in Pediatric Hyperlipidemia Wong H, Chahal N, Manlhiot C, Niedra E, McCrindle BW. Flaxseed in pediatric hyperlipidemia: a placebo-controlled, blinded, randomized clinical trial of dietary flaxseed supplementation for children and adolescents with hypercholesterolemia. JAMA Pediatr. Published online June 3, 2013. doi:10.1001/jamapediatrics.2013.1442.
in youth are risk factors for early development of atherosclerotic lesions and cardiovascular disease. – Pharmacologic interventions are used when lifestyle approaches fail to decrease low-density lipoprotein cholesterol within acceptable ranges. – Dietary flaxseed may be a functional food that contains agents hypothesized to have hypolipidemic activity and/or other properties that may benefit cardiovascular health. • Study Objective – To determine the safety and efficacy of dietary flaxseed supplementation in the management of hypercholesterolemia in children. Introduction
clinical trial. – Duration of intervention: 4 weeks. • Setting – Specialized dyslipidemia clinic at a tertiary pediatric care center. • Patients – 32 participants aged 8 to 18 years. – Low-density lipoprotein cholesterol from 135 mg/dL (3.5 mmol/L) to less than 193 mg/dL (5.0 mmol/L). Methods
ate 2 muffins and 1 slice of bread daily containing ground flaxseed (30 g flaxseed total). – The control group ate muffins and bread substituted with whole-wheat flour. Nutritional Content per Serving of Muffins and Breads Used in the Study Methods
change in fasting lipid profile levels of high-density lipoprotein cholesterol and triglycerides. – Secondary: Attributable change in fasting total cholesterol, low-density lipoprotein cholesterol, body mass index z score, and total caloric intake. • Limitations – Flaxseed may lose nutritional value and thus effectiveness when ground for the consumption of muffins and bread by pediatric patients. – Increases in body mass index and daily caloric intake were noted in both study groups during the trial. – Compliance assessments were based on self-report from patient- completed intake logs and not through a direct biological measure. – Small sample size (n = 32) and short duration of intervention (4 weeks).
associated with no attributable benefit regarding lipid levels. • Dietary flaxseed supplementation, while safe, was associated with adverse changes in the lipid profile of children with hypercholesterolemia: – Significant decrease noted in high-density lipoprotein cholesterol level. – Significant increase in triglyceride levels. • The use of flaxseed supplementation in children with hypercholesterolemia may not be a viable option for lipid management.
in children is challenging, with few available options. • Flaxseed has been proposed as a possible alternative therapy for treating dyslipidemia. • The predominant mechanism by which flaxseed influences lipid profiles remains unknown. • Flaxseed supplementation remains an unverified strategy for the clinical management of cardiovascular risk factors in youths with hyperlipidemia and may adversely affect the lipid profile.
contact the corresponding author: – Brian W. McCrindle, MD, MPH, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada ([email protected]). Funding/Support • This study was supported by a research grant from the Labatt Family Innovation Fund. Conflict of Interest Disclosures • None reported. Contact Information
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