Does fish oil help lower cholesterol

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The Impact of Fish Oil on Cholesterol Levels: A Comprehensive Review

Introduction to Fish Oil and Cholesterol

Fish oil, rich in omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is widely recognized for its potential health benefits, particularly in cardiovascular health. This article synthesizes current research to determine whether fish oil supplementation can help lower cholesterol levels.

Fish Oil and Triglyceride Reduction

Significant Reduction in Triglycerides

Multiple studies consistently show that fish oil supplementation significantly reduces fasting blood triglyceride (TG) levels. A meta-analysis of 47 studies found that a daily intake of 3.25 grams of EPA and DHA resulted in a clinically significant reduction in TG levels by 0.34 mmol/L . Similarly, a randomized clinical trial involving patients with nonalcoholic fatty liver disease (NAFLD) associated with hyperlipidemia reported a decrease in TG levels by 0.58 mmol/L after three months of fish oil supplementation . These findings are supported by additional research indicating that fish oil lowers plasma TG levels in both hypertriglyceridemic patients and healthy subjects 37.

Fish Oil and Total Cholesterol

Minimal Impact on Total Cholesterol

While fish oil is effective in reducing triglycerides, its impact on total cholesterol levels appears minimal. The meta-analysis mentioned earlier found no significant change in total cholesterol levels (-0.01 mmol/L) . This is corroborated by other studies that also reported no significant changes in total cholesterol levels following fish oil supplementation 37.

Fish Oil and LDL Cholesterol

Increase in LDL Cholesterol

Interestingly, fish oil supplementation has been associated with a slight increase in low-density lipoprotein (LDL) cholesterol levels. The meta-analysis observed a small increase in LDL cholesterol by 0.06 mmol/L . Another study noted that fish oil supplementation led to an increase in LDL cholesterol and apolipoprotein B levels, suggesting the need for careful monitoring during fish oil intake . This increase in LDL cholesterol was also observed in a study focusing on hypertriglyceridemic adults, where LDL cholesterol levels increased by 13% .

Fish Oil and HDL Cholesterol

Minor Increase in HDL Cholesterol

The effect of fish oil on high-density lipoprotein (HDL) cholesterol is generally positive but modest. The meta-analysis reported a slight increase in HDL cholesterol by 0.01 mmol/L . Other studies have shown similar minor increases in HDL cholesterol levels, indicating a potential benefit for cardiovascular health 37.

Conclusion

In summary, fish oil supplementation is highly effective in reducing triglyceride levels, which can be beneficial for cardiovascular health. However, its impact on total cholesterol is negligible, and it may slightly increase LDL cholesterol levels. The minor increase in HDL cholesterol could offer additional cardiovascular benefits. Overall, while fish oil is beneficial for lowering triglycerides, its effects on cholesterol levels warrant careful consideration and monitoring.

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Most relevant research papers on this topic

Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis.

Fish oil supplementation significantly reduces fasting blood triglyceride levels in hyperlipidemic individuals, but does not significantly affect total, HDL, or LDL cholesterol levels.

Meta-AnalysisHighly Cited

2009·

289citations

·G. Eslick et al.

Fish Oil Supplements Lower Serum Lipids and Glucose in Correlation with a Reduction in Plasma Fibroblast Growth Factor 21 and Prostaglandin E2 in Nonalcoholic Fatty Liver Disease Associated with Hyperlipidemia: A Randomized Clinical Trial

Fish oil supplements can improve metabolic abnormalities in nonalcoholic fatty liver disease associated with hyperlipidemia by reducing fibroblast growth factor 21 and prostaglandin E2.

RCTRigorous JournalHighly Cited

2015·

92citations

·Yu Qin et al.

Effects of a low saturated fat, low cholesterol fish oil supplement in hypertriglyceridemic patients. A placebo-controlled trial.

Fish oil supplements can lower plasma triglyceride levels in hypertriglyceridemic patients, but monitoring of lipoprotein changes is necessary due to potential long-term benefits.

RCTHighly Cited

1988·

94citations

·William S. Harris et al.

Fish oil attenuates the cholesterol induced rise in lipoprotein cholesterol.

Fish oil rich in n-3 fatty acids can lower lipoprotein cholesterol even when the intake of cholesterol is high, even when triglyceride levels are high.

Non-RCTHighly Cited

1986·

128citations

·P. Nestel

Supplementation with saury oil, a fish oil high in omega-11 monounsaturated fatty acids, improves plasma lipids in healthy subjects.

Saury oil supplementation is well-tolerated and improves cardiovascular parameters like LDL particle counts, HDL particle size, and plasma TG levels in healthy individuals.

RCT

2019·

16citations

·Zhi-Hong Yang et al.

Effects of diets containing fish oils or fish oil concentrates with high cetoleic acid content on the circulating cholesterol concentration in rodents. A systematic review and meta-analysis

Intake of cetoleic acid-rich fish oils and concentrates significantly lowers circulating total cholesterol concentration in rodents, suggesting potential as functional dietary ingredients or supplements to reduce the risk of developing cardiovascular disease in humans.

Meta-Analysis

2023·

2citations

·Margrete Mjaatveit et al.

Fish diet, fish oil and docosahexaenoic acid rich oil lower fasting and postprandial plasma lipid levels.

Moderate intakes of long-chain n-3 fatty acids from a fish diet, fish oil, and pure DHA can decrease fasting and postprandial triglyceride levels in healthy male students.

RCTHighly Cited

1996·

131citations

·J. Ågren et al.

Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review.

Fish oil supplements rich in omega-3 fatty acids can lower triglyceride levels but have little effect on total cholesterol levels, with potential alternative sources like fatty fish and linolenic acid.

Literature ReviewHighly Cited

1989·

1154citations

·W. S. Harris

A double-blind randomized trial of fish oil to lower triglycerides and improve cardiometabolic risk in adolescents.

Fish oil (4 g/day) slightly lowers triglycerides and may have an antithrombotic effect in children, but has no effect on LDL particles.

RCT

2014·

46citations

·S. Gidding et al.

Effect of fish oil supplementation on serum triglycerides, LDL cholesterol and LDL subfractions in hypertriglyceridemic adults.

Fish oil supplementation significantly lowers triglycerides and increases LDL-cholesterol, with a relatively even distribution across smaller and less atherogenic particles in hypertriglyceridemic adults.

RCT

2013·

39citations

·Beibei Oelrich et al.

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