Abstract
Metabolic syndrome (MetS) is a chronic disease with inflammatory and hypercoagulable states. The current study aimed to compare the effects of flaxseed oil and sunflower oil consumption on the coagulation score and selected oxidative and inflammatory parameters in patients with MetS. In this randomized controlled clinical trial, 60 patients with MetS were allocated into 2 groups. One group received 25 mL/day flaxseed oil and the other group received 25 mL/day sunflower oil for 7 weeks. Maintenance diet including 15% protein, 55% carbohydrate, and 30% fat from daily total energy intake was designed for each participant. Serum levels of total antioxidant capacity (TAC) and interleukin 6 (IL-6), as well as coagulation score were measured before and after the intervention. Three 24-hour food records were taken during the study. Fifty-two of participants (27 in sunflower oil and 25 in flaxseed oil groups) completed the study. The baseline characteristics and dietary intakes were similar between patients. After 7 weeks, no significant difference was observed between the 2 groups regarding the serum TAC level and coagulation score (p > 0.05). However, serum IL-6 levels significantly decreased in the flaxseed oil group compared to the sunflower oil group (p = 0.017). No side effect was observed during the study due to the use of sunflower and flaxseed oils. We observed that consumption of flaxseed oil improved serum IL-6 levels but had no effect on oxidative stress and coagulation score in patients with MetS. Further studies are needed to confirm the veracity of our results.
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Key Points
Metabolic syndrome (MetS) is a chronic disease with inflammatory and hypercoagulable states. This chronic inflammatory condition is called metaflammation or para inflammation, having increased levels of inflammatory cytokines, including interleukin-6 (IL-6). MetS patients are also vulnerable to oxidative stress due to excessive production of reactive oxygen species (ROS) and a weak antioxidant defense system. Oxidative stress is associated with insulin resistance and chronic inflammation. This study aims to compare the effects of flaxseed oil as a good source of ALA to those of sunflower oil as a common vegetable oil in the family food basket on the total antioxidant capacity (TAC), IL-6, and coagulation score.
The study results revealed that flaxseed oil had favorable effects on reducing the inflammatory status, including serum IL-6 concentration, in MetS patients. The adjusted diet for the participants altered the n-6: n-3 ratio. n-6 and n-3 compete for the main enzymes in the fatty acid metabolism pathway, namely lipoxygenase and cyclooxygenase. Consumption of the two fatty acids leads to a decline in the production of prostaglandin E2 and leukotriene B4. It has been proposed that the reduction of these two eicosanoids could decrease the production of inflammatory markers, such as IL-6. Dietary intake of flaxseed oil as the main source of dietary fat could improve the inflammatory status among MetS patients. However, no significant changes were observed in serum levels of TAC and coagulation score. With regard to the baseline level of inflammation in MetS that leads to CVD and T2DM and the importance of dietary fat in these patients, flaxseed oil might be helpful.