure by an average of 8 mmHg and diastolic blood pressure by an average of 5 mmHg (24). Calcium channel blockers are not much better. Their maximum blood pressure reduction is between 8 and 10 mmHg for systolic blood pressure and between 6 and 7 mmHg for diastolic blood pressure (25). Flaxseed intake is more than a match for these drugs especially when you consider that, unlike pharmaceuticals, eating flaxseed comes without any negative side effects (22). Further to this, the study showed that, in people taking blood pressure medication, flaxseeds lowered blood pressure even further so that the number of patients with uncontrolled high blood pressure decreased by 17% (22).
Consumption of flaxseed reduces blood lipid levels
A 2014 study examined the potential role of flaxseed in reducing lipid levels. After 3 months of ingesting 30 gm of roasted, ground flaxseeds, participants lost weight, lowered their blood pressure and showed a highly significant reduction in total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein-cholesterol (VLDL-C) along with elevations in high density lipoprotein-cholesterol (HDL-C). Researchers concluded that eating flaxseed has a protective effect on the heart (26).
These cholesterol-lowering effects appear to stem from fact that the fiber in flaxseed binds to bile salts allowing the resulting combination to be excreted from the body. Cholesterol is consumed in the production of replacement bile salts, thus lowering cholesterol blood levels (27).
Consumption of flaxseed is linked to lower risk of stroke
Alpha linolenic acid (ALA) is showing promise in animal models in conferring protection to the brain against the occurrence of stroke and limiting the extent of brain damage if stroke occurs (28).
Consumption of flaxseed may reduce atherosclerotic plaques
Animal studies are showing that atherosclerotic plaques can regress (decrease in size) by about 40% after eighteen weeks of a diet supplemented with flaxseed (29).
BENEFITS OF FLAXSEED ON DIABETES
Flaxseed lignans are known to be protective against diabetes.
One study showed that eating 50 gm of carbohydrate from flaxseed decreased post-meal blood sugar levels by 27% (30).
Another study looked at supplementation of 15 gm and 20 gm of ground flaxseed daily for 2 months in diabetic females. Researchers found that after-meal blood glucose levels were decreased by 7.9% and 19.1% respectively (31).
In type-2 diabetics, supplementing the diet with 10 gm of ground flaxseed (1 tablespoonful) for only one month reduced fasting blood glucose by 19.7% and lowered A1C levels, as well as reducing levels of blood triglycerides and cholesterol (32).
Flaxseed may be able to improve insulin sensitivity through the effect of flaxseed antioxidants on reducing oxidative stress (33).
BENEFITS OF FLAXSEED ON OBESITY
Findings of randomized controlled trials regarding the association of flaxseed consumption with obesity have been conflicting. However, many studies have found benefits.
Adding flax to the diet appears to cause no weight gain. A 2010 study illustrated that, though the intervention groups and the control group all consumed a similar number of calories, the control group experienced a 4% weight gain while the flax group remained weight stable (34).
A systematic review looked at 45 available studies and found that eating flaxseed in doses higher than 30 gm per day for more than 12 weeks in persons with a BMI greater than 27 had the positive effect of lowering body weight and waist circumference (35).
A 2012 study found that drinking a beverage containing 2.5 gm of ground flaxseed suppressed appetite and lowered overall food intake (36).
BENEFITS OF FLAXSEEDS FOR SKIN
Irritated and itchy skin is not uncommon in humans. Flaxseed supplementation has shown some benefit for skin health. A randomized, double-blind study had women ingesting approximately one-half of a teaspoonful of flaxseed oil daily for 12 weeks. At the end of the study participants reported significantly less skin redness along with smoother and less scaly skin compared to similar ingestion of safflower oil (37).
BENEFITS OF FLAXSEEDS FOR MENSTRUAL SYMPTOMS
Flaxseed in the diet can regulate the menstrual cycle and relieve symptoms such as breast pain (38,39). Research from 2014 reported that breast pain, swelling and lumpiness decreased by a significantly greater amount in young women ingesting a muffin containing three and a half tablespoonsful of flaxseed daily compared to those eating a muffin containing no flaxseed (39).
BENEFITS OF FLAXSEEDS ON BONES
Studies in animals point to beneficial effects of flaxseed on the risk of osteoporosis. Postmenopausal rats fed flaxseed oil for 2 months showed increased levels of the bone-creating protein, osteocalcin. This suggests that flaxseed oil may help to decrease the risk of osteoporosis. The researchers believe that the omega-3 fatty acid, alpha linolenic acid (ALA), present in flax can support and protect the processes that form bone. Human studies are needed. (40)
BENEFITS OF FLAXSEEDS FOR LONGEVITY
A Canadian study from 2014 showed that eating flaxseed daily can reduce inflammation, an effect thought to come from oxylipin production (41). Oxylipins are chemical messengers produced by the body from the oxidation of polyunsaturated fatty acids. Oxylipins that are derived from omega-3 fatty acids tend to decrease inflammation while those from omega-6 fatty acids cause an increase. Oxylipins appear to play a major role in the progression of chronic diseases and the aging process.
In this study, oxylipins were found in much higher amounts in the older group (age 45 to 64) than in the group of younger people (age 19 to 28) at the start of the study. Subjects in both groups then ate a muffin containing 30 gm of ground flaxseed daily for four weeks. Results showed that the number of oxylipins in the older subjects had decreased compared to the those in the younger group. At the start of the study there were 13 oxylipins in the older group that were present in levels at least twice those of the younger group. At the end of the study only three oxylipins remained higher in the older subjects compared to the younger subjects (41). Researchers concluded that dietary sources of omega-3 fatty acids such as flaxseeds, which contain a high omega-3 to omega-6 ratio (45), can bring the ratio between these two polyunsaturated fatty acid types into a healthier balance (41).
HOW MUCH FLAXSEED SHOULD BE EATEN DAILY?
In 2014 Health Canada approved a health claim linking the consumption of ground whole flaxseed and the lowering of blood cholesterol. This claim is based on consistent clinical trials showing reductions in both total cholesterol and LDL-cholesterol with consumption of flaxseed. These effects are associated with improved cardiovascular health. The health claim advocates the consumption of 16 gm (2 tablespoonsful) of ground flaxseed to be eaten up to three times a day (42).
Considering all the health benefits that flaxseeds have, it is good advice for everyone to consume some of these little seeds every day but the dose needn’t be very high. One to two tablespoonsful of ground flaxseed eaten daily will ensure intake of enough to have physiological effects.
HOW TO ADD FLAXSEED TO YOUR DAILY DIET
Happily, incorporating a tablespoonful or two of flaxseed into a daily diet is quite easy and enjoyable. Flaxseeds have a fairly neutral, subtly nutty taste and are compatible with many of the regular foods we eat at breakfast, lunch and supper. Here are a few considerations to keep in mind.
Flaxseeds are available in two basic varieties; brown and golden. Both have similar nutritional characteristics and equal amounts of short-chain omega-3 fatty acids (1).
Whole flaxseeds have a tough outer shell that can allow them to travel through the intestines without releasing much of their nutritional contents (43). To increase the release and absorption of the healthful nutrients in flaxseed, grind the seeds using a spice or coffee grinder. Flaxseed tends to oxidize once they are ground so it is best to do the grinding right before the eating. If you do grind more than you need, ground flaxseed can be stored in the freezer in an airtight container for a few weeks.
Use whole flaxseeds, not the flaxseed oil. The oil is rich in ALA but it does not contain the host of other beneficial nutrients such as fiber and lignan that is found in the whole seed (9,44). Remember also that oils of any kind are processed foods. It is much healthier to eat the whole food.
Flaxseeds are versatile and can be added to many meals quite easily. Here are some suggestions.
- Add a tablespoonful or so of ground flaxseeds to the batter of baked goods such as cookies, muffins and breads.
- Ground flaxseed mixed in water is a good substitute for eggs in recipes.
- When added to a smoothie, ground flaxseeds mix in easily and help to thicken up the final product.
- Sprinkle some ground flaxseed over your morning porridge or other cereal.
- Add a shake or two of ground flaxseed to your sandwich or soup at lunch or your chili at supper.
Whatever way you do it, be sure to eat some of this nutrient rich super food every day. It is an enjoyable way to reduce your risks of developing many of the chronic diseases that are all too common in our highly developed world of today.
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