The effect of flaxseed on physical and mental fatigue in children and adolescents with overweight/obesity: a randomised controlled trial

Abstract

Anti-inflammatory agents such as long-chain ω-3 fatty acids have been recognized to improve disease-related fatigue. We hypothesized that α-linolenic acid may also benefit in reduction of fatigue in low-grade inflammation such as overweight/obesity. Seventy two healthy children and adolescents with body mass index (BMI) >25 kg/m2 were randomized to flaxseed (n=38) and puffed wheat (n=34) groups. Participants consumed isocaloric amounts of either 20 g/day flaxseed or 25 g/day puffed wheat for 4 weeks. Fatigue, mood feelings (depression, anxiety, and stress), appetite, energy intake, weight, height, and waist circumference were measured. Analysis was performed based on per-protocol (PP) and intention-to-treat (ITT) approaches. Consumption of flaxseed decreased mental fatigue and caused a significant between-group difference (P<0.001). Although no significant change in physical and total score of fatigue was observed in either group, a significant between-group difference occurred due to a more remarkable change in these parameters in flaxseed group. General fatigue, motivation, activity, and mood feelings did not change significantly between groups. Flaxseed showed less benefit than puffed wheat on anthropometric measures as it caused smaller increase in height (0.53±0.89 vs. 1.09±0.87, P=0.03) and reduction in BMI (-0.25±0.63 vs. -0.67±0.56, P=0.01) than puffed wheat. Appetite and waist circumference decreased in both groups but no significant difference was observed between groups. In ITT analysis, only alteration in mental fatigue was significant. In conclusion, consumption of flaxseed may improve mental fatigue in children with overweight/obesity. However, because of smaller increase in height it is better to hinder administration of flaxseed in growth ages.

The effect of flaxseed intake on appetite reduction: A systematic review of randomized clinical trials

“…Moreover, one study was done on children (Gholami & Akhlaghi, 2021), while the other's participants were adults. As presented in Table 1, four studies were conducted in Brazil (Candido et al, 2018; Cohen et al, 2013; Cosendey Menegati et al, 2012; Monteiro et al, 2016), three in Denmark (Ibrugger et al, 2012; Kristensen et al, 2012, 2013), two in the UK (Almehmadi et al, 2018; Lakhani & Ibrahim, 2016), and one study in each country of USA (Lafond et al, 2015), India (Kapoor et al, 2017), Iran (Gholami & Akhlaghi, 2021), and Canada (Vuksan et al, 2017). In different studies, the sample size of the intervention group ranged from 6 to 65 and the mean age of the intervention group ranged from 22.5 to 48.3 years old in adults studies and 11.5 years old in the study done on children and adolescents.…”

“…Amount and type of fiber : Flaxseed as a high fiber content snack, especially between main meals, may induce a reduction in overall energy intake (Gholami & Akhlaghi, 2021). since the exact physiological response following flaxseed fiber intake is not known, there are various ideas about how flaxseed fiber can affect satiety and appetite.…”

“…Iran (Gholami & Akhlaghi, 2021), and Canada (Vuksan et al, 2017). In different studies, the sample size of the intervention group ranged from 6 to 65 and the mean age of the intervention group ranged from 22.5 to 48.3 years old in adults studies and 11.5 years old in the study done on children and adolescents.…”

Pediatric quality of life multidimensional fatigue scale (PedsQL-MFS) detects the effects of a 3-week Inpatient body weight reduction program for children and adolescents with obesity

“…In the case of the 3-week BWRP, continued use might reveal that the program has stronger effects on physical fatigue but weaker effects on sleep/rest and cognitive fatigue. This could lead to focusing future program development on trialling new components targeting sleep/rest and cognitive fatigue symptoms, for example, like the addition of flaxseed to diets to reduce mental fatigue [ 23 ].…”

Executive Function-Related Improvements on a Commercial CBT-Based Weight Management Intervention: Pilot Randomized Controlled Trial

“…We speculate that mental fatigue may explain the control condition’s decline in performance over time for the Flanker and Stroop tasks. There is evidence suggestive that obesity could be related to greater experienced and perceived mental fatigue [ 58 , 59 , 60 , 61 , 62 ]. In the current study, the 2-back task was always completed first, followed by the Stroop and Flanker tasks.…”