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Indian Journal for the Practising Doctor

Role of Flax and Flax Gum in Health and Diabetes

Author(s): Mitra A, Bhattacharya D

Vol. 5, No. 6 (2009-01 - 2009-02)

Mitra A, Bhattacharya D

Dr Analaya Mitra, B. C. Roy Technology Hospital,
Dr D. Bhattacharya, Chemical Engineering Department, Indian Institute of Technology, Kharagpur – 721 302.
[Email: [email protected]]

ISSN: 0973-516X


In order to find out whether flaxseed gum, like guargum, is effective in reducing the blood glucose level in non insulin dependent diabetes mellitus (NIDDM), 20 NIDDM patients were fed, for 3 months, 5 chapattis each containing 5 g flaxseed gum and 25 g wheat flour. Blood biochemistry of these patients when on normal monitored diet for the preceding 3 months, before initiation of therapy with flax gum, was measured monthly using standard procedures and monthly thereafter, after the initiation of therapy. 20 other (non-diabetic) patients subjected to identical conditions acted as controls. It was observed that flax gum-containing therapeutic diet reduced TLC, LDLC and FBS significantly.

Key words: NIDDM, Flax gum, TLC, LDLC and FBS


Flax (Linum usitattisimum L.) is one of the oldest crops known to mankind, and is cultivated for fibre and oil. The flax seed is flat and oval with a pointed end having approximate dimension of 2.5 × 5 × 1 mm3. The hull is tough and fibrous, containing a little of protein and oil, and consists of four layers; the outer one containing a mucilaginous carbohydrate material. The mucilage accounts for about 8% flaxseed weight, and is known to be composed primarily of polysaccharides which, on acid- catalyzed hydrolysis yield L-galactose, D-xylose, Larabinose, L-rhamnose, D-galacturonic acid and perhaps, traces of D-glucose. Polysaccharide gums are of commercial importance in the food and other industries. For example, seed gums (e.g. guar and locust bean gums) and plant exudates (Gum Arabic) are used as viscosity enhancers and stabilizers of colloidal solutions. Functionally, flax seed mucilage appears to resemble gum Arabic more closely than any one of the common gums.

In ancient times, flax was a crop used in many aspects of everyday life. In addition to the use of its fibres for weaving linen, flaxseed was a staple food item for the ancient Greeks, Romans, and Egyptians. Flaxseed was also used for various medicinal purposes such as treatment for gastric disorders, as a soothing balm for inflammation, and as a laxative. Presently, flaxseed is largely grown for the use of its oil in paints and varnishes. This industrial association may be responsible for the slow acceptance of flaxseed as a potential neutraceutical. Now flaxseed is being considered for evidence of its beneficial effects in cancer, cardiovascular diseases, diabetes, inflammatory diseases such as lupus nephritis, renal function and even for its anti malarial activity.

Results from clinical trials using ω-3 fatty acids to treat various disorders are only now becoming available, and it is too early to draw any definite conclusion. However, it appears as if there may be benefits in the use of ω -3 fatty acids in cardiovascular disease, renal disease and some autoimmune disease, such as inflammatory bowel disease and rheumatoid arthritis. The evidence is, however, inconclusive in respect of benefits in respiratory disease, lung disorder and asthma.

When the levels of ω-3 poly unsaturated fatty acid (PUFA) are increased, the antioxidant intake level should be above that obtainable by natural foods alone. This may become soon one of those rare circumstances in which a case for supplementation of foods for the general population can be made. It is prudent to increase the intake of peroxidized substances with an inadequate intake of natural antioxidants.

Flax oil has become one of the most exciting and sought after products in health food stores today, both for its preventive and curative properties. Researches on flax show it contains high concentration of ω-3 fatty acids, which can relieve and cure a number of diseases and afflictions. Flax oil fights heart disease by lowering dangerous LDL cholesterol and triglycerides, as well as decreasing the viscosity of thick blood, and reducing the build up of atherosclerotic plaque on artery walls. The list goes on to include relief and amelioration of cancer, cardiovascular disease, skin conditions including dry skin, psoriasis, eczema, acne, immunosuppression, depression, fatigue, allergies, behavioural disorders, arthritis, chronic viral, bacterial and fungal infections, inflammatory bowel disease, kidney disease etc1.

Effect of flaxseed oil on Athletes: Flaxseed oil enhances athletic performance and endurance, shortens recovery time from athletic events and strenuous workouts, acts as reliable source of energy without increasing body fat, serves as precursor to prostaglandins and hormones, increases uptake and utilization of oxygen, and keeps unfavorable saturated fats mobile in the blood stream for better utilization1.

Perhaps the most exciting news on flax yet is in regard to cancer. A study of one hundred and twenty women revealed that those with the highest breast tissue levels of ω-3 fatty acids had the lowest incidence of breast cancer. Further, of those that did develop the disease, they still showed the lowest probability of the cancer spreading to other organs, offering hope for women with an existing breast tumor.1

Emerging scientific evidence has begun to focus on another healing ingredient found in the fibrous shell hull of the flaxseed2. Special phytochemical constituents have been isolated from flax, that once ingested are converted to potent cancer fighting and preventive compounds called the mammalian lignans. Extensive evidence from numerous research institutes has revealed the potent anti-cancer properties exhibited by these amazing natural plant chemicals. Lignans have been shown to prevent the evolution of colon and breast cancers where they start, by normalizing hormone metabolism responsible for the disease3. Flaxseed is by far the richest source of phytonutrients; it yields an extraordinary 800 mcg/g. The flaxseed oil has less than 2% of lignans. The lignan found in flaxseed is called secoisolariciresinol glucoside (SDG). The lignan in flaxseed is a type of carbohydrate, classed as a phenolic compound (polyphenol). When plant lignan SDG from flaxseed is ingested, it is converted in the colon by friendly bacteria to mammalian lignans - enterodial (ED) and enterolactone (EL). Thus flaxseed lignan SDG is a precursor to mammalian lignans ED and EL. SDG lignan not only has anti-cancer properties but also has anti-viral, antibacterial and anti-fungal activities. It is also a powerful antioxidant and has been shown to enhance the immune system functioning, being effective against many different diseases. A major reason why lignans provide certain health benefits is because they are “phytoestrogens” ie the plant chemicals that mimic the hormone estrogen. Studies have shown that individuals who consume more lignan-containing foods have lower incidence of breast and colon cancers due to this phytoestrogen effect3. The American Cancer Society estimates that one in eight women will contract breast cancer. Unfortunately, breast cancer may be present for as long as 4 years before it can be detected by mammography or self-examination. Further, many women are under the misconception that if they do not have a family history of breast cancer, they need not be concerned. The truth is that today majority of women who are diagnosed with breast cancer show no family predisposition. The above facts call for every woman to implement a proactive approach to prevent the disease. Pelton4 suggests that every woman should take at least one tablespoon of flaxseed oil (as a Lignan source) as a daily protocol to prevent breast cancer. High in Lignan, flaxseed oil is unique, as unlike regular flaxseed oil, flax particulate matter from flaxseeds is retained in the oil, delivering the powerful cancer fighting mammalian lignan precursors. High-lignan flax oil can easily be incorporated into any diet by using it as an ingredient in salad oils, stirred into oat meal combined with a blender drink, mixed into yogurt, or simply taking it straight, chased by fresh fruit juice. Although the body readily makes most of the fat that it needs from dietary starch or sugar, humans lack the ability to make essential fatty acids (EFA) and must get them in food. EFAs are found in all foods but are most abundant in certain oils. They come in two distinct families based upon their chemical structure (omega 6 and omega 3). The two EFA families are not interchangeable and, in fact, tend to compete with each other in the body’s metabolic pathways.

The larger family, called ω-6 EFAs, is abundant in many vegetable seed oils, including corn, sunflower, and safflower. Deficiencies of ω-6 EFAs cause impairment of growth and fertility, hormonal disturbances, and immunologic abnormalities. People living in North America and Europe have relatively high levels of ω-6 EFAs in their diets, because of an inclination to increase the consumption of vegetable oil during the last century5.

The smaller family, called ω-3 EFAs, is most concentrated in fish oils and in flaxseed (linseed oil). It is also found in green, leafy vegetables and in the flesh of animals that feed on grass and leaves. The human brain is rich in ω-3 EFAs; their deficiency causes abnormalities in the development and function of the nervous system, as well as immune defects. The Omega-3 fatty acids (ω-3 EFAs) formed an important part of the diet of the Stone Age man, who relied heavily on wild game and leafy plants for nourishment. Consumption of fish, flaxseed meal, and soybeans supplied ω-3 fats to our more recent ancestors. The past century has witnessed a systematic depletion of ω-3 EFAs from the Western diet because of changes in food choice and in techniques of animal husbandry and food processing. Some theorists have traced the origins of numerous different diseases to a lifetime depletion of ω-3 EFAs. Most recently, it has been suggested that ω -3 fatty acids act in a manner similar to that of lithium carbonate and valproate, two effective treatments for bipolar disorder. To test whether ω -3 fatty acids could help, researchers conducted a four-month, double-blind, placebo-controlled study, comparing ω -3 fatty acids (9.6 g/d) vs placebo (olive oil), in addition to usual treatment, in 30 patients with bipolar disorder. They found that the ω -3 fatty acid patient group had a significantly longer period of remission than the placebo group. In addition, at nearly every other outcome measure, the ω -3 fatty acid group performed better than the placebo group. Clearly, the work of Rudin on Flax Oil and Mood Disorders II6 opens up new pathways of healing in cases of tragic mental states, The researcher recommends a dosage of 2-8 tablespoons daily for this therapeutic effect.

Flaxseed is the richest known plant source of the ω - 3 fatty acid (α linolenic acid or ALA, >50% of the fatty acids present in the oil fraction). Flaxseed oil has been shown to modulate immune response, to have anti cancer effects, to inhibit platelet aggregation and to attenuate renal function decline in a rat renal ablation model. All of these have been attributed to the high ALA content of flaxseed oil1. The inverse correlation observed between ALA intake and cardiac deaths and coronary events in two large epidemiological trials, the Lyon Diet Heart Study and the Multiple Risk Factor Intervention Trial (MRFIT), might be related to ALA’s ability to inhibit platelet aggregation.

The availability of ω-6 fatty acid, linoleic acid, far exceeds that of the ω-3 fatty acid, the latter being available mostly in fish and green leafy. Therefore, a proper ratio of the two fatty acids is not being maintained, leading to an imbalance, more so for the vegetarians. This imbalance has a direct bearing on the incidence of cardiac diseases. Another point to be noted is that no interconversion between ω-3 fatty acids and ω-6 fatty acids is possible in the human system7.

Gums and mucilages exert a physical and reflexive, rather than chemical, action on the surface of the gut and the gastric and enteric nervous systems found in different plexuses. They produce a coating, which acts to sooth, and protect exposed surfaces. Their action is referred to as demulcent or emollient. They find primary indication for intestinal inflammations, lesions and ulcers, and for reducing irritation from excess acid and digestive secretions8 Besides physically coating the digestive tract, gums and mucilages induce a reflex causing relaxation in the gut (and respiratory and urinary tracts as well). These properties provide for symptom relief in such cases as dyspepsia, colic, spastic bowel, flatulence, reflux oesophagitis, vomiting, diarrhoea, dysphagia, as well as many cases of abdominal pain, especially in children9.

Agents Useful in the management of hyperglycaemia in Type II diabetes mellitus:

The development of new therapeutic agents for the regulation of hyperglycaemia in patients with non-insulin-dependent (Type II) diabetes mellitus depends on an understanding of normal glucose regulation and how it is altered in Type II diabetes. Four major abnormalities appear to account for the inappropriate hyperglycaemia seen in such patients10:

  1. decrease in quantity of insulin secreted;
  2. delay in the time of release of insulin;
  3. impairment of the effects of insulin on peripheral tissues;
  4. increase in hepatic glucose production.

It is clear that Type II diabetes mellitus is a heterogeneous disorder and that the disturbed glucose metabolism in various subsets is due to differing degrees of these four abnormalities. Improvement of disturbed glucose metabolism in Type II diabetic patients can be effected by agents, which act either on glucose production (nutrient entry through the gastrointestinal tract or hepatic glucose production) or glucose utilization (oxidative or non-oxidative).

Altering glucose production: There are two obvious sources of glucose: exogenous and endogenous. When nutrients are ingested, the carbohydrate is digested and absorbed. The ensuing rise in plasma glucose and insulin suppresses endogenous glucose production and facilitates the oxidation and storage of glucose by peripheral tissues. In the absence of adequate insulin secretion and/or action, endogenous glucose production is not adequately suppressed, glucose uptake is diminished and exaggerated hyperglycaemia ensues10.

One might then speculate that a diet low in carbohydrate would be effective in reducing hyperglycaemia in Type II diabetic patients. This, however, is not true since low carbohydrate diets decrease proinsulin synthesis and insulin secretion and result in diminished peripheral responsiveness to insulin. A more effective approach is to provide relatively good quantities of complex carbohydrates that are digested and absorbed slowly so that the rate of glucose delivery into the extracellular space is not excessive and rapid, but rather modest and sustained, thereby giving endogenous insulin a diminished task and a longer time to effect glucose disposal10. High fibre diets and guar gum have been used in NIDDM (and in diabetics in general) to decrease and delay carbohydrate digestion and absorption11,12. Difficulties with compliance and limited effectiveness have been major problems with these approaches. Up till now no study was done with flax gum and its role to control blood sugar. Flaxseed is also the richest source of lignan precursors and contains high amounts of soluble fibre. These components, in addition to the oil, appear to contribute to the beneficial effects of flaxseed observed in chronic diseases. Dietary fibre is a term used to describe the supporting structures of plant cell walls and the substances intimately associated with them. It is a generic term that covers a wide variety of substances with different physical properties and various physiological effects. Chemically these substances belong to the family of carbohydrates. There are two main types of dietary fibre13.

1) Water insoluble fibers, which include lignin, cellulose and many hemi-celluloses, are present in grains and vegetables. Insoluble fibers shorten bowel transit time, increase stool bulk, render stool softer, and delay glucose absorption and starch hydrolyses

2) Soluble fibers, which include pectin, gums, some hemicelluloses and polysaccharides, are also present in grains and vegetables. They tend to increase intestinal transit time, delay gastric emptying, slow glucose absorption, and lower serum cholesterol levels. Soluble fibre is almost fully fermented in the colon into short chain fatty acids that may inhibit liver cholesterol synthesis and increase the body clearance of lowdensity lipoprotein cholesterol (LDLC). Fibre supplementation of 20 g per day decreased cholesterol levels13.


Composition of flaxseed14
Moisture- 7.1-8.3 %,
Oils- 1.9-37.8 %,
Proteins- 26.9-31.8 %,
Total Dietary fiber- 36.7-46.8 %,
Insoluble Dietary fiber- 30 % (app.)
Soluble Dietary fiber- 10 %

Flaxseed mucilage: Seed mucilage of flax contains lot of protein, which may later be easily separated from lignin15. Trivedi and Shah16 found that the linseed mucilage obtained from linseed cake had suspending properties comparable to those of tragacanth and was next only to Na alginates as suspending agent. Minker et al17 observed that linseed mucilage had emulsifying properties better than those of tween 80, gum arabic and gum tragacanth. Obviously linseed mucilage has considerable potential of industrial use.

Anti-nutritional components: HCN formation in linseed can be increased to lethal concentration by damp-water treatment. Therefore, it is recommended that only purified linseed may be used in bread18. A study to determine whether cycloserine present in linseed meal was pyridoxine antagonist in chick diet showed that free cycloserine was not pyridoxine antagonist although it might be so in a bound form19. The inhibitor of vitamin B6 found in flax seed was isolated by Trosten in 196520.

Anti-selenium factors: Linseed meal prepared without removing mucilage by water soaking was found to protect rats21 and chicks22 from the harmful effects of consuming 10 mg/kg or more selenium in the diet. This protective factor in linseed meal could be isolated by methanol and ethanol and was heat stable, organic and polar in nature. Studies on the mode of action of this protective factor showed that it interacts with selenium in the tissues to reduce its toxic effects22,22a.

Flaxseed differs from most other common oilseeds in having a high content of mucilaginous material composed of polysaccharides. This material, which has thickening and emulsifying properties, has potential use as a stabilizer and thickener in food products, as a lubricant in the chemical industry, and as an additive in cosmetics and pharmaceutical preparations. In addition, flaxseed polysaccharide gum has nutritional value as a dietary fiber, which plays a role in reducing diabetes and coronary heart disease risk, preventing colon and rectal cancer, and reducing the incidence of obesity.

Flaxseed mucilage, found in the seed coat, is composed of both arabinoxylan and rhamnogalacturonan components. The mucilage is extracted with hot water. Alcohol precipitation after hot water extraction is necessary for the removal of the potentially toxic cyanogenic glycosides (linamarin, linustatin and neolinustatin) present in the flaxseed. The viscosity of flaxseed mucilage is influenced by concentration, pH, and temperature of the mucilage solution and by the concentration of electrolytes in the mucilage. Mucilage with the highest viscosity is extracted at a pH of 5-7, a temperature of 50 °C - 80 °C and at a water to seed ratio of 13:1. The presence of sodium chloride in the solution reduces viscosity.

Removal of Cyanogenic Compounds from Flaxseed: Treatments to remove the cyanogenic compounds from flaxseed meal include boiling in water, dry and wet autoclaving, and acid treatment. The cyanogenic glycosides were extracted by treating the mucilage dispersion with 95% (v/v) methanol containing 10% (w/v) ammonia. This way, more than 50% of the cyanogenic glycosides could be removed.

Flax Gum as Food Component: The gum produced from the flax seeds may be mixed with wheat flour to prepare chapatti (the hand made bread). Addition of flax gum to wheat flour make kneading easier during the preparation of the chapatti and there is a significant improvement in tolerability, with no perceptible change in taste, smell and flavor. However, there is a significant improvement in chewability and foldability. The product with gum is similar to that obtained when chapatti is coated with ghee.

The viscous gel-like gum water solution after filtration of the residue was found to be suitable for incorporation in to the wheat flour. The required intake of 20 g per day of soluble dietary fibre needed for control of blood glucose was found possible through use of flax seed gum. About 5 g of flax gum was mixed with 25 g of wheat flour and a chapatti was made23. Daily consumption of 5 to 6 chapattis met the requirements.


Forty NIDDM patients, aged 45-55 years, free from other diseases and complications of diabetes mellitus, were selected. Of this, 2 homogenous groups of 20 patients were formed - one consented as volunteer and the other as control. The patients with known renal and hepatic dysfunction and lipid lowering therapy were excluded from the study. The patients underwent clinical and anthropometrical evaluation before the study. Flax gum was prepared by methods described earlier. As suggested by Garden-Robinson (1994)23, 5 g of flax gum was mixed with 25 g of wheat flour and a chapatti was made with the mixture. Daily 5 such chapattis were prescribed to the NIDDM patients for consumption. The neutraceutical was given for 3 months and the effects observed.

In order to document the probable effect of flaxgum on the NIDDM patients, blood samples were taken by an indwelling catheter into ante-cubital vein and analyzed for fasting blood glucose (FBS), triglyceride (TG), total cholesterol (TLC), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), and very low-density lipoprotein cholesterol (VLDLC). The reagents were procured from M/S Monozyme India Limited and tests were done as per the standard catalogue supplied by them.

Results and Discussion:

The patients underwent clinical and anthropometrical evaluation before the study. Initial blood samples were analysed for plasma glucose and lipid profile.

The characteristics of the patients were (Mean + Average):

Age- 48.29± 4.56 years
Sex- Males 33, Females 07
Weight- 79.26± 13.02 kg
BMI- 24.46± 3.29

Table 1 shows the prestudy blood biochemistry of the NIDDM patients while on normal diet. It shows that with normal diet different parameters of lipid profile such as TLC, HDLC, LDLC, VLDLC and TG remained unaffected while LDLC showing an increase of 6-8 mg/dl. FBS shows no changes.

Table 1: Values of blood parameters of 40 NIDDM patients who were on normal diet and before receiving flax gum.

(months) (mg/dl) (mg/dl) (mg/dl) (mg/dl) (mg/dl) (mg/dl)
0 180±12 48±5 104±11 28±5 136±11 152±10
1 180±18 48±4 104±10 28±4 140±14 152±12
2 184±14 46±5 112±11 26±3 130±12 150±11
3 182±12 45±5 110±11 27±5 135±11 154±12

Table 2 shows the blood biochemistry of the NIDDM patients who were fed with flax gum through chapatti. It is clear that TLC, LDLC and FBS were significantly reduced whereas reduction in TG was not so appreciable. Values of HDLC remained more or less constant.

Table 2: Effect of flax gum on NIDDM patients observed through blood biochemistry

(month) (mg/dl) (mg/dl) (mg/dl) (mg/dl) (mg/dl) (mg/dl)
0 182±12 45±4 110±11 27±6 135±11 154±12
1 170 ± 9 45 ± 5 99 ± 10 26 ± 5 133 ± 10 142 ± 11
2 163 ± 11 45 ± 4 92 ± 12 26 ± 6 130 ± 12 136 ± 07

Diabetes Mellitus is a common disorder, which has been partly related to deficiency of dietary fibre. It has been argued that the disease was virtually non-existent before the introduction of processing of cereals by milling and polishing giving products such as polished rice and white flour. Early studies with different forms of fibre given to normal or diabetic subjects in combination with a carbohydrate in test meals showed that the blood glucose response was reduced when soluble fibre with a high viscosity was given, which reflected a significant reduction in postprandial glucose. Only few foods in Western diet contain viscous polysaccharides at high enough levels. Legumes, beans, and pulses also are very low in Westernized diet. The discovery that viscous polysaccharides can improve postprandial glucose response in diabetics11,12 has given an opportunity to develop neutraceutical products containing plant gums such as guar gum, flax gum, etc. These products can assist in the management of diabetic patients. Statistical analysis of the data confirmed that flax gum caused significant reduction of TLC (p=0.025), LDLC (p=0.030) and FBS (p=0.045). The changes in other parameters were not statistically significant.


Flax seed gum is an inexpensive, abundant, natural material with no side effects. It is helpful in curing various diseases by lowering the recognised risk factors like TLC, LDLC and FBS. In diabetes, this is a useful neutraceutical for its effects in controlling blood sugar and dyslipidaemia.


The authors are indebted to the Late Prof. S. K. Sawarkar (Department of Chemical Engineering, Indian Institute of Technology, Kharagpur, India) for his valuable suggestions and encouragement throughout the work. The authors are also indebted to Prof. P. Chattaraj of the Chemistry Department, Indian Institute of Technology, Kharagpur, India, for his valuable suggestions and comments regarding the work.


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