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FLAX

The upshot: Flaxseed meal (not the oil) may be beneficial for people with IBS who do not respond well to psylium. Freshly ground flax meal is an excellent source of fiber mucilage. Any cholesterol lowering and PMS reducing effects are probably due to the bulking and improved intestinal function. If you are using flax products to increase your omega 3 fatty acid levels, it takes about 7 times more flax oil than fish oil to achieve the same effect. Flax contains ALA (alpha-linoleic acid) which is a precursor of omega-3's, getting converted in the liver. The Natural Standard Research Collaboration sees the current evidence as being inadequate to recommend flax for any condition at this time. Flax in any form goes rancid easily when exposed to light, heat, or oxygen.

NOTES
--Flaxseed and flaxseed oil have effects on menstrual, intestinal, and cardiovascular health
--flaxseed products are rich sources of the essential fatty acid alpha-linoleic acid (ALA)
--ALA is a precursor of omega-3 fatty acids, which is converted by the liver into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
--EPA and DHA are now recommended and prescribed for hypertriglyceridemia, but are more efficiently obtained in oily fish than in plants.
--flaxseed (not the oil) is THE RICHEST FOOD SOURCE OF LIGNANS (one of three major classes of phytoestrogens)
--LIGNANS MAY have partial agonist or antagonist action on estrogen receptors (if it did this would be a big deal in cancer treatments)
--such actions are the basis for studies on flax for possible antioxidant properties and effects on menopausal and menstrual symptoms
--soy products also contain phytoestrogens
--oral flaxseed is a source of fiber mucilage (may act as laxative)
--flaxseed comes in many non-standardized product forms
--forms include: flour or whole, ground or bruised
--can be taken as flour, powder or fiber dissolved in water
--oil is available as liquid or capsule
--flaxseed is approximately 35% oil
--more than half of the oil consists of ALA, of which 58% to 60% are omega-3 fatty acids and 18% to 20% are omega-6 fatty acids
--anecdotally, a dose of 7.2 g of flaxseed is equivalent to 1 g of fish oil
--flaxseed contains fiber and lignan
--flaxseed oil contains only ALA, may share putative lipid-lowering but not laxative & phytoestrogenic properties of seed.
--whole or bruised can be sprinkled on food, mixed with liquid or taken orally
--dosage: drink 1 TBS mixed with 6 to 12 oz of water up to 3 times daily
--usual dose of whole flaxseed is 10 to 60 g/day
--often used as a laxative when mixed with 10 times the amount of water
--doses of up to 60 to 80 g/kg body weight of flaxseed mucilage or fiber have been used in studies
--whole flaxseed can be stored up to 1 year in a dry location and ground flaxseed can be stored in a refrigerator for 3 months or in a freezer for up to 6 months
--I RECOMMEND THAT PEOPLE PURCHASE WHOLE SEED AND GRIND IT UP ONE PACKAGE AT A TIME, STORING IT IN THE FRIDGE IN AN AIRTIGHT JAR
--flaxseed Powder or flour can be dissolved in liquid as a source of fiber, not as good a source as freshly ground meal
--anecdotally, 50 g of whole flaxseed correlates with 250 g of flaxseed flour
--flaxseed oil has 7 g of ALA per 15 mL tablespoon, must be kept cool, airtight and away from sunlight
--FDA says flax is safe to use for up to 4 months
--ALA has been studied for up to 5 years as part of the Mediterranean diet
--RISKS: intestinal obstruction from too much seed and not enough water,
--ContraIndications: those with gastrointestinal strictures, diverticulitis, or risk for bowel obstruction
--immature flaxseed seedpods = potentially poisonous
--can cause loose stools
--phytoestrogens may increase prostate cancer risk, men with prostate cancer should avoid flax
--flaxseed but not the oil can be used with caution in those with estrogen-dependent conditions such as breast, uterine, and ovarian cancers because of potential phytoestrogenic effects
--theoretical risk for bleeding associated with reduced platelet aggregation has been reported
--allergic rxns incl anaphylaxis to linseed oil has been reported
--one study of patients with constipation, predominantly IBS, those who used roughly ground flaxseed experienced improvements in constipation, bloating, and abdominal pain compared with those taking psyllium
--another study, flax supplement taken orally or baked in a food product was associated with increased fecal weight equivalent to that found with psyllium
--flaxseed's actions as a bulking agent may cause its lipid lowering effect, studies have been conducted in healthy people, postmenopausal women, and those with hyperlipidemia, with small or nonsignificant clinical outcomes on cholesterol levels
--2008 double-blind, randomized, controlled clinical trial of subjects taking 40 g/day of ground flaxseed in baked goods, LDL was lowered but the effect was modest and short lived
--flaxseed was also associated with lower HDL-C, which warrants further attention
--no long-term randomized clinical trials compare flaxseed with other treatments and show significant clinically important cardiovascular outcomes
--recent randomized, double-blind, controlled 12-month trial in healthy menopausal women comparing flaxseed with wheat germ showed an increase in levels of plasma ALA and docosapentaenoic and omega-3 fatty acids but no clinically significant effect on apolipoprotein metabolism
--evidence for the efficacy of flaxseed for diabetes and hypertension is poor or lacking
--effects on Menstrual Disorders and Menopause: Only one small study suggests a benefit of flaxseed (not flaxseed oil) for premenstrual mastalgia when flaxseed was consumed as 25 g in a muffin daily for 6 months
--insufficient human evidence to recommend the use of flaxseed or flaxseed oil during pregnancy and lactation.
--little evidence supporting the use of flaxseed for menopausal symptoms
--in postmenopausal women, flaxseed not associated with significant changes in serum hormones or markers of bone metabolism compared with soy
--2 other studies of postmenopausal women, consumption of flaxseed-containing muffins was not associated with improved endothelial function or with changes in menopause-specific quality of life or hot flashes
--the Natural Standard Research Collaboration reviewed 13 conditions and many studies and decided that the studies were mostly of poor quality. They found no evidence to support recommending this product for any condition at this time.

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