Fish oil to lower cholesterol
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Fish Oil to Lower Cholesterol: 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), has been widely studied for its potential benefits in managing lipid levels, particularly in individuals with hyperlipidemia. This article synthesizes findings from multiple studies to evaluate the efficacy of fish oil in lowering cholesterol levels.
Fish Oil and Triglyceride Reduction
Significant Reduction in Triglycerides: Numerous studies have consistently shown that fish oil supplementation leads to a significant reduction in fasting blood triglyceride levels. A systematic review and meta-analysis of 47 studies found that fish oil intake (average 3.25 g/day of EPA and DHA) resulted in a clinically significant reduction in triglycerides by 0.34 mmol/L2. Similarly, a study involving healthy male students demonstrated that both fish diet and fish oil supplementation decreased fasting plasma triglyceride levels3.
Fish Oil and Total Cholesterol
Mixed Results on Total Cholesterol: The impact of fish oil on total cholesterol levels appears to be less consistent. While some studies report no significant change in total cholesterol2, others have observed slight reductions. For instance, a study on patients with nonalcoholic fatty liver disease (NAFLD) associated with hyperlipidemia found that fish oil significantly decreased total cholesterol levels by 0.49 mmol/L1.
Fish Oil and LDL Cholesterol
Potential Increase in LDL Cholesterol: The effect of fish oil on low-density lipoprotein (LDL) cholesterol is complex. Some studies indicate that fish oil may increase LDL cholesterol levels. For example, a placebo-controlled trial found that fish oil supplementation raised LDL cholesterol levels in hypertriglyceridemic patients6. Another study reported a 9.1% increase in LDL cholesterol in middle-aged men with hypercholesterolemia10. However, a study involving a low-fat spread with added plant sterols and fish oil showed a significant reduction in LDL cholesterol by 5.2%5.
Fish Oil and HDL Cholesterol
Minor Effects on HDL Cholesterol: The influence of fish oil on high-density lipoprotein (HDL) cholesterol is generally minimal. Most studies report either no change or slight increases in HDL cholesterol levels. For instance, a meta-analysis found a very slight increase in HDL cholesterol by 0.01 mmol/L2. Another study noted an increase in the HDL2/HDL3-cholesterol ratio by over 50% in subjects consuming fish oil3.
Fish Oil and Other Lipid Parameters
Additional Benefits: Fish oil supplementation has also been associated with improvements in other lipid parameters. For example, a study on saury oil, rich in omega-11 monounsaturated fatty acids, found beneficial effects on LDL particle counts and HDL particle size7. Additionally, fish oil has been shown to lower apolipoprotein B levels and the ratio of LDL cholesterol to HDL cholesterol6.
Conclusion
Fish oil supplementation is effective in significantly reducing triglyceride levels, which is beneficial for cardiovascular health. However, its effects on total and LDL cholesterol are mixed, with some studies indicating potential increases in LDL cholesterol. The impact on HDL cholesterol is generally minimal. Given these mixed results, individuals considering fish oil supplements for cholesterol management should consult healthcare professionals for personalized advice and monitoring.
Sources and full results
Most relevant research papers on this topic
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.
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Rigorous Journal
Highly CitedBenefits 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 CitedFish 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 CitedEffects 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-AnalysisA low-fat spread with added plant sterols and fish omega-3 fatty acids lowers serum triglyceride and LDL-cholesterol concentrations in individuals with modest hypercholesterolaemia and hypertriglyceridaemia
A low-fat spread with added plant sterols and fish omega-3 fatty acids significantly lowers serum triglyceride and LDL-cholesterol concentrations in individuals with modest hypercholesterolaemia and hypertriglyceridaemia.
RCTRigorous JournalEffects 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 CitedSupplementation 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.
RCTFish 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 CitedFish 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 CitedFish 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.
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