Next Article in Journal
The Role of Omega-3 Polyunsaturated Fatty Acid Supplementation in Postoperative Recovery of Colorectal Cancer: Systematic Review and Meta-Analysis
Previous Article in Journal
An Acebuche Oil-Enriched Diet Prevents Early-Stage Cerebrovascular Alterations in the 5xFAD Mouse Model of Alzheimer’s Disease
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Reply

Reply to Spitz et al. Conclusions Are Not Supported by the Published Statistical Analysis. Comment on “López-Toledo et al. Flaxseed Improves Glucose and Lipid Metabolism in Mexican Subjects with Type 2 Diabetes: A Parallel Randomized Clinical Trial. Nutrients 2025, 17, 709”

by
Sabina López-Toledo
Center for Studies in Health Sciences and Disease, “Benito Juarez” Autonomous University of Oaxaca, Oaxaca 68000, Mexico
Nutrients 2026, 18(1), 171; https://doi.org/10.3390/nu18010171
Submission received: 25 November 2025 / Accepted: 16 December 2025 / Published: 5 January 2026

1. Correction of Figure 3

We sincerely thank the Editor and the commenting authors for their careful review and constructive observations regarding our article [1]. Below we address their concerns and provide updated analyses.
During manuscript preparation, Figure 3 (Behavior of biochemical parameters of participants in the intervention group) was inadvertently duplicated from Figure 2, leading to misrepresentation of the control group data. We regret this oversight. The textual results and underlying dataset remain correct and unaffected. The corrected Figure 3 and data are provided as follows.
Figure 3. Behavior of biochemical parameters of participants in the intervention group (n = 82) before and after 12 weeks of flaxseed supplementation. Significant reductions were observed in fasting glucose, total cholesterol, and triglycerides (p < 0.001), while the change in glycated hemoglobin was not significant (p = 0.234). Data are presented as mean ± SD.
Figure 3. Behavior of biochemical parameters of participants in the intervention group (n = 82) before and after 12 weeks of flaxseed supplementation. Significant reductions were observed in fasting glucose, total cholesterol, and triglycerides (p < 0.001), while the change in glycated hemoglobin was not significant (p = 0.234). Data are presented as mean ± SD.
Nutrients 18 00171 g003

2. Reanalysis to Avoid DINS Error

To address the concern about Difference in Nominal Significance (DINS) and to properly test between-group differences, we reanalyzed our data using analysis of covariance (ANCOVA) with baseline values as covariates. The results strongly confirm our original conclusions:
  • Glycated Hemoglobin (HbA1c): F(1163) = 192.89, p < 0.001. Adjusted means (±SE): 7.15 ± 0.13% (intervention) vs. 9.75 ± 0.13% (control); adjusted difference: −2.60% (95% CI: −2.97 to −2.23).
  • Glucose: F(1163) = 58.42, p < 0.001. Adjusted means (±SE): 100.9 ± 3.6 mg/dL vs. 139.9 ± 3.6 mg/dL; difference: −38.96 mg/dL (95% CI: −49.02 to −28.89).
  • Total Cholesterol: F(1163) = 266.99, p < 0.001. Adjusted means (±SE): 144.3 ± 2.7 mg/dL vs. 207.8 ± 2.7 mg/dL; difference: −63.53 mg/dL (95% CI: −71.20 to −55.85).
  • Triglycerides: F(1163) = 296.11, p < 0.001. Adjusted means (±SE): 130.8 ± 4.3 mg/dL vs. 235.8 ± 4.3 mg/dL; difference: −105.08 mg/dL (95% CI: −117.14 to −93.02).

3. Data Availability

De-identified raw data and the R/SPSS code used for these analyses have been deposited in Zenodo for independent verification [2].

4. Conclusions

The corrected figure and new ANCOVA analyses confirm that daily supplementation with 16 g of flaxseed for 12 weeks significantly improves glucose and lipid metabolism in adults with type 2 diabetes compared to the control. We respectfully request that the journal publish this Author’s Reply and the associated corrigendum to update the record.
Thank you for the opportunity to clarify and strengthen our findings.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Spitz, R.W.; Thapa, D.K.; Mokalla, T.R.; Najam, W.; Brown, A.W.; Allison, D.B. Conclusions Are Not Supported by the Published Statistical Analysis. Comment on López-Toledo et al. Flaxseed Improves Glucose and Lipid Metabolism in Mexican Subjects with Type 2 Diabetes: A Parallel Randomized Clinical Trial. Nutrients 2025, 17, 709. Nutrients 2026, 18, 170. [Google Scholar]
  2. López Toledo, S. Flaxseed RCT in Adults with Type 2 Diabetes—De-identified dataset (v1.0.0) [Data set]. Zenodo. 2025. [Google Scholar] [CrossRef]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

López-Toledo, S. Reply to Spitz et al. Conclusions Are Not Supported by the Published Statistical Analysis. Comment on “López-Toledo et al. Flaxseed Improves Glucose and Lipid Metabolism in Mexican Subjects with Type 2 Diabetes: A Parallel Randomized Clinical Trial. Nutrients 2025, 17, 709”. Nutrients 2026, 18, 171. https://doi.org/10.3390/nu18010171

AMA Style

López-Toledo S. Reply to Spitz et al. Conclusions Are Not Supported by the Published Statistical Analysis. Comment on “López-Toledo et al. Flaxseed Improves Glucose and Lipid Metabolism in Mexican Subjects with Type 2 Diabetes: A Parallel Randomized Clinical Trial. Nutrients 2025, 17, 709”. Nutrients. 2026; 18(1):171. https://doi.org/10.3390/nu18010171

Chicago/Turabian Style

López-Toledo, Sabina. 2026. "Reply to Spitz et al. Conclusions Are Not Supported by the Published Statistical Analysis. Comment on “López-Toledo et al. Flaxseed Improves Glucose and Lipid Metabolism in Mexican Subjects with Type 2 Diabetes: A Parallel Randomized Clinical Trial. Nutrients 2025, 17, 709”" Nutrients 18, no. 1: 171. https://doi.org/10.3390/nu18010171

APA Style

López-Toledo, S. (2026). Reply to Spitz et al. Conclusions Are Not Supported by the Published Statistical Analysis. Comment on “López-Toledo et al. Flaxseed Improves Glucose and Lipid Metabolism in Mexican Subjects with Type 2 Diabetes: A Parallel Randomized Clinical Trial. Nutrients 2025, 17, 709”. Nutrients, 18(1), 171. https://doi.org/10.3390/nu18010171

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop