Fish oil and hdl
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The Impact of Fish Oil on HDL Cholesterol: A Comprehensive Review
Introduction to Fish Oil and HDL Cholesterol
Fish oil, rich in omega-3 fatty acids such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), has been extensively studied for its cardiovascular benefits. One area of interest is its effect on high-density lipoprotein (HDL) cholesterol, often referred to as "good" cholesterol due to its role in transporting cholesterol away from the arteries and back to the liver for excretion.
Fish Oil and HDL Particle Size and Composition
Increase in HDL Particle Size
Research indicates that the intake of fatty fish, which is high in long-chain omega-3 PUFAs, can lead to an increase in the average size of HDL particles. A study involving volunteers with impaired glucose metabolism found that consuming fatty fish significantly increased the size of HDL particles and the concentration of lipid components in HDL, suggesting enhanced antiatherogenic properties .
HDL Subclasses and Fish Oil
In type 2 diabetic patients, fish oil supplementation was shown to raise the concentrations of HDL-2b and HDL-2a cholesterol, which are considered beneficial subclasses of HDL. This suggests that fish oil can partially correct dyslipidemia in these patients by improving the distribution of HDL subclasses .
Fish Oil and HDL Cholesterol Levels
Modest Increases in HDL Cholesterol
Several studies have reported modest increases in HDL cholesterol levels with fish oil supplementation. A systematic review and meta-analysis found that fish oil consumption resulted in a slight increase in HDL cholesterol by approximately 0.01 mmol/L . Another review supported these findings, indicating a net increase in HDL cholesterol of about 1.6 mg/dL .
No Significant Change in HDL Cholesterol
Contrarily, some studies have found no significant changes in HDL cholesterol levels with fish oil supplementation. For instance, a study on hypertriglyceridemic patients reported no significant changes in HDL or its subfractions after fish oil supplementation, despite reductions in triglycerides and increases in LDL cholesterol .
Mechanisms and Genetic Factors
Influence of ApoE Polymorphism
The efficacy of fish oil in modifying HDL cholesterol levels may also be influenced by genetic factors such as the apolipoprotein E (apoE) polymorphism. Research has shown that individuals with different apoE genotypes respond differently to fish oil supplementation. For example, apoE2 carriers exhibited a marked reduction in postprandial triglyceride response and a trend towards increased lipoprotein lipase activity, which could influence HDL metabolism .
Cholesterol Efflux Capacity
While fish oil has been shown to affect HDL particle size and composition, its impact on the functional properties of HDL, such as cholesterol efflux capacity, remains less clear. Some studies have reported no significant changes in HDL's ability to promote cholesterol efflux from cells, suggesting that the functional benefits of fish oil on HDL may be limited .
Conclusion
Fish oil supplementation appears to have a modest but positive effect on HDL cholesterol levels and particle size, which may contribute to its cardioprotective properties. However, the extent of these benefits can vary based on individual genetic factors and the specific characteristics of the population studied. Further research is needed to fully understand the mechanisms by which fish oil influences HDL function and to identify the populations that may benefit the most from its supplementation.
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