One of the frequently asked questions about omega-3 fatty acids is whether they lower cholesterol levels. The straightforward answer is no; they do not lower cholesterol. However, omega-3 fatty acids impact other risk factors related to heart disease, such as triglycerides, blood pressure, and the Omega-3 Index.
Despite articles claiming that omega-3 lowers cholesterol, it's important to clarify the misconception and set the record straight.
Understanding cholesterol
Cholesterol is a fat-like substance produced by the body to aid in hormone production and the absorption of nutrients like vitamin D. It's made in the liver and found throughout the body, especially in the bloodstream.
The issue arises when there's an excess of low-density (LDL) lipoprotein in the arteries. This can lead to plaque formation, narrowing arteries, and impeding blood flow. Insufficient blood supply to the heart may result in heart attacks or strokes.
Modern diets are often laden with substances that can overwhelm the body, including cholesterol. Excess dietary cholesterol combines with the body's natural cholesterol to form plaque, clogging arteries. When situations escalate, doctors may prescribe cholesterol-lowering medications like statins or recommend surgical interventions such as stents.
Research questions whether cholesterol levels should even be a factor in diagnosing and treating heart disease, challenging the traditional stance on LDL cholesterol as a primary cause of cardiovascular diseases. Therefore, even if omega-3 could lower cholesterol, it might not be significant.
Omega-3 and triglycerides
Beyond cholesterol, triglycerides are another type of fat that can wreak havoc on the arteries. They're produced when the body converts unused calories into stored fat, released between meals as an energy source. High triglyceride levels, known as hypertriglyceridemia, occur when caloric intake exceeds what the body burns.
Research consistently shows that omega-3 fatty acids significantly reduce triglyceride levels, offering a clinical benefit without affecting total, LDL, or HDL cholesterol levels.
Omega-3 and blood pressure
The American Heart Association (AHA) describes blood pressure as the result of two forces: the force created when the heart pumps blood into the arteries and the force when the heart rests between beats. High blood pressure can damage the delicate tissues inside the arteries over time, with cholesterol forming plaque that further restricts arteries and increases blood pressure.
Research published in the American Journal of Hypertension and Hypertension journal has shown that omega-3 fatty acids are as effective at lowering blood pressure as lifestyle modifications such as exercising, diet changes, and reducing alcohol consumption.
Beyond cholesterol: The Omega-3 index
Proposed in 2004 by Dr. Bill Harris, PhD, the Omega-3 Index measures the two primary omega-3 fatty acids in the diet - EPA and DHA. These fatty acids, found in salmon and other fatty fish, come along with other essential nutrients like selenium and vitamin D but can also be consumed through supplements derived from fish oil, krill oil, or algal oil.
Research indicates that consuming these fatty acids is independently associated with a reduced risk of coronary heart disease (CHD) death. Randomized secondary prevention studies have demonstrated that fish or fish oil consumption can decrease total and CHD mortality at about 1 g/day.
The Omega-3 Index fulfills many criteria of a risk factor, including consistent epidemiological evidence, a plausible mechanism of action, a reproducible analysis, independence from classic risk factors, modifiability, and most importantly, the demonstration that increasing levels will reduce the risk of heart events. In other words, it might be as important, if not more so, than your cholesterol level.
Omega-3 index risk zones:
High Risk = <4%
Intermediate Risk = 4–8%
Low Risk = >8%
Establishing the Omega-3 Index as a risk factor required clinical and laboratory experiments to generate the necessary data for validating the Omega-3 Index as a predictor of CHD death, particularly sudden cardiac death (SCD). When Dr. Harris proposed the Omega-3 Index years ago, he highlighted it as a new, physiologically relevant, easily modifiable, independent, and graded risk factor for death from CHD that could have significant clinical utility.
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