Pakistan is among the most populous nations, which has fewer healthcare facilities, and it is presently in the dual burden of communicable and non-communicable diseases. The continuous demographic and epidemiological change has made people more vulnerable to different health conditions1. Although communicable diseases are not new, non-communicable diseases are now making a significant contribution to the healthcare system because of the increasingly sedentary community and poor eating habits.

With the Asian-specific body mass index (BMI), where overweight is considered to be 25kg/m2 and obesity is considered to be 27kg/m2, research has found the prevalence of overweight in Pakistan to be 22.8% and obesity to be 3.2%.2,3 Although obesity is on the rise, it is still underestimated, and continues to affect in both age groups.4

Flaxseed, which is among the oldest domesticated crops,5 is a good source of bioactive compounds, including alpha-linolenic acid (ALA), secoisolariciresinol diglucoside (SDG) lignans, and dietary fiber,6 which have been shown to have physiologically beneficial effects and have been linked to benefits in metabolic health.

The dietary lignans can also be involved in the balance of hormones by raising the level of sex hormone-binding globulin (SHBG), which reduces the availability of free testosterone, and by the antidiabetic effects of the flaxseed hydrolysates, which implies a greater metabolic outcome.7, 8.

In clinical settings, BMI is widely used to assess obesity and classify individuals according to health risk. Defined as weight in kilograms divided by height in square meters (kg/m²), BMI provides a simple and effective tool for monitoring body weight and adiposity.9 A BMI greater than 30 kg/m² is strongly associated with increased morbidity and mortality, often showing a J-shaped relationship with health outcomes.¹0 Despite certain limitations, BMI remains a widely accepted measure for population-level assessment and monitoring of obesity.¹1

Given the increasing burden of obesity and its associated health risks, there is growing interest in functional foods such as flaxseed that may aid in weight management. The presence of dietary fiber and bioactive compounds suggests that flaxseed may play a role in regulating body weight and improving anthropometric parameters. Therefore, evaluating the effects of flaxseed on body weight is important for understanding its potential as a dietary intervention in managing obesity and related metabolic disorders.

The present experimental study was conducted at the Medical Outpatient Department of Peoples University of Medical and Health Sciences for Women over a period of six months following approval from the institutional ethical review committee. An estimated prevalence of 25% of the total population was used to obtain a total of 300 women using a 95% confidence interval and 5% error margin. Participants were randomly assigned to two groups: a control (Group A) and an intervention (Group B), and selected using a non-probability consecutive method with 150 participants each. The sample was composed of women whose body mass index (BMI) exceeded 25 kg/m2 and had no known comorbidities but women with less than 25 kg/m2, younger than 20 years or older than 50 years, pregnant or lactating women were excluded.

Baseline demographic and anthropometric data were collected on a pre-structured questionnaire, after receiving written informed consent. In the intervention group, the flax seeds were bought in a local market in Nawabshah and ground to a fine powder in a domestic grinder, and flax powder was taken daily, in normal amounts of about two tablespoons (30g) daily, mixed with their normal foods, e.g., yogurt, salads, or soups, and consumed at breakfast time during the study period12.

Anthropometric measurements were taken at baseline and then at 4, 8, and 12 weeks using a standard weighing machine. All measurements were made when the participants were not wearing shoes and in light clothes. BMI was computed as weight/kg/m2 and was utilized as the main variable in measuring changes in body weight with time.

All the data were entered and analyzed in SPSS. Continuous variables like age and BMI were provided in mean and standard deviation. Mean BMI in the control group and the intervention group at baseline, 4 weeks of intervention, 8 weeks of intervention and 12 weeks of intervention was compared using an independent sample t-test. A p-value of ≤ 0.05 was considered statistically significant to determine the effect of flaxseed consumption on body weight among overweight women.

A total of 300 overweight women aged 20-50 years participated in the study, with a mean age of 35.06 ± 9.01 years. The mean baseline body mass index (BMI) of the participants was 27.44 ± 1.40 kg/m². Table 1 shows that participants were evenly allocated into two groups: Group A (control) and Group B (intervention), each comprising 150 individuals.

Table 1: Baseline Characteristics of Study Participants (n = 300)

At baseline, there was no statistically significant difference between the two groups in terms of age (34.98 ± 9.21 vs. 35.14 ± 8.83 years; p = 0.878) or BMI (27.50 ± 1.44 vs. 27.37 ± 1.36 kg/m²; p = 0.425) (Fig 1), indicating that both groups were comparable at the start of the study.

Figure1: Comparison of Mean BMI between the Groups

During the 12-week period of study, the two groups exhibited different trends in the BMI. Group A had a rather stable BMI that did not significantly differ between baseline and Week 12 (27.50 ± 1.44 to 27.49 ± 1.44 kg/m²). Group B, on the other hand, exhibited slow and steady decline in BMI throughout the study period. The mean BMI in Group B decreased from 27.37 ± 1.35 kg/m² at baseline to 27.27 ± 1.36 kg/m² at Week 4, 27.20 ± 1.36 kg/m² at Week 8, and further to 26.97 ± 1.36 kg/m² at Week 12 (Tab 2).

Table 2: Comparison of Mean BMI between Study Groups at Baseline, 4, 8, and 12 Weeks

By Week 12, the difference in BMI between the two groups was statistically significant (p = 0.001), the participants who received flaxseed supplementation reduced their body weight by a greater extent. These results indicate that the daily intake of flaxseed powder was linked to the fact that the BMI of the group of participants improved significantly as compared to the control group during the 12-week time frame.

The high level of serum cholesterol and excess body weight are considerable issues among women, increasing the risks of cardiovascular diseases and metabolic disorders.13,14,15 Thus, the research was carried out to fill this knowledge gap by examining the effect of flax seeds on body weight in women. 13,14,15

The mean age of the participants in this study was 35.06 ± 9.01 years. The participants were categorized into two age groups: 155 (51.7%) aged 20 to 35 years and 145 (48.3%) aged 36 to 50 years. However, previously in similar studies, a lower mean age of 26.68 ± 6.11 years and 24.8 ± 3.3 years was reported by Akrami et al. (2018)16 in Iran and Kristensen et al. (2012)¹2 in Denmark. Toulabi et al. (2021)17 reported that 62.5% of their study population had age <60 years while 37.5% participants had an age ≥60 years.

The mean body mass index (BMI) of the participants in this study was 27.44 ± 1.40 kg/m². Akrami et al. (2020)16 reported a higher mean BMI of 28.65 ± 5.64 kg/m², while Toulabi et al. (2021)17 reported a mean BMI of 28.67 ± 5.30 kg/m². This indicates that the baseline BMI of participants in the present study was comparable but slightly lower than that reported in some international studies, which may reflect differences in population characteristics, dietary habits, and lifestyle factors.

Group A's mean age was 34.98 ± 9.21 years and Group B's was 35.14 ± 8.83 years, with no significant difference observed between the groups. The age distribution was also similar across both groups. The mean BMI was 27.50 ± 1.44 kg/m² in Group A and 27.37 ± 1.36 kg/m² in Group B, with no statistically significant difference at baseline. The lack of significant differences in baseline age and BMI ensures that both groups were comparable, allowing the observed changes in body weight to be attributed to the intervention rather than initial disparities.

Over the 12-week study period, a significant reduction in BMI was observed in the intervention group compared to the control group. At 4 weeks, Group B showed a slight reduction in BMI (27.27 ± 1.36) compared to Group A (27.50 ± 1.45), although this difference was not statistically significant. At 8 weeks, the difference became more apparent, with Group B showing a further reduction (27.20 ± 1.36), approaching statistical significance. By 12 weeks, Group B demonstrated a significant decrease in BMI (26.97 ± 1.36) compared to Group A (27.49 ± 1.44), indicating a meaningful effect of flaxseed supplementation on body weight reduction. Previously, similar findings were reported by Akrami et al. (2020)16, who observed a significantly lower BMI in the flaxseed group compared to the control group (29.31 ± 5.59 vs. 27.99 ± 5.13 kg/m²; p = 0.003). Toulabi et al. (2021)17 also reported a significantly lower BMI in the experimental group compared to controls (28.61 ± 5.38 vs. 27.91 ± 4.13 kg/m²; p < 0.001). However, Kristensen et al. (2012)¹2 reported no significant change in body weight following flaxseed supplementation, suggesting variability in response depending on population characteristics, dosage, and study duration.

Overall, the findings of the present study suggest that flaxseed supplementation has a positive effect on reducing body weight and BMI over time, particularly when administered consistently over a 12-week period, supporting its potential role as a dietary intervention for weight management in overweight women.

The flaxseed supplementation produces a valuable impact on body weight loss in overweight women. The results indicate that flaxseed can be effectively used as a weight management tool in overweight women as a supplement to a normal diet because it contains a lot of dietary fiber and bioactive compounds. Nevertheless, additional large-scale and long-term research is advised to validate these results and measure the long-term impact on obesity treatment.

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