Flaxseed oil in the context of a weight loss programme ameliorates fatty liver grade in patients with non-alcoholic fatty liver disease: a randomised double-blind controlled trial
Open accessAbstract
Long-chain n-3 fatty acids have been shown to regulate lipid metabolism and reduce fat accumulation in the liver. This trial investigated the effect of flaxseed oil, as a rich source of α-linolenic acid, on fatty liver and cardiometabolic risk factors in patients with non-alcoholic fatty liver disease (NAFLD). The randomised, double-blind, controlled trial was performed on sixty-eight NAFLD patients who were divided into flaxseed (n 34) and sunflower (n 34) oil groups. Patients were given a hypoenergetic diet (−2092 kJ/d) and 20 g/d of the corresponding oil for 12 weeks. Fatty liver grade, liver enzymes and cardiometabolic parameters were determined. The intention-to-treat approach was used for data analysis. Fatty liver grade significantly decreased in both groups (−0·68 in flaxseed v. −0·29 in sunflower, P = 0·002). Alanine aminotransferase and aspartate aminotransferase decreased in both groups (P < 0·01). Also, significant reduction was observed in blood glucose (P = 0·005) and fat mass (P = 0·01) in the flaxseed and muscle mass (P = 0·01) in the sunflower group. However, none of these alterations was significantly different between the groups. Weight, waist circumference and blood pressure were significantly decreased in both groups but only weight change was significantly different between the groups (P = 0·01). IL-6 did not significantly change in either group but showed a significant between-group difference (P = 0·03). Overall, the results showed that in the context of a low-energy diet and moderate physical activity, flaxseed oil may benefit NAFLD patients to improve fatty liver grade, weight and IL-6 compared with sunflower oil.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Six RCTs had low risk of bias for random sequence generation, three had high risk, and the remaining had unclear risk.
“Six RCTs indicated the method for random sequence generation was low risk [29, 34, 44, 47, 48, 52], three other studies indicated high risk [21, 41, 53], and the remaining studies have unclear risk of bias.”
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 [47]
The Intervention section (page unavailable) says participants in this trial were assigned using block randomisation, supporting its identification as a trial that reported a randomisation method. The paper does not assess risk of bias across multiple RCTs or substantiate the counts of six low-risk and three high-risk studies. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
International physical activity questionnaire: 12-country reliability and validity
CRAIG, C. L., MARSHALL, A. L., SJ??STR??M, M., BAUMAN, A. E., BOOTH, M. L., AINSWORTH, B. E., PRATT, M., EKELUND, U., YNGVE, A., SALLIS, J. F., et al. (2003) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000078924.61453.fb · Cited by 21,619 · see citing works
Byrne, C. D., & Targher, G. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2014.12.012 · Cited by 3,082 · see citing works
A new predictive equation for resting energy expenditure in healthy individuals
Mifflin, M., St Jeor, S., Hill, L., Scott, B., Daugherty, S., & Koh, Y. (1990) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/51.2.241 · Cited by 2,544 · cited 1× · see citing works
“Jeor equations and gave necessary recommendations for following the diets (21) .”
Omega-3 fatty acids and inflammatory processes: from molecules to man
Calder, P. C. (2017) · Biochemical Society Transactions · doi:10.1042/bst20160474 · Cited by 1,456 · see citing works
Improved analysis of malondialdehyde in human body fluids
Jentzsch, A. M., Bachmann, H., Fürst, P., & Biesalski, H. K. (1996) · Free Radical Biology and Medicine · doi:10.1016/0891-5849(95)02043-8 · Cited by 805 · see citing works
Fracanzani, A., Valenti, L. N., Bugianesi, E., Andreoletti, M., Colli, A., Vanni, E., Bertelli, C., Fatta, E., Bignamini, D., Marchesini, G., et al. (2008) · Hepatology · doi:10.1002/hep.22429 · Cited by 692 · see citing works
Increased Hepatic and Circulating Interleukin-6 Levels in Human Nonalcoholic Steatohepatitis
Wieckowska, A., Papouchado, B. G., Li, Z., Lopez, R., Zein, N. N., & Feldstein, A. E. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2007.01774.x · Cited by 597 · see citing works
Portillo-Sanchez, P., Bril, F., Maximos, M., Lomonaco, R., Biernacki, D., Orsak, B., Subbarayan, S., Webb, A., Hecht, J., & Cusi, K. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-1966 · Cited by 503 · see citing works
Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
Dyson, J. K., Anstee, Q. M., & McPherson, S. (2013) · Frontline Gastroenterology · doi:10.1136/flgastro-2013-100403 · Cited by 358 · see citing works
Overweight, Obesity, and Blood Pressure: The Effects of Modest Weight Reduction
Mertens, I. L., & Gaal, L. F. V. (2000) · Obesity Research · doi:10.1038/oby.2000.32 · Cited by 330 · see citing works
Omega-3 Fatty Acids, Hepatic Lipid Metabolism, and Nonalcoholic Fatty Liver Disease
Scorletti, E., & Byrne, C. D. (2013) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-071812-161230 · Cited by 326 · see citing works
Verma, S. S., Jensen, D. M., Hart, J. A. L., & Mohanty, S. R. (2013) · Liver International · doi:10.1111/liv.12226 · Cited by 311 · see citing works
Marchesini, G., Petta, S., & Grave, R. D. (2015) · Hepatology · doi:10.1002/hep.28392 · Cited by 291 · see citing works
Dietary Flaxseed as a Strategy for Improving Human Health
Parikh, M., Maddaford, T. G., Austria, J. A., Aliani, M., Netticadan, T., & Pierce, G. N. (2019) · Nutrients · doi:10.3390/nu11051171 · Cited by 282 · see citing works
Meta-analysis of the effects of flaxseed interventions on blood lipids
Pan, A., Yu, D., Demark-Wahnefried, W., Franco, O. H., & Lin, X. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.27469 · Cited by 264 · cited 1× · see citing works
“A meta-analysis showed that flaxseed interventions reduced total and LDL-cholesterol when whole flaxseed or lignan was used but not when flaxseed oil was administered (41) .”
Omega-3 fatty acids and adipose tissue function in obesity and metabolic syndrome
Martínez‐Fernández, L., Laiglesia, L. M., Huerta, A. E., Martínez, J. A., & Moreno-Aliaga, M. J. (2015) · Prostaglandins & Other Lipid Mediators · doi:10.1016/j.prostaglandins.2015.07.003 · Cited by 208 · see citing works
Modulation of hepatic steatosis by dietary fatty acids
Ferramosca, A. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i7.1746 · Cited by 185 · see citing works
Lipoprotein Metabolism, Dyslipidemia, and Nonalcoholic Fatty Liver Disease
Fisher, E. A. A., & Cohen, D. E. (2013) · Seminars in Liver Disease · doi:10.1055/s-0033-1358519 · Cited by 178 · see citing works
Patel, N. S., Doycheva, I., Peterson, M. R., Hooker, J., Kisselva, T., Schnabl, B., Seki, E., Sirlin, C. B., & Loomba, R. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2014.08.039 · Cited by 173 · see citing works
Scorletti, E., & Byrne, C. D. (2018) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2018.03.001 · Cited by 161 · see citing works
Nutritional Modulation of Non-Alcoholic Fatty Liver Disease and Insulin Resistance
Yki‐Järvinen, H. (2015) · Nutrients · doi:10.3390/nu7115454 · Cited by 153 · see citing works
Potential protective properties of flax lignan secoisolariciresinol diglucoside
Imran, M., Ahmad, N., Anjum, F. M., et al. (2015) · Nutrition Journal · doi:10.1186/s12937-015-0059-3 · Cited by 151 · see citing works
Role of diet and lifestyle changes in nonalcoholic fatty liver disease.
Nseir, W., Hellou, E., & Assy, N. (2014) · PubMed Central · doi:10.3748/wjg.v20.i28.9338 · Cited by 145 · see citing works
Bidirectional Relationships and Disconnects between NAFLD and Features of the Metabolic Syndrome
Wainwright, P., & Byrne, C. D. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17030367 · Cited by 145 · see citing works
Clinical association between non‐alcoholic fatty liver disease and the development of hypertension
Ryoo, J., Suh, Y. J., Shin, H. C., Cho, Y. K., Choi, J., & Park, S. K. (2014) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.12643 · Cited by 132 · see citing works
Khalesi, S., Irwin, C. G., & Schubert, M. M. (2015) · Journal of Nutrition · doi:10.3945/jn.114.205302 · Cited by 131 · see citing works
Effect of α linolenic acid on cardiovascular risk markers: a systematic review
Wendland, E., Farmer, A., Glasziou, P., & Neil, A. (2006) · Heart · doi:10.1136/hrt.2004.053538 · Cited by 128 · see citing works
Jańczyk, W., Lebensztejn, D. M., Wierzbicka, A., Mazur, A., Neuhoff-Murawska, J., Matusik, P., & Socha, P. (2015) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2015.01.056 · Cited by 126 · see citing works
Yari, Z., Rahimlou, M., Eslamparast, T., Ebrahimi-Daryani, N., Poustchi, H., & Hekmatdoost, A. (2016) · International Journal of Food Sciences and Nutrition · doi:10.3109/09637486.2016.1161011 · Cited by 118 · see citing works
Ursoniu, S., Sahebkar, A., Andrica, F., Șerban, M.-C., & Banach, M. (2015) · Clinical Nutrition · doi:10.1016/j.clnu.2015.05.012 · Cited by 113 · see citing works
Chemical Composition and Health Benefits of Flaxseed
BERNACCHIA, R., PRETI, R., & VINCI, G. (2014) · IRIS Research product catalog (Sapienza University of Rome) · Cited by 105 · see citing works
Ren, G.-Y., Chen, C.-Y., Chen, G.-C., Chen, W.-G., Pan, A., Pan, C.-W., Zhang, Y.-H., Qin, L.-Q., & Chen, L.-H. (2016) · Nutrients · doi:10.3390/nu8030136 · Cited by 88 · see citing works
Flaxseed dietary fibers suppress postprandial lipemia and appetite sensation in young men
Kristensen, M., Savorani, F., Christensen, S., Engelsen, S. B., Bügel, S., Toubro, S., Tetens, I., & Astrup, A. V. (2011) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2011.03.004 · Cited by 84 · see citing works
Monteiro, J., Leslie, M. A., Moghadasian, M. H., Arendt, B. M., Allard, J. P., & David, W. L. (2014) · Food & Function · doi:10.1039/c3fo60551e · Cited by 82 · see citing works
Mohammadi‐Sartang, M., Mazloom, Z., Raeisi‐Dehkordi, H., Barati‐Boldaji, R., Bellissimo, N., & de Zepetnek, J. O. T. (2017) · Obesity Reviews · doi:10.1111/obr.12550 · Cited by 71 · see citing works
Quantification of Underivatized Fatty Acids From Vegetable Oils by HPLC with UV Detection
Guarrasi, V., Mangione, M. R., Sanfratello, V., et al. (2010) · Journal of Chromatographic Science · doi:10.1093/chromsci/48.8.663 · Cited by 65 · see citing works
Effect of the Use of Ground Flaxseed on Quality and Chemical Composition of Bread
Menteş, Ö., Bakkalbaşşi, E., & Ercan, R. (2008) · Food Science and Technology International · doi:10.1177/1082013208097192 · Cited by 63 · see citing works
Hodson, L., Bhatia, L. S., Scorletti, E., Smith, D. E., Jackson, N. C., Shojaee‐Moradie, F., Umpleby, A. M., Calder, P. C., & Byrne, C. D. (2017) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2017.9 · Cited by 63 · see citing works
Takeuchi, H., Chika, S., Noda, R., Sekine, S., Murano, Y., Wanaka, K., Kasai, M., Watanabe, S., AOYAMA, T., & Kondo, K. N. (2007) · Journal of Oleo Science · doi:10.5650/jos.56.347 · Cited by 62 · see citing works
Effects of hydration changes on bioelectrical impedance in endurance trained individuals
Saunders, M. J., BLEVINS, J. E., & Broeder, C. E. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199806000-00017 · Cited by 60 · see citing works
Soltanian, N., & Janghorbani, M. (2018) · Nutrition & Metabolism · doi:10.1186/s12986-018-0273-z · Cited by 59 · see citing works
Han, H., Qiu, F., Zhao, H., Tang, H., Li, X., & Shi, D. (2017) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2017/3256241 · Cited by 52 · see citing works
Rahimlou, M., Jahromi, N. B., Hasanyani, N., & Ahmadi, A. R. (2019) · Advances in Nutrition · doi:10.1093/advances/nmz048 · Cited by 52 · see citing works
Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease
Gupta, V. K. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i37.10621 · Cited by 50 · see citing works
Marina, A. L., von Frankenberg, A. D., Suvag, S., Callahan, H. S., Kratz, M., Richards, T. L., & Utzschneider, K. M. (2014) · Nutrients · doi:10.3390/nu6114678 · Cited by 43 · see citing works
Flaxseed Oil Attenuates Nonalcoholic Fatty Liver of Hyperlipidemic Hamsters
Yang, S., Tseng, J., Chang, Y., et al. (2009) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf900499v · Cited by 38 · see citing works
NAFLD-NASH: An Under-Recognized Epidemic
Jennings, J. J., Faselis, C. J., & Yao, M. D. (2017) · Current Vascular Pharmacology · doi:10.2174/1570161115666170622074007 · Cited by 37 · see citing works
Effects of Palm and Sunflower Oils on Serum Cholesterol and Fatty Liver in Rats
Go, R., Hwang, K., Kim, Y.-S., Kim, S., Nam, K., & Choi, K. (2014) · Journal of Medicinal Food · doi:10.1089/jmf.2014.3163 · Cited by 36 · see citing works
Patel, N. S., Hooker, J. C., Gonzalez, M. P., Bhatt, A., Nguyen, P., Ramirez, K., Richards, L., Rizo, E., Hernandez, C., Kisseleva, T., et al. (2016) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2016.09.150 · Cited by 34 · see citing works
Kelley, N. S. (2016) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2016.0051 · Cited by 32 · see citing works
Díez-Rodríguez, R., Ballesteros-Pomar, M. D., Calleja‐Fernández, A., et al. (2014) · PubMed · Cited by 23 · see citing works
Bouchi, R., Takeuchi, T., Akihisa, M., Ohara, N., Nakano, Y., Nishitani, R., Murakami, M., Fukuda, T., Fujita, M., Minami, I., et al. (2015) · Journal of Diabetes Investigation · doi:10.1111/jdi.12443 · Cited by 16 · see citing works
Akhlaghi, M., Kamali, M., Dastsouz, F., et al. (2016) · International Journal of Preventive Medicine · doi:10.4103/2008-7802.181328 · Cited by 12 · see citing works
Self-citationEFFECTS OF HYDRATION CHANGES ON BIOELECTRICAL IMPEDANCE IN ENDURANCE TRAINED INDIVIDUALS 324
Saunders, M. J., Blevins, J. E., & Broeder, C. E. (1997) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199705001-00324 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Fat infiltration in skeletal muscle: Influential triggers and regulatory mechanism
Wang, L., Valencak, T. G., & Shan, T. (2024) · iScience · doi:10.1016/j.isci.2024.109221 · Cited by 149 · 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
- Authors
- Rezaei, S., Sasani, M. R., Akhlaghi, M., & Kohanmoo, A.
- Affiliations
- Shiraz University of Medical Sciences (IR)
- Corresponding author
- Akhlaghi, Masoumeh
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2020-01-29
- Volume
- 123
- Issue
- 9
- Pages
- 994-1002
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- OpenAlex
- W3004126406
- Cited by
- 63
- References
- 54
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 13 · 2023: 16 · 2022: 8 · 2021: 16 · 2020: 1
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Shiraz University of Medical Sciences
- Shiraz University
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- linseed oil, non-alcoholic fatty liver disease, alpha-linolenic acid, omega-3 fatty acids, sunflower oil, weight loss, hypocaloric diet, liver enzymes, interleukin-6, cardiometabolic risk factors, fat mass, muscle mass, blood glucose
- MeSH terms
- Adult, Double-Blind Method, Female, Humans, Linseed Oil, Liver, Male, Middle Aged, Obesity, Caloric Restriction, Lipid Metabolism, Weight Reduction Programs, Non-alcoholic Fatty Liver Disease
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 ›
Are you an author, or do you see a problem with this page? Request a review
