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|
|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|
|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.|