Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
8 Sep

Dear Mark: Is Flax Bad?

503074250 6992bbbb6fDear Mark,

I’ve been researching flax and am ready to pull the plug on my dedicated flaxseed grinder. The kicker was seeing flaxseeds associated with prostate cancer. What’s your take?

Thanks to reader Clare for the thoughtful correspondence on flax. This is exactly why I love doing this blog. Research continues to unfold, and the conversation never fails to engage and inspire me.

As Apples know, I’ve been a flax supporter. Lately, I’ve been mulling that position. While I don’t think a single study’s results should rewrite the book on any issue, when a number of studies suggest that it may be linked to serious illness in some people, that’s enough to give me pause. And, well, it’s enough to incite me to do some digging – and pondering. Flax is one of those cases lately.

The deal is this. Flax seed is rich in a form of omega-3 fatty acids called ALA (alpha-linolenic acid). Omega-3 fatty acids as a whole (group) are especially vital for the development and ongoing well-being of the nervous system and for the health of the cardiovascular system. They improve lipid profiles, thin blood, and combat inflammation like nobody’s business. (You know how I feel about that one, eh?) They can also help curb insulin resistance.

232329562 d17b3b481e

Research time and again supports the role of omega-3s (again, as a group) in overall health; however, some studies and reviews over the last few years have linked high ALA intake (from both flax oil and milled seed) with higher incidence of prostate cancer. ALA blood levels are higher in response to flax oil intake than they are with milled seed intake. (Eating whole seeds isn’t recommended unless you’re looking for some serious abdominal havoc.)

I’ve always maintained that other animal-based forms of DHA and EPA offer more health-related bang for your buck, and I stand by that point. The preponderance of research supports the particular power of EPA and DHA in the omega-3 fatty acids. One study suggests that fish intake (rich in both DHA and EPA) actually reduces the risk for prostate cancer.

The bottom line is ALA doesn’t do much that DHA and/or EPA can’t do and probably do better. As avid Apples know, I suggest that everyone take a fish supplement. In the past I’ve seen ALA as a decent secondary choice for vegetarians and as a useful addition to a healthy Primal eating strategy (e.g. a bit of ground flax seed on some berries). The human body isn’t terribly effective at converting ALA to either DHA or EPA, hence the need for added dietary intake or supplementation. (An interesting side nugget: women’s bodies are a little better at this conversion. Research has shown that young women convert 21% of ALA to EPA (compared to 8% in men) and 9% to DHA (compared to 0-4% in men). The difference, apparently, is linked to estrogen levels.)

2456103088 92a0efacd4

So, what’s my current suggestion in light of the potential prostate cancer link? If you’re a woman, the obvious point of the research isn’t relevant. Nonetheless, the underlying role of phytoestrogens in flax is nonetheless an important one. I’d say that healthy women can consume low to moderate amounts of flax without concern. Sure, a large amount of research suggests the protective effect of phytoestrogens against breast cancer (in healthy women), and this research includes flax. Nonetheless, a lot of a seemingly good thing isn’t necessarily better or even safe. My advice would be to use fish oil as your primary omega-3 source and keep the ALA on the lower side.

If you’re a man? Particularly an older man? I’d definitely suggest you make fish oil your principal source of omega-3s. Is it time to chuck the flax grinder all together? Based on the research, I’d at least put it into semi-retirement. (I’d suggest forgoing flax oil entirely.) In the meantime, we’ll stay on top of this one and let you know about any new developments on this front.

As always, thanks for your questions and comments. Keep ‘em coming!

diglyesica, tellumo, spdrecrd Flickr Photos (CC)

Further Reading:

Omega 3 Fatty Acids Round Up:

Omega 3 to 6 Ratio

Omega 3 Daily Dose

Omega 3 Food Sources

Cooking Omegas

Modern Forager: The Vaunted Flax Seed

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. It appears that the cited study had a publication bias:

    “A recent (2009) meta-analysis, however, found evidence of publication bias in earlier studies, and concluded that if ALA contributes to increased prostate cancer risk, the increase in risk is quite small.[21]

    In contrast, alpha-linoleic acid was recently shown to negatively regulate the growth of cancer cells, but not healthy cells, in vitro.[22]” [23]

    [21] Simon, JA; Chen, YH; Bent, S (2009). “The relation of alpha-linolenic acid to the risk of prostate cancer”. American Journal of Clinical Nutrition 89 (5): 1558S–1564S http://ajcn.nutrition.org/content/89/5/1558S

    [22] Deshpande, R; Mansara, P; Suryavanshi, S; Kaul-Ghanekar, R (2013). “Alpha-linolenic acid regulates the growth of breast and cervical cancer cell lines through regulation of NO release and induction of lipid peroxidation”. Journal of Molecular Biochemistry 2 (1): 6–17.

    [23] http://en.wikipedia.org/wiki/%CE%91-linolenic_acid#Potential_role_in_nutrition_and_health

    Art wrote on May 18th, 2013
    • Hi Art. This is why I stated that Flaxseed without cottage cheese is a loaded gun. Those studies do not contain the mix. The cottage cheese makes the flax “water soluble” so you get all the benefits without any of the risks associated with those studies. The mix adds electrons and oxygen to your system. The lipids(flax) carry oxygen safely throughout the body removing the fake chemically created fats in salad dressing etc. from your system.

      “Dr Johanna preaches against the use of what she calls ‘pseudo’ fats. In order to extend the shelf life of their products, manufacturers use chemical processes that render their food products harmful to the body. These harmful fats go by a number of names, including ‘hydrogenated’, ‘partially hydrogenated’ and even ‘polyunsaturated’.
      The chemical processing of fats destroys the vital electron cloud within the fat. Once the electrons have been removed, these fats can no longer bind with oxygen, and they actually become a harmful substance deposited within the body. The heart, for instance, rejects these fats and they end up as inorganic fatty deposits on the heart muscle itself. Chemically processed fats are not water-soluble when bound to protein. They end up blocking the circulation, damaging heart action, inhibiting cell renewal and impeding the free flow of blood and lymph fluids. The bio-electrical action in these areas slows down and may become completely paralyzed.”

      There are plenty of people on the Budwig diet that are not getting prostrate cancer or enlarged prostrates. There are also plenty of studies saying quite the opposite of the studies you cite. http://tinyurl.com/nzdbuo9

      Additionally the people at Lipitor aren’t too happy about this either.
      http://archive.news.iastate.edu/news/2010/mar/flaxseed

      So it’s really up to the consumer. I use the mix every day, and if anything the swelling I used to feel in my prostrate totally disappeared as well as those annoying Actinic Keratosis (AK) red dots I used to get on my face. It’s up to you, but for me, I’ll believe the people that had miraculous cures from cancer rather than the pharma funded studies that keep the cancer doctors in business.

      NEO wrote on June 10th, 2013
  2. Are you still so gung ho about fish oil considering new studies this year (2013) show a 70% increase risk in prostate cancer in men from consuming fish oil?

    Steve wrote on July 27th, 2013
  3. This is confusing. I was told to avoid all animal based sources of omega 3s due to higher cancer risk. Newer studies published in the

    Jerry wrote on February 28th, 2014

Leave a Reply

If you'd like to add an avatar to all of your comments click here!

© 2014 Mark's Daily Apple