Obes Surg., 2007, Volume 17; Issue 3: Pages 341 - 347.

Systemic Inflammation in Morbidly Obese Subjects: Response to Oral Supplementation with Alpha-Linolenic Acid.

Faintuch, J. Horie, LM. Barbeiro, HV. Barbeiro, DF.

Key Findings

Elevated body weight is associated with high white blood cell count and acute-phase proteins, and obesity is regarded as a low grade chronic inflammatory disease. Omega-3 fatty acids can reduce the inflammatory response. Various inflammatory markers were elevated in the obese population, although not necessarily exceeding the normal range. Clear anti-inflammatory effects of flaxseed flour were found despite the comparatively modest dosage and duration protocol. These effects were noted for up to 2 weeks after discontinuation of flaxseed on the basis of the pattern of white blood cells and fibronectin measurements.

ABSTRACT

Background: Morbidly obese patients frequently display asymptomatic chronic activation of acute phase response, with potentially adverse metabolic and cardiovascular consequences. Nutritional preparations to improve this phenomenon have rarely been administered.  Aiming to investigate the supplementation of flaxseed flour, a source of omega-3 fatty acids, a prospective randomized double-blind cross-over study was designed. Methods: Outpatient obese subjects (n=41) were clinically and biochemically screened, and results for 24 randomized subjects are shown. Age was 40.8 ± 11.6 years (83.3% females) and body mass index (BMI) was 47.1 ± 7.2 kg/m2. Flaxseed flour (Farinha de Linhaca Dourada LinoLive, Cisbra, Brazil) in the amount of 30 g/day (5 g of alpha-linolenic acid –omega-3) and an equal mass of placebo (manioc flour) were administered for 2 weeks each. Variables included general biochemical investigation, white blood cell count (WBC), C-reactive protein (CRP), serum amyloid A (SAA) and fibronectin.

Results: No intolerance was registered. Body weight and general biochemical indices remained stable.  Initial CRP and SAA were elevated (13.7 ± 9.9 and 17.4 ± 8.0 ). WBC ( 8100 ± 2100/mm3 ) and fibronectin ( 463.2 ± 61.3 mg/dL) were acceptable but in the upper normal range . Corresponding findings after supplementation of flaxseed were 10.6 ± 6.2 mg/L, 14.3 ± 9.2 mg/L, 7300 ± 1800/mm3 and 412.8 ± 38.6 respectively (P<0.05 ). No change during the control period regarding baseline occurred when placebo was randomized to be given first; however, when it followed omega-3 supplementation, CRP and SAA recovered, whereas WBC and fibronection remained depressed during those 2 weeks (7500 ± 2100/mm3 and 393.2 ± 75.8 mg/dL, P<0.05). Conclusions: 1) Various inflammatory markers were elevated in the studied population, although not necessarily exceeding the normal range; 2) Significant reduction could be demonstrated; 3) Some persistent effects of flaxseed supplement 2 weeks after discontinuation were observed.

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