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

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          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: G riceLC (35% of carbohydrate and 60g of raw rice powder per day) and G flaxLC (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 G riceLC and 40 ± 9 years to G flaxLC. 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 G flaxLC respectively). All groups also showed improvement in levels of total cholesterol, LDL-c, uric acid and adiponectin. Only G flaxLC 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.

          Electronic supplementary material

          The online version of this article (doi:10.1186/1475-2891-14-5) contains supplementary material, which is available to authorized users.

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          Most cited references33

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          Inflammation: the link between insulin resistance, obesity and diabetes.

          Recent data have revealed that the plasma concentration of inflammatory mediators, such as tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), is increased in the insulin resistant states of obesity and type 2 diabetes, raising questions about the mechanisms underlying inflammation in these two conditions. It is also intriguing that an increase in inflammatory mediators or indices predicts the future development of obesity and diabetes. Two mechanisms might be involved in the pathogenesis of inflammation. Firstly, glucose and macronutrient intake causes oxidative stress and inflammatory changes. Chronic overnutrition (obesity) might thus be a proinflammatory state with oxidative stress. Secondly, the increased concentrations of TNF-alpha and IL-6, associated with obesity and type 2 diabetes, might interfere with insulin action by suppressing insulin signal transduction. This might interfere with the anti-inflammatory effect of insulin, which in turn might promote inflammation.
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            Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome.

            Limited data on the relation between the risk of the metabolic syndrome and fruit and vegetable intakes and inflammatory marker concentrations are available. We evaluated the relation between fruit and vegetable intakes and C-reactive protein (CRP) concentrations and the prevalence of the metabolic syndrome. Fruit and vegetable intakes were assessed with the use of a validated semiquantitative food-frequency questionnaire in a cross-sectional study of 486 Tehrani female teachers aged 40-60 y. Anthropometric measurements were made and blood pressure was assessed according to standard methods. Fasting blood samples were taken for biochemical measurements. The metabolic syndrome was defined on the basis of the National Cholesterol Education Program Adult Treatment Panel III guidelines. The reported mean daily fruit and vegetable intakes were 228 +/- 79 and 186 +/- 88 g/d, respectively. Both fruit and vegetable intakes were inversely associated with plasma CRP concentrations. After statistical control for age, body mass index, and waist circumference, mean plasma CRP concentrations across increasing quintile categories of fruit intakes were 1.94, 1.79, 1.65, 1.61, and 1.56 mg/L and of vegetable intakes were 2.03, 1.82, 1.58, 1.52, and 1.47 mg/L (P for trend < 0.01 for both). These inverse associations remained significant after additional control for other potential confounding variables and dietary factors. After control for potential confounders, persons in the highest quintile of fruit intake had a 34% (95% CI: 20%, 46%) lower and those in the highest quintile of vegetables intake had a 30% (95% CI: 16%, 39%) lower chance of having the metabolic syndrome than did those in the lowest quintiles. Higher intakes of fruit and vegetables are associated with a lower risk of the metabolic syndrome; the lower risk may be the result of lower CRP concentrations. These findings support current dietary recommendations to increase daily intakes of fruit and vegetables as a primary preventive measure against cardiovascular disease.
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              Polyphenols and disease risk in epidemiologic studies.

              Plant polyphenols, a large group of natural antioxidants, are serious candidates in explanations of the protective effects of vegetables and fruits against cancer and cardiovascular diseases. Epidemiologic studies are useful for evaluation of the human health effects of long-term exposure to physiologic concentrations of polyphenols, but reliable data on polyphenol contents of foods are still scarce. The aim of this review is to summarize available epidemiologic data on the health effects of polyphenols, focusing on the flavonoid subclasses of flavonols, flavones, and catechins and on lignans. Data obtained to date suggest beneficial effects of both flavonoids and lignans on cardiovascular diseases but not on cancer, with the possible exception of lung cancer. There is a need for more research on stroke and lung diseases such as asthma and chronic obstructive pulmonary disease. Most studies to date have included only flavonols and flavones. With data becoming available for other polyphenols, these compounds should be included in future studies. Careful design of prospective studies is important to offset some of the major drawbacks of epidemiologic studies, including residual confounding (by smoking and other dietary factors) and exposure assessment.
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                Author and article information

                Contributors
                rcassani@terra.com.br
                priscilafassini@usp.br
                ozeenrique@gmail.com
                cristiane.martires@gmail.com
                jsmarchi@fmrp.usp.br
                Journal
                Nutr J
                Nutr J
                Nutrition Journal
                BioMed Central (London )
                1475-2891
                10 January 2015
                2015
                : 14
                : 5
                Affiliations
                [ ]Institute of Nutrition. Itu, São Paulo, Brazil
                [ ]Department of Medicine, Division of Medical Nutrition, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900 Bairro Monte Alegre, CEP: 14049-900 Ribeirão Preto São Paulo, Brazil
                Article
                864
                10.1186/1475-2891-14-5
                4326402
                25577201
                b9315dec-5710-4b1e-acc1-401d0f694902
                © Cassani et al.; licensee BioMed Central. 2015

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 9 September 2014
                : 29 December 2014
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Nutrition & Dietetics
                flaxseed,inflammation,weight loss,obesity
                Nutrition & Dietetics
                flaxseed, inflammation, weight loss, obesity

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