From the Guidelines
Omega-3 fatty acids have a beneficial effect on lipid profiles, particularly in reducing triglyceride levels.
Key Effects on Lipid Profiles
- Triglyceride reduction: Omega-3 fatty acids, specifically EPA and DHA, have been shown to decrease triglyceride and remnant lipoprotein levels 1.
- Anti-arrhythmic and anti-thrombotic effects: Omega-3 fatty acids may also decrease the risk for arrhythmias and thrombosis, which can lead to sudden cardiac death, heart attack, and stroke 1.
- Endothelial function improvement: Additionally, omega-3 fatty acids may improve endothelial function and slightly lower blood pressure 1.
Prescription Omega-3 Fatty Acid Preparations
Prescription omega-3 fatty acid preparations, such as ethyl ester and carboxylic acid preparations of DHA and EPA mixtures, have been demonstrated to be effective in reducing triglyceride levels in adult patients with severe hypertriglyceridemia (triglycerides ≥500 mg/dL) 1.
Nonprescription Fish Oil Products
Nonprescription fish oil products, on the other hand, are not FDA-approved to treat elevated triglyceride levels and may contain impurities, including saturated fat and oxidized lipids, contaminants, or other ingredients that may be harmful 1.
Important Considerations
When considering the use of omega-3 fatty acids for lipid profile management, it is essential to evaluate the potential net benefit, particularly in patients at high risk of atrial fibrillation, as some studies have suggested an increased risk of AF with omega-3 fatty acid therapy 1.
From the Research
Effects of Omega-3 Fatty Acids on Lipid Profiles
- Omega-3 fatty acids, found in fish oil, have been shown to reduce high triglycerides in clinically used doses 2.
- Fish oil consumption has been associated with a reduction in serum triglycerides, with a summary net change of -27mg/dL, as well as an increase in HDL cholesterol of +1.6mg/dL and an increase in LDL cholesterol of +6mg/dL 3.
- The evidence supports a dose-dependent beneficial effect of fish oil on serum triglycerides, particularly among people with more elevated levels 3.
- Omega-3 fatty acids have also been found to reduce plasma levels of triglycerides and increase levels of high-density lipoprotein in patients with marked hypertriglyceridemia 4.
- The most important lipid effect of fish oils is reducing plasma triglycerides, and the main potential protection against cardiovascular events is very probably mediated also through other mechanisms including anti-inflammatory ones 5.
Mechanisms and Effects
- The underlying mechanism of fish oil's action on triglyceride reduction, plaque stability, and effect in diabetes has been explored, and fish oil has been found to have anti-inflammatory effects 2.
- Fish oil consumption does not appear to adversely affect glucose homeostasis, and the evidence regarding the effects of omega-3 fatty acids on hs-CRP is inconclusive 3.
- Omega-3 fatty acids have been found to have antiarrhythmic properties, and a pharmaceutical-grade preparation has recently received approval from the US Food and Drug Administration to market for this purpose 4.
- The in vivo data on the effect of omega-3 fatty acids on lipid peroxidation are inconclusive, but one study found that omega-3 fatty acids do not increase lipid peroxidation 6.