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Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review

  • Ethan M. Balk
    Correspondence
    Corresponding author at: Tufts-New England Medical Center, Box 63, 750 Washington Street, Boston, MA 02111, United States. Tel.: +1 617 636 3282; fax: +1 617 636 8628.
    Affiliations
    Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, 750 Washington Street, Boston, MA 02111, United States
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  • Alice H. Lichtenstein
    Affiliations
    Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, United States
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  • Mei Chung
    Affiliations
    Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, 750 Washington Street, Boston, MA 02111, United States
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  • Bruce Kupelnick
    Affiliations
    Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, 750 Washington Street, Boston, MA 02111, United States
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  • Priscilla Chew
    Affiliations
    Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, 750 Washington Street, Boston, MA 02111, United States
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  • Joseph Lau
    Affiliations
    Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, 750 Washington Street, Boston, MA 02111, United States
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      Abstract

      Greater fish oil consumption has been associated with reduced CVD risk, although the mechanisms are unclear. Plant-source oil omega-3 fatty acids (ALA) have also been studied regarding their cardiovascular effect. We conducted a systematic review of randomized controlled trials that evaluated the effect of consumption of fish oil and ALA on commonly measured serum CVD risk factors, performing meta-analyses when appropriate. Combining 21 trials evaluating lipid outcomes, fish oil consumption resulted in a summary net change in triglycerides of −27 (95% CI −33, −20) mg/dL, in HDL cholesterol of +1.6 (95% CI +0.8, +2.3) mg/dL, and in LDL cholesterol of +6 (95% CI +3, +8) mg/dL. There was no effect of fish oil on total cholesterol. Across studies, higher fish oil dose and higher baseline levels were associated with greater reductions in serum triglycerides. Overall, the 27 fish oil trials evaluating Hgb A1c or FBS found small non-significant net increases compared to control oils. Five studies of ALA were inconsistent in their effects on lipids, Hgb A1c or FBS. Four studies investigating the effects of omega-3 fatty acids on hs-CRP were also inconsistent and non-significant. The evidence supports a dose-dependent beneficial effect of fish oil on serum triglycerides, particularly among people with more elevated levels. Fish oil consumption also modestly improves HDL cholesterol, increases LDL cholesterol levels, but does not appear to adversely affect glucose homeostasis. The evidence regarding the effects of omega-3 fatty acids on hs-CRP is inconclusive, as are data on ALA.

      Abbreviations:

      ALA (alpha linolenic acid (18:3 n-3)), CI (confidence interval), CVD (cardiovascular disease), DHA (docosahexaenoic acid (22:6 n-3)), EPA (eicosapentaenoic acid (20:5 n-3)), FBS (fasting blood sugar), HDL (high density lipoprotein), Hgb A1c (hemoglobin A1c), hs-CRP (highly sensitive C-reactive protein), LDL (low density lipoprotein), VLDL (very low density lipoprotein)

      Keywords

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