Omega-3s Lower Triglycerides
The clinical uses of omega-3 fatty acids (n-3 FAs) include treatment of hypertrglyceridaemia, use in statin-treated patients with elevated triaclyglycerol (TG) concentrations or non-HDL (high-denisty lipoprotein) cholesterol (mixed hyperlipidaemia), and use in the secondary and primary prevention of cardiovascular disease.
A recent pooled meta-analysis with multiple doses of n-3 FAs ranging from 0.8-5.4/g revealed highly significant (p<0.001) changes in TG, HDL cholesetrol and low-density lipoprotein (LDL) cholesterol (see Table 1).
Table 1: Effect of n-3 FAs on lipids | ||
Lipids | Change | 95% Confidence Interval |
TG | -27mg/dL | -33, -20 |
HDL Cholesterol | +1.6mg/dL | +.08, +2.3 |
LDL Cholesterol | +6mg/dL | +3, +8 |
Across the studies, each 1g/d increase in fish oil dose was associated with a decrease in TG of 8mg/dL.
Several meta-analyses have also been conducted to determine the degree of TG reductions seen with n-3 FAs. In a meta-analysis of 72 placebo-controlled trials, average TG reductions with fixed doses of 3-4g n-3 FAs as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) were between 25-35 %, with greater reductions seen in those with high TG concentrations of >500ml/dL.
The American Heart Association recommends regular m-3 FA intake for primary and secondary prevention of coronary heart disease (CHD), as summarised in Table 2.
Table 2: Amerian Heart Association recommendations for n-3 FA intake | |
Population | Recommendation |
Patients without documented coronary heart disease (CHD) | Eat a variety of oily fish at least twice weekly. Include oils and foods rich in a-linolenic acid (e.g. flaxseed, walnuts) |
Patients with documented CHD | Consume ~1g EPA + DHA per day either from oily fish or supplementation. |
Patients requiring TG-lowering | 2-4g EPA + DHA per day. |