The Centers for Disease Control and Prevention reports that nearly 35% of Americans have high LDL cholesterol. Elevated LDL doubles the likelihood of being diagnosed with heart disease. In a 2015 double-blind, randomized, placebo-controlled study featured in the Journal of Nutrition, Canadian researchers set out to determine if dietary flax could lower high cholesterol in a high-risk patient population.
In this study, a total of 110 patients with peripheral artery disease were randomized to receive either 30 grams of milled flaxseeds daily or a placebo (30 grams of whole wheat). There was also a subset of this population who were taking cholesterol-lowering medications, primarily statins. The key outcome was circulating LDL cholesterol and measurements were taken at baseline and then again at month 1, 6 and 12. At baseline, lipid measurements were similar between the flax group and the placebo group.
The group eating the dietary flaxseeds had a 15 percent reduction in total circulating LDL cholesterol at month one and month six compared to placebo. However, at 12 months, there was no difference between lipid measurements in the flax group compared to the placebo group. In the sub-group of patients taking flax and cholesterol-lowering medication, at 12 months, LDL cholesterol decreased by 8.5% ± 3% from baseline. In contrast, the cholesterol-lowering medication plus placebo group experienced a increase of 3.0% + 4.4%. As to the lack of lipid-lowering effect at 12 months in the patients not taking cholesterol-lowering medication, the researchers cite potential lack of compliance due to the length of the study.
These results are consistent with previous studies involving flax and cholesterol. In fact, the authors report that Health Canada has approved a cholesterol-lowering health claim for 40 grams of flaxseed. What makes this study unique is the sub-set of patients taking cholesterol-lowering medications. Previous studies involving flax and cholesterol excluded people who were taking medications like statins. In this study, the flax did not interfere with the medication. Because of the widely published side effects of statin medications, perhaps it’s time to consider flaxseeds as an effective first-line treatment.
Edel AL, et al. Dietary flaxseed independently lowers circulating cholesterol and lowers it beyond the effects of cholesterol-lowering medications alone in patients with peripheral artery disease. J Nutr. 2015;145:749-57.

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