Effect of flaxseed supplementation on lipid profile: An updated systematic review and dose-response meta-analysis of sixty-two randomized controlled trials
Abstract
Raised plasma lipids are one the most important risk factors for cardiovascular disease. Flaxseed contains considerable amounts of α-linolenic acid, phenolic compounds, and lignans, which each have the capacity to reduce circulating lipid concentrations. This study aimed to systematically review current evidence to identify the potential effects of flaxseed supplementation on blood lipid profiles using a meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Web of Science, and Google Scholar databases were searched for publications between January 1900 and May 2019. Weighted mean differences (WMDs) were analyzed using a random-effects model. The Cochrane Collaboration tool was also used to assess the risk of bias of the studies included. Sixty-two RCTs with a total of 3772 participants met the eligibility criteria. Our analysis showed that flaxseed supplementation significantly reduced total cholesterol (TC) (WMD = -5.389 mg/dL; 95% CI: -9.483, -1.295, p = 0.010), triglyceride (TG) (WMD = -9.422 mg/dL; 95% CI: -15.514, -3.330, p = 0.002), and low-density lipoprotein cholesterol (LDL-C) (WMD = -4.206 mg/dl; 95% CI: -7.260, -1.151, p = 0.007) concentrations. However, it had no effects on high-density lipoprotein cholesterol (WMD = 0.047 mg/dl; 95% CI: -0.777, 0.872, p = 0.910). This meta-analysis suggested that flaxseed supplementation improves serum TC, TG, and LDL-C, which could delay the progression of heart disease. Further studies with large-scale and better design are now needed to confirm these results.
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The present results on TC, LDL-C and TG in patients with dyslipidemia-related diseases were consistent with a meta-analysis that studied the whole population.
“Our present results on TC, LDL-C and TG in patients with dyslipidemia related diseases were consistent with a meta-analysis [13] that studied on the whole population.”
From Comparisons of the effects of different flaxseed products consumption on lipid profiles, inflammatory cytokines and anthropometric indices in patients with dyslipidemia related diseases: systematic review and a dose-response meta-analysis of randomized controlled trials (2021) · cites this paper as [13]
The finding of no significant effect of flaxseed on HDL cholesterol was completely consistent with a prior meta-analysis.
“These findings were completely consistent with that meta-analysis [13, 63].”
From Comparisons of the effects of different flaxseed products consumption on lipid profiles, inflammatory cytokines and anthropometric indices in patients with dyslipidemia related diseases: systematic review and a dose-response meta-analysis of randomized controlled trials (2021) · cites this paper as [13]
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Mahmud, K., Kaplan, M. E., Ripley, D., et al. (1974) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/27.1.51 · Cited by 14 · see citing works
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Genetically Modified Flax Expressing NAP-SsGT1 Transgene: Examination of Anti-Inflammatory Action
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Motavas, M., Shojaee, M., & Aldavood, D. (2018) · Journal of Preventive Epidemiology · Cited by 2 · see citing works
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Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300 · see citing works
Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001052 · Cited by 5,987 · see citing works
Yang, C., Xia, H., Wan, M., Lu, Y., Xu, D., Yang, X., Yang, L., & Sun, G. (2021) · Nutrition & Metabolism · doi:10.1186/s12986-021-00619-3 · Cited by 40 · see citing works
Musazadeh, V., Nezamoleslami, S., Faghfouri, A. H., Shidfar, F., & Aryaeian, N. (2025) · Diabetes & Metabolic Syndrome: Clinical Research & Reviews · doi:10.1016/j.dsx.2025.103241 · Cited by 9 · see citing works
- Authors
- Hadi, A., Askarpour, M., Salamat, S., Ghaedi, E., Symonds, M. E., & Miraghajani, M.
- Affiliations
- Tehran University of Medical Sciences (IR)
- Ahvaz Jundishapur University of Medical Sciences (IR)
- University of Nottingham (GB)
- Corresponding author
- Ghaedi, Ehsan
- Miraghajani, Maryam
- Venue
- Pharmacological Research
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 152
- Pages
- 104622
- ISSN
- 1043-6618 (ISSN-L)
- OpenAlex
- W2998510612
- Cited by
- 71
- References
- 101
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 20 · 2023: 8 · 2022: 14 · 2021: 11 · 2020: 4
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacological Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Surgery › Natural Products and Biological Research
- Health Sciences › Nursing › Nutrition and Dietetics › Nuts composition and effects
- Keywords
- flaxseed supplementation, lipid profile, total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, alpha-linolenic acid, lignans, phenolic compounds, cardiovascular risk, dose-response relationship
- MeSH terms
- Animals, Dose-Response Relationship, Drug, Humans, Randomized Controlled Trials as Topic, Dietary Supplements, Flax, Lipid Metabolism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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