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Fish Oil, Fish Consumption, and Omega-3 Fatty Acids: Do They Lower Cholesterol?

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Updated May 16, 2014

Fish Oil, Fish Consumption, and Omega-3 Fatty Acids: Do They Lower Cholesterol?

Omega-3 fatty acid supplements can lower lipids and support heart health.

Brian A. Jackson, istockphoto
Omega-3 fatty acids, or fish oil, are polyunsaturated fats found in fish, fish oil, and in the form of supplements. They typically consist of a combination of polyunsaturated fatty acids that include DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). Polyunsaturated fats, especially EPA and DHA, have a reputation for being heart-friendly fats because they do not promote atherosclerosis associated with causing heart disease. Previous research has shown that individuals consuming omega-3 fatty acids have decreased risk of sudden death from heart disease. Recent research has indicated that it may also lower the risk for heart disease by improving your lipid profile. So, does it help lower triglyceride and cholesterol levels?

The Studies Look Promising…

The usual dose used in these studies ranges between 900 mg and 5 grams a day of a combination of EPA and DHA. In order to achieve this amount, one would need to consume a lot of fish. Therefore, supplements are typically used. Ingesting 900 mg of omega-3 fatty acids each day resulted in a 4-percent decrease in triglyceride levels after six months. The average effective dose used in most studies was between 2 to 4 grams, and this resulted in an average drop in triglycerides between 25 to 45 percent. The effectiveness of omega-3 fatty acids on triglycerides is dose-dependent, meaning that the more omega-3 fatty acids ingested, the lower your triglyceride levels will fall. This works best when following a healthy diet. Omega-3 fatty acids seemed to affect recently ingested triglycerides more. Additionally, individuals with extremely high triglyceride levels (greater than 500 mg/dL) seem to derive the most benefit from omega-3 fatty acid supplementation.

Although it can lower triglyceride levels, it may slightly raise low density lipoproteins (known also as LDL or the “bad” cholesterol). This change, however, is modest and ranges from 3 to 10 percent. High density lipoproteins (also known as HDL or the “good” cholesterol) do not seem to be affected by omega-3 fatty acid supplementation, if not slightly increased.

How Much Should I Take Each Day?

Omega-3 fatty acids are either available as a prescription or as a supplement at your local pharmacy or nutritional store. One gram of omega-3 fatty acid supplementation a day would cause a decrease in triglycerides and would help prevent sudden death from heart disease. An average of four grams of omega-3 fatty acids are typically used to reduce triglycerides in individuals with high trigylceride levels. It is recommended that individuals taking more than 3 grams a day should be under the supervision of a health-care provider, since high doses of omega-3 fatty acids decrease the aggregation of platelets, which may cause bleeding to occur more easily.

What is the Difference Between Prescription Omega-3 Fatty Acids and Over-The-Counter Supplements?

Prescription omega-3 fatty acids (Omacor®) contain a certain amount of EPA and DHA, are purified, and are thoroughly rid of impurities such as trans-fats, mercury, or other contaminants. Supplements that are available over the counter are classified as “foods” by the Food and Drug Administration. Therefore, they do not have to undergo the rigorous purification processes or efficacy studies that prescription drugs have to go through. Sources:

McKenney JM, Sica D. Prescription omega-3 fatty acids for the treatment of hypertriglyceridemia. Am J Health Syst Pharm.2007 Mar 15;64(6):595-605.

Balk EM, Lichtenstein AH, Chung M et al. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis. 2006 Nov;189(1):19-30.

Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002; 106:2747-2757.

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