Previously, I've explored the potent antihypertensive effect

of dietary flaxseed in hypertensive patients.

This was a double-blind, randomized, placebo-controlled trial

where they disguised ground flaxseed in baked goods,

versus like flax- free placebo muffins,

and got an extraordinary drop in high blood pressures.

As you can imagine, the flaxseed industry was overjoyed,

praising the impressive findings, as was I.

After all, high blood pressure is the single largest risk factor

for death on the planet earth.

Yes, we give people medications,

lots and lots of medications, but most people don't take them,

as in 9 out of 10 people take less than 80 percent

of their prescribed blood pressure pills.

Just 8 percent.

It's not difficult to understand why. Patients are asked to follow an

inconvenient and potentially costly regimen,

which will likely have a detrimental effect on their

health-related quality of life to treat a mostly asymptomatic condition;

so, they may feel worse instead of better, due to the side effects.

The answer, then, is to give them more drugs to counteract

the effects of the first drugs, like giving men Viagra to counter

the erectile dysfunction caused by their blood pressure pills.

How about using a dietary strategy instead,

especially if it can be just as effective?

And indeed, the drop in blood pressures they got in the flaxseed study

was greater than the average decrease observed

with the standard dose of anti-hypertensive drugs.

And, flaxseeds are cheaper too, compared to even a single medication;

and most patients are on multiple drugs.

And has good side effects beyond their anti-hypertensive actions,

but not all good...

Taking tablespoons of flaxseed a day is a lot of fiber for people

who have been living off of cheeseburgers and milkshakes

their whole lives, and it can take a little while

for your gut bacteria to adjust to the new bounty.

So, people who start out with low-fiber diets

may want to take it slow at first.

Not all studies have shown significant blood pressure-lowering effects.

There have been over a dozen trials

by now involving more than a thousand subjects.

And yes, put them all together and overall there were significant reductions

in both systolic and diastolic blood pressures—

the upper and lower numbers—

following supplementation with various flaxseed products.

None were as dramatic as that six-month trial.

The longer trials tended to show better results,

and some of the trials just used flaxseed oil or some kind of flaxseed extract.

The thought is that the whole is greater than the sum of its parts.

Each of the components of interest within flaxseed,

the omega-3's, the cancer-fighting lignans, all the soluble fiber

and plant proteins, all contribute toward the blood pressure reduction.

OK, but how? Why? What's the mechanism?

Some common blood-pressure medications like Norvasc or Procardia

work by reducing the ability of the heart to contract, or slowing the heart down;

and so, it's possible that's how flaxseeds works too.

But no.

Dietary flaxseed reduces blood pressure without cardiac involvement

but rather through changes in plasma oxylipins.

What are oxylipins?

Oxylipins are a group of fatty acid metabolites involved in inflammation,

and as a result, have been implicated in many pro-inflammatory

conditions including cardiovascular disease and aging.

The best characterized oxylipins in relation to cardiovascular disease

are derived from the long chain omega- 6 fatty acid known as arachidonic acid,

found preformed in animal products, particularly chicken and eggs,

and can be made inside the body from junky

omega-6 rich oils, such as cottonseed oil.

But, elevated levels of pro-inflammatory oxylipins in older subjects

are normalized by flaxseed consumption.

See that's how we think flaxseed consumption reduces blood pressure

in patients with hypertension: by inhibiting the enzyme

that makes these pro- inflammatory oxylipins.

I'll spare you from the acronym overload, but basically,

eating flaxseeds inhibits the activity of the enzyme

that makes these pro-inflammatory oxylipins, called leukotoxin diols,

which in turn may lower blood pressure.

Identifying the molecular mechanisms adds confidence

to the antihypertensive actions of dietary flaxseed,

but that's not all oxylipins do.

Oxylipins may play a role in the aging process.

But we may be able to beneficially disrupt these biological changes

associated with inflammation and aging

with a nutritional intervention like flaxseed.

Older adults (around age 50) have higher levels of these arachidonic

acid-derived oxylipin compared to younger adults (around age 20).

These elevated concentrations of pro-inflammatory oxylipins

in the older age group may help explain the higher levels

of inflammation in older versus younger individuals.

As we get older, we're more likely to be stricken

with inflammatory conditions like arthritis;

and so, this elevation of pro- inflammatory oxylipins may pre-dispose

individuals to chronic disease conditions.

But what if you took these older adults and gave them muffins—

ground flaxseed-containing muffins?

Four weeks later their levels dropped to here,

down to like 20-year-old levels, demonstrating that a potential

therapeutic strategy to correct the deleterious

pro-inflammatory oxylipin profile is via

a dietary supplementation with flax.