The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.
Meta-analysis of the effects of flaxseed interventions on blood lipids
Open accessAbstract
Background Several clinical trials have investigated the effects of flaxseed and flaxseed-derived products (flaxseed oil or lignans) on blood lipids; however, the findings have been inconsistent.Objective We aimed to identify and quantify the effectiveness of flaxseed and its derivatives on blood lipid profiles.Design A comprehensive literature search was performed on the basis of English reports of randomized controlled trials of flaxseed or its derivatives on lipid profiles in adults, which were published from January 1990 to October 2008. Attempts also were made to access unpublished data. Study quality was assessed by using the Jadad score, and a meta-analysis was conducted.Results Twenty-eight studies were included. Flaxseed interventions reduced total and LDL cholesterol by 0.10 mmol/L (95% CI: -0.20, 0.00 mmol/L) and 0.08 mmol/L (95% CI: -0.16, 0.00 mmol/L), respectively; significant reductions were observed with whole flaxseed (-0.21 and -0.16 mmol/L, respectively) and lignan (-0.28 and -0.16 mmol/L, respectively) supplements but not with flaxseed oil. The cholesterol-lowering effects were more apparent in females (particularly postmenopausal women), individuals with high initial cholesterol concentrations, and studies with higher Jadad scores. No significant changes were found in the concentrations of HDL cholesterol and triglycerides.Conclusions Flaxseed significantly reduced circulating total and LDL-cholesterol concentrations, but the changes were dependent on the type of intervention, sex, and initial lipid profiles of the subjects. Further studies are needed to determine the efficiency of flaxseed on lipid profiles in men and premenopausal women and to explore its potential benefits on other cardiometabolic risk factors and prevention of cardiovascular disease.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
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?
In the citing paper
“Another possible explanation was that the effects of flaxseed oil may have been masked by the use of MUFA- or n-6 PUFA–enriched oils as the control regimen in these included studies [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 [63]
In the citing paper
“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 [63]
Citations
Cites
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Zhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609
Dong, Y., Hao, L., Shi, Z., Wang, G., Zhang, Z., & Han, C. (2013) · Urologia Internationalis · doi:10.1159/000351405 · Cited by 4,557
Simopoulos, A. P. (2008) · Experimental Biology and Medicine · doi:10.3181/0711-mr-311 · Cited by 3,003
Cholesterol-lowering effects of dietary fiber: a meta-analysis
Brown, L., Rosner, B., Willett, W. W., & Sacks, F. M. (1999) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/69.1.30 · Cited by 1,857
Dietary Fat Intake and the Risk of Coronary Heart Disease in Women
Hu, F. B., Stampfer, M. J., Manson, J. E., Rimm, E. B., Colditz, G. A., ROSNER, B. A., Hennekens, C. H., & Willett, W. C. (1997) · New England Journal of Medicine · doi:10.1056/nejm199711203372102 · Cited by 1,774
Advanced methods in meta‐analysis: multivariate approach and meta‐regression
van Houwelingen, H. C., Arends, L. R., & Stijnen, T. (2002) · Statistics in Medicine · doi:10.1002/sim.1040 · Cited by 1,599
n-3 fatty acids and serum lipoproteins: human studies
Harris, W. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.5.1645s · Cited by 1,243
Flaxseed as a functional food source
Oomah, B. D. (2001) · Journal of the Science of Food and Agriculture · doi:10.1002/jsfa.898 · Cited by 594
Blood pressure control by home monitoring: meta-analysis of randomised trials
Cappuccio, F. P., Kerry, S., Forbes, L. J. L., & Donald, A. (2004) · BMJ · doi:10.1136/bmj.38121.684410.ae · Cited by 503
Mechanisms by which Dietary Fatty Acids Modulate Plasma Lipids
Fernandez, M. L., & West, K. L. (2005) · The Journal of Nutrition · doi:10.1093/jn/135.9.2075 · Cited by 469
Nutritional attributes of traditional flaxseed in healthy young adults
Cunnane, S. C., Hamadeh, M. J., Ac, L., Thompson, L., Wolever, T. M. S., & Jenkins, D. (1995) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/61.1.62 · Cited by 329
(2003) · AOCS Publishing eBooks · doi:10.1201/9781003040378 · Cited by 311
Prasad, K. (1999) · Circulation · doi:10.1161/01.cir.99.10.1355 · Cited by 290
Rallidis, L. S., Paschos, G., Liakos, G. K., Velissaridou, A. H., Anastasiadis, G., & Zampelas, A. (2003) · Atherosclerosis · doi:10.1016/s0021-9150(02)00427-6 · Cited by 288
Mantzioris, E., James, M., Gibson, R. A., & Cleland, L. (1994) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/59.6.1304 · Cited by 281
Bloedon, L. T., Balikai, S., Chittams, J. L., Cunnane, S. C., Berlin, J. A., Rader, D. J., & Szapary, P. O. (2008) · Journal of the American College of Nutrition · doi:10.1080/07315724.2008.10719676 · Cited by 253
Dodin, S., Lemay, A., Jacques, H., Légaré, F., Forest, J.-C., & Mâsse, B. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1148 · Cited by 244
Jenkins, D. J. A., Kendall, C. W. C., Vidgen, E., Agarwal, S., Rao, A. V., Rosenberg, R. S., Diamandis, E. P., Novokmet, R., Mehling, C. C., Perera, T., et al. (1999) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/69.3.395 · Cited by 242
Flaxseed and Cardiovascular Risk
Bloedon, L. T., & Szapary, P. O. (2004) · Nutrition Reviews · doi:10.1111/j.1753-4887.2004.tb00002.x · Cited by 217
Zhang, W., Wang, X., Liu, Y., Tian, H.-M., Flickinger, B. D., Empie, M. W., & Sun, S. Z. (2007) · British Journal Of Nutrition · doi:10.1017/s0007114507871649 · Cited by 212
Demark‐Wahnefried, W., Polascik, T. J., George, S. L., Switzer, B. R., Madden, J. F., Ruffin, M. T., Snyder, D. C., Owzar, K., Hárs, V., Albala, D. M., et al. (2008) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-08-0008 · Cited by 209
Self-citationDietary flax seed in prevention of hypercholesterolemic atherosclerosis
Prasad, K. (1997) · Atherosclerosis · doi:10.1016/s0021-9150(97)06110-8 · Cited by 208
Pan, A., Sun, J., Chen, Y., Ye, X., Li, H., Yu, Z., Wang, Y., Gu, W., Zhang, X., Chen, X., et al. (2007) · PLoS ONE · doi:10.1371/journal.pone.0001148 · Cited by 198
Self-citationEffect of dietary α-linolenic acid on thrombotic risk factors in vegetarian men
Li, D., Sinclair, A. J., Wilson, A., Nakkote, S., Kelly, F., Abedin, L., Mann, N. J., & Turner, A. (1999) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/69.5.872 · Cited by 197
Lucas, E. A., Wild, R. D., Hammond, L. J., Khalil, D. A., Juma, S., Daggy, B. P., Stoecker, B. J., & Arjmandi, B. H. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.4.8374 · Cited by 193
Barceló‐Coblijn, G., Murphy, E. J., Othman, R. A., Moghadasian, M. H., Kashour, T. S., & Friel, J. K. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.3.801 · Cited by 190
Kestin, M., Clifton, P. M., Belling, G. B., & Nestel, P. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/51.6.1028 · Cited by 175
Flaxseed Reduces Total and LDL Cholesterol Concentrations in Native American Postmenopausal Women
Patade, A., Devareddy, L., Lucas, E. A., Korlagunta, K., Daggy, B. P., & Arjmandi, B. H. (2008) · Journal of Women's Health · doi:10.1089/jwh.2007.0359 · Cited by 164
Kaul, N., Kreml, R., Austria, J. A., Richard, M. N., Edel, A. L., Dibrov, E., Hirono, S., Zettler, M. E., & Pierce, G. N. (2008) · Journal of the American College of Nutrition · doi:10.1080/07315724.2008.10719674 · Cited by 162
Abbey, M., Clifton, P. M., Kestin, M., Belling, B., & Nestel, P. J. (1990) · Arteriosclerosis An Official Journal of the American Heart Association Inc · doi:10.1161/01.atv.10.1.85 · Cited by 161
Cholesterol reduction yields clinical benefits: meta-analysis including recent trials
Gould, A. L., Davies, G., Alemao, E., Yin, D., & Cook, J. R. (2007) · Clinical Therapeutics · doi:10.1016/j.clinthera.2007.05.012 · Cited by 147
Schwab, U., Callaway, J. C., Erkkilä, A. T., Gynther, J., Uusitupa, M. I. J., & Järvinen, T. (2006) · European Journal of Nutrition · doi:10.1007/s00394-006-0621-z · Cited by 144
Hall, C., Tulbek, M. C., & Xu, Y. (2006) · Advances in food and nutrition research · doi:10.1016/s1043-4526(06)51001-0 · Cited by 144
Kelley, D. S., Nelson, G. J., Love, J. E., Branch, L. B., Taylor, P. C., Schmidt, P. C., Mackey, B. E., & Iacono, J. M. (1993) · Lipids · doi:10.1007/bf02536085 · Cited by 135
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
Wilkinson, P. M. H., Leach, C., Ah-Sing, E., Hussain, N., Miller, G. J., Millward, D. J., & Griffin, B. A. (2005) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2004.12.029 · Cited by 121
Arjmandi, B. H., Khan, D. A., Juma, S., Drum, M. L., Venkatesh, S., Sohn, E., Wei, L.-L., & Derman, R. J. (1998) · Nutrition Research · doi:10.1016/s0271-5317(98)00100-6 · Cited by 118
Cornish, S. M., Chilibeck, P. D., Paus-Jenssen, L., Biem, H. J., Talaei‐Khozani, T., Senanayake, V. K., Vatanparast, H., Little, J. P., Whiting, S. J., & Pahwa, P. (2009) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h08-142 · Cited by 105
Hallund, J., Ravn‐Haren, G., Bügel, S., Tholstrup, T., & Tetens, I. (2006) · Journal of Nutrition · doi:10.1093/jn/136.1.112 · Cited by 99
de Castro, I. A., Barroso, L. P., & Sinnecker, P. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn.82.1.32 · Cited by 95
Faintuch, J., Horie, L. M., Barbeiro, H. V., Barbeiro, D. F., Soriano, F. G., Ishida, R. K., & Cecconello, I. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9062-x · Cited by 92
Prasad, K. (2007) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2007.07.043 · Cited by 92
Harper, C. R., Edwards, M. C., & Jacobson, T. A. (2006) · Journal of Nutrition · doi:10.1093/jn/136.11.2844 · Cited by 89
Lucas, E. A., Lightfoot, S. A., Hammond, L. J., Devareddy, L., Khalil, D. A., Daggy, B. P., Smith, B. J., Westcott, N. D., Mocanu, V., Soung, D. Y., et al. (2004) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2003.12.032 · Cited by 88
Effects of flaxseed oil supplementation on plasma adiponectin levels in dyslipidemic men
Paschos, G. K., Zampelas, A., Panagiotakos, D. B., Katsiougiannis, S., Griffin, B. A., Votteas, V., & Skopouli, F. N. (2007) · European Journal of Nutrition · doi:10.1007/s00394-007-0668-5 · Cited by 85
Rallidis, L. S., Paschos, G. K., Papaioannou, M. L., Liakos, G. K., Panagiotakos, D. B., Anastasiadis, G., & Zampelas, A. (2004) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2004.01.013 · Cited by 79
de Castro, I. A., Barroso, L. P., & Sinnecker, P. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.1.32 · Cited by 78
Singer, P., Jaeger, W., Berger, I., Barleben, H., Wirth, M., Richter-Heinrich, E., Voigt, S., & Gödicke, W. (1990) · PubMed · Cited by 69
Flaxseed supplementation in hyperlipidemic patients.
Mandaşescu, S., Mocanu, V., Dăscaliţa, A.-M., Haliga, R., Nestian, I., Stitt, P. A., & Luca, V. C. (2005) · PubMed · Cited by 68
Flax and Flaxseed Oil (Linum usitatissimum): A Review by the Natural Standard Research Collaboration
Basch, E., Bent, S., Collins, J., Dacey, C., Hammerness, P. G., Harrison, M., Smith, M. H., Szapary, P. O., Ulbricht, C. E., Vora, M., et al. (2007) · Journal of the Society for Integrative Oncology · doi:10.2310/7200.2007.005 · Cited by 65
Perimenopausal changes in serum lipids and lipoproteins: A 7-year longitudinal study
Fukami, K., Koike, K., Hirota, K., Yoshikawa, H., & Miyake, A. (1995) · Maturitas · doi:10.1016/0378-5122(95)00927-d · Cited by 63
Flax LignansAnalytical Methods and How They Influence Our Understanding of Biological Activity
Muir, A. D. (2006) · Journal of AOAC International · doi:10.1093/jaoac/89.4.1147 · Cited by 62
Flax lignans--analytical methods and how they influence our lunderstanding of biological activity.
Muir, A. D. (2006) · PubMed · Cited by 50
Pang, D., Allman-Farinelli, M. A., Wong, T., Barnes, R., & Kingham, K. (1998) · PubMed · Cited by 47
Functional foods for the prevention and treatment of cardiovascular diseases: cholesterol and beyond
Rudkowska, I., & Jones, P. J. H. (2007) · Expert Review of Cardiovascular Therapy · doi:10.1586/14779072.5.3.477 · Cited by 45
Pang, D., Allman-Farinelli, M. A., Wong, T., Barnes, R., & Kingham, K. (1998) · British Journal Of Nutrition · doi:10.1017/s0007114598001068 · Cited by 37
The Effects of Flaxseed SDG on Perimenopausal Women with Mild Hyperlipidemia
Marblestone, B. (2008) · doi:10.22371/07.2008.07 · Cited by 2
Flagged first, then by citations
Cited by
Sorted by citations
The 2015 Dutch food-based dietary guidelines
Kromhout, D., Spaaij, C. J. K., de Goede, J., & Weggemans, R. M. (2016) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2016.52 · Cited by 416
Dietary lignans: physiology and potential for cardiovascular disease risk reduction
Peterson, J. J., Dwyer, J. T., Adlercreutz, H., Scalbert, A., Jacques, P. F., & McCullough, M. L. (2010) · Nutrition Reviews · doi:10.1111/j.1753-4887.2010.00319.x · Cited by 376
Retting process of some bast plant fibers and its effect on fibre quality: A review
Tahir, P. M., Ahmed, A. B., SaifulAzry, S. O. A., & Ahmed, Z. (2011) · BioResources · doi:10.15376/biores.6.4.5260-5281 · Cited by 342
Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O. S., Djuric, D. M., Владиславович, Е. М., Fras, Z., Katsiki, N., Langlois, M. R., Latkovskis, G., et al. (2017) · Nutrition Reviews · doi:10.1093/nutrit/nux047 · Cited by 303
Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O., Djuric, D. M., Ezhov, M., Fras, Z., Katsiki, N., Langlois, M., Latkovskis, G., et al. (2017) · Archives of Medical Science · doi:10.5114/aoms.2017.69326 · Cited by 281
“The cholesterol-lowering effects were more significant in females (in particular in postmenopausal women) and in individuals with high cholesterol levels at baseline [177].”
Background
Metadata
- Authors
- Pan, A., Yu, D., Demark-Wahnefried, W., Franco, O. H., & Lin, X.
- Affiliations
- Unilever (United Kingdom) (GB)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 90
- Issue
- 2
- Pages
- 288-297
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3361740
- OpenAlex
- W2117685492
- Cited by
- 264
- References
- 59
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 12 · 2023: 13 · 2022: 15 · 2021: 27 · 2020: 29 · 2019: 16 · 2018: 11 · 2017: 18 · 2016: 11 · 2015: 23 · 2014: 22 · 2013: 18 · 2012: 9
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01CA085740)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Natural Products and Biological Research
- Keywords
- flaxseed, linseed oil, lignans, serum lipids, LDL cholesterol, total cholesterol, HDL cholesterol, triglycerides, cholesterol-lowering effect, sex differences, postmenopausal women, cardiovascular disease prevention, dietary supplements
- MeSH terms
- Anticholesteremic Agents, Cardiovascular Diseases, Cholesterol, Female, Humans, Hypercholesterolemia, Linseed Oil, Cholesterol, HDL, Cholesterol, LDL, Male, Seeds, Triglycerides, Randomized Controlled Trials as Topic, Treatment Outcome, Lignans, 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 ›
Are you an author, or do you see a problem with this page? Request a review
