Why does fish oil reduce triglycerides?

2. November 2009 William Davis (9)
Beyond its ability to slash risk for cardiovascular events, omega-3 fatty acids from fish oil also reduce triglycerides.

There's no remaining question that omega-3s do this quite effectively. After all, the FDA approved prescription fish oil, Lovaza, to treat a condition called familial hypertriglyceridemia, an inherited condition in which very high triglycerides in the 100s or 1000s of milligrams typically develop.

The omega-3 fraction of fatty acids are unique for their triglyceride-reducing property. No other fraction of fatty acids, such as omega-6 or saturated, can match the triglyceride-reducing effect of omega-3s.

But why does fish oil reduce triglycerides?

First of all, what are triglycerides? As their name suggests, triglycerides consist of three ("tri-") fatty acids lined up along a glycerol (sugar) "backbone." Triglycerides are the form in which most fatty acids occur in the bloodstream, liver, and other organs. (Fatty acids, like omega-3, omega-6, mono- or polyunsaturated, or saturated, rarely occur as free fatty acids unbound to glycerol.) In various lipoproteins in the blood, like LDL, VLDL, and HDL, fatty acids occur as triglycerides.

Of all lipoproteins, chylomicrons (the large particle formed through intestinal absorption of fatty acids and transported to the liver via the lymph system) and VLDL (very low-density lipoprotein, very low-density because they are mostly fat and little protein) particles are richest in triglycerides. Thus, we would expect that omega-3s exert their triglyceride-reducing effect via reductions in either chylomicrons or VLDL.

Indeed, that seems to be the case. The emerging evidence suggests that omega-3 fatty acids from fish oil reduce triglycerides through:

--Reduced VLDL production by the liver (Harris 1989)
--Accelerating chylomicron and VLDL elimination from the blood
--Activation of peroxisome proliferator-activated receptor gamma (PPAR-gamma)--Omega-3s ramp up the cellular equipment used to convert fatty acids to energy (oxidation) (Gani 2008)

Combine omega-3 fatty acids from fish oil with wheat elimination and you have an extremely potent means of reducing triglycerides. Read a previous Heart Scan Blog post here to read how a patient reduced triglycerides 93.5% from 3100 mg/dl to 210 mg/dl in just a few weeks using fish oil and wheat elimination.
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Comments (9) -

  • Anonymous

    11/2/2009 12:34:35 AM |

    Very informative article.  Thank you for this posting. I better keep remembering to take my fish oil every morning!

    Diane Michel
    Founder GlobalMedicalResearch.org

  • Anonymous

    11/2/2009 4:55:48 PM |

    So much for the little boy with the loaves and the fishes, huh? I did not know that reduction of triglycerides involved the elimination of wheat products. I am not sure I am up to doing that part. I may just have to die.

  • Makoss

    11/2/2009 10:41:21 PM |

    Is DHA more favorable than EPA in lowering triglycerides?

  • Ellen

    11/3/2009 10:30:19 AM |

    Dr. Davis, my triglycerides are really low at 33 (and yes, I take fish oil). They are so slow that they are below the lab reference range.

    Is there such a thing as too low?

  • Dr. William Davis

    11/3/2009 12:41:57 PM |

    Makoss--

    To my knowledge, there are no data exploring the differential effect of DHA vs. EPA strictly for triglyceride reduction. Remember also that most data exploring cardiovascular risk reduction involve both, except for JELIS which showed event reduction with EPA alone.

    Hi, Ellen--

    In fact, your triglyceride level is what I believe to be the physiologically perfect level. So, no, not too low.

  • Kamila

    12/13/2009 2:52:33 PM |

    How do you respond to this Dr Davis.

    Q: Are fish oils good for you?

    Some of the unsaturated fats in fish are definitely less toxic than those in corn oil or soy oil, but that doesn't mean they are safe. Fifty years ago, it was found that a large amount of cod liver oil in dogs' diet increased their death rate from cancer by 20 times, from the usual 5% to 100%. A diet rich in fish oil causes intense production of toxic lipid peroxides, and has been observed to reduce a man's sperm count to zero. [H. Sinclair, Prog. Lipid Res. 25, 667, 1989.] Source:http://raypeat.com/articles/articles/unsaturated-oils.shtml

  • Kamila

    12/13/2009 3:10:00 PM |

    Another link:

    http://raypeat.com/articles/articles/fishoil.shtml

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    11/3/2010 9:11:46 PM |

    Of all lipoproteins, chylomicrons (the large particle formed through intestinal absorption of fatty acids and transported to the liver via the lymph system) and VLDL (very low-density lipoprotein, very low-density because they are mostly fat and little protein) particles are richest in triglycerides. Thus, we would expect that omega-3s exert their triglyceride-reducing effect via reductions in either chylomicrons or VLDL.

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24. January 2009 William Davis (0)
Heart health without a 12" incision



Heart health for less than $44,483 (Cost of a coronary stent according to the American Heart Association 2008 Update)



Track Your Plaque: A drug-free zone



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More on the “Rule of 60”

More on the “Rule of 60”

6. November 2006 William Davis (0)
Despite its apparent simplicity, there’s a lot of thought and wisdom in the Rule of 60.

What if you achieve only a single value in the Track Your Plaque “Rule of 60”? What if, for instance, you got LDL down to 60 mg/dl, but ignored the fact that your HDL was 41 mg/dl and triglycerides were up to 145 mg/dl? Can you still do pretty well?

Probably not. In fact, this specific combination of low HDL and high triglycerides tells me several things:

1) LDL is really much higher than suggested by the 60 mg/dl, which is a calculated value, often much higher. Recall that calculated LDL is prone to immense inaccuracy. When measured, the LDL is commonly somewhere between 120 and 160 mg/dl. However, when you raise HDL to 60 and reduce triglycerides to 60, much of the inaccuracy is removed, i.e., calculated LDL becomes more accurate. LDL can be measured as LDL particle number (NMR), apoprotein B, or direct LDL.

2) LDL particles are small. This is yet another reason why the weight-based LDL measures can be inaccurate. Imagine you have two identical glass jars full of marbles. One jar has small marbles, the other has large marbles, but both jars have the same weight in marbles. Which jar has more marbles? The one with small marbles, of course. The same phenomenon occurs with LDL particles: at the same weight, you can have different numbers of LDL particles. It’s the number of particles that better determine risk for heart disease, not the weight.

3) Triglycerides of 145 mg/dl is actually below the target advised by the National Cholesterol Education Panel Adult Treatment Panel-III guidelines, i.e., you’re okay by conventional standard. But look beneath the surface, and you’ll find that triglycerides at 145 mg/dl are associated with flagrant excesses of VLDL lipoprotein particles and a greater likelihood of a postprandial (after-eating) disorder (increased IDL or postprandial triglycerides), both of which add to coronary plaque.

4) This pattern is also commonly associated with higher blood sugar, higher blood pressure, increased inflammation (e.g., C-reactive protein), increased fibrinogen—all the facets of the metabolic syndrome, or pre-diabetes.

In fact, some of the most aggressive plaque growth—increasing heart scan scores—will occur with this specific pattern. So just achieving one facet of the Track Your Plaque Rule of 60 does not suffice. It’s the whole package that really stacks the odds in your favor of stopping or dropping your heart scan score.
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