**2.1 Paper-based information**

Published researches that include the food formulation containing flaxseeds have been included in this category.

Lifestyle choices, such as energy-dense foods and low levels of physical activity, significantly raise obesity rates and adipose tissue stores, leading to an increased risk of Type II Diabetes. Lifestyle changes, such as dietary changes, can help to reduce the risk of T2D. Flaxseed and its byproducts are becoming more popular as functional ingredients in low-glycemic-index foods as a result of their numerous health benefits. Until now, many efforts have been made to ensure the functionality of a wide range of cereal-based products, including bread, pasta, muffins, biscuits, and cakes. In this context, flaxseed hulls were investigated as a functional supplement for wheat bread enrichment and their relationship with the Glycemic Index. Furthermore, the antioxidant capacity, nutritional value, and consumer satisfaction all were investigated in 1–5% flaxseed hull (FH) supplemented wheat bread. Supplementation with 5% FH increased phenolic content by 93 percent, radical scavenging ability by 176 percent, and reducing power by 220 percent when compared to control. It was seen that fortification reduced in vitro starch digestibility slightly but had no effect on the expected glycemic index (eGI); however, it resulted in a reduction in relative protein digestibility of up to 8%. The addition of fortification reduced the volume of the loaf while enhancing the firmness of the crumb. The sensory evaluation results showed that the addition of FH particularly at higher doses had a slightly adverse impact on bread sensory properties but assure satisfactory customer acceptability [17]. According to these findings, flaxseed hulls might be a useful functional food in terms of nutrition, but they were not beneficial to diabetics.

Improving the content of soluble dietary fiber (SDF) in carbohydrate-rich foods is one strategy for lowering the risk of T2D. However, more research is needed into the glycemic response to specific soluble DFs, particularly the role of soluble DF-induced viscosity. Using a randomized, double-blind, crossover design, the acute postprandial glycemic response of puddings containing soluble DF derived from yellow mustard mucilage (YMM), fenugreek gum (FG), and flaxseed mucilage (FM), in 15 people (10 male and 5 female; age 55.1 ± 12.0 years; BMI 29.5 ± 3.4 kg/ m2) who were at extremely high risk of developing T2D was investigated. The nutritional composition of the puddings confirmed that the prepared puddings contained more energy and less fat. YMM incorporated pudding had the highest total dietary fiber content, while FG incorporated pudding had the lowest. Results revealed that all soluble DF puddings significantly reduced blood glucose and plasma insulin at maximum concentration and definite time points when compared to a control pudding, but not differed from one another [18]. This study showed that using viscosity-matched single DF in a pudding matrix can lower acute postprandial peak glucose and insulin levels, as well as the risk of T2D.

Another study looked into the use of oat (OB), flax (FB), and apple (AB) as dietary fiber (DF) fortifiers in wheat bread (WB). In this, wheat bread was compared to flax, oat, and apple bread. The fatty acid profiles were significantly altered when oat and flax fibers were added to bread. Oleic acid (33.83 percent of lipids) and linoleic acid were the most abundant in OB (24.31 percent of lipids). Only FB had a significant amount of Linolenic fatty acid with 18.32 percent. The


**Table 1.**

*Information of Flaxseed incorporated functional foods, published since 2017.*

bioaccessibility trials disclosed that the DF reduced saturated fatty acid intake. In the range of fatty acids, polyunsaturated fatty acids (PUFA) were the least bioaccessible (72 percent in OB to 87 percent in FB). In terms of glycemic load, the commercial bread had the highest value (80.5), which was markedly greater than the values for OB, FB, and AB. The addition of OB, FB, and AB resulted in low glycemic value. In addition, AB had the highest overall phenolic value (897.2 mg/kg), while FB had the least (541.2 mg/kg). In this study, AB had the only significant reduction in caloric values [19].



#### **Table 2.**

*Information about Flaxseed supplemented Functional Foods, patented since 2017.*

Chinese steamed bread (CSB) is a fermented basic food popular in China and Asia. Because of the widespread usage and low cost of CSB, there are many chances to create 'nutritious' CSB with added natural products to combat the rising prevalence of chronic illnesses such as diabetes and cancer among the population. Development of CSB fortified with ground flaxseeds at a fortification level of up to 20% was investigated [20]. The resulting CSB was studied for its physicochemical, nutritional, and sensory properties. According to findings, Flaxseed addition reduced the specific volume and spread ratio of CSB while boosting unsaturated lipids, dietary fiber, phenolic content, and hardness in a dose-dependent manner. Flaxseed additions of up to 15% had a slight impact on the total acceptability of CSB. In terms of nutrition, adding flaxseed to CSB increased in vitro antioxidant activities while lowering in vitro starch digestibility and glycemic index from 117 to 97, and the glycemic load from 50 to 32.9 g.

In another study, fresh salted noodles with ground flaxseed flour that replaced wheat flour up to 200 g/kg were formulated. It was noticed that Flaxseed supplementation increased in vitro antioxidant activities while reducing the expected

#### *How Can Flaxseed be Utilized as Functional Food DOI: http://dx.doi.org/10.5772/intechopen.100201*

glycemic index of cooked noodles in different dosages. The inclusion of flaxseed increased cooking loss whereas lowered the hardness and thickness of cooked noodles. According to kinetic analysis, adding 200 g/kg flax seed to noodles reduced the eGI from 60 to 52. Flaxseed replacement reduced the glycemic load of the noodles significantly, from 13.4 g in control noodles to 8.5 g in noodles with 200 g/kg flax seed addition in a dose-dependent manner. The noodles developed in this study were found to be beneficial to people suffering from chronic diseases such as diabetes and stroke [21].

Soluble fiber, protein, and resistant starch-rich foods aid digestion and may improve blood sugar response after meals. In this instance, three ingredients in bread production strike equilibrium between nutrition and palatability: lupine grit flour which consists of 60 percent protein, lupine hulls flour, and flaxseed expeller flour which is an excellent source of dietary fiber all were tested for their medical benefits. A customer acceptability test was also conducted on 259 volunteers using the bread deemed best by its balance of sensory and nutritional value. Compared to the control bread the final bread had 125 percent more fiber and 55 percent more protein. In all aspects surveyed, the bread was rated as acceptable by more than 90% of those polled. It was discovered that lupine can replace animal protein very well, and in addition, flaxseed supplemented bread had hypoglycemic properties [22].

In 53 constipated T2D patients, the effects of baked flaxseed cookies versus placebo cookies on constipation symptom scores, body mass, blood glucose, and lipid control were compared. Constipated T2D patients with BMI 20.5–48.9 kg/ m2 were randomly assigned to either 10 g of flaxseed cookies two times a day or placebo cookies, for twelve weeks in a single-blind, randomized controlled trial. Participants in the control group were given sugarless orange-flavored maltodextrin cookies as a placebo. Constipation symptom rating, BMI, fasting blood sugar, glycosylated hemoglobin (HbA1c), and lipid level were measured at the start and end of four, eight, and twelve weeks. A stool diary was used to assess constipation. It was observed that the flaxseed group's constipation symptom scores (2.46), weight (3.8 kg), BMI (1.5 kg/m2), FPG (26.7 mg/dl), cholesterol (37.3 mg/dl), triglycerides (10.4 mg/dl), LDLC (21.0 mg/dl), HDLC (4.7 mg/dl), and cholesterol/ HDLC ratio (1.4 mg/dl) all decreased significantly from reference point after the 12-week intervention. The differences in absolute change between the flaxseed and placebo groups in all of the studied profiles were statistically significant. This study found that eating 10 g of flaxseed baked into cookies every day for 12 weeks improved constipation symptoms, glycemic and lipid control, BMI, and body weight [23]. Following this study, the effects of baked flaxseed or psyllium versus placebo on constipation symptoms, weight, glycemia, and lipid levels in T2D patients were also compared. Psyllium is a soluble, viscous, gel-forming non-fermented fiber supplement that contains pentoses, hexoses, anduronic acids. It has previously been shown to reduce constipation signs, body fat, glycemic, and lipid profile. In constipated T2D patients, no medical study had done to compare the effects of flaxseed and psyllium on lowering constipation symptoms, mass, glycemic, and lipid status. As a result, 77 patients participated in this clinical trial. 77 constipated T2D patients were randomly assigned to three groups in a singleblinded, randomized controlled trial. For a total of 12 weeks, patients were given either 10 g flaxseed or psyllium supplemented cookies or placebo cookies twice a day. Constipation symptoms (P 1/4 0.002), stool consistency (P 0.001), weight (P 0.001), BMI (P 0.001), FPG (P 1/4 0.004), cholesterol (P 1/4 0.010), LDLC (P 1/4 0.031), and cholesterol/HDLC ratio (P 1/4 0.019) all improved significantly in the flaxseed and psyllium groups compared to the placebo group. It was observed that although both flaxseed and psyllium could help with constipation, weight loss, glycemic control, and lipid levels, flaxseed appears to be better than psyllium [24].

Raw flaxseed-enriched noodles were prepared and their physical properties such as Resistant Starch (RS), Total Starch, Total Dietary Fiber (TDF) content, estimated glycemic index (eGI) value, and nutrient composition of the resultant product was investigated. Flaxseed was added to the noodle blend in 3 different amounts (10, 15, and 20 g/100 g). According to findings, the RS content of the samples was found to be in the range of 0.61–2.14 g/100 g, with the sample containing 10% flaxseed having the highest RS. The noodle sample enriched with 20% flaxseed had a maximum TDF value of 8.28 percent, while the control had a value of 1.68 percent. The flaxseed addition did not affect the estimated eGI of the samples, but it showed very little impact on the mineral content of the noodle samples. Sodium, potassium, magnesium, and phosphorus were the most common mineral compounds found in the samples [25]. It could be concluded that a 10% flaxseed supplemented noodle would be a healthy and nutritious effective alternative to consume, but it would be less effective to diabetics.

An investigation was done to see how flaxseed enriched yogurt affected the elevated glucose and lipid levels, along with hypertension in T2D patients. On 57 patients with T2D, a randomized, open-label, controlled clinical trial was performed. For 2 months, participants were given either 200 g 2.5 percent fat yogurt with 30 g flaxseed or plain yogurt. At the start and end of the study, anthropometric and biochemical parameters were assessed. The findings revealed that Hemoglobin A1c levels in the treatment group were significantly lower than in the control group after 2 months of supplementation. At the end of the trial, there were substantial variations in triglyceride and total cholesterol (p = 0.04 and p = 0.01), systolic blood pressure, and diastolic blood pressure (p = 0.02 and p = 0.002, respectively) seen between flaxseed enriched yogurt and control groups. Fasting blood sugar levels were also reduced. Moreover, no differences in low- as well as high-density lipoprotein, body mass, or waist size were found between the two groups [26].

Sherbet is a frozen dessert just like ice cream, but it is made with more fruit pulp and has a more acidic flavor. In addition to glycemic load, two major parameters that should be considered for good quality ice cream, sherbet, or sorbet are sugar crystallization and ice recrystallization. The unwanted mechanism of ice recrystallization occurs during the processing and storage of ice creams and sherbets. In this context, analysis of the effects of different concentrations of golden flaxseed flour (GFF) on the glycemic index and ice recrystallization in uvaia (Eugenia pyriformis Cambess.) diet sherbets fortified with iron was studied. In the study, samples were moved from a freezer designed to perform 14 temperature fluctuation phases ranging from 20 °C/12 h to 10 °C/12 h from storage (25 °C) (each cycle, 48 h). Before the temperature cycles, the chemical structure, acidity, and physical parameters such as overrun, rheology of static and transient shear, firmness, thermal properties, and crystallite sizes were evaluated. An optimized descriptive profile was used to evaluate the sensory attributes. The findings revealed that the glycemic load decreased as GFF concentration increased, while the ash content and pH values increased significantly. GFF addition was found to be a viable option for the preparation of an iron-fortified uvaia diet sherbet with a reduced glycemic load and smaller ice crystal sizes. As a result, to obtain a high-quality diet product with improved rheological, thermal, and microstructural properties, GFF should be added at a rate of 1 to 2% [27].

Regardless of the potential benefits of amaranth and flaxseed, there is little information on their combined effect on the physicochemical and functional properties of extruded products. Extrusion of six mixtures in a twin extruder was done with different proportions of amaranth (18.7–33.1%), flaxseed (6.6–9.3%), maize grits (55.6–67.3%), and minor ingredients (4.7%) for the production of extrudates. According to the study, the amount of amaranth and flaxseed used in the development of extruded products had major effects on their functional

#### *How Can Flaxseed be Utilized as Functional Food DOI: http://dx.doi.org/10.5772/intechopen.100201*

and physicochemical properties. Extrudates with higher proportions of amaranth and flaxseed had higher insoluble and soluble fiber content. The highest flaxseed proportion had the highest soluble fiber content (1.9 percent). The protein content of the extruded products was high (>12%), which was significantly high than that of commercial breakfast cereals. Aside from these attributes, the extruded products obtained had a healthy caloric density (<5%). Extruded products containing low amounts of starch and high levels of fiber produced extrudates with a low expansion index and more hardness. As a result, extruded products containing amaranth (18.7–22.9 percent), flaxseed (8.6–9.3 percent), and maize grits (63.8–67.3 percent) had acceptable physicochemical and functional properties [28].

Flaxseed is a vital oil crop. By-products of flaxseed oil extraction have a high nutritional value. Therefore, the effectiveness of flaxseed industry by-products (flour (FF) and marc (FM)) as functional raw materials in bread production was highlighted in one study. Flaxseed by-products were added to wheat bread in amounts of 5, 10, and 15%. The effect of adding FF and FM to bread on its quality, chemical composition, and consumer acceptance was studied. According to the outcome of the research, adding FF and FM increased bread yield by 146.6 and 148.4 percent, respectively, for samples with 15% FF and FM addition, compared to the control bread (13.5%). According to texture analysis, Both by-products changed the average values of hardness, chewiness, and firmness, as well as the color of the crumb. Flaxseed by-products improved crumb water content but showed a negative impact on specific volume and pore size distribution, whereas FM has a lesser impact. The introduction of 5% flax components increased the bread's nutritional value while lowering its calorie content thus being beneficial for diabetics. According to the findings, adding 10% flaxseed marc to bread results in bread with high nutritional quality and satisfactory sensory attributes [29].

Diabetes management relies heavily on nutrition, and foods with a low glycemic index are becoming increasingly popular because they slow the release of glucose into the bloodstream. It's critical to create a low-glycemic food mix using locally available ingredients for daily diets. Therefore, an investigation of the glycemic index of traditional recipes (dosa, mudde, and roti) made from developed milletbased food mix, as well as their impact on pre-diabetic subjects was conducted in research. Finger millet, little millet, defatted soy flour, whole green gram, fenugreek seeds, flax seeds, curry leaves, bitter gourd, and skimmed milk powder were used to make a millet-based food mix. Protein (19.41 g/100 g) and dietary fiber (21.11 g/100 g) both were present in the developed millet-based food mix. With a glycemic load of 11.05, 18.43, and 18.09, the glycemic index of dosa, mudde, and roti was found to be 37, 48, and 53, respectively. All three developed products, however, had a lower glycemic index (<55), as well as a reasonable glycemic load of (<20). Moreover, dietary supplementation on pre-diabetic subjects revealed a significant decrease in FBS (120.50 ± 18.73 to 97.81 ± 20.00) and HbA1c (6.14 ± 0.30 to 5.67 ± 0.40), indicating that they were a wiser choice for diabetes management [30].

The previous studies discovered the impact of diet and various nutrients on metabolism, including the use of low-carb food in the treatment of cardiovascular disease, diabetes, and metabolic syndrome. In this frame of reference, an optimal combination of ingredients for the development of bread, which could be used to improve the course of these diseases, as well as to be consumed by groups of individuals with gluten, milk, and sugar intolerances was studied. Two bread formulations containing flaxseed flour, eggs, vegetable oil, baking soda, salt, and natural apple cider vinegar were formulated and evaluated during the project. The liquid component was represented by oat milk in the first sample and hazelnut drink in the second. The resulting bread was compared to commercially available analogs. The quality analysis revealed that the resultant bread met the quality standards.

Both samples had lower calorie (18%), carbohydrate (37.5%), and higher protein content (13.5%). It was discovered that adjusting the nutritional value allowed the product to be integrated into a low-carb diet, which was particularly essential for people with diabetes and metabolic syndrome [31].

Flaxseed has been found to help lower and stabilize blood glucose levels in various investigations. While one study was conducted to investigate whether flaxseed could reduce blood glucose response more successfully when consumed as a single 30 g portion or as a split portion thrice a day. It was a cross-over study with a randomized, repeated measures design. 15 healthy members were provided one of three options: (1) 3 flaxseed muffins containing a total of 30 g flaxseed consumed once in the early hours, (2) 3 flaxseed muffins consumed at 3 distinct time intervals throughout the day (10 g flaxseed per muffin), or (3) 3 control muffins consumed at 3 distinct time intervals throughout the day (0 g flaxseed per muffin). A continuous glucose monitor was used to assess the 24-hour blood glucose reaction. Muffins made were high in crude protein, fatty acids, energy, and fiber profile while low in carbohydrates. The findings showed that flaxseed muffins given thrice a day were more effective than control muffins at reducing and sustaining blood glucose levels over 24 hours. It was observed that Flaxseeds should be consumed in small amounts throughout the day, not all at once [32].

Analysis of the impact of varying sugar, fat, and prebiotic fiber levels in powder preparations used to make mangaba ice cream was studied in one research. P1, P2, and P3 were the first three simple powder mixes for ice creams, and they were also known as powder preparation. Cream milk powder, light milk powder, flaxseed meal powder, corn syrup powder, inulin, FOS, and stabilizers (at different concentrations) were among the ingredients that were required for the production of ice cream. The powdered preparations were tested for solubility, hygroscopicity, water content, and microscopic characteristics. The physicochemical properties, quality attributes, overrun, nutrient profile, mineral absorption simulation in vitro, rheological characteristics, fructooligosaccharide quantitative analysis, and sensory acceptability of the ice cream produced by these mixtures were all examined. As it was discovered that the ice cream mangaba is a source of vitamin C (17–25 mg.100 g-1), dietary fiber (4.9–8.6 g.100 g-1), and prebiotic (FOS content: 3.06–5.68 g.100 g-1), calcium (3.38–3.64 g/kg-1), and contains low sodium (0.48–0.60 g/kg-1) the study concluded that the incorporation of prebiotic fibers and the reduction of sugar and fat levels can provide nutritional benefits. Inulin and FOS, on the other hand, were likely accountable for the increase in solubility (64.22 percent, 71.67 percent, and 79.73 percent) and reduction in hygroscopicity (6.06, 4.23, and 3.14 g/100 g) of powdered ice cream preparations. It was concluded based on findings that incorporating ingredients such as mangaba pulp, flaxseed, prebiotic fibers (inulin and FOS), and lowering sugar and fat levels can strengthen the technological and nutritional characteristics of ice cream [33].

Oropharyngeal dysphagia is a serious type of dysphagia, which refers to difficulty swallowing – moving food from the mouth to the stomach, requires more effort than usual. This mechanical disorder has been linked to aging, neurological issues, brain and neck cancer, cerebral palsy, Parkinson's disease, and benign esophageal stricture, among other things. Oropharyngeal dysphagia patients are given a viscosity-modified diet with thickeners to avoid swallowing problems. Although most commercial products contain xanthan and starch, flaxseed gum (FG) is a potential thickener for liquid foods that also has health benefits. Concerning the use of flaxseed gum (FG) in thickening methodologies for dysphagia patients, one investigation was done to check the relationship between the rheological properties of thickeners and their advantages in terms of nutrition such as enhancing fibers, and phenolic content while reducing glucose absorption. FG was combined with

modified starch (MS) and Xanthan gum (XG), with the concentrations of the biopolymers varied according to a central composite rotational design, with the evaluated responses being rheological and color properties in water. Furthermore, the amount of glucose released following in vitro digestion was assessed and compared to a commercial MS-based thickener. It was observed that the shear time-independent and shear-thinning behavior of all formulations was primarily influenced by the concentrations of XG and MS. The formulations exhibited a predominant elastic character in oscillatory measurements, which was attributed to MS and primarily to XG, which, despite its lower concentration, imposed a similar influence on this rheological property. The most significant factor influencing viscosity, however, was the increase in FG concentration. Surprisingly, the commercial formulation had a significantly higher glucose release than the suggested FG/MS/XG-based formulations. Hence, FG-based thickened beverages could have an advantage over those based on MS in this due consideration, enhancing the quality of life of dysphagia patients and lowering the amount of glucose released in vitro after digestion [34].

### **2.2 Patent based information**

Patented inventions that include the food formulation containing flaxseeds have been included in this category, and it was also investigated whether these foods can be included in the diabetic patient's diet in the information.

Over the last century, human dietary habits have changed dramatically due to the advancement of civilization & industrialization. The dietary intake of linoleic acid, an essential fatty acid of the omega 6 fatty acid group, increased as the production and consumption of oil seeds and oil rose. This resulted in a shift in the omega 6:3 fatty acid ratio in human diets from around 1:1 to 10–40:1. This shift plays a critical role in the treatment of so-called "lifestyle diseases," such as cardiovascular disease, hypertension, type 2 diabetes, and viral infections. In this context, one research was conducted and patented under application number, US0360073A1. The primary goal of this invention was to develop an optimized nutrient fatty acid composition that can be used to resolve a dietary imbalance in essential fatty acid consumption in human beings in a simple, safe, practical, and cost-effective manner. Oil seeds with omega 6 to 3 fatty acid ratios of 1:1 to 1: 1.25 were used to make optimized nutrient fatty acid compositions, which were stabilized with vitamin E 0.8–4 mg/ml. After cleaning, drying, and dehydrating the ingredients, oil was extracted from soybeans, flaxseed, walnut, perilla seed, rice bran, sunflower seed, evening primrose seed, high GLA safflower seed, garden cress seed, sachainchi beans, and green algae using conventional methods. After the final product formulation, 10 patients with metabolic syndrome (high blood pressure, abdominal obesity, increased fasting glucose, elevated fasting triglyceride, and low HDL) were chosen for the study. The patients were divided into two groups after their physical examination. Both groups were told to keep taking their medications and to follow a low-calorie, low-fat, low-carbohydrate diet with moderate exercise. In addition, the second group was instructed to consume 25 mL of optimized nutrient oil as cooking oil daily. When compared to the first group, the second group on optimized nutrient oil had a considerable reduction in weight, abdominal girth, blood pressure, sugar levels, CRP, SGPT, and triglyceride, as well as an increase in HDL. Furthermore, the optimized fatty acid composition could be used as food, beauty products, and a delivery vehicle for drugs and nutrients [35].

With the constant intensification of the rhythm of real-life and work, people's spirits are constantly in a state of high pressure, overload, causing a rise in blood sugar, if things continue like this, easily cause some people to develop diabetes. Which affects their standard of living. A good eating style is needed to prevent

and treat the serious problems associated with diabetes. Therefore, CN107373642A disclosed a kind of diabetic special food formula including; whey separated protein powder with a precise weight of 15,30 parts by weight of plant fat powders (including 18 parts by weight of medium-chain triglycerides) 8 parts by weight sunflower oil powders, 4 parts by weight flaxseed oil), 10 parts by weight dietary fibers, 45 parts by weight carbon water compound, 2 parts by weight soybean phosphatide, 0.2 parts by weight phytosterol, 0.3 part by weight of vitamin, 0.3 parts by weight mineral matter. Following the formulation of the food product, a functional test on 30 diabetic patients was performed. Patients were told to keep taking foodstuff on daily basis. Evaluation at the end of the test discovered that the diabetic patient's symptoms had significantly improved [36].

In another patent CN106266429A, formulation of preparation of a kind of diet therapy soup including; Radix Puerariae 20–50 parts, Fructus Lycii 10–30 parts, Flaxseeds 5–30 parts, Rhizoma Dioscoreae 10–30 parts, leaf of Moringa 5–20 parts was Described. It was a powdered formulation that could reconstitute in boiling water, all ingredients of diet therapy soup worked together in harmony to treat diabetes and improve the immune system of Susceptible people by lowering blood glucose levels. Each ingredient, such as Radix Puerariae, Rhizoma Dioscoreae, Fructus Lycii, and Flaxseeds, was cleaned, pulverized, and concentrated to form a thick paste, which was then pulverized and dried to form a powder. All of the powders were combined, resulting in a uniform dry soup mix. Furthermore, this composition can be used to make beverages, food, medicine, and so on, and it is relatively suitable for diabetic patients, as it has the potential to have a blood sugar lowering function [37].

Regardless of the type of diabetes, keeping blood glucose levels within a healthy range is critical. Along with seeds, cereals have an important role in the diet of a diabetic patient. Barley is a cereal grain that has traditionally been referred to as "gluten grains." Barley is high in dietary fiber, beta-glucan, molybdenum, manganese, and selenium. Barley is also high in copper, vitamin B1, chromium, phosphorus, magnesium, and niacin. However, because whole grain barley is not easily palatable, it is not widely consumed as a staple food. As a result, there is a need for a technique of processing whole-grain barley that is palatable while retaining the grain's nutrients. The technique of formulation of barley-based compositions comprising barley, other cereals, pulses, spices, dry fruits, and flavoring agents was disclosed in patent application AU100571A4. The pre-mixed barley-based composition was made up of barley in the 45–75 wt percent range; wheat in the 20–40 wt percent range; and soybean in the 5–20 wt percent range. Whole green gram, broken green gram, whole Bengal gram, broken Bengal gram, whole lentil, and broken lentil were among the pulses. Coriander, cumin, carom, flaxseed, fenugreek, red chili, turmeric, asafetida, and salt were among the spices used. The steps for preparing the pre-mixed barley-based composition included cleaning the raw materials, optionally roasting the cleaned raw materials, mixing the cleaned and optionally roasted material to obtain a mixture, grinding the mixture to obtain a fine flour or powder, and packaging the flour or powder. Resultant Pre-mixed barley-based compositions could be used to make a variety of food products (flat bread, roti, chapatti, paratha, khakra, thalipeeth, cutlet, pancake, health drink) that could be consumed by both healthy people and people suffering from obesity, dyslipidemia, diabetes, and other conditions. Another advantage of this technique was powder formulation was free from chemical preservatives [38].

Flaxseed cake is a byproduct of flaxseed de-oiling that contains lignan, flaxseed gum, and cyanogenic glycoside. After consumption, cyanogenic glycosides can decompose in vivo into hydrogen cyanide, causing poisoning in the human body and death. The presence of cyanogenic glycoside in flaxseed limits the use of

#### *How Can Flaxseed be Utilized as Functional Food DOI: http://dx.doi.org/10.5772/intechopen.100201*

flaxseed and its byproducts in the food industry. To broaden the use of flaxseed in the food industry, The inventors revealed a type of red yeast rice Flaxseed cake fermentate and its application in the field of food processing technology in patent CN107136183A.The following steps were taken to prepare the product: The first step involved the detoxification of the Flaxseed cake, in which the water content of the Flaxseed cake was controlled at 170-200 g/kg and the detoxification was performed using a microwave power of 800 W for 8 minutes. The Flaxseed cake was fermented and detoxified further in the second step by activating the Monascus slant 3–4 times and accessing the seed culture medium. Then, after accessing the fermentation medium, concentration was done at 30 degrees Celcius for 3 days. The total incubation period was 5–7 days. As cyanogenic glycoside is unable to meet food safety requirements due to the limitations of traditional Flaxseed cake detoxification mode, so, flaxseed cake is never used as raw food material, but the main advantage of this invention was that it used microwave detoxification and secondary microbial fermentation to remove the mode of poison so that cyanogenic glycoside reaches below 0.015 mg/kg. Another advantage was that the entire process was inexpensive. In the functional test, Red yeast rice Flaxseed cake fermentate was used to make biscuits. 2 L Flax seed oil was used in the preparation of the biscuits. Wheat flour, egg, white granulated sugar, edible salt, ammonium hydrogen carbonate, sodium bicarbonate, and water were also used. The made biscuits were found to be free of cyanogenic glycosides. In addition, Both red yeast rice and flaxseeds can help with hypotension, blood glucose control, and cholesterol reduction. Flaxseeds have antitumor, anti-aging, and anti-renal failure properties. Therefore, Red yeast rice Flaxseed cake fermentate was beneficial to diabetic patients, aged women who lack nutrition, and people suffering from obesity [39].

We all know about the benefits of flaxseed, but such ingredients should be used in conjunction with flaxseed, which can make a significant contribution to the treatment of diabetes, so such food cannot be considered anything less than a boon. Edible seaweed is high in sugar, terpene, alkaloid, and polyphenols; these active materials have a variety of benefits including hypoglycemic, decompression, antibacterial, and anti-oxidant properties. Kelp is a rich source of dietary fiber, nutrients like vegetable protein, and has a high nutritive value, is extremely beneficial for the auxiliary treatment of diabetes. In this context, patent CN108522970A disclosed a full nutrition formula food made of a type of seaweed raw material for diabetic patients. Kelp powder, Buckwheat, soybean powder, Peanut powder, Walnut powder, Flaxseed meal, Kudzu-vine root powder, and Tomato powder were used in a 3:15:8:4:1:1:8:2 ratio, along with a small amount of nutrition fortifier. Preparation methods included polishing, mixing, homogeneous, and freeze-drying. The formula food produced could effectively control blood glucose and replace staple food to provide sufficient daily nutrition demand for diabetes patients and also cost was relatively low. Furthermore, because it is made entirely of natural food ingredients, it retains a wide range of natural sugar-reducing substances [40].

The process for preparing a mixture by mixing two types of ingredients was disclosed in Patent KR101850955B1. The type 1 ingredient was 54.5–71.5 percent by weight of flax, 8.0–11.5 percent by weight of acid, 4.5–7.4 percent by weight of onion, 1.5–2.5 percent by weight of pine needle, 1.5–2.5 percent by weight of Angelica keiskei, 1.5–2.5 percent by weight of blackberry, and type 2 ingredient was 50–54% by weight of the upper leaves and 46–50% by weight of the oak. The leaves were extracted for 2 to 3 hours at a temperature of 70 to 80 °C using hot water. The extract was then filtered to obtain filtrate, which was concentrated until it reached 23 Brix or higher, after which the mixture of type 1 ingredients and extract concentrate of type 2 ingredients was mixed in a ratio of 1: 0.4–0.6. The final food produced could be used to prevent or treat diabetes [41].

Omega-3 fatty acids can be found in a variety of foods, including fish and flaxseed, as well as dietary supplements like fish oil. Alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) are the three main omega-3 fatty acids. Plant oils such as flaxseed, soybean, and canola oils are high in ALA. Fish and other seafood contain DHA and EPA. Omega-3 fatty acid-rich diets may help diabetics lower their insulin resistance. Omega-3 fatty acid-rich diets may lower the risk of heart attacks, strokes, macular degeneration, and certain cancers. Many types of research have been conducted to create omega-rich foods. A type of −3 sour milk powder preparation was discovered in one of these studies, and it was patented under the number CN104542974B. It was made up of 15–25 parts of flaxseed oil microcapsule powder, 70–83 parts of milk powder, and 25% parts of probiotic powder in weight proportions. Each component material was mixed in equal increments, and the resulting powder was packed in a vacuum nitrogen filling packing machine with a sterile aluminum foil bag. Omega-3 supplemented sour milk powder could be stored at room temperature and had a long shelf life. It had numerous health benefits; it was easily soluble in water, could be dispersed into yogurt liquid, and could be reconstituted with 30–37 °C warm water to make instant drinks. It was found to be beneficial in the improvement of intestinal canal function, nutrient absorption, immunity, brain cell, intelligence, and optic nerve systematic growth, memory, and could prevent and improve chronic diseases like cardiovascular and cerebrovascular disease, cancer, and diabetes [42]. Another study, Patented in 2018 under application number CN108685006A disclosed the preparation of omega-3 solid beverage comprised of 60–96 parts by weight of linseed oil microcapsule powder, 0.02–0.1 parts by weight of probiotics, 3–10 parts by weight of compound fruit, and vegetable ferment, 3–20 parts by weight of bamboo-leaves flavones, 1–10 parts by weight of inulin. *Bifidobacteriumlongum*, *Lactobacillus paracasei*, and *Lactobacillus rhamnosus* were used as probiotics in the invention. Pawpaw, pineapple, berries, blackcurrant, melon, walnut, 10 parts black fungus, banana, grape, apple, lemon, longan, mango, radish, mushroom, cucumber, pumpkin, wild rice stem, tomato, and green cucumber were the main vegetables and fruits used in the vegetable and fruit ferment. Probiotics and linseed oil microcapsule powder were first pressed and uniformly mixed, then compound fruit and vegetable ferment was added and uniformly mixed, after that bamboo-leaves flavone were added and uniformly mixed, and finally plus inulin was uniformly mixed using the equal increments method. The resulting solid beverage was found to be effective in preventing and treating diabetes, as well as slowing diseases like kidney disease, cancer, and gastrointestinal function weakness, as well as promoting nutrient absorption [43].

US0335796A1 described the preparation of a low-calorie optimized nutrient food that contained all of the essential and non-essential nutrients in the proper proportions for optimization of body systems and, as a result, maintaining health, preventing diseases such as hypertension, heart diseases, cancer and diabetes, and delaying aging, with a calorie count of about 650. More specifically, the optimized nutrient food contained a 1:1 ratio of omega 3 to omega 6 fatty acids; high dietary fiber content; high protein with complete amino acids; and vitamins and minerals optimized according to FDA daily value recommendations, capable of providing about 650 calories per 150 g, but free of cholesterol, trans fat, preservatives, and artificial flavorants and colorants. Protein source was obtained from soya beans, goa beans, watermelon seeds, flaxseed, perilla seed, hemp seed, sachainchi seed, sunflower seed, safflower seed, almond, garden cress seed, oats, gingili seed, fenugreek, pumpkin seeds, pistachio, corn seed, rapeseed, poppy seed, sesame seed, black gram, Bengal gram, and green gram. Flaxseed, perilla seed, garden cress seed, mustard seed, canola seed, chia seed, sachainchi, hemp seed, walnut, clary sage seed were chosen as omega

#### *How Can Flaxseed be Utilized as Functional Food DOI: http://dx.doi.org/10.5772/intechopen.100201*

3 sources, and gingili seed, sunflower seed, safflower seed, watermelon seed, corn seed, almond, cashew nut, groundnut, pumpkin seed, hemp seed, black currant seed, poppy seed, rapeseed, borage seed, were chosen as omega 6 sources. Oats bran, rice bran, fenugreek seed, soya beans, flaxseed, garden cress seed, rice bran, chicory root, aniseed, sun root, perilla seed, and safflower seed were chosen as dietary fiber sources. The functional test included 30 patients between the ages of 25 and 40 who were diabetics with fertility issues who were planning a pregnancy. Two groups of patients were created. Metformin 500 mg twice daily was given to all patients, along with dietary advice. Other standard modern medical treatment for their fertility issues was also given to them. All of the patients in the first group were instructed to cut back on fat, starch, and sugar in their diets, as well as engage in light to moderate exercise. The second group was told to eat 100 grams of optimized nutrient food every day for 2 months, along with low-calorie vegetables and fruits, and to avoid eating anything else. It was observed that both groups improved their blood sugar levels for 30 days, but the second group, which followed an optimized nutrient food diet, had significantly better blood sugar control. Both groups had improved blood sugar and HbA1C levels at the end of the 60 days. However, 80% of the first group had not achieved adequate blood sugar control before conception, necessitating the use of insulin. Due to exhaustion, the patients in the first group were unable to restrict their carbohydrate intake. Those on a nutrient-dense food diet, on the other hand, saw significant improvements in blood sugar and HbA1C. With an optimized nutrient food diet, even overweight and obese diabetic patients improved significantly, and none of them required insulin before conception. As a result, Optimized nutrient food having about 650 calorie optimal nutrition was the simple, safe, and economic answer to the prevention of lifestyle-related diseases [44].

CN110384123A disclosed the preparation method of Low-sugar high-fat mooncakes. Ketobodies are produced by a high-fat diet, which regulates glucose metabolism, reduce carbohydrate intake, block the energy source of tumor cells, reduce intracellular active oxygen ROS (reactive oxygen species), and thus including high-fat diet on daily basis can protect the human body against diabetes, Alzheimer's disease, and Parkinson's disease. In the invention, Mooncake wrapper 33 g and fillings 17 g were used to make a low-sugar, high-fat mooncake, with a fat: protein+sugar mass ratio of 1.0–10: 1–0.1. The moon cake wrapper was made of the following materials in the following mass percents: fatty microcapsule powder 26–48 percent, resistant starch 21–35 percent, sugar alcohol 4–7%, resistant dextrin 9–20 percent, polydextrose 3–6%, phosphatidase 2–6%, dried hen egg yolk 2–10%, egg liquid 11–18 percent. The material used for fillings were taken in the following mass percents: fat meat 11–22 percent, veterinary antibiotics or nut powder 19–33 percent, yolk 30–47 percent, calcium caseinate 2–6%, grease 1–5%, sugar alcohol 0.5–3%, resistant starch 3–11 percent. Antierythrite, D-sorbate, maltitol, xylitol, isomalt, lactitol, and one or more mannitol were among the sugar alcohols used. In the filling for grease, coconut oil, palm kernel oil, medium-chain triglyceride, peanut oil, rapeseed oil, olive oil, tea oil, high oleic sunflower oil, rice oil, pine-seed oil, soybean oil, corn oil, flaxseed oil, cottonseed oil, sesame oil, walnut oil, perilla herb oil, docosahexaenoic acid DHA algal oil, arachidonic acid ARA oil, fish oil, pig One or more of oil, chicken fat, and sheep oil were used. Ovum Anas Domestica yolk, egg yolk, goose egg yolk, turkey yolk, pigeon yolk, ostrich yolk, quail One or more of quail egg and emu egg were among the fillings' yolks. Filling vegetables included pumpkin, wax gourd, purple sweet potato, sweet potato, taro, Chinese chestnut, carrot, potato, water chestnut, corn, cassava, and lotus rhizome dry product; fruit included pawpaw, apple, pear, coconut, orange, lemon, strawberry, blueberry, and blackberry dry product; and nut powder included pine nut, walnut, and peanut powder. Furthermore, technical issues were resolved to make it low in sugar but still palatable [45].

US10765318B2 disclosed a regimen that included a meal plan, exercise, and specific supplements for cleansing, overcoming bodily deficiencies, and reversing Type II diabetes. In the invention, nutritional supplement preparation was described. Vitamins A, C, D, E, K, K2, B1, B2, B3, B6, B9, B12, B7, B5, Minerals Calcium, Iron, Magnesium, Zinc, Selenium, Copper, Manganese, Chromium, Molybdenum, Potassium, and stabilized fatty acid blend consisting of Borage Oil, Flax Seed Oil, and Algae Oil was included in the recommended supplement. Aside from that, the supplement contained an organic vegetable and fruit blend that included Garlic, Jerusalem Artichoke, Cinnamon Verum, Raspberry Ketones, Rhodiola Crenulated and Glucomannanase, Turmeric, CoQ10 Ubiquinol, Black Strap Molasses, Kelp, and Probiotics like Lactobacillus, Acidophilus, L-Plantarum, Bulgaricus, Streptococcus, Thermophilus and *Enterococcus Faecium*. Furthermore, the meal plan and mild to moderate exercise were also advised in the disclosure. A case study was carried out on 20 patients who had Type 2 Diabetes and were taking diabetic medication. The study's patients all have A1c levels ranging from 6.0 to 12.5. All patients were advised to take supplements in addition to a healthy diet and exercise. It was discovered that everyone who used the invention reduced or eliminated their diabetic medications, lost weight, or had personally expressed having more energy [46].

CN111466425A revealed a method of making a low-carbohydrate flaxseed nut wafer. The wafer was made up of the following raw materials in weight order: 40–80 parts flaxseed, 5–30 parts nut grains, 0–0.06 part sweetening agent, 0–0.5 part psyllium husk powder, 15–30 parts sugar substitute powder, 2–6 parts thickening powder, 3–5 parts edible oil, 1–5 parts tackifying powder, 0–1 part yeast extract and 80–100 parts of water. Material preparation, dissolution, whipping, soaking, quantitative squeezing, trowelling and forming, and baking were all used to make the wafer. The low-carbohydrate nutritional wafer was high in protein and dietary fiber, and it was also high in Omega-3 and other minerals. It had a thin, sweet, delicious, and crispy mouthfeel and was suitable for people of all ages. It could be used as a fat-reducing meal replacement for obese people, diabetes patients, polycystic ovary syndrome patients, hyperlipidemia, and hypertension patients, and it could also be used as a leisure breakfast or nutritional meal for constipation sufferers [47].

In WO2020081417A1, a dietary supplement formulation for the treatment or prevention of digestive and immune-related disorders was disclosed. The dietary supplement could be compounded in a solid form (such as bars, wafers, or pills), a paste form, a granular form, a powder form, or a liquid form, and it could be taken orally. The ingredients of the dietary supplement include L-glutamine, mucogenic amino acid, both produced by vegan bacterial fermentation of sugar beets; lecithin derived from soy oil, oat oil, sunflower oil, safflower oil, com oil; fructooligosaccharides derived from yacon root, chicory root, Jerusalem artichoke, blue agave; beta-glucan derived from oats, barley, mushrooms, seaweed, algae, yeast cell wall; A oligosaccharide derived from the bran tissues of wheat, oats, barley, rice, millet, psyllium, flax, rye; RS-4 starch derived from oats, yacon root, chicory root, flax, acacia, com. Emulsifiers and nutricine, (that bind to and eliminates pathogenic bacteria in the digestive tract), were also included in the formulation. The dietary supplement was said to reduce systemic inflammation, which is the cause of most chronic diseases like diabetes, cardiovascular disease, and cancers, by increasing the impermeability of the gut lining and balancing the bacteria components of the microbiota [48].

An enteral or oral nutritional composition comprised of whole food components, herbs or spices blend, fat, carbohydrates, protein source, fiber source, and micronutrients was described in WO2020039277A1. Cereals, fruits, and vegetables were included in the whole food supplement. Fruits included banana, apple, guava, orange, grapes, mango, pomegranate, and chickoo; vegetables included

*How Can Flaxseed be Utilized as Functional Food DOI: http://dx.doi.org/10.5772/intechopen.100201*

beetroot, tomato, carrot, radish, onion, and spinach; and cereals included wheat, rice, soybean, and chickpea were utilized in the supplement. For fatty acids supplementation α-linolenic acid, docosahexaenoic acid, eicosapentaenoic acid, flaxseed, walnuts, almonds, algae, krill, were used. All of the ingredients were cooked for 10–30 minutes at 60–80 degrees Celsius, then blended and homogenized into a powder that could be reconstituted with water or juice. It was noticed that the invention of enteral/oral nutritional composition satisfied the specific nutritional needs of patients with various illnesses, such as cancer, diabetes, kidney, and liver diseases, as well as patients who had undergone surgery [49].

In KR20210012287A, meat powder and antidiabetic ingredients were mixed with whole wheat flour, rye flour, and wheat flour used to make noodles for diabetic patients. Based on a total of 100 parts by weight of nutritional noodles, the meat powder was 5 to 30 parts by weight and the antidiabetic material powder was 5 to 30 parts by weight. Broccoli, onion, eggplant, garlic, arbor, deodeok, burdock, purple pork potato, bitter gourd, flaxseed, nuts, brown rice, and barley were among the anti-diabetic ingredients. The noodles were cooked at a low temperature, which has the advantage of reducing nutrient loss by minimizing nutrient destruction. The meat powder was made using beef, pork, chicken, lamb, and duck. The resulting noodles were low in calories, high in protein, high in vitamins and minerals, and low in cholesterol, making them an ideal diabetic food [50].
