Guest guest Posted March 11, 2002 Report Share Posted March 11, 2002 Alpha-linolenic acid is the major plant omega 3 fatty acid. Flax seed oil is the richest natural source of this fatty acid, but it is also present in large amounts in a variety of other plant oils. Increased intake of this fatty acid has been associated with a decrease in blood cholesterol levels and may reduce the risk of heart attack. Similarly, there is some evidence to suggest that alpha-linolenic acid may slow the growth of cancers of the breast and colon. These observations have led a number of physicians and dietitians to recommend flaxseed oil or alpha linolenic acid extracts to all cancer patients. In previous newsletters and in our book " Eating your way to better health " , we have repeatedly pointed out that there are two problems with recommending alpha linolenic acid to prostate cancer patients. First, there is no evidence that increased alpha linolenic acid extracts or flaxseed oil provide any benefit. Second, those clinical studies that are available suggest that alpha linolenic acid may actually be dangerous. An additional epidemiology study that examines the association of alpha linolenic acid and prostate cancer risk has just been published. Dr. De Stefani and colleagues from Registro Nacional de Cancer, Montevideo, Uruguay examined the association between prostate cancer and alpha linoleic acid, linoleic acid, total fat, saturated fat, and monounsaturated fat. Additionally, they tested whether there was a difference between alpha linolenic acid obtained from animal or vegetable sources. One of the reasons this study is interesting is that Uruguay has one of the higher death rates from prostate cancer as well as one of the highest rates of red meat consumption .. This study found that the major risk factors associated with the development of prostate cancer were family history of this disease and intake of alpha linolenic acid. When the risk was adjusted for intake of linoleic acid, saturated fat, monunsaturated fat and red meat intake, those with the highest intake of alpha linolenic acid had a 440% increase in risk compared with those at the lowest level. Also, alpha linolenic acid from both vegetable and animal sources were associated with an increase in the risk of prostate cancer. There are now six epidemiology studies that have examined the association between dietary alpha linolenic acid and risk of prostate cancer. Five out of six of these studies found an increase in the risk of prostate cancer associated with alpha-linolenic acid. The one negative study is from Sweden. It is important to note that the Swedish study did not show any benefit from alpha linolenic acid, but rather found this fatty acid had no impact. Thus, six out of six studies found no benefit to increased alpha linolenic acid, while five found potential harm! I should also note that our laboratory as well as others find that alpha linolenic acid is one of the most powerful growth stimuli for human prostate cancer cells. Every time I write on alpha linolenic acid and flaxseed oil, we receive a flood of emails and letters asking if we are we really saying that these fats are dangerous rather than helpful. After all, these other experts are all telling us to take flaxseed oil. To this I can only repeat that the evidence currently available certainly fail to document any benefit as far as prostate cancer treatment. Further, laboratory and epidemiology studies continue to suggest that it may be quite dangerous to increase your intake of alpha linolenic acid as it may well increase the growth and spread of your cancer. I have been asked to comment on flaxseed as compared to flaxseed oil. My major concern is with the flaxseed oil, which permits patients to ingest very large amounts of alpha linolenic acid in a short period of time. While flaxseed contain alpha linolenic acid, it is quite unlikely that someone will eat enough flaxseed to match the alpha linolenic acid content of even a modest dose of the oil. Additionally, flaxseed contain a number of phytochemicals, such as lignans, that are of potential value. One of the major lignans in flaxseed is Secoisolariciresinol, a phytoestrogen and antioxidant. While I am not as concerned about the safety of flaxseed, I certainly do not recommend it as treatment for prostate cancer. In preparation for this issue of the newsletter, I have reviewed every paper on the health benefits of flaxseed in the National Library of Medicine database, Medline. There is no evidence that flaxseed slows or prevents the growth and spread of prostate cancer. Rats fed flaxseed for their entire life have smaller prostate glands, but the dose required to do this altered the sexual performance and anatomy of both sexes. Flaxseed and its lignans do appear to alter the development and spread of breast cancer and melanoma in animal models and may have benefit for patients with these diseases. There is considerable evidence that flaxseed intake can reduce your risk of heart disease and ameliorate the damage caused by rheumatoid arthritis. Some patients have written to say that they have heart disease and my stance means they must chose whether to treat their heart and stay on flax or treat their prostate and discontinue it. There are other effective options available for preventing or treating atherosclerosis. For example, cholesterol-lowering drugs, such as Pravacol, Lipitor, and Zocor are effective at lowering the cholesterol and have a favorable influence on the outcome of heart disease. I might also mention that there are other source of antioxidants and phytoestrogens with greater evidence to support their use by prostate cancer patients: green tea and soy products come to mind. 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