Lowering low density lipoproteins (LDL-cholesterol) can significantly reduce the likelihood of a heart attack or stroke. Many medications, including statins, have been reported in numerous studies to be very effective in lowering LDL-cholesterol.
Lowering LDL-cholesterol and triglycerides
LDL-cholesterol and triglycerides can also be altered through nutritional changes and/or by taking dietary supplements. Patients who are not able, or not willing, to take medications, or individuals who would like to enhance their dietary changes by choosing healthier ones, welcome these modifications to their diets.
Benefits of fish oil
Omega-3 fatty acids and fish oils
Fish oil and LDL-cholesterol
Fish oil supplementation raises the blood LDL- cholesterol level by almost 5 percent. I know you’re little confused, we know that lower LDL-cholesterol level is better. Therefore, the question is whether consuming fish oil cause more harm than good.
Fish oil increases the blood LDL cholesterol concentration but at the same time it transforms the bad small LDL cholesterol structures to bigger and better ones. It is an important point that we should be aware of, otherwise, it could cause a lot of confusion.
Fish oil and triglycerides
Interest in fish oils grew following reports that the native people of Greenland had lower rates of death from coronary heart disease because of their heavy seafood diet. Later studies confirmed that eating of increased amounts of polyunsaturated fatty acids, such as the omega-3 fatty acids, resulted in lower rates of heart disease.
Long-chain polyunsaturated fatty acids in fish oil, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are the most likely active elements.
EPA and DHA are primarily absorbed through the gastrointestinal tract, they travel through the liver and then are released into the blood as triglycerides, LDL-cholesterol, high density lipoproteins (HDL) and phospholipids.
A review of three studies shows that men who ate fish every week had lower death rates because of heart disease than the population who did not eat fish regularly. However, in spite of the evidence describing the beneficial effects of omega-3 on heart disease, there is only a limited amount of information about the positive association between omega-3 acids and fewer strokes.
The American Heart Association has acknowledged that EPA and DHA may decrease the incidence of sudden death (sudden heart related death) and hardening of the arteries, and lower blood pressure slightly, and has also recommended the supplementation of Omega-3s, in the form of fish oils, as a way of reducing heart disease.
The sources of Omega-3 in food
The best sources of omega-3 fatty acids are from fatty fish, such as salmon, anchovies, herring, mackerel and tuna, and from plants, including flaxseed oil, canola oil, soybean oil and English walnuts.
To obtain 250 mg per day DHA+EPA, the following amounts of fish should be consumed per week
|Anchovy||Canned||2 oz./57 g|
|Salmon (Wild King)||Filet||3 oz./85 g|
|Sardine||Canned||6 oz./170 g|
|Shrimp||Frozen||20 oz./567 g|
Omega-3 fatty acids could lower triglycerides
Fish or fish oil concentrate eaten in high doses (more than 6 g per day) can reduce levels of triglycerides. In some studies, fish oil consumption of 15 g per day lowered triglyceride levels in individuals by approximately 50%.
Ingesting fish oil also increased blood HDL-cholesterol level by about 3%; this is especially true of patients with high triglyceride levels.
In addition, fish oil might also decrease the concentration of small LDL-cholesterol by lowering plasma triglyceride concentrations.
In general, multiple trials have found that eating fish oil capsules appears to be safe. The Federal Drug Administration (FDA) approved fish oil supplements at a dose of 4 g per day for treatment of patients with high triglyceride levels.
Studies have confirmed that the fish oil sold in stores contains little to no mercury.
It is also important to state that no large randomized trial found taking fish oil associated with cancer.
Concerns about mercury in fish
People have asked me several times which source of Omega-3 fatty acids would be best: eating fish or taking supplements. My preference is always to eat fish, whenever possible, rather than take supplements. Unlike the supplements, fish and other seafood are sources of vitamins, minerals, niacin and selenium.
However, many people continue to be concerned about mercury contamination in wild fish. It is important to mention that nearly all fish and shellfish contain traces of mercury and that, for most people, consuming these trace amounts will not result in any health problems.
The FDA and the Environmental Protection Agency (EPA) have advised women who may become pregnant, pregnant women, nursing mothers and young children avoid some types of fish and to eat fish and shellfish that are low in mercury.
Shark, swordfish, king mackerel and tilefish have higher levels of mercury than other type of fish and you should generally avoid them.
Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock and catfish.
How much fish oil is necessary?
In order to receive adequate amounts of Omega-3 fatty acids, EPA and DHA, you should consume 2 to 3 servings of fish per week.
If this is not possible, you should consume 250 to 500 mg of EPA plus DHA (supplements), each day.
In patients whose blood triglyceride levels are more than 750 mg/dl, an intake of 3 to 5 g per day of EPA plus DHA is recommended.
The FDA recommends that patients who are on a higher dosage of EPA, plus DHA (>3g), should be under the direct care of a physician, because of the possibility of excessive bleeding in some individuals.
|Patients without heart disease||Eat fish at least twice a week. Include oils and foods rich in linolenic acid (flaxseed, canola and soybean oils; flaxseed and walnuts)|
|Patients with heart disease||Consume 1 g of EPA+DHA per day, preferably from oily fish. EPA+DHA supplements could be considered in consultation with the physician.|
|Patients with high triglyceride levels||Two-to-four grams of EPA+DHA per day, provided as capsules under a physician’s care|
Omega-3 fatty acids (EPA+DHA) can be beneficial for a wide variety of purposes such as preventing sudden death, cardiac death and heart failure, as well as lowering triglyceride levels and blood pressure.
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