Background and Objectives: Currently, most consumers equate the benefits of omega-3 fatty acids with fish, since the vast majority of research on omega-3 fatty acids has been done on fish. Therefore, the purpose of our proposal was to add to an ongoing clinical trial to determine the effect of flax compared to fish oil on immune cell inflammation and oxygen metabolism. Secondly, we estimated the cost-effectiveness of flax consumption in people with type 2 diabetes (T2D) to the Manitoba health care system, and estimated the impact of such flax consumption on Manitoba flax production needs.

Methods and procedures: In a double-blind crossover design, 22 female subjects with obesity consumed either flax oil or fish oil for 4 weeks each. We measured plasma levels of mediators and effectors of inflammation (namely, oxylipins and cytokines). Secondly, we measured the production of these inflammatory molecules by immune cells obtained from these subjects that were stimulated with a bacterial mimic. Cytokines were measured with a Meso Scale Discovery instrument, and oxylipins using liquid-chromatography-tandem mass spectrometry. Oxygen metabolism in immune cells was measured with a Seahorse XFe24 analyzer.
For the economic analyses, we calculated the average annual health care cost savings that may be realized in patients with T2D if they consumed more flaxseed and estimated the increased acreage required to meet such an increased demand for flaxseed.

Results and Conclusions: Neither oil altered the cytokines present in the blood or in the stimulated immune cells. However, flax oil (but not fish oil) reduced oxygen consumption and increased spare respiratory capacity in immune cells and countered the shift in oxygen consumption induced by the bacterial mimic challenge.
The economic modeling analysis, based on the literature showing that flaxseed consumption can improve glucose handling in T2D, showed that flaxseed consumption by half of patients with T2D in Manitoba would result in a savings of $3.3 million over the next ten years and would increase the demand for flaxseed production, resulting in an increased demand of 995 acres in 2021, growing to 1321 in ten years.

Hence, our studies have elucidated a unique effect of flax oil supplementation on oxygen metabolism in immune cells from women with obesity. This novel finding needs to be explored further, but could potentially provide the basis for a niche role for flax oil use in disorders that are characterized by dysfunctional cellular oxygen metabolism.
Further, the economic models show that increased flaxseed consumption would reduce costs to the Manitoba healthcare system. Importantly, the benefits of flaxseed are not limited to those with T2D in Manitoba and indeed T2D is a vast and growing problem world-wide. Hence, increased flaxseed consumption world-wide would not only save billions in healthcare costs, but also increase the demand for flaxseed acreage.