Th.e Nutri.ti.onaJ Benefits of FLAXSEED Inside: Nutritional Content • Health Benefits • Recipes 1 1X [it>5 .:2.'t> �3 • Michelle Hobbs, MS, RD ��--���������__J --� '11he Nutritional .lJenefJts of FLAXSEED Enhancing a Healthy Diet Michelle Hobbs, MS, RD First Edition Michelle Hobbs is a registered dietitian and a member of the American Dietetic Association. Acknowledgements The author wishes to express sincere appreciation to Cindy Heiss, Carol Koprowski and Alyce Blackmon for their assistance in the preparation and editing ofthis project. First Edition, 2003 Michelle Hobbs, MS, RD Thanks also to the members of California State University, Northridge and St. John's Regional Medical Center for their support and valuable input. The information presented here is intended solely as educational and not as medical advice. Always consult your physician . This booklet is dedicated to my mother, who introduced me to the simple joy ofhealthy food. Table of Contents Grown readily in cool climates and dry soil, flaxseed flowers bloom in beautiful shades of red, yellow, white or blue. ··'. 6 ,. . : ~. •. ; 'I Introduction 8 What is Flaxseed? 9 Reported Health Benefits 10 Nutritional Content of Flaxseed 14 General Use and Preparation 16 Storing Flaxseed 17 Safety and Regulatory Status 18 Recipes 19 Summary 28 References 30 Appendix 34 The Nutritional Benefits ofFLAXSEED 7 Introduction Nothing can take the place of a healthy diet. There is no magic pill, vitamin, powder or any other substance that can completely match the power of a well-balanced diet which includes all the basic food groups and their nutrients. In addition, most nutrients are best used by the body in food form, versus an extract or supplement. Scientists are not quite sure why many nutrients consumed in food form perform more optimally than when isolated, and the effect of whole foods is still being studied. The US Dietary Guidelines and Food Guide Pyramid are guides to good nutrition for the general, healthy public over age two. The Dietary Guidelines recommend the following: Aim for a healthy weight-be physically active each day. Let the Food Guide Pyramid guide your food choices. Choose a variety ofgrains daily, especially whole grains. Choose a variety offruits and vegetables daily. Keep food safe to eat. Choose a diet that is low in saturated fat and calories and moderate in total fat. Choose beverage and foods that limit your intake ofsugars. Choose and prepare foods with less salt. Ifyou drink alcoholic beverages, do so in moderation. The USDA Food Guide Pyramid recommends eating about 50-60% of your total calories daily as complex carbohydrates, 10-15% as protein, and about 25-30% of calories as fat. In addition, the American Heart Association recommends limiting saturated fat intake to 7-10 % of total fat intake per day. People today are looking for ways to improve their health. This booklet is designed to introduce an easily accessible food called flax that is rich in healthy fats and fibers, vitamins, minerals and phytonutrients. According to scientific studies, adding flaxseed to a healthy diet may help reduce the risk of certain diseases such as heart disease and some cancers. What a simple way to enhance nutrition! What is Flaxseed? Flaxseeds are small, brown, oval-shaped seeds not unlike sesame seeds, though darker in color. They have a tough outer hull and are chewy inside. There are many varieties in production today. Most have a similar nutty flavor and aroma. Flaxseed is currently used mainly in breads and bakery products in small amounts to add texture and flavor. Historical documentation suggests flaxseed has been used as a food supplement since about 3,000 B.C. in Babylon. Later, Hippocrates reportedly wrote about its use to relieve abdominal pain. In 8th century A.O., Charlemagne passed laws regarding the consumption for the health of his people! By 1875, European settlers began to seed the North American west. Canada is now the largest flax exporter in the world. Flaxseed (also known as linseed) is used for its oils in creating coatings to protect wood. Its fibers are used to produce cloth (linen). Flaxseed has long been used as livestock feed to maintain a healthy coat and skin and to improve digestion. Today, people are beginning to use flax in their diet on a daily basis to reap its benefits. While some people use the flax oil capsules, they may not be getting all the beneficial constituents like dietary fiber and lignans that the whole seed has to offer. In addition, flaxseed in its seed form is much less expensive than oil capsules. The Nutritional Benefits ofFLAXSEED 9 Reported Health Benefits of Flaxseed Diet and nutrition play a large role in overall health. Potential healthy constituents of flaxseed include omega-3 faery acids, soluble and insoluble fiber, phytonutriencs called lignans, and vitamins and minerals. These constituents may not be found in flax oil capsules in levels chat equal those present in the whole seed. Omega-3 Fatty Acids Flaxseed is rich in polyunsaturated fats called omega-3 faery acids. We know chat too much fat in the diet is not good for us, and the American Heart Association recommends 30-35% of total calories a day from fat, with a majority from polyunsaturated and monounsaturaced fats . Omega-3 and some omega-6 fats cannot be made by the body and must come from food sources. Omega-6 fats are found in many foods while omega-3 is harder to find and is present in some planes and in cold water fish. There is some evidence chat people do not consume enough omega-3 fats for the optimal balance of omega-3 and omega-6 fats. Fat balance is important for the body to function optimally to help reduce risks of heart disease and . inflammation. Current ratios of omega-6 fat to omega-3 fat m the modern diet of the United Scates are thought to be about 10-25 co 1 . This may be off balance. A more desirable goal is a ratio of 4-5 to 1. Recommended amounts of omega-3 fats to achieve chis goal are about 0.75 to 1.1 grams per day to balance out the ratio of omega-3's to omega-6's. Flax is 41 % oil, over half of which is omega-3 type and at least two times more than any ocher food! . < Reported Health Benefits of Flaxseed Fiber Insoluble fiber helps regulate bowel movements and soluble fiber has been shown to help improve cholesterol levels. Flaxseed contains both of these kinds of fiber, especially the soluble type. Lignans Lignans are phytonucriencs (substances derived from planes with nutritional properties) chat act in the body the way some natural bodily substances do . Lignans are also referred to as phytoestrogens because they have been shown to mimic the effects of some hormones in the body in favorable ways. Flaxseed is quite high in phycoestrogens. Vitamins and Minerals Flaxseed is rich in certain vitamins and minerals such as folate, calcium, magnesium, phosphorous, potassium, selenium and iron. ' : 10 The Nuh-itional Benefits ofFI.AXSEED , 11 Reported Health Benefits of Flaxseed Reported Health Benefits of Flaxseed Heart Disease and Flaxseed Other Potential Benefits Soluble fiber from oats is well-known for its ability to improve blood cholesterol levels. In addition, omega-3 fatty acids, such as chose found in coldwacer fish, may decrease blood cholesterol levels. Rich in both soluble fiber and omega-3 fatty acids, flaxseed also provides lignans, substances believed co provide additional help reducing the risk of heart disease. Studies show an average of 11-16% total cholesterol reduction in people who consumed 30-50 grams of flaxseed per day for four weeks. Omega-3 fatty acids are reported to help lower LDL (" bad") cholesterol and blood triglycerides, and increase HDL ("good") cholesterol levels. Up to 4 grams of omega-3's have been recommended for people with high triglycerides. There is addi cional evidence regarding flaxseed's potential ability to benefit the immune system, help control blood sugar levels in diabetics, improve dry skin conditions as well as reduce the painful effects of inflammation in different types of arthritis. Cancer and Flaxseed Currently, the American Institute for Cancer Research is studying flaxseed as a potential cancer-fighting food due to its high lignan content. Lignans are converted in the intestine to hormone-like substances chat may be able to reduce absorption of and rid the body of potential cancer-causing agents. Researchers are also studying the effect of omega-3 fatty acids on cancer risk reduction. . 12 ' The Nutritional Benefits ofFLAXSEED 13 Nutritional Content of Flaxseed The suggested intake of Omega-3 fatty acid intake to achieve optimal fatty acid balance is minimum 0.7-1.lgrams per day. This can be accomplished with many foods, but flaxseed has more omega-3 fatty acids than most other foods. Also, it contains up to 800 times more lignans than any other plant food! FLAXSEED Per serving: 4 milled Tablespoons (1 ounce or about 26-28 grams) Total Calories Protein 120 6.0 g Total Fat 9.0 g Og Saturated Monounsaturated 2.2 g Polyunsaturated 6.8 g Omega-3 fatty acids 4.6 g Omega-6 fatty acids 2.2 g Dietary Fiber *8.0 g * The American Dietetic Association recommends 25-35 (maximum of 40) grams of fiber per day. Flaxseed can provide a significant amount of your daily fiber at 8 grams per serving. Note: Omega-3 fatty acids in excessive amounts may have blood-thinning properties that may cause unwanted side effects and interact with certain medications. Keep consumption oftotal fat to a moderate amount (less than or equal to 30% oftotal calories per day) and check with a doctor first, to see ifadding flaxseed to your diet is right for you. Nutritional Content of Flaxseed OMEGA-3 FATTY ACID CONTENT In Grams Per 100 g Food Flaxseed Walnuts (English) Salmon Pecans Tuna Halibut Cod Soybeans Tofu Broccoli (raw) Sunflower seeds 18.30 9.08 2.22 0.98 0.93 0.55 0.47 0.35 0.30 0.13 0.07 Approximately 3 Tablespoons of whole flaxseed has more omega-3 fatty acids than 3 1/2 ounces cooked salmon or 114 cup walnuts! Source: FSHA Food Processor database Flaxseed is rich in vitamins and minerals like calcium for strong bones and Jolie acid and iron for healthy blood and energy. LIGNAN content In Micrograms Per 100 g Food Flaxseed Dried Seaweed Legumes Cereals Vegetables Fruit 52,679 900 562 359 144 84 Source: Thompson LU. Flaxseed in Human Nutrition. 1995: AOCS Press, Champaign, IL p. 219 The Nutritional Benefits ofFLAXSEED 15 General Use and Preparation IN ORDER TO GET ALL THE GREAT BENEFITS OF FLAXSEED, IT IS IMPORTANT TO CRACK OPEN THE TOUGH HULL BY GRINDING OR MILLING THE SEEDS TO A COARSE MEAL. THIS CAN BE DONE BY PULSING Storing Flaxseed Flaxseed, whether whole or milled, is highly resistant to rancidity, making it easy to store since it is so stable. While best stored in the refrigerator, flax can be stored well at room temperature of about 68-72 degrees F. SEEDS A FEW TIMES IN A FOR FRESHNESS, STORE COFFEE BEAN GRINDER OR A BLENDER. WHOLE FLAXSEED FOR UP TO According to research, flaxseed becomes effective at levels of intake of about 25-50 grams of flax per day. This is equal to about 4-6 tablespoons of milled seed. Flax is versatile and can be added to or baked in a variety foods . It is also quite heat stable and whether it is used raw, baked, cooked or any other way, you still get all the healthy benefits. When adding flaxseed to your diet, you may want to start slowly and work up to the full amount since flax is so high in dietary fiber. If you are not used to consuming a lot of fiber in your usual diet, your stomach may need a transition period to build tolerance to higher daily intakes of dietary fiber. In addition, it is important to increase your fluid intake as you eat more fiber. ONE YEAR IN YOUR REFRIGERATOR, OR 6 MONTHS AT ROOM TEMPERATURE. STORE MILLED FLAXSEED FOR UP TO 6 MONTHS IN THE REFRIGERATOR, OR 3 MONTHS AT ROOM TEMPERATURE. Remember to keep flaxseed, especially milled, in a bag or container that seals well to maintain freshness and limit exposure to air, which can cause the flaxseed to become stale or hasten deterioration. Also, baking or cooking with flaxseed does not significantly reduce the benefits of flaxseed's healthy nutrients. Store baked items as usual. ,...... 16. '" The Nutritional Benefits ofFLAXSEED 17 Safety and Regulatory Status Flaxseed is considered safe for human consumption based on its long history of safe use and studies confirm amounts up to 50 grams per day do not cause adverse effects in generally healthy people. The Food and Drug Association (FDA) lists specific constituents naturally found in flaxseed, such as solin oil, linolenic and linoleic fatty acids, and lignans as Generally Recognized as Safe (GRAS). While flax has been petitioned and amended as safe for human consumption, it has not yet been added to the GRAS list, nor have regulations been established that define its use. Flaxseed may not be suitable for persons with certain conditions warranting restriction of whole grains or seeds, such as kidney disease. Flaxseed is gluten-free and will not likely negatively affect persons with celiac disease. Potential effects of flaxseed include blood-thinning. Check with your doctor if you are taking blood-thinning medications or if you plan to have surgery. e ,/ 'i RECIPES Banana Pecan Flax Bread Fruit & Flax Breakfast Shake Oatmeal Flax Cookies Italian Vegetable Salad Roasted Vegetable-Barley Soup Chicken Wild Rice Casserole Carrot Flax Cake Note: if you are following a sodium-restricted diet. you may omit the salt from the following recipes and substitute low-sodium broth or soup. In addition, low-sodium baking soda is usually available in health food stores. · 18 . ... , 3. ' ' The Nutritional Benefits ofFLAXSEED 19 Banana Pecan Flax Bread Sweet and moist with a toasty crust-great for breakfast or as a snack. Each serving provides about 6. 5 grams of flaxseed and 2 grams Omega-3 fats. l 3/4 cup All-purpose flour 3/4 tsp. salt 2 tsp . baking powder l /2 tsp. baking soda l /2 cup flax seeds, milled l l /2 cup mashed, ripe bananas l /2 cup liquid egg substitute l /4 cup canola oil l T. vanilla extract l /2 cup nonfat sour cream Topping: l T. ground cinnamon l T. Brown sugar l /2 cup pecan pieces Fruit & Flax Breakfast Shake Refreshing, fast and easy! Yields about 6. 5 grams flaxseed and 2 grams Omega-3 fats per serving. l medium ripe banana l /2 cup fresh strawberry halves l /2 cup low-fat vanilla yogurt 3/4 cup unsweetened pineapple juice, chilled 2 T. Flax seeds, milled l . Place fruit, yogurt, juice and milled flaxseed in a blender and blend until smooth. Serve immediately. Makes 2-3 servings . l . Preheat oven to 350 degrees F. Grease and flour a 9inch loaf pan or springform pan. 2 . In one bowl combine the flour, baking soda, baking 3 . powder, salt and milled flaxseed. 3 . In another bowl, blend the bananas , eggs, oil , vanilla, sour cream and 3/4 cup packed brown sugar. Blend well. Add dry ingredients and blend until smooth. Pour into pan. 4 . Blend l T. brown sugar and l T. cinnamon and sprinkle on top of batter along with pecans. Bake 40-45 m inutes or until toothpick inserted in center comes out clean. Cool and serve. Makes about l O servings. Nutritional analysis Calories Protein Carbohydrates Dietary Fiber % Calories from fat per serving: 332 6 .6 g 49 g 4 .3 g 3 5% Total Fat Satu rated fat Vitamin A Vitamin C 13.3 g l .2 g 46 RE 3 .3 mg Nutritional analysis Calories Protein Carbohydrates Dietary Fiber % Calories from fat per serving: 21 8 6.1 g 41 g 5.2 g l 8% Total Fat Saturated fat Vitamin A Vitamin C The Nutri.tional Benefits ofFLAXSEED 4 .6 g l .0 g 14 RE 37.5 mg 21 Oatmeal Flax Cookies A traditional favorite with an extra wholesome boost. Provides approximately 8 grams of flaxseed and 2.7 grams Omega-3 fats per 2 cookies. 1 tsp. vanilla extract 3 cups dry, old-fashioned oats 3/4 cup All-purpose white flour 3/4 cup flaxseed, milled 1 tsp. baking soda 1 tsp. ground cinnamon 1 cup seedless raisins 1/2 cup dried English walnuts, chopped 1. Preheat oven to 3 50 degrees F. Beat together sugars and cano la oil, add egg and vanilla until blended . 2. Combine flour, baking soda, cinnamon, oats and flax. Add to egg and sugar mixture . Mix well and stir in raisins and nuts . 3. Drop by heaping teaspoon onto un-greased cookie sheet. Bake 10-25 minutes until golden brown . Cool and serve. Makes about 24 cookies. Serving size 2 cookies . , 22 ; . per serving: 3 70 7.6 g 60 g 5.9 g 29% Simple and flavorful. Substitute vegetables you have on hand. Each serving contains about 8. 1 grams flaxseed and 1. 8 grams Omega-3s. 1/2 cups raw cauliflower florets (bite size pieces) cup broccoli florets 1 cup white onions, chopped 2 cups fresh button mushrooms , cleaned 2 large , raw, green bell peppers 2 cups red , ripe , cherry tomatoes 1 cup fat free Italian salad dressing 1/2 cup flaxseed, milled 1/4 cup liquid egg substitute 1 /4 cup canola oil 1 cup brown sugar, packed 1/2 cup white granulated sugar Nutritional analysis Calories Protein Carbohydrates Dietary Fiber % Calories from fat Italian Vegetable Salad Total Fat Saturated fat Vitamin A Vitamin C 12.6 g 1.2 g 14 RE 0 .7 mg 1. Wash and cut vegetables into bite-sized pieces. Combine together and pour dressing over vegetables. Blend in milled flaxseed . 2 . Cover; marinate in refrigerator several hours. Makes about 8 servings . Nutritional analysis Calories Protein Carbohydrates Dietary Fiber % Calories from fat per serving: 107 4 .8 g 15 g 5.8 g 31 % Total Fat Saturated fat Vitamin A Vitamin C The Nutritional Benefits ofFLAXSEED 4 .0 g 0.5 g 85 RE 73.6 mg 23 Roasted Vegetable-Barley Soup Heart-healthy and chock full of phytonutrients. Freeze some for later! About 5.4 grams flaxseed and 2.5 grams Omega-3 fatty acids. 3 lb fresh red tomatoes, seeded/chopped 1 lb white onion, chopped 1/4 tsp salt 1 1/2 tsp. crushed garlic 1/8 tsp bl~ck pepper 1 lb raw carrots, sliced 8 oz can kidney beans 1 T . olive oil 1/2 cup flaxseed, milled 3/4 cup pearl barley 2 quarts chicken broth 2 cups sliced, canned black olives 1/4 cup chopped, fresh parsley 1. In a large bowl mix tomatoes, onions , garlic, carrots and olive oil. Transfer to sheet pan and roast in a 450 degree F. oven for 45 minutes . Stir occasionally. Transfer mixture to a large stock pot . 2. Add barley and broth to vegetable mixture . Heat to a boil. Reduce heat. Cover. Simmer until barley is tender , about 45 minutes . 3. Add beans , milled flaxseed, olives and parsley. . 4 . Adjust seasoning with salt and pepper. 4 Serve in shallow bowls with a slice or wedge of focacc1a ~ hearty crusted bread. Makes about 12 servings. 0 Nutritional analysis per serving: Calories 21 8 Protein 9.3 g Carbohydrates 31 g Dietary Fiber 8 .5 g 2 9% % Calories from fat Total Fat Saturated fat Vitamin A Vitamin C 7.5 g 1.0 g 526 RE 30.0 mg Chicken Wild Rice Casserole Casseroles are a great place to add flaxseed since it blends so well and adds a nutty flavor. Each serving of this dish provides around 11 grams flaxseed and 2.5 grams Omega-3 fats. 2 cups chicken broth l cup dry wild rice 2 T. olive oil l /2 medium onion, chopped l /2 cup green bell pepper, chopped 1/2 tsp . salt l cup sli ced mushrooms 1/8 tsp. thyme 3 roasted chicken breasts , chopped 6 ounce can cream of asparagus soup l /2 cup flaxseed, mil led 2 garlic cloves, crushed l /4 tsp . Black pepper 1/2 cup sliced almonds l . Prepare rice according to package directions using broth as liquid ; set aside . 2. Place olive oil in a heavy saucepan over low heat. Saute onion in oil until golden. Add green pepper and mushrooms. Continue cooking until tender. 3. Combine condensed soup, cooked rice, sauteed vegetables, chopped chicken breasts and remaining ingredients. 4 . Pour into lightly greased 2-quart casserole . Sprinkle with sliced almonds . Cover and bake at 350 degrees F. for 35 minutes. Makes 6 servings. Nutritional analysis Calories Protein Carbohydrates Dietary Fiber % Calories from fat per serving: 433 37.5 g 34 g 6 .9 g 3 5% Total Fat 16.9 g Saturated fat 2.6 g Vitamin A 23 RE Vitamin C 1 3. 5 mg The Nutritional Benefits ofFLAXSEED 25 . A word on adding flaxseed to recipes. • • Carrot Flax Cake Who says dessert can't be good for you? How about a treat with 11 or so grams of flaxseed and 3.2 grams Omega-3 fatty acids per serving. 4 cups grated , raw carrots 2 cups white granulated sugar 8 oz can crushed pineapple with juice l /2 cup canola oil l /4 cup liquid egg substitute l /4 cup orange juice 2 tsp. vanilla extract l 3/4 cup all-purpose flour l /2 tsp. salt 2 tsp . ground cinnamon 2 tsp. Baking soda l cup flaxseed, milled 9 oz fat-free cream cheese 6 T. powdered confectioner 's sugar 3 T . nonfat milk h d A!though a generally healthy amount of flaxseed to eat eac ay r_s about 4-6 tablespoons, this does not mean you must consu~e It all at one time, in or on one food or just one meal If you like, spread out the amount over the day in different . ways. Get accustomed to adding flaxseed to your baked p~oduc~s and on meals. There are many foods to which flax ~111 easily blend _and add texture and flavor. You can add it to Just about anythmg: Cereal Juice Yogurt Casseroles Tacos Soups Salads Stews Sauces and dressings Dips Hot cereals Tuna, chicken or egg salad Pancakes, waffles or muffins Cakes and cookies Chili or even atop pizza! l. Preheat oven to 375 degrees F. Coat a 9 x l 3- in ch baking pan with vegetable cooking spray; set aside . In large bowl combine carrots, sugar, pineapple, oil, egg substitute , orange juice and vanilla; stir to blend thoroughly . 2. Add flour, baking soda, salt , milled flaxseed, cin namon; mix completely. 3. Spread batter in prepared pan. Bake about 45 minutes until pick inserted into center comes out clean. Cool on rack. 4. Whip cream cheese, milk and powdered sugar. Frost cake . Cut into 3 x 3 l /4 inch pieces. Makes 12 servings. Nutritional analysis per serving: 407 8.7 g 63 g 5.7 g 31 % Calories Protein Carbohydrates Dietary Fiber % Calories from fat Total Fat Saturated fat Vitamin A 11 Vitamin C 14.2 l .3 03 .0 6.9 g g RE mg Al The p~ssi~ilities are endless . . . use your imagination! fl so, try subsmuung 113 of the oil or flour in recipes with ~seed. If you do, you may need to reduce baking time a few mmutes. The Nutritional Benefits ofFLAXSEED 27 Summary The connection between nutrition and health is an important one. The health benefits associated with flaxseed consumption make it a valuable complement to your daily diet Flax is easy to use and imparts a good flavor and texture to foods . As a rich source of essential fats, fiber and plant compounds, flaxseed is a good addition because of its potential health benefits to reduce risks of heart disease and cancer, and contributes to overall good health. Consuming flax in its humble, ground food form is the best and safest way to get all the great benefits flax has to offer. The Nutritional Benefits ofFLAXSEED .· 28 . . ' 29 . References Alonso L, Marcos ML, Blanco JG, et al. Anaphylaxis caused by linseed (fl axseed) intake. J Allergy Clin Jmmun ol. 1996;98:469-70. Alpers L, Sawyer-Morse M. Eating quality of banana nut muffi ns and oatmeal cookies made with gro und flaxseed. J Am Diet Assoc. I 996 August;96(8):794-97 . Annussek G, Flaxseed. Gale Encyclopedia of Alternative Medicine. 200 1: 45658. Babu U, Mitchell G, Wiesenfeld P, et al. Nutritional and hematological impact of dietary flaxseed and defatted fl axseed meal in rats. Int J Food Sci Nutr. 2000;5 I: I 09-17. Bolt H, Janning P, Michna H, Degen G. Comparative assessment of endocrine modulators with oestrogenic activity: definition of a hygiene-based margin of safety (H BMOS) for xeno-oestrogens against the background of european developments. Arch Toxicol. 2001 ;74:649-62. Brzezi nski A, Debi A. Phytoestrogens: the " natural" selective estrogen receptor modulators? Eur J Obst Gyn Repr Biol. I 999;85:47-51. Cunn ane s, Hamadeh M, Leide A et al. N utriti onal attributes of traditional flaxseed in healthy young adults. Am J Clin Nutr. 1995;6 l :62-8. Demark-Wah nefried W, Price D, Polascik T, Robertson C, et al. Pilot study of dietary fat restriction and flaxseed supplementation in men with prostate cancer before surgery: exploring the effects on hormonal levels, prostate-specific antigen, and hi stopathol ogic features. Adult Urology. 2001 ;58( 1):47-52. ES HA Food Processor Software, version 7.5 Ferretti A, Flanagan V. Antithromboxane activ ity of dietary alpha-linolenic ~cid : a pilot study. Prostaglandins, Leukotrienes and Essential Fatty Acids. 1996;:,4 (6) :451 -55 . Haggans C, Travelli E, Thomas W, et al. '.he ~ffect offla,'<seed and wheat bran consumption on urinary estrogen metabolttes in premenopausal women. Cancer, Epidemiology. Biomarkers & Prevention. 2000;9:719-2 5. Hall D. Nutritional infl uences on estrogen metabolism. App Nutr Sci Reports. 2001 Jan ;451 l-17 . References Hambly R, Rumney C, Fletcher J. Effects of hi gh- and low-risk diets on gut microflora-associated biomarkers of colon cancer in human flora-associated rats. Nutr and Cancer. l 997;27(3):250-55. Hutchins A, Martini M, Olson B, et al. Flaxseed co nsumption influences end ogenous hormone concentrations in postmenopausal women. Nutr and Cancer. 200 I ;39( I ):58-65. James M, Gibson R, Cleland L. Dietary polyunsaturated fatty ac ids and inflammatory medi ator prod uction. Am J Clin Nutr. 2000;7 l (supple):343S-8S. Jenkins D, Kendall C, Yigdin E, et al. Health aspects of partially defatted flaxseed, including effects on serum li pids, oxidative measures, an d ex vivo androgen and progestin activity: a controlled crossover tri al. Am J Clin Nutr. 1999 :69 (3):395-402. Ketts D, Yuan Y, Wijewickreme A, Tho mpson L. Antioxidant activi ty of the flaxseed lignan secoisolarici resinol di glycos ide and its mamm ailian lignan metabo lites enterodiol and enterolacto ne. Molecular and Cellular Biochem. 1999;202:91 - 100. Kuiper G, Lemmen G, Carl sson BO, et al. Interaction of estrogenic chemicals and phytoestrogens with estrogen receptor [beta]. Endocrinology. 1998; 139 ( I 0):4252-62. Lewis NM , Sebu rg S, Flanagan N. Enriched eggs as a so urce ofn-3 polyunsaturated fatty ac ids fo r humans. Poultry Science. 2000;79 :97 1-4. Mantz ioris E, Cleland L, Gibson R, et al. Biochemical effects of a di et containing foods enriched with n-3 fatty ac ids. Am J Clin Nutr. 2000;72 :42-8. Mantziori s E, James M, Gi bson R, Cleland L. Dietary substitution with an alphalinolenic ac id-rich vegetable oil increases eicosapentaeno ic aci d concentrations in tissues. Am J Cl/in Nutr. 1994;59: 1304-9. Meagher L, Beecher G, Flanagan Y, Li B. Isolation and characterization of the lignans, isolariciresinol and pinoresi nol, in flaxseed meal. J Agric Good Chem. 1999;47:3 I 73-80. Meilahn EN, De Stavo la B, Allen OS, et al. Do uri nary estrogen metabolites predict breast cancer? Guernsey III cohort fo llow-up. Brit J Cancer. 1998;78: I 25055 . The Nutritional Benefits ofFLAXSEED 31 . Appendix Conversions: 454 grams or 16 ounces 1 pound = 1 gram = 0.035 ounces 1 ounce = 1 cup whole flaxseed = r}80 grams 1 cup milled flaxseed, packed = 2 T. milled flaxseed :r }3 grams 1 oz. milled flaxseed = 34 r28 grams r}30-150 grams r28 grams