Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study

Roberta Soares Lara Cassani, Priscila Giacomo Fassini, Jose Henrique Silvah, Cristiane Maria Mártires Lima, Júlio Sérgio Marchini, Roberta Soares Lara Cassani, Priscila Giacomo Fassini, Jose Henrique Silvah, Cristiane Maria Mártires Lima, Júlio Sérgio Marchini

Abstract

Background: Flaxseed has received attention for its anti-inflammatory and antioxidant role. The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease.

Methods: In a prospective, single blinded 42 days protocol, subjects were allocated into two groups with low carbohydrates intake: GriceLC (35% of carbohydrate and 60g of raw rice powder per day) and GflaxLC (32% of carbohydrate and 60g of flaxseed powder per day). Blood pressure, anthropometric measures and serum levels of isoprostane, C-reactive protein, Tumor Necrosis Factor-alpha, glucose, lipidic profile, uric acid, adiponectin, leptin and insulin were measured at baseline and at the end of interventions. Serum and urinary enterodiol and enterolactione were also measured.

Results: A total of 27 men with cardiovascular risk factors were evaluated, with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC. Both groups experienced weight loss and systolic blood pressure reduction. A decrease in inflammatory markers (CRP and TNF-α) was observed after flaxseed intake (mean decrease of 25% and 46% for GflaxLC respectively). All groups also showed improvement in levels of total cholesterol, LDL-c, uric acid and adiponectin. Only GflaxLC group showed a decrease in triglyceride levels.

Conclusion: This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α.

Trial registration: ClinicalTrials.gov NCT02132728.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Serum and urinary levels of enterodiol and enterolactone according to group and time of assessment. (▲) GriceLC; (●) GflaxLC. *significant difference between initial and final times (p < 0,05).
Figure 3
Figure 3
Serum levels of CRP, TNF-α and isoprostane according to group and time of assessment. (▲) GriceLC; (●) GflaxLC. *significant difference between initial and final times (p < 0,05).
Figure 4
Figure 4
Leptin and adiponectin levels according to group and time of assessment. (▲) GriceLC; (●) GflaxLC. *significant difference between initial and final times (p < 0,05).

References

    1. Hansson GK. Immune mechanisms in atherosclerosis. Arterioscl Throm Vas. 2001;21:1876–1890. doi: 10.1161/hq1201.100220.
    1. Couillard C, Ruel G, Archer WR, Pomerleau S, Bergeron J, Couture P, Lamarche B, Bergeron N. Circulating levels of oxidative stress markers and endothelial adhesion molecules in men with abdominal obesity. J Clin Endocr Metab. 2005;90:6454–6459. doi: 10.1210/jc.2004-2438.
    1. Paschos G, Zampelas A, Panagiotakos DB, Katsiougiannis S, Griffin B, Votteas V, Skopouli FN. Effects of flaxseed oil supplementation on plasma adiponectin levels in dyslipidemic men. Eur J Nutr. 2007;46:315–320. doi: 10.1007/s00394-007-0668-5.
    1. Shoelson SE, LEE J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest. 2006;116:1793–1801. doi: 10.1172/JCI29069.
    1. Fantuzzi G, Mazzone T. Adipose tissue and atherosclerosis. Exploring the connection. Arterioscl Throm Vas. 2007;27:996–1003. doi: 10.1161/ATVBAHA.106.131755.
    1. Fukumitsu S, Aida K, Ueno N, Ozawa S, Takahashi Y, Kobori M. Flaxseed lignan attenuates high fat diet induced fat accumulation and induces adiponectin expression in mice. Brit J Nutr. 2008;100:669–676. doi: 10.1017/S0007114508911570.
    1. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American college of cardiology/American heart association task force on practice guidelines and the obesity society. Circulation. 2014;129(25 Suppl 2):S102–S138. doi: 10.1161/.
    1. Matarese LE, Pories WJ. Adult weight loss diets: metabolic effects and outcomes. Nutr Clin Pract. 2014;29:759–767. doi: 10.1177/0884533614550251.
    1. Esmaillzadeh A, Mirmiran P, Azizi F. Whole grain intake and the prevalence of hypertriglyceridemic waist phenotype in tehranian adults. Am J Clin Nutr. 2005;81:55–63.
    1. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr. 2006;84:1489–1497.
    1. Lemieux I, Pascot A, Prud'homme D, Alméras N, Bogaty P, Nadeau A, Bergeron J, Després JP. Elevated C-reactive protein. Another component of the aterosthrombotic profile of abdominal obesity. Arterioscl Throm Vas. 2001;21:961–967. doi: 10.1161/01.ATV.21.6.961.
    1. Kris-etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;106:2747–2757. doi: 10.1161/01.CIR.0000038493.65177.94.
    1. Bloendon LT, Balikai S, Chittams J, Cunnane SC, Berlin JA, Rader DJ, Szapary OP. Flaxseed and cardiovascular risk factors: results from a double blind, randomized, controlled clinical trial. J Am Coll Nutr. 2008;27:65–74. doi: 10.1080/07315724.2008.10719676.
    1. IDF: International Diabetes Federation: The IDF Consensus Worldwide Definition of the Metabolic Syndrome.
    1. WHO . Obesity: Presenting and Managing the Goal Epidemic. Report of a WHO Consulation on Obesity. Geneva: World Health Organization; 1998.
    1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) JAMA. 2001;285:2486–2497. doi: 10.1001/jama.285.19.2486.
    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Jr, Materson BJ, Oparil S, Wright JT, Roccella EJ., Jr Seventh report of the joint national committee on: prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–1252. doi: 10.1161/01.HYP.0000107251.49515.c2.
    1. Nicoletti CF, Camelo JS, Jr, dos Santos JE, Marchini JS, Salgado W, Jr, Nonino CB. Bioelectrical impedance vector analysis in obese women before and after bariatric surgery: changes in body composition. Nutrition. 2014;30:569–574. doi: 10.1016/j.nut.2013.10.013.
    1. NHANES III . National Health and Nutrition Examination Survey. National Center for Health Statistics. 2009.
    1. Mion D, Jr, Gomes MAM, Nobre F, Amodeo C, Kohlmann O, Jr, Praxedes JN, Machado CA. IV Brazilian guidelines on hypertension. Arq Bra Cardiol. 2004;82(2):15–22.
    1. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.
    1. Vasques ACJ. Análise crítica do uso dos índices do homa na avaliação da rersistencia à insulina e capacidade funcional das celulas –β panceráticas. Arq Bras Endocrinol. 2008;2:52–61.
    1. Hallund J, Tetens I, Bugel S, Tholstrup T, Bruun JM. The effect of a lignan complex isolated from flaxseed on inflammation markers in healthy postmenopausal women. Nutr Metab Cardiovas. 2008;18:497–502. doi: 10.1016/j.numecd.2007.05.007.
    1. Pan A, Wahnefried WD, Xingwang Y, Yu Z, Li H, Qi Q, Sun J, Chen Y, Chen X, Liu Y, Lin X. Effects of a flaxseed derived lignan supplement on C-reactive protein, IL-6 and retinol binding protein 4 in type 2 diabetic patients. Brit J Nutr. 2008;74:1–5.
    1. Prasad K. Hypocholesterolemic and antiatherosclerotic effect of flax lignan complex isolated from flaxseed. Atherosclerosis. 2005;179:269–275. doi: 10.1016/j.atherosclerosis.2004.11.012.
    1. Arts ICW, Hollman PCH. Polyphenols and disease risk in epidemiologic studies. Am J Clin Nutr. 2005;81:317S–325S.
    1. Kivelã AM, Kansanen E, Jyrkkânen HK, Nurmi T, Ylã-herttuala S, Levonen AL. Enterolactone induces heme oxygenase-1 expression trough nuclear factor E2 related factor 2 activation in endothelial cells. J Nutr. 2008;138:1263–1268.
    1. Dandona P, Aljada A, Bandyopadhyay A. Inflammation: the link between insulin resistance, obesity and diabetes. Trends Immunol. 2004;25:4–7. doi: 10.1016/j.it.2003.10.013.
    1. Radulian G, Rusu E, Dragomir AD, Posea M. Metabolic effects of low glycaemic index diets. Nutr J. 2009;8:1–8. doi: 10.1186/1475-2891-8-5.
    1. Madsen EL, Rissanen A, Bruun JM, Skogstrand K, Tonstad S, Hougaard DM, Richelsen B. Weight loss larger than 10% is neede for general improvement of levels of circulation adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study. Euro J Endocrinol. 2008;158:179–187. doi: 10.1530/EJE-07-0721.
    1. Redman LM, Heilbronn LK, Martin CK, Jonge L, Williamson DA, Delany JP, Ravussin E. Metabolic and behavioral compensations in response to caloric restriction: Implications for the maintenance of weight loss. PLoS One. 2009;4:e4377. doi: 10.1371/journal.pone.0004377.
    1. Guimarães ICB, de Almeida A, Santos AS, Barbosa DBV, Guimarães AC. Pressão arterial: efeito do índice de massa corporal e da circunferência abdominal em adolescentes. Arq Bras Cardiol. 2008;90:426–432. doi: 10.1590/S0066-782X2008000600007.
    1. Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, Milas C, Mattfeldt-Beman M, Belden L, Bragg C, Millstone M, Raczynski J, Brewer A, Singh B, Cohen J. Long-term weight loss and changes in blood pressure: results of the trials of hypertension prevention, phase II. Ann Intern Med. 2001;134:1–11. doi: 10.7326/0003-4819-134-1-200101020-00007.
    1. Pan A, Sun J, Chen Y, Ye X, Li H, Yu Z, Wang Y, Gu W, Zhang X, Chen X, Demark-Wahnefried W, Liu Y, Lin X. Effects of a flaxseed-derived lignan supplement in type 2 diabetic patients: a randomized, double-blind, cross-over trial. PLoS One. 2007;2:e1148. doi: 10.1371/journal.pone.0001148.
    1. Bassett CM, Rodriguez-Leyva D, Pierce GN. Experimental and clinical research findings on the cardiovascular benefits of consuming flaxseed. Appl Physiol Nutr Me. 2009;34:965–974. doi: 10.1139/H09-087.
    1. Prim CR, Baroncini LAV, Précoma LB, Caron PHL, Winter G, Poletti MO, Précoma DB. Effects of linseed consumption for a short period of time on lipid profile and atherosclerotic lesions in rabbits fed a hypercholesterolaemic diet. Brit J Nutr. 2012;107:660–664. doi: 10.1017/S0007114511003539.
    1. Harris WS. n-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65:1645S–1654S.
    1. Kontogianni MD, Vlassopoulos A, Gatzieva A, Farmaki AE, Katsiougiannis S, Panagiotakos DB, Kalogeropoulos N, Skopouli F. Flaxseed oil does not affect inflamatory markes and lipid profile compared to olive, in young, healthy, normal weight adults. Metabolism. 2013;62:686–693. doi: 10.1016/j.metabol.2012.11.007.
    1. Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis. 2006;189:19–30. doi: 10.1016/j.atherosclerosis.2006.02.012.
    1. Jump DB, Depner CM, Tripathy S. Omega-3 fatty acid supplementation and cardiovascular disease. J Lipid Res. 2012;53:2525–2545. doi: 10.1194/jlr.R027904.
    1. Santos RD, Gagliardi ACM, Xavier HT, Magnoni CD, Cassani R, Lottenberg AM. Sociedade brasileira de cardiologia. I diretriz sobre o consumo de gorduras e saúde cardiovascular. Arq Bras Cardiol. 2013;100:1–40.
    1. Vanharanta M, Voutilainen S, Nurmi T, Kaikkonen J, Roberts LJ, Morrow JD, Adlercreutz H, Salonen JT. Association between low serum enterolactone and increased plasma f2-isoprostanes, a measure of lipid peroxidation. Atherosclerosis. 2002;160:465–469. doi: 10.1016/S0021-9150(01)00603-7.

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