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Effects of flaxseed supplementation on erythrocyte fatty acids and multiple cardiometabolic biomarkers among Chinese with risk factors of metabolic syndrome



We investigated effects of ground whole flaxseed supplementation on erythrocyte polyunsaturated fatty acids (PUFAs) and serum biomarkers of inflammation, endothelial dysfunction, oxidative stress, and thrombosis in Chinese with risk factors of metabolic syndrome (MetS).


This study was a secondary analysis of a 12-week, randomized, parallel-group trial in participants screened for MetS. The analysis included only those with 2 or more components of MetS before receiving either lifestyle counseling (LC, n = 90) or LC + 30 g/day flaxseed supplementation (LCF, n = 83).


Compared to the LC group, those in the LCF group experienced significant increases in total erythrocyte n-3 PUFAs, α-linolenic acid, eicosapentenoic acid, and docosapentenoic acid (all P < 0.001), while total n-6 PUFAs (P < 0.05) and n-6/n-3 ratio decreased (P < 0.001). Arachidonic acid increased significantly in the LC group (P < 0.001), and serum high-sensitivity C-reactive protein, interleukin-18, soluble intracellular adhesion molecular-1, E-selectin, and plasminogen activator inhibitor-1 declined significantly in both groups (all P < 0.05), but no between-group differences were observed. There was no significant change in serum interleukin-6, tumor necrosis factor-α, soluble vascular adhesion molecular-1, monocyte chemoattractant protein-1, and oxidized low-density lipoprotein in either group.


These data suggest that flaxseed supplementation increases erythrocyte n-3 PUFAs, decreases n-6 PUFAs and n-6/n-3 ratio in participants with risk factors of MetS, but has no additional benefits beyond the lifestyle consulting for the multiple biomarkers tested in the current study.

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α-Linolenic acid


Polyunsaturated fatty acid


Metabolic syndrome


Lifestyle counseling


LC + 30 g/day flaxseed


Fatty acid methyl ester


High-sensitivity C-reactive protein




Tumor necrosis factor-α


Monocyte chemotactic protein-1


Soluble intercellular adhesion molecule-1


Soluble vascular adhesion molecule-1


Plasminogen activator inhibitor-1


Oxidized low-density lipoprotein




Eicosapentenoic acid


Docosahexenoic acid


Docosapentenoic acid


Linoleic acid


Arachidonic acid


  1. Prasad K (2009) Flaxseed and cardiovascular health. J Cardiovasc Pharmacol 54:369–377

    Article  CAS  Google Scholar 

  2. Brenna JT, Salem N Jr, Sinclair AJ, Cunnane SC (2009) Alpha-linolenic acid supplementation and conversion to n-3 long-chain polyunsaturated fatty acids in humans. Prostaglandins Leukot Essent Fatty Acids 80:85–91

    Article  CAS  Google Scholar 

  3. Burdge GC, Calder PC (2005) Conversion of alpha-linolenic acid to longer-chain polyunsaturated fatty acids in human adults. Reprod Nutr Dev 45:581–597

    Article  CAS  Google Scholar 

  4. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002) 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) final report. Circulation 106:3143–3421

    Google Scholar 

  5. Koh KK, Han SH, Quon MJ (2005) Inflammatory markers and the metabolic syndrome: insights from therapeutic interventions. J Am Coll Cardiol 46:1978–1985

    Article  CAS  Google Scholar 

  6. Zhao G, Etherton TD, Martin KR, West SG, Gillies PJ, Kris-Etherton PM (2004) Dietary alpha-linolenic acid reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women. J Nutr 134:2991–2997

    CAS  Google Scholar 

  7. Faintuch J, Horie LM, Barbeiro HV, Barbeiro DF, Soriano FG, Ishida RK, Cecconello I (2007) Systemic inflammation in morbidly obese subjects: response to oral supplementation with alpha-linolenic acid. Obes Surg 17:341–347

    Article  Google Scholar 

  8. Dodin S, Cunnane SC, Masse B, Lemay A, Jacques H, Asselin G, Tremblay-Mercier J, Marc I, Lamarche B, Legare F, Forest JC (2008) Flaxseed on cardiovascular disease markers in healthy menopausal women: a randomized, double-blind, placebo-controlled trial. Nutrition 24:23–30

    Article  CAS  Google Scholar 

  9. Bloedon LT, Balikai S, Chittams J, Cunnane SC, Berlin JA, Rader DJ, Szapary PO (2008) Flaxseed and cardiovascular risk factors: results from a double blind, randomized, controlled clinical trial. J Am Coll Nutr 27:65–74

    Article  CAS  Google Scholar 

  10. Finnegan YE, Howarth D, Minihane AM, Kew S, Miller GJ, Calder PC, Williams CM (2003) Plant and marine derived (n-3) polyunsaturated fatty acids do not affect blood coagulation and fibrinolytic factors in moderately hyperlipidemic humans. J Nutr 133:2210–2213

    CAS  Google Scholar 

  11. Wu H, Pan A, Yu Z, Qi Q, Lu L, Zhang G, Yu D, Zong G, Zhou Y, Chen X, Tang L, Feng Y, Zhou H, Li H, Demark-Wahnefried W, Hu FB, Lin X (2010) Lifestyle counseling and supplementation with flaxseed or walnuts influence the management of metabolic syndrome. J Nutr 140:1937–1942

    Article  CAS  Google Scholar 

  12. Taylor CG, Noto AD, Stringer DM, Froese S, Malcolmson L (2010) Dietary milled flaxseed and flaxseed oil improve N-3 fatty acid status and do not affect glycemic control in individuals with well-controlled type 2 diabetes. J Am Coll Nutr 29:72–80

    Article  CAS  Google Scholar 

  13. Portolesi R, Powell BC, Gibson RA (2007) Competition between 24: 5n-3 and ALA for Delta 6 desaturase may limit the accumulation of DHA in HepG2 cell membranes. J Lipid Res 48:1592–1598

    Article  CAS  Google Scholar 

  14. Simopoulos AP (2008) The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood) 233:674–688

    Article  CAS  Google Scholar 

  15. Austria JA, Richard MN, Chahine MN, Edel AL, Malcolmson LJ, Dupasquier CM, Pierce GN (2008) Bioavailability of alpha-linolenic acid in subjects after ingestion of three different forms of flaxseed. J Am Coll Nutr 27:214–221

    Article  Google Scholar 

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This study was supported by the National Natural Science Foundation of China (30930081 and 81021002), the Ministry of Science and Technology of China (2011CB504002) and the Chinese Academy of Sciences (KSCX2-EW-R-10). The authors’ responsibilities were as follows: H.W. and X.L. were involved in the study design; G.Z. and H.W. were in charge of participant management; G.Z., H.W, and X.L. took part in the data collection; G.Z completed the data analysis and drafted the initial manuscript, with help from H.W. W.D-W and X.L for interpretation of the findings. All authors were responsible for critical revisions and final approval of the manuscript. All authors declared no conflict of interest.

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Correspondence to Xu Lin.

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Zong, G., Demark-Wahnefried, W., Wu, H. et al. Effects of flaxseed supplementation on erythrocyte fatty acids and multiple cardiometabolic biomarkers among Chinese with risk factors of metabolic syndrome. Eur J Nutr 52, 1547–1551 (2013).

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  • Flaxseed
  • PUFA
  • Cytokines
  • Metabolic syndrome