title: Dietary flaxseed independently lowers circulating cholesterol and lowers it beyond the effects of cholesterol-lowering medications alone in patients with peripheral artery disease.
abstract: BACKGROUND
  Dietary flaxseed lowers cholesterol in healthy subjects with mild biomarkers of cardiovascular disease (CVD).
  
  
  OBJECTIVE
  The aim was to investigate the effects of dietary flaxseed on plasma cholesterol in a patient population with clinically significant CVD and in those administered cholesterol-lowering medications (CLMs), primarily statins.
  
  
  METHODS
  This double-blind, randomized, placebo-controlled trial examined the effects of a diet supplemented for 12 mo with foods that contained either 30 g of milled flaxseed [milled flaxseed treatment (FX) group; n = 58] or 30 g of whole wheat [placebo (PL) group; n = 52] in a patient population with peripheral artery disease (PAD). Plasma lipids were measured at 0, 1, 6, and 12 mo.
  
  
  RESULTS
  Dietary flaxseed in PAD patients resulted in a 15% reduction in circulating LDL cholesterol as early as 1 mo into the trial (P = 0.05). The concentration in the FX group (2.1 ± 0.10 mmol/L) tended to be less than in the PL group (2.5 ± 0.2 mmol/L) at 6 mo (P = 0.12), but not at 12 mo (P = 0.33). Total cholesterol also tended to be lower in the FX group than in the PL group at 1 mo (11%, P = 0.05) and 6 mo (11%, P = 0.07), but not at 12 mo (P = 0.24). In a subgroup of patients taking flaxseed and CLM (n = 36), LDL-cholesterol concentrations were lowered by 8.5% ± 3.0% compared with baseline after 12 mo. This differed from the PL + CLM subgroup (n = 26), which increased by 3.0% ± 4.4% (P = 0.030) to a final concentration of 2.2 ± 0.1 mmol/L.
  
  
  CONCLUSIONS
  Milled flaxseed lowers total and LDL cholesterol in patients with PAD and has additional LDL-cholesterol-lowering capabilities when used in conjunction with CLMs. This trial was registered at clinicaltrials.gov as NCT00781950.
authors.affiliation: Canadian Center for Agri-Food Research in Health and Medicine, and the Asper Clinical Research Institute, St. Boniface Hospital, Department of Physiology and Pathophysiology, Faculty of Health Sciences.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Edel
authors.affiliation: Cardiovascular Research Division, V.I. Lenin University Hospital, Holguin, Cuba.
authors.forename: Delfin
authors.initials: D
authors.lastname: Rodriguez-Leyva
authors.affiliation: Canadian Center for Agri-Food Research in Health and Medicine, and the Asper Clinical Research Institute, St. Boniface Hospital, Department of Physiology and Pathophysiology, Faculty of Health Sciences.
authors.forename: Thane G
authors.initials: TG
authors.lastname: Maddaford
authors.affiliation: Canadian Center for Agri-Food Research in Health and Medicine, and the Asper Clinical Research Institute, St. Boniface Hospital, Department of Physiology and Pathophysiology, Faculty of Health Sciences.
authors.forename: Stephanie Pb
authors.initials: SP
authors.lastname: Caligiuri
authors.affiliation: Canadian Center for Agri-Food Research in Health and Medicine, and the Asper Clinical Research Institute, St. Boniface Hospital, Department of Physiology and Pathophysiology, Faculty of Health Sciences.
authors.forename: J Alejandro
authors.initials: JA
authors.lastname: Austria
authors.affiliation: the Asper Clinical Research Institute, St. Boniface Hospital, Department of Surgery, and.
authors.forename: Wendy
authors.initials: W
authors.lastname: Weighell
authors.affiliation: the Asper Clinical Research Institute, St. Boniface Hospital, Department of Surgery, and.
authors.forename: Randolph
authors.initials: R
authors.lastname: Guzman
authors.affiliation: Canadian Center for Agri-Food Research in Health and Medicine, and Department of Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada; and gpierce@sbrc.ca aliani@cc.umanitoba.ca.
authors.forename: Michel
authors.initials: M
authors.lastname: Aliani
authors.affiliation: Canadian Center for Agri-Food Research in Health and Medicine, and the Asper Clinical Research Institute, St. Boniface Hospital, Department of Physiology and Pathophysiology, Faculty of Health Sciences, gpierce@sbrc.ca aliani@cc.umanitoba.ca.
authors.forename: Grant N
authors.initials: GN
authors.lastname: Pierce
mesh_terms: D000328:Adult; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D004032:Diet; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D019597:Flax / Q000737:chemistry*; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000188:drug therapy*; D008517:Phytotherapy; D028321:Plant Preparations / Q000494:pharmacology; D010974:Platelet Aggregation / Q000187:drug effects; D012639:Seeds / Q000737:chemistry; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D028321:Plant Preparations; D014280:Triglycerides
keywords: cholesterol lowering; flaxseed; peripheral artery disease; platelet aggregation; statins