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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Can I eat quinoa?

Can I eat quinoa?

29. July 2011 William Davis (15)
. . . or beans, or brown rice, or sweet potatoes? Or how about amaranth, sorghum, oats, and buckwheat? Surely corn on the cob is okay!

These are, of course, non-wheat carbohydrates. They lack several crucial undesirable ingredients found in our old friend, wheat, including no:

Gliadin--The protein that degrades to exorphins, the compound from wheat digestion that exerts mind effects and stimulates appetite to the tune of 400 additional calories (on average) per day.
Gluten--The family of proteins that trigger immune diseases and neurologic impairment.
Amylopectin A--The highly-digestible "complex" carbohydrate that is no better--worse, in fact--than table sugar.

So why not eat these non-wheat grains all you want? If they don't cause appetite stimulation, behavioral outbursts in children with ADHD, addictive consumption of foods, dementia (i.e., gluten encephalopathy), etc., why not just eat them willy nilly?

Because they still increase blood sugar. Conventional wisdom is that these foods trend towards having a lower glycemic index than, say, table sugar, meaning it raises blood glucose less.

That's true . . . but very misleading. Oats, for instance, with a glycemic index of 55 compared to table sugar's 59, still sends blood sugar through the roof. Likewise, quinoa with a glycemic index of 53, will send blood sugar to, say, 150 mg/dl compared to 158 mg/dl for table sugar--yeah, sure, it's better, but it still stinks. And that's in non-diabetics. It's worse in diabetics.

Of course, John Q. Internist will tell you that, provided your blood sugars after eating don't exceed 200 mg/dl, you'll be okay. What he's really saying is "There's no need for diabetes medication, so you're okay. You will still be exposed to the many adverse health consequences of high blood sugar similar to, though less quickly than, a full diabetic, but that's not my problem."

In reality, most people can get away with consuming some of these non-wheat grains . . . provided portion size is limited. Beyond limiting portion size, there are two ways to better manage your carbohydrate sensitivity to ensure that metabolic distortions, such as high blood sugar, glycation, and small LDL particles, are not triggered.

More on that in the future.


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Comments (15) -

  • Jordi Posthumus

    7/29/2011 1:01:43 AM |

    This is exactly what Ron Rosedale said back in 2004.

  • Payam

    7/29/2011 4:45:07 AM |

    If the only problem is that they raise blood sugar then are they okay if you eat them with fiber/fat?  If not, please explain why..

  • Anne

    7/29/2011 12:44:09 PM |

    I found that all grains, even when eaten with fat, raise my blood sugar to unacceptable levels. Grains can easily get me to over 200. Get a glucometer and see what these grains do to your blood sugar. I also found that when I want to see what a food does to my blood glucose I have to test every 15-20 min after I eat. If I test only at 2 hours I might miss the spike and be falsely reassured that I can eat that food. My fasting is in the 80's and I try to keep postprandial spikes under 110 and even that may be too high.

    If you are gluten sensitive, it is very common to have problems with oats(even the ones that are certified gluten free). Corn also seems to be a a problem for a good number of people who can't eat gluten.

  • Renfrew

    7/29/2011 12:44:24 PM |

    Sorry for disgressing a bit. Here is an excellent discussion about NIACIN and its effectiveness for decreasing cardiac events:
    http://www.theheart.org/article/1231453.do
    Do we have to give up NIACIN?
    Renfrew

  • Might-o'chondri-AL

    7/29/2011 6:09:41 PM |

    Hi Renfrew,
    Statin used with niacin, anti-fungals, genfibrozil, cyslosporin and erythromycin are already known by Mayo Clinic to have the potential to trigger muscle breakdown, called rhabdo-myolysis. This sends a byproduct called myo-globin into the blood that when reaches kidneys and degrades causes kidney renal tubule obstructive damage.

    HDL traffics mainly with the Apoliprotein A-1 (ApoA1), which is key to bring cholesterol to HDL for binding cholesterol molecules to transport for recycling. Compromised kidneys create a uremic environment which depresses ApoA1 bio-syntheis,  while proteinuria physically overloads the kidney tubule cells; in other words HDL ends up just carrying more triglycerides around and  HDL is not properly performing desired reverse cholesterol transport (recycling).

    Statins , to be fair, are showing  good results in preventing post surgery human acute kidney failure and some other kidney cases.  Of course  niacin  in rats with chronic renal failure ameliorated hypertension, proteinuria, inflammation and oxidative stress (see 2009: Am. J. Physiol. Renal Physiol. 297, F106-F113 and follow similarly related 2010: "Niacin Improves Renal Lipid Metabolism and Slows Progression in Chronic Kidney Disease" in Biochim. Biophys. Acta 1800, 6-15) .  So my non-clinician take is that niacin use, such as Doc's, without co-administered statins is largely preventative of lipo-toxicity; whereas the experiment you read of  dosing statins plus niacin risked a potential drug interaction Mayo Clinic already warned about .

  • conrack

    7/29/2011 7:13:16 PM |

    Allow me to rephrase your question: If the only problem with eating glucose is that it raises your blood sugar then is it ok to eat glucose with fats & just eat donuts?

    Brilliant.

  • Buckaroo Banzai

    7/29/2011 8:57:46 PM |

    I've never heard of table sugar being rated on the glycemic index as low as 59.  Nutritiondata says 68 and I have read 70 in books.  http://nutritiondata.self.com/topics/glycemic-index#values

  • Payam

    7/30/2011 2:15:50 AM |

    Thanks for putting words in my mouth wise guy.  What I was saying is that if I eat a sweet potato with enough coconut oil that it doesnt spike my blood sugar, what is the problem.  Dr. Davis said in the article that it wouldnt " cause appetite stimulation, behavioral outbursts in children with ADHD, addictive consumption of foods, dementia, etc."  If the only problem is that it spikes blood sugar and you avoid that problem, then whats wrong with a sweet potato.  But you already knew what my question was.. you just wanted to take out your frustration on me...

  • steve

    7/30/2011 8:08:17 PM |

    Dr Davis:
    What is a safe level for post prandial glucose measurement?  Is it under 120, under 100 or what?  Also, are you advocating a zero carb-starch diet?

    Thanks,

  • conrack

    7/30/2011 9:50:10 PM |

    Thanks for giving me another opportunity to make fun of your insistence on eating anything made of glucose.  What you were saying is that if you eat a GLUCOSE potato with enough coconut oil that it BECOMES A DONUT, it WILL still spike your blood sugar, that is the problem. (ANY glucose + ANY fat = DONUTS!)  Dr. Davis said in the article "IF they don't cause (conditions & behaviors caused by high blood sugar)" and then said "That’s...very misleading." If you think the only problem (and it's NOT) is that it spikes blood sugar, and you THINK you can, but actually CAN NOT avoid that OR the other problems, then that's whats wrong with a glucose potato. But you already knew what the answer is.. you just wanted to justify & take out your glucose addiction on me…

  • conrack

    7/30/2011 9:58:58 PM |

    Oops, that should read (conditions & behaviors caused by wheat). Got lost in the cuts & pastes.

  • Payam

    7/30/2011 11:39:23 PM |

    Okay, so rather than speaking in generalities, answer this.  I just had a baked potato with cinnamon and melted coconut oil.  Measured my blood glucose every 30 mins for 2 hours and it didn't go over 100.  It could be and probably is because I am a triathlete and I worked out in the morning so my muscle glycogen stores were empty.  So, glucose would preferentially go to muscle.  But what is wrong with eating a baked potato after a workout.  In other words, what are these "other problems" that you mention. (I didn't eat the skin by the way, b/c of the glycoalkaloids).  

    I am not trying to get into an argument with you, I really dont care.  I am just trying to get more informed.  I understand however, that Dr. Davis's information applies more to diabetics and insulin resistant, so maybe for someone active like me, its not as big a deal.  But if a potato doesn't spike my blood sugar, why, specifically, should I avoid it? Thanks

  • Tim Dietz

    7/31/2011 8:40:53 PM |

    I've monitored this blog for quite a while now and either I"ve forgotten the reasons or I've never seen them, but could somebody point me to the article(s) that outline the effects of high post prandial glucose?

    Thanks,

    Tim

  • conrack

    8/5/2011 7:30:52 PM |

    The answer is in the second half of this article posted on August 5, 2011 here: http://www.trackyourplaque.com/blog/2011/08/carb-counting.html

  • Sami Paju

    8/12/2011 3:06:48 PM |

    Hello,

    I would like to add to the discussion one significant issue with quinoa; saponins. They are molecules that are supposedly a major gut-irritant, and when compared to e.g. plant and animal foods have a high likelihood to cause leaky gut and inflammation of the small intestine. And inflammation is rather counterproductive for anyone trying to lose weight.

    //sami

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