Does fish oil 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, is often touted for its cardiovascular benefits. However, its effect on cholesterol levels remains a topic of debate. This article synthesizes findings from multiple studies to provide a clear understanding of how fish oil influences cholesterol levels.

Fish Oil and Total Cholesterol Levels

Mixed Results in Human Studies

Several studies have investigated the impact of fish oil on total cholesterol levels in humans, yielding mixed results. A randomized clinical trial found that fish oil supplementation did not significantly lower total cholesterol levels in men with hypercholesterolemia . Similarly, a systematic review and meta-analysis concluded that fish oil supplementation did not produce a significant change in total cholesterol levels in hyperlipidemic subjects .

Rodent Studies Show Promise

In contrast, rodent studies have shown more promising results. A systematic review and meta-analysis of rodent studies indicated that diets rich in cetoleic acid (a component of fish oil) significantly lowered circulating total cholesterol levels . These findings suggest potential species-specific differences in response to fish oil supplementation.

Fish Oil and LDL Cholesterol

Increase in LDL Cholesterol

Several studies have reported an increase in LDL cholesterol levels following fish oil supplementation. A placebo-controlled trial found that fish oil raised LDL cholesterol levels in hypertriglyceridemic patients . Another study observed a significant increase in LDL cholesterol in men with hypercholesterolemia after fish oil supplementation . These findings highlight the need for careful monitoring of LDL cholesterol levels during fish oil supplementation.

Potential Mitigating Factors

Interestingly, a study on saury oil, a fish oil high in omega-11 monounsaturated fatty acids, found that it lowered LDL particle counts compared to control oil, suggesting that the type of fish oil may influence its effect on LDL cholesterol .

Fish Oil and HDL Cholesterol

Minimal Impact on HDL Cholesterol

The impact of fish oil on HDL cholesterol appears to be minimal. A meta-analysis found only a slight increase in HDL cholesterol levels in hyperlipidemic subjects . Similarly, a study on hypertriglyceridemic patients reported no significant changes in HDL cholesterol levels following fish oil supplementation .

Specific Fish Oils Show Benefits

However, some specific types of fish oil may have beneficial effects. Saury oil supplementation was found to increase HDL particle size, which could be beneficial for cardiovascular health .

Fish Oil and Triglycerides

Significant Reduction in Triglycerides

One of the most consistent findings across studies is the significant reduction in triglyceride levels with fish oil supplementation. Multiple studies have reported a clinically significant decrease in triglyceride levels in hyperlipidemic subjects 349. This triglyceride-lowering effect is one of the primary reasons fish oil is recommended for cardiovascular health.

Mechanisms of Action

The reduction in triglycerides is likely due to the high content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in fish oil, which have been shown to lower triglyceride levels effectively 210.

Conclusion

In summary, while fish oil supplementation consistently lowers triglyceride levels, its effects on total, LDL, and HDL cholesterol are more variable. Fish oil does not significantly lower total cholesterol and may increase LDL cholesterol levels, necessitating careful monitoring. The type of fish oil and the specific fatty acids it contains can influence these outcomes. Further research is needed to fully understand the mechanisms and to optimize fish oil formulations for cardiovascular health benefits.

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Most relevant research papers on this topic

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 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.

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.

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.

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.

Fish oil supplementation does not lower plasma cholesterol in men with hypercholesterolemia. Results of a randomized, placebo-controlled crossover study.

Fish oil supplements do not lower plasma cholesterol levels in middle-aged men with hypercholesterolemia without elevated triglycerides, and should not be recommended as a method to lower cholesterol in these patients.

RCT

1989·

40citations

·T. Wilt 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

Effects of varying dietary fat, fish, and fish oils on blood lipids in a randomized controlled trial in men at risk of heart disease.

Fish or fish oil with a 40%-fat diet improves blood lipids, while a 30%-fat diet reverses negative effects of omega-3 fats on cholesterol.

RCTHighly Cited

1994·

89citations

·Trevor A. Mori 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 Oil and Glycemic Control in Diabetes: A meta-analysis

Fish oil effectively lowers triglyceride levels by 30% in diabetic patients without adverse effects on HbA1c levels, making it useful in treating dyslipidemia in diabetes.

Meta-AnalysisHighly Cited

1998·

322citations

·C. E. Friedberg et al.

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