Flaxseed oil in the context of a weight loss programme ameliorates fatty liver grade in patients with non-alcoholic fatty liver disease: a randomised double-blind controlled trial

Long-chain n-3 fatty acids have been shown to regulate lipid metabolism and reduce fat accumulation in the liver. This trial investigated the effect of flaxseed oil, as a rich source of alpha-linolenic acid, on fatty liver and cardiometabolic risk factors in patients with non-alcoholic fatty liver disease (NAFLD). The randomised, double-blind, controlled trial was performed on sixty-eight NAFLD patients who were divided into flaxseed (n 34) and sunflower (n 34) oil groups. Patients were given a hypoenergetic diet (-2092 kJ/d) and 20 g/d of the corresponding oil for 12 weeks. Fatty liver grade, liver enzymes and cardiometabolic parameters were determined. The intention-to-treat approach was used for data analysis. Fatty liver grade significantly decreased in both groups (-0 center dot 68 in flaxseed v. -0 center dot 29 in sunflower, P = 0 center dot 002). Alanine aminotransferase and aspartate aminotransferase decreased in both groups (P < 0 center dot 01). Also, significant reduction was observed in blood glucose (P = 0 center dot 005) and fat mass (P = 0 center dot 01) in the flaxseed and muscle mass (P = 0 center dot 01) in the sunflower group. However, none of these alterations was significantly different between the groups. Weight, waist circumference and blood pressure were significantly decreased in both groups but only weight change was significantly different between the groups (P = 0 center dot 01). IL-6 did not significantly change in either group but showed a significant between-group difference (P = 0 center dot 03). Overall, the results showed that in the context of a low-energy diet and moderate physical activity, flaxseed oil may benefit NAFLD patients to improve fatty liver grade, weight and IL-6 compared with sunflower oil.