 Canada now allows a health claim on the labels of products with flax seeds, seeing that we know with sufficient certainty that flax seeds do indeed help lower cholesterol levels. The products have to contain two tablespoons and have to be relatively healthy in the first place so they can't, like, boast about the cholesterol-lowering effects of a flax seed rich in meatball or something. Such claims are based on studies like this double-blind, randomized, placebo-controlled trials. Wait, how do you come up with placebo food? I mean, there's sugar pills for drugs, but how can you slip spoonfuls of flax past someone? The researchers made all these special products, snack bars and muffins and bagels, so the research subjects unknowingly would be getting tablespoons of ground flax seeds, or just tablespoons of the control, whole wheat, and they did this for a year. No one knew who got which muffins until the code was broken at the end. And the dietary flax seed groups saw a 15% reduction in LDL cholesterol as early as one month into the trial, but only fell significantly lower than the whole wheat group in those on cholesterol-lowering drugs. In those off drugs, the whole wheat group's cholesterol went down to diminishing the efficacy of the flax in comparison. That's why food placebos are so hard, like in this study. The reason they give for doing a so-called open-label study, where the study group is aware that they're eating flax seeds, is because they couldn't come up with an inert placebo for flax seeds. I mean, whole wheat flour is a whole grain. It could be beneficial in its own right, and white flour could make the control group look even worse. So what they did in this study was that overweight patients were randomly assigned to receive either lifestyle advice and daily ground flax seeds, or just the lifestyle advice alone as the control group. And not surprisingly, body weight, waist circumference and body mass index decreased significantly in both groups. Even without the lifestyle advice, just enrolling people in a study where they're going to keep weighing you can get people to lose weight, though there was a significantly greater reduction in the flax seed group, and not just by a little. The control group that just got lifestyle advice over a 12-week period lost nearly 7 pounds and an inch off their waist. But the group that got the same advice plus spoonfuls of flax a day, so in effect, given more food to eat, lost over 20 pounds on average over the same period, cut nearly 4 inches off their waist. Those are extraordinary numbers for an intervention that added rather than actively removed calories from the diet. Was that just some crazy fluke? How about flax seed supplementation for non-alcoholic fatty liver disease? Thanks to the obesity epidemic, that's now the most common liver disease, recognized as a major public health problem around the world. A high-fat diet is the most common cause, but flax seed fat may be better compared to lard. Well, that's not very helpful, so let's put it to the test. Same as last time, lifestyle modification advice with or without flax seeds. They were told to just mix it with water and juice and drink it down after breakfast, and body weight went down, along with liver inflammation and scarring, and fat inside the liver in both groups, but better in the flax seed group. And again, that extraordinary 20-pound weight loss telling people to add something to their diet, so maybe that first study wasn't a fluke, or maybe they both were. There have been dozens of randomized control trials of flax seeds and weight loss, and as you can see, most were more equivocal. Here's those two recent 20-pound weight loss studies, which appear to be the outliers. But still, I put all the studies together, and you do see a significant reduction in body weight, BMI, and waist lines following flax seed supplementation in randomized control trials, though one would expect more like two pounds of weight loss rather than 20.