Lignans' Potential in Pre and Post-onset Type 2 Diabetes Management

Author(s): Douglas Edward Barre*, Kazimiera Amella Mizier-Barre

Journal Name: Current Diabetes Reviews

Volume 16 , Issue 1 , 2020

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Introduction: Type 2 Diabetes (T2D) cases continue to rise dramatically despite efforts to get people to exercise and eat with a view to health and combatting the cluster of 7 issues (central obesity (elevated waist circumference), hyperglycaemia, hypertension, dyslipidemia, pro-thrombotic state, increased oxidation (including Low-density Lipoprotein (LDL)) and the pro-inflammatory state associated with pre- and post-onset T2D.

Background: There are numerous medications available to deal with these seven major issues. However, each medication currently available manages a maximum of two cluster members at a time. Consequently, polypharmacy is frequently required to manage the cluster of seven. Polypharmacy brings with it high financial costs for numerous medications, the risk of poor compliance (particularly so in older patients), side effects and drug interactions. Thus, there is a search for new agents that reduce the high costs and risks of polypharmacy while at the same time combatting three or more of the cluster of seven. There is very limited evidence to suggest that one or more lignans may efficaciously and safely, in the short and long term, manage at least three of the cluster of seven, pre- and post-T2D onset, thus reducing polypharmacy. However, multi-centre, large clinical trials are required before any definitive conclusions about these lignans can be reached regarding their safe and efficacious polypharmacy reduction potential, both long and short-term, in pre and post-onset T2D management.

Conclusion: It is concluded that some lignans appear to have the potential to manage at least three members of the cluster of seven in pre- or post-T2D onset and hence reduce polypharmacy but much more investigation is required to confirm if such is the case. At the moment, there is not enough evidence that any of the lignans will, in the long or short term, safely and efficaciously manage the cluster of seven via polypharmacy reduction.

Keywords: Lignans, type 2 diabetes, polypharmacy, low density lipoprotein, plasma, glucose.

Grundy SM. Metabolic syndrome: Connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol 2006; 47(6): 1093-100.
Mittermayer F, Caveney E, De Oliveira C, et al. Addressing unmet medical needs in type 2 diabetes: a narrative review of drugs under development. Curr Diabetes Rev 2015; 11: 17-31.
Huang ES. Appropriate application of evidence to the care of elderly patients with diabetes. Curr Diabetes Rev 2007; 3: 260-3.
Myers A. Editorial: Management of Diabetes in Unique Populations. Curr Diabetes Rev 2017; 13: 193-4.
American Diabetes Association. Older adults. Sec. 10. In Standards of Medical Care in Diabetes. Diabetes Care 2016; 39(Suppl. 1): S81.
Orlando V, Guerriero F, Putignano D, et al. Prescription patterns of antidiabetic treatment in the elderly. results from southern italy. Curr Diabetes Rev 2015; 12: 100-6.
Lipska KJ, Krumholz H, Soones T, Lee SJ. Polypharmacy in the aging patient: a review of glycemic control in older adults with type 2 diabetes. JAMA 2016; 315: 1034-45.
Ziegler D. Current concepts in the management of diabetic polyneuropathy. Curr Diabetes Rev 2011; 7: 208-20.
Grant RW, Devita NG, Singer DE, et al. Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care 2003; 26: 1408-12.
Myers AK, Trivedi MH. Death by Insulin: Management of Self-Harm and Suicide in Diabetes Management. Curr Diabetes Rev 2017; 13: 251-62.
Pompili M, Forte A, Lester D, et al. Suicide risk in type 1 diabetes mellitus: A systematic review. Psychosom Res 2014; 76: 352-60.
Austin RP. Polypharmacy as a risk factor in the treatment of type 2 diabetes. Diabetes Spectr 2006; 19: 13-6.
van Bruggen R, Gorter K, Stolk RP, et al. Refill adherence and polypharmacy among patients with type 2 diabetes in general practice. Pharmacoepidemiol Drug Saf 2009; 18: 983-91.
Huang ES, Karter AJ, Danielson KK, et al. The association between the number of prescription medications and incident falls in a multi-ethnic population of adult type-2 diabetes patients: the diabetes and aging study. J Gen Intern Med 2010; 25: 141-6.
Dunn JD. Diabetes pharmacy management: balancing safety, cost, and outcomes. Am J Manag Care 2010; 16(7)(Suppl.): S201-6.
Moreira Bde S, Sampaio RF, Furtado SR, Dias RC, Kirkwood RN. The relationship between diabetes mellitus, geriatric syndromes, physical function, and gait: a review of the literature. Curr Diabetes Rev 2016; 12: 240-51.
Azuma K, Heilbronn LK, Albu JB, et al. Adipose tissue distribution in relation to insulin resistance in type two diabetes. Am J Physiol Endocrinol Metab 2007; 293: E435-42.
Erkelens DW. Insulin resistance syndrome and type 2 diabetes mellitus. Am J Cardiol 2001; 88(Suppl.): 38J-42J.
Hawkins M, Tonelli J, Kishore P, et al. Contribution of elevated free fatty acids to the lack of glucose effectiveness in type 2 diabetes. Diabetes 2003; 52: 2748-58.
Pi-Sunyer FX. Pathophysiology and long-term management of the metabolic syndrome. Obes Res 2004; 12(Suppl.): 174S-80S.
Avogaro A, Fadini GP, Gallo A, et al. Endothelial dysfunction in type two diabetes mellitus. Nutrition, Metabolism & Cardiovascular Diseases 2006; 16(Suppl.): S39-45.
Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology and management. JAMA 2002; 287: 2570-81.
Cheung BM. The hypertension-diabetes continuum. J Cardiovasc Pharmacol 2010; 55: 333-9.
Kalofoutis C, Piperi C, Kalofoutis A, et al. Type II diabetes mellitus and cardiovascular risk factors: Current therapeutic approaches. Exp Clin Cardiol 2007; 12: 17-28.
Tancredi M, Rosengren A, Svensson AM, et al. Excess mortality among persons with type 2 diabetes. N Engl J Med 2015; 373: 1720-32.
Salvetti A, Brogi G, Di Legge V, et al. The inter-relationship between insulin resistance and hypertension. Drugs 1993; 46(Suppl. 2): 149-59.
Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care 2004; 27: 1496-504.
Carr MC, Brunzell JD. Abdominal obesity and dyslipidemia in the metabolic syndrome: importance of type two diabetes and familial combined hyperlipidemia in coronary artery disease risk. J of Clin Endocrinol Metab 2004; 89: 2601-7.
Gresele P, Guglielmini G, De Angelis M, et al. Acute, short-term hyperglycemia enhances shear stress-induced platelet activation in patients with type II diabetes mellitus. J Am Coll Cardiol 2003; 41: 1013-20.
Feher MD. Diabetes: Preventing coronary heart disease in a high risk group. Heart 2004; 90(Suppl. IV): iv18-21.
Roper NA, Bilous RW, Kelly WF, et al. South tees diabetes mortality study. cause-specific mortality in a population with diabetes: south tees diabetes mortality study. Diabetes Care 2002; 25: 43-8.
Wright E Jr, Scism-Bacon JL, Glass LC. Oxidative stress in type 2 diabetes: the role of fasting and postprandial glycaemia. Int J Clin Pract 2006; 60: 308-14.
Locatelli F, Canaud B, Eckardt KU, et al. Oxidative stress in endstage renal disease: an emerging threat to patient outcome. Nephrol Dial Transplant 2003; 18: 1272-80.
Keane WF, Brenner BM, de Zeeuw D, et al. The risk of developing end-stage renal disease in patients with type 2 diabetes and neph- ropathy: the RENAAL study. Kidney Int 2003; 63: 1499-507.
Njajou OT, Kanaya AM, Holvoet P, et al. Association between oxidized LDL, obesity and type 2 diabetes in a population based cohort, the health aging and body composition study. Diabetes Metab Res Rev 2009; 25: 733-9.
Guldiken B, Guldiken S, Turgut B, et al. The roles of oxidized low- density lipoprotein and interleukin-6 levels in acute atherothrom- botic and lacunar ischemic stroke. Angiology 2008; 59: 224-9.
Boudjeltia KZ, Legssyer I, Antwerpen PV, et al. Triggering of inflammatory response by myeloperoxidase-oxidized LDL. Biochem Cell Biol 2006; 84: 805-12.
Devaraj S, Tang R, Adams-Huet B, Harris A, et al. Effect of high- dose α- tocopherol supplementation on biomarkers of oxidative stress and inflammation and carotid atherosclerosis in patients with coronary artery disease. Am J Clin Nutr 2007; 86: 1392-8.
Hulthe J, Wikstrand J, Fagerberg B. Relationship between c- reactive protein and intima-media thickness in the carotid and femoral arteries and to antibodies against oxidized low-density lipoprotein in healthy men: the atherosclerosis and insulin resistance (AIR) study. Clin Sci 2001; 100: 371-8.
Lodh M, Goswami B, Parida A, et al. Assessment of serum leptin, pregnancy- associated plasma protein A and CRP levels as indicators of plaque vulnerability in patients with acute coronary syndrome. Cardiovasc J Afr 2012; 23: 330-5.
Nishi K, Itabe H, Uno M, et al. Oxidized LDL in carotid plaques and plasma associates with plaque instability. Arterioscler Thromb Vasc Biol 2002; 22: 1649-54.
Niccoli G, Mongiardo R, Lanza GA, et al. The complex link between oxidised low-density lipoprotein and unstable angina. J Cardiovasc Med (Hagerstown) 2007; 8: 387-91.
Ragino YI, Chernjavski AM, Polonskaya YV, et al. Oxidation and endothelial dysfunction biomarkers of atherosclerotic plaque instability: Studies of the vascular wall and blood. Bull Exp Biol Med 2012; 153: 331-5.
Kobayashi S, Inoue N, Ohashi Y, et al. Interaction of oxidative stress and inflammatory response in coronary plaque instability: important role of c-reactive protein. Arteriosclersclerosis Thrombosis and Vascular Biology 2003; 23: 1398-404.
Calabrò P, Golia E, Yeh ET. CRP and the risk of atherosclerotic events. Semin Immunopathol 2009; 31: 79-94.
Koenig W, Sund M, Fröhlich M, et al. C-Reactive protein, a sensi- tive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease. Augsburg Cohort Study, 1984 to 1992. Circulation 1999; 99: 237-42.
Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105: 1135-43.
Bastard JP, Maachi M, Lagathu C, et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw 2006; 17: 4-12.
Prasad K. C-reactive protein and cardiovascular diseases. International Journal of Angiology 2003; 12: 1-12.
Pradhan AD, Ridker PM. Do atherosclerosis and type two diabetes share a common inflammatory basis. Eur Heart J 2002; 23: 831-4.
Schwedler SB, Filep JG, Galle J, et al. C-reactive protein: A family of proteins to regulate cardiovascular function. American Journal of Kidney Diseases 2006; 47: 212-22.
Dandona P, Aljada A, Chaudhuri A, et al. Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 111: 1448-54.
Setchell KDR, Brown NM, Zimmer-Nechemias L, et al. Metabolism of secoisolariciresinol-diglycoside the dietary precursor to the intestinally derived lignan enterolactone in humans. Food & Funct 2014; 5: 491-501.
Nurmi T, Mursu J, Peñalvo JL, et al. Dietary intake and urinary excretion of lignans in Finnish men. Br J Nutr 2010; 103: 677-85.
Bannwart C, Adlercreutz H, Wähälä K, et al. Detection and identi- fication of the plant lignans lariciresinol, isolariciresinol and secoisolariciresinol in human urine. Clin Chim Acta 1989; 180: 293-301.
Milder IE, Feskens EJ, Arts IC, et al. Intake of the plant lignans secoisolariciresinol, matairesinol, lariciresinol, and pinoresinol in Dutch men and women. J Nutr 2005; 135: 1202-7.
Frankenfeld CL. Cardiometabolic risk factors are associated with high urinary enterolactone concentration, independent of urinary enterodiol concentration and dietary fiber intake in adults. J Nutr 2014; 144: 1445-53.
de Kleijn MMJ, van der Schouw YT, Wilson PWF, et al. Dietary intake of phytoestrogens is associated with a favorable metabolic cardiovascular risk profile in postmenopausal US women: The Framingham study. J Nutr 2002; 132: 276-82.
Barre DE, Mizier-Barre KA, Stelmach E, et al. Flaxseed lignan complex administration in older human type 2 diabetes patients manages central obesity and prothrombosis - an invitation to further investigation into polypharmacy reduction. J Nutr Metab 2012; (585170): 1-7.
Meagher LP, Beecher GR, Flanagan VP, et al. Isolation and characterization of the lignans, isolariciresinol and pinoresinol, in flaxseed meal. J Agric Food Chem 1999; 47: 3173-80.
Thompson LU, Boucher BA, Liu Z, et al. Phytoestrogen content of foods consumed in Canada, including isoflavones, lignans, and coumestan. Nutr Cancer 2006; 54: 184-201.
Hu Y, Song Y, Franke AA, et al. A prospective investigation of the association between urinary excretion of dietary lignan metabolites and weight change in US Women. Am J Epidemiol 2015; 182: 503-11.
Morisset AS, Lemieux S, Veilleux A, et al. Impact of a lignan-rich diet on adiposity and insulin sensitivity in post-menopausal women. Br J Nutr 2009; 102: 195-200.
Kang J, Park J, Kim HL, et al. Secoisolariciresinol diglucoside inhibits adipogenesis through the AMPK pathway. Eur J Pharmacol 2018; 820: 235-44.
Snijder MB, Dekker JM, Visser M, et al. Associations of hip and thigh circumferences independent of waist circumference with the incidence of type 2 diabetes: The Hoorn Study. Am J Clin Nutr 2003; 77: 1192-7.
Zhang W, Wang X, Liu Y, et al. Dietary flaxseed lignan extract lowers plasma cholesterol and glucose concentrations in hypercho- lesterolaemic subjects. Br J Nutr 2008; 99: 1301-9.
Hano C, Renouard S, Molinié R, et al. Flaxseed (Linum usitatis- simum L.) extract as well as (+)-secoisolariciresinol diglucoside and its mammalian derivatives are potent inhibitors of α-amylase activity. Bioorg Med Chem Lett 2013; 23: 3007-12.
Wikul A, Damsud T, Kataoka K, et al. (+)-Pinoresinol is a putative hypoglycemic agent in defatted sesame (Sesamum indicum) seeds though inhibiting α-glucosidase. Bioorg Med Chem Lett 2012; 22: 5215-7.
Rasouli H, Hosseini-Ghazvini SM, Adibi H, Khodarahmi R. Differential α-amylase/α-glucosidase inhibitory activities of plant- derived phenolic compounds: a virtual screening perspective for the treatment of obesity and diabetes. Food Funct 2017; 8: 1942-54.
Zhou F, Furuhashi K, Son MJ, et al. Antidiabetic effect of enterolactone in cultured muscle cells and in type 2 diabetic model db/db mice. Cytotechnology 2016; 69: 493-502.
Prasad K. Suppression of phosphoenolpyruvate carboxykinase gene expression by secoisolariciresinol diglucoside (SDG), a new an- tidiabetic agent. Int J Angiol 2002; 11: 107-9.
Huang SL, Yu RT, Gong J, et al. Arctigenin, a natural compound, activates AMP-activated protein kinase via inhibition of mitochon- dria complex I and ameliorates metabolic disorders in ob/ob mice. Diabetologia 2012; 55: 1469-81.
Sun Y, Zang Z, Zhong L, et al. Identification of adiponectin recep- tor agonist utilizing a fluorescence polarization based high throughput assay. PLoS One 2013; 8(5)e63354
Yang S, Na MK, Jang JP, et al. Inhibition of protein tyrosine phos- phatase 1B by lignans from Myristica fragrans. Phytother Res 2006; 20: 680-2.
Lee A, Choi KM, Jung WB, et al. Enhancement of glucose uptake by meso-dihydroguaiaretic acid through GLUT4 up- regulation in 3T3-L1 adipocytes. Molecules 2017; 22(9)E1423
Mohammad Shahi M, Zakerzadeh M, Zakerkish M, et al. Effect of sesamin supplementation on glycemic status, inflammatory mark- ers, and adiponectin levels in patients with type 2 diabetes mellitus. J Diet Suppl 2017; 22: 65-75.
Badole SL, Zanwar A, Bodhankar SL. Antihyperglycemic potential of secoisolaricinol diglucoside in bioactive food as dietary interventions for diabetes. Elsevier 2013; pp. 53-7.
Hallund J, Tetens I, Bügel S, et al. Daily consumption for six weeks of a lignan complex isolated from flaxseed does not affect endothelial function in healthy postmenopausal women. J Nutr 2006; 136: 2314-8.
Kreijkamp-Kaspers S, Kok L, Bots ML, et al. Dietary phytoestrogens and vascular function in postmenopausal women: a crosssectional study. J Hypertens 2004; 22: 1381-8.
Cornish SM, Chilibeck PD, Paus-Jennsen L, et al. A randomized controlled trial of the effects of flaxseed lignan complex on metabolic syndrome composite score and bone mineral in older adults. Appl Physiol Nutr Metab 2009; 34: 89-.
Kong X, Yang JR, Guo LQ, et al. Sesamin improves endothelial dysfunction in renovascular hypertensive rats fed with a high-fat, high-sucrose diet. Eur J Pharmacol 2009; 620: 84-9.
van der Schouw YT, Pijpe A, Lebrun CE, et al. Higher usual die- tary intake of phytoestrogens is associated with lower aortic stiffness in postmenopausal women. Arterioscler Thromb Vasc Biol 2002; 22: 1316-22.
Fukumitsu S, Aida K, Shimizu H, et al. Flaxseed lignan lowers blood cholesterol and decreases liver disease risk factors in moderately hypercholesterolemic men. Nutr Res 2010; 30: 441-6.
Kreijkamp-Kaspers S, Kok L, Bots ML, et al. Dietary phytoestro- gens and plasma lipids in Dutch postmenopausal women; a crosssectional study. Atherosclerosis 2005; 178: 95-100.
Adlercreutz H. Lignans and human health. Crit Rev Clin Lab Sci 2007; 44: 483-525.
Ide T, Ashakumary L, Takahashi Y, et al. Sesamin, a sesame lig- nan, decreases fatty acid synthesis in rat liver accompanying the down-regulation of sterol regulatory element binding protein-1. Biochim Biophys Acta 2001; 1534: 1-13.
Hirata F, Fujita K, Ishikura Y, et al. Hypocholesterolemic effect of sesame lignan in humans. Atherosclerosis 1996; 122: 135-6.
Hong L, Yi W, Liangliang C, et al. Hypoglycaemic and hypolipidaemic activities of sesamin from sesame meal and its ability to ameliorate insulin resistance in KK-Ay mice. J Sci Food Agric 2013; 93: 1833-8.
Peñalvo JL, López-Romero P. Urinary enterolignan concentrations are positively associated with serum HDL cholesterol and negatively associated with serum triglycerides in U.S. adults. J Nutr 2012; 142: 751-6.
Clark WF, Muir AD, Westcott ND, et al. A novel treatment for lupus nephritis: lignan precursor derived from flax. Lupus 2000; 9: 429-36.
Cox CP, Wood KL. Selective antagonism of platelet-activating factor (PAF)- induced aggregation and secretion of washed rabbit platelets by CV-3988, L-652731, triazolam and alprazolam. Thromb Res 1987; 47: 249-57.
Freedman JE. Oxidative stress and platelets. Arterioscler Thromb Vasc Biol 2008; 28(3): s11-6.
Moree SS, Rajesha J. Investigation of in vitro and in vivo antioxi- dant potential of secoisolariciresinol diglucoside. Mol Cell Biochem 2013; 373: 179-87.
Hu C, Yuan YV, Kitts DD. Antioxidant activities of the flaxseed lignan secoisolariciresinol diglucoside, its aglycone secoisolarici- resinol and the mammalian lignans enterodiol and enterolactone in vitro. Food Chem Toxicol 2007; 45: 2219-27.
Frank J, Eliasson C, Leroy-Nivard D, et al. Dietary secoisolariciresinol diglucoside and its oligomers with 3-hydroxy-3-methyl glutaric acid decrease vitamin E levels in rats. Br J Nutr 2004; 92: 169-76.
Vanharanta M, Voutilainen S, Nurmi T, et al. Association between low serum enterolactone and increased plasma F2-isoprostanes, a measure of lipid peroxidation. Atherosclerosis 2002; 160: 465-9.
Salonen JT, Nyyssönen K, Salonen R, et al. Antioxidant Supple- mentation in Atherosclerosis Prevention (ASAP) study: a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis. J Intern Med 2000; 248: 377-86.
Prasad K. Antioxidant activity of secoisolariciresinol diglucoside- derived metabolites, secoisolariciresinol, enterodiol, and enterolactone. Int J Angiol 2000; 9: 220-5.
Hosseinian FS, Muir AD, Westcott ND, et al. Antioxidant capacity of flaxseed lignans in two model systems. J Am Oil Chemists’. Soc 2006; 83: 835-40.
Mukker JK, Michel D, Muir AD, Krol ES, Alcorn J. Permeability and conjugative metabolism of flaxseed lignans by Caco-2 human intestinal cells. J Nat Prod 2014; 77: 29-34.
Kuijsten A, Arts IC, Vree TB, et al. Pharmacokinetics of enterolignans in healthy men and women consuming a single dose of secoisolariciresinol diglucoside. J Nutr 2005; 135: 795-801.
Kitts DD, Yuan YV, Wijewickreme AN, et al. Antioxidant activity of the flaxseed lignan secoisolariciresinol diglycoside and its mammalian lignan metabolites enterodiol and enterolactone. Mol Cell Biochem 1999; 202: 91-100.
Almario RU, Karakas SE. Lignan content of the flaxseed influences its biological effects in healthy men and women. J Am Coll Nutr 2013; 32: 194-9.
Niemeyer HB, Metzler M. Differences in the antioxidant activity of plant and mammalian lignans. J Food Eng 2003; 56: 255-6.
Song CW, Wang SM, Zhou LL, et al. Isolation and identification of compounds responsible for antioxidant capacity of Euryale ferox seeds. J Agric Food Chem 2011; 59: 1199-204.
Prasad K. Secoisolariciresinol diglucoside from flaxseed delays the development of type two diabetes in Zucker rat. J Clin Lab Medic 2001; 138: 32-9.
Prasad K. Reduction of serum cholesterol and hypercholes- terolemic atherosclerosis in rabbits by secoisolariciresinol diglucoside isolated from flaxseed. Circulation 1999; 99: 1355-62.
Prasad K. Regression of hypercholesterolemic atherosclerosis in rabbits by secoisolariciresinol diglucoside isolated from flaxseed. Atherosclerosis 2008; 197: 34-42.
Nasermoaddeli A, Sekine M, Kagamimori S. Gender differences in associations of c-reactive protein with atherosclerotic risk factors and psychosocial characteristics in Japanese civil servants. Psychosom Med 2006; 68: 58-63.
Pan A, Demark-Wahnefried W, Ye X, et al. Effects of a flaxseed- derived lignan supplement on C-reactive protein, IL-6 and retinol- binding protein 4 in type 2 diabetic patients. Br J Nutr 2009; 101: 1145-9.
Pellegrini N, Valtueña S, Ardigò D, et al. Intake of the plant lignans matairesinol, secoisolariciresinol, pinoresinol, and lariciresinol in relation to vascular inflammation and endothelial dysfunction in middle age-elderly men and post- menopausal women living in Northern Italy. Nutr Metab Cardiovasc Dis 2010; 20: 64-71.
Spilioti E, Holmbom B, Papavassiliou AG, et al. Lignans 7- hydroxymatairesinol and 7-hydroxymatairesinol 2 exhibit anti- inflammatory activity in human aortic endothelial cells. Mol Nutr Food Res 2014; 58: 749-59.
Hallund J, Tetens I, Bügel S, et al. The effect of a lignan complex isolated from flaxseed on inflammation markers in healthy post- menopausal women. Nutr Metab Cardiovasc Dis 2007; 18: 497-502.
Hallund J, Ravn-Haren G, Bugel S, et al. A lignan complex isolated from flaxseed does not affect plasma lipid concentrations or anti- oxidant capacity in healthy postmenopausal women. The J Nutr 2006; 136: 112-6.

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Year: 2020
Published on: 13 December, 2019
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