Life Extension Magazine®
Plenty of people worry about their atherogenic lipids like oxidized LDL and apolipoprotein B (ApoB).
But having high levels of another lipid called triglycerides can also increase risk of heart disease and strokes.1
Drugs are frequently prescribed to reduce elevated LDL and usually work to reduce ApoB. However, in many people statins fail to adequately lower triglycerides.2
According to a study of nearly 10,000 U.S. adults, over 30% of statin users have triglyceride levels of 150 mg/dL or above.3
Inadequately controlled triglyceride levels leave behind a significant residual risk for cardiovascular disease even with statin use.4
One meta-analysis found that supplementation with omega-3 fatty acids is associated with a lower risk of heart attacks, total coronary disease events and mortality, along with a 35% reduced risk of fatal heart attacks.5
Why Are Triglyceride Levels Important?
Triglycerides are the most common type of fat (lipid) in our body. In the blood, they are transported by particles called lipoproteins.6
Our body stores unused or excess fat as triglycerides, in fat cells. Excess triglycerides in the blood significantly increase the risk of cardiovascular events, such as heart attack or stroke. This condition may be genetic, related to diet, or a part of metabolic syndrome.6
Elevated triglyceride levels are also associated with dangerous, small, dense, low density lipoprotein particles. These can significantly increase risk for atherosclerosis (the buildup of plaque in arteries).7
Triglyceride levels are usually considered to be healthy when lower than 150 mg/dL on blood tests.6
However, at Life Extension, we have long advocated for aiming to keep levels below 100 mg/dL. This is particularly important for those with any other risk factors for cardiovascular disease, such as obesity, high blood pressure, abnormal cholesterol levels, type II diabetes, and a history of smoking.
How Fish Oil Helps
Fish oil is rich in the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).
Fish oil consumption has been shown to have a wide range of health benefits, including helping to prevent abnormal blood clots, reducing inflammation, lowering blood pressure, and preventing heart arrhythmias.8,9
Fish oils appear to lower triglycerides in several different ways, including by:10-12
- Reducing the liver’s production and secretion of triglyceride-containing lipoproteins,
- Speeding up the clearance of triglyceride-rich lipoproteins from the blood, and
- Increasing the activity of the enzyme lipoprotein lipase, which breaks down triglycerides.
Lowering Triglycerides
Hypertriglyceridemia, characterized by elevated levels of triglyceride-rich lipoproteins and their remnants, is a risk factor for atherosclerosis or hardening of the arteries.13 Inadequately controlled triglyceride levels leave a significant residual risk for cardiovascular disease, even with statin use.4
A study analyzed data from the Health and Nutrition Examination Survey (NHANES) 2007-2014 and examined the prevalence of elevated triglycerides in over 9,000 U.S. adults, some of whom were taking statins and some who were not.
The study found that over 30% of statin users have triglyceride levels of 150 mg/dL or above. The odds of high triglycerides in this population were associated with greater age, high BMI, low HDL, high LDL and diabetes.3
Fish oil may be the answer.
The ability of fish oils to lower triglycerides has been observed in numerous human trials, some of which compared them head-to-head against statins.
Fish oils have been found to be effective in lowering triglycerides in subgroups who are at particularly high risk for cardiovascular disease, including overweight or obese adults. In two separate clinical trials of overweight or obese adults, fish oil doses of 2-4 grams daily for a period of 12 -16 weeks reduced triglycerides by 16%- 24%.14,15
What You Need To Know
Omega-3s Reduce High Triglycerides
- Elevated triglycerides significantly increase the risk of cardiovascular disease and strokes.
- Inadequately controlled triglyceride levels leave behind a significant residual risk for cardiovascular disease even with statin use.
- Human trials show that fish oil-derived omega-3 fatty acids can effectively lower triglyceride levels by up to over 50%.
- Fish oil intake has been shown in some studies to lower the risk of heart attacks and cardiovascular mortality.
Non-alcoholic fatty liver disease (NAFLD) is a risk factor for cardiovascular disease.16 A meta-analysis of 22 clinical trials of individuals with NAFLD found that the addition of fish oil produced "a remarkable decrease in triglycerides."17
A review of over 20 clinical trials of EPA and/or DHA in healthy adults with normal or borderline-high triglycerides revealed that daily supplementation with omega-3s, for a range of two weeks to a year at doses of 1-4 grams, reduced fasting triglyceride levels by 4%-51%.18
Reduced Cardiovascular Risk
These reductions in triglyceride levels translate to reduced risk for cardiovascular disease and its potentially devastating consequences.
Extensive evidence supports the cardiovascular benefits of fish oil.
A large meta-analysis of 40 clinical trials found that EPA and DHA intake were associated with a significant reduction in several cardiovascular disease events, including a stunning 35% reduction in risk of fatal heart attack. Higher doses of omega-3 fatty acids were found to provide more robust risk reduction against cardiovascular events and heart attacks.5
Another meta-analysis of 86 randomized controlled trials found that omega-3 fat consumption lowers triglycerides and is associated with a lower risk of cardiovascular mortality, and may reduce the risk of coronary heart disease events and mortality.19
A science advisory from the American Heart Association stated that taking 4,000 mg per day of the omega-3 fatty acids EPA and DHA reduces very high triglycerides by 30% or more.11
ADDITIONAL CARDIOVASCULAR BENFITS
Fish oils with EPA + DHA work in various ways to reduce cardiovascular risk.
A clinical trial demonstrated that patients taking 2 grams of EPA/DHA per day for 90 days significantly reduced levels of various markers of chronic inflammation such as TNF-α and CRP in hypertensive patients.20
In patients with type II diabetes who were also overweight, 4 grams of fish oil per day for eight weeks, reduced levels of markers of inflammation such as TNF-α, IL- 1β, and IL-6, and improved insulin sensitivity and lipid profile.21
Meta-analysis of seven clinical trials of patients on hemodialysis found daily fish oil supplementation reduced CRP levels, especially in those with elevated baseline CRP.22
Summary
Elevated triglyceride levels increase the risk for cardiovascular diseases and strokes.
Inadequately controlled triglyceride levels leave behind a significant residual risk for cardiovascular disease, even with statin use.
Numerous studies show that taking fish oil containing omega-3 fatty acids can effectively reduce triglyceride levels by up to over 50%.
Fish-oil intake has also been shown to reduce risk for heart disease events like heart attacks as well as death from coronary heart disease.
If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.
References
- Available at: https://www.health.harvard.edu/heart-health/should-you-worry-about-high-triglycerides. Accessed December 10, 2024.
- Laufs U, Parhofer KG, Ginsberg HN, et al. Clinical review on triglycerides. Eur Heart J. 2020 Jan 1;41(1):99-109c.
- Fan W, Philip S, Granowitz C, et al. Hypertriglyceridemia in statin-treated US adults: the National Health and Nutrition Examination Survey. J Clin Lipidol. 2019 Jan-Feb;13(1):100-8.
- Farnier M, Zeller M, Masson D, et al. Triglycerides and risk of atherosclerotic cardiovascular disease: An update. Arch Cardiovasc Dis. 2021 Feb;114(2):132-9.
- Bernasconi AA, Wiest MM, Lavie CJ, et al. Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Mayo Clin Proc. 2021 Feb;96(2):304-13.
- Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/cholesterol-in-the-blood. Accessed December 13, 2024.
- Packard CJ, Boren J, Taskinen MR. Causes and Consequences of Hypertriglyceridemia. Front Endocrinol (Lausanne). 2020;11:252.
- Rimm EB, Appel LJ, Chiuve SE, et al. Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association. Circulation. 2018 Jul 3;138(1):e35-e47.
- Liao J, Xiong Q, Yin Y, et al. The Effects of Fish Oil on Cardiovascular Diseases: Systematical Evaluation and Recent Advance. Front Cardiovasc Med. 2021;8:802306.
- Backes J, Anzalone D, Hilleman D, et al. The clinical relevance of omega-3 fatty acids in the management of hypertriglyceridemia. Lipids Health Dis. 2016 Jul 22;15(1):118.
- Skulas-Ray AC, Wilson PWF, Harris WS, et al. Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association. Circulation. 2019 Sep 17;140(12):e673-e91.
- Oscarsson J, Hurt-Camejo E. Omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and their mechanisms of action on apolipoprotein B-containing lipoproteins in humans: a review. Lipids Health Dis. 2017 Aug 10;16(1):149.
- Peng X, Wu H. Inflammatory Links Between Hypertriglyceridemia and Atherogenesis. Curr Atheroscler Rep. 2022 May;24(5):297-306.
- Kuszewski JC, Wong RHX, Wood LG, et al. Effects of fish oil and curcumin supplementation on cerebrovascular function in older adults: A randomized controlled trial. Nutr Metab Cardiovasc Dis. 2020 Apr 12;30(4):625-33.
- Thota RN, Acharya SH, Garg ML. Curcumin and/or omega-3 polyunsaturated fatty acids supplementation reduces insulin resistance and blood lipids in individuals with high risk of type 2 diabetes: a randomised controlled trial. Lipids Health Dis. 2019 Jan 26;18(1):31.
- Kasper P, Martin A, Lang S, et al. NAFLD and cardiovascular diseases: a clinical review. Clin Res Cardiol. 2021 Jul;110(7):921-37.
- Lee CH, Fu Y, Yang SJ, et al. Effects of Omega-3 Polyunsaturated Fatty Acid Supplementation on Non-Alcoholic Fatty Liver: A Systematic Review and Meta-Analysis. Nutrients. 2020 Sep 11;12(9).
- Leslie MA, Cohen DJ, Liddle DM, et al. A review of the effect of omega-3 polyunsaturated fatty acids on blood triacylglycerol levels in normolipidemic and borderline hyperlipidemic individuals. Lipids Health Dis. 2015 Jun 6;14:53.
- Abdelhamid AS, Brown TJ, Brainard JS, et al. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2020 Feb 29;3(3):CD003177.
- Yang B, Ren XL, Li ZH, et al. Lowering effects of fish oil supplementation on proinflammatory markers in hypertension: results from a randomized controlled trial. Food Funct. 2020 Feb 26;11(2):1779-89.
- Souza DR, Pieri B, Comim VH, et al. Fish oil reduces subclinical inflammation, insulin resistance, and atherogenic factors in overweight/obese type 2 diabetes mellitus patients: A pre-post pilot study. J Diabetes Complications. 2020 May;34(5):107553.
- Zhou J, Tang G, Tang S, et al. The effect of fish oil on inflammation markers in adult patients undergoing hemodialysis: A meta-analysis. Semin Dial. 2022 Jan;35(1):6-14.