Following years of taking a back seat to traditional cholesterol lowering treatments like statins, fibrates, niacin and bile acid resins, fish oil has now emerged as one of the most impressive ways to improve your lipids and reduce your risk of heart disease. A study published in the March, 2013 issue of the Canadian Medical Association Journal reported that in 207 subjects with no history of heart disease, using fish oil omega-3 supplements combined with diet and exercise after only one year of therapy had reduced their heart risk by 17%. A separate study reported in the March, 2013 issue of the Annals of Internal Medicine found that high blood levels of omega-3 fatty acids, especially the EPA variety, in older adults were associated with up to a 27% reduced risk of premature death.
These studies, along with numerous others have further cemented the notion that fish oil derived from diet, supplements and prescription medications offer significant health benefits. The GISSI-P study of over 11,000 adults found that taking one prescription strength fish oil capsule per day reduced the risk of a second heart attack and sudden death by 30% within just one year in survivors of a first heart attack. The JELLIS trial of over 18,000 subjects followed for 5 years found that a highly purified form of fish oil containing only the EPA variety of omega-3 fatty acid reduced the risk of heart attacks, death, need for bypass surgery or angioplasty by 19% compared to patients treated with statin therapy alone.
Omega-3 oils are a healthy form of fat known as polyunsaturated fatty acids. One of their main benefits in heart disease is that they dramatically lower triglycerides. Triglycerides have been considered a “minor” fat particle compared to cholesterol, but recent evidence suggests that they may significantly contribute to atherosclerosis and growth of arterial plaque. Omega-3 fatty acids also reduce inflammation inside plaque that can cause it to become unstable, leading to strokes and heart attacks. They help to stabilize the heart’s electrical system, and thus prevent life-threating arrhythmias. Other known cardiovascular benefits of fish oil are reducing the tendency of platelets to form blood clots, reducing blood pressure and improving glucose metabolism.
Moreover, omega-3 fatty acids have been shown to be beneficial outside the heart. They appear to boost memory and may retard Alzheimer’s disease, both of which may be mediated by inflammation in the brain. They have been shown to be beneficial in the systemic inflammatory illnesses, rheumatoid arthritis, lupus and psoriasis.
Many heart healthy diets and wellness-oriented organizations such as the American Heart Association recommend an increase in dietary intake of cold water fish that are abundant in the omega-3 fish oils. However, not all fish oil supplements and prescription medications are created equal. To derive the maximal health benefits for prevention, make sure you take a preparation that contains at least 850 mg of combined content of the two major omega-3 fatty acids, EPA and DHA. Just looking at the fish oil content will not reveal how much EPA and DHA are contained in the capsules. Read the back label for the exact EPA ad DHA content and for prevention purposes, make sure you get a minimum of 850 mg of combined EPA + DHA.
For treating high triglycerides or for preventing a recurrence of heart problems, the dose of fish oil must be increased to 2-4 grams per day. This is best done using prescription fish oil preparations. In the U.S. there are only two such preparations, Lovaza and the recently released Vascepa. Vascepa offers several advantages because it is a pure EPA omega-3 preparation. Compared to Lovaza, a combined EPA and DHA preparation, Vascepa does not raise LDL-C, the so called bad cholesterol. LDL-C may rise up to 45% when patients receive Lovaza. Vascepa lowers triglycerides by 20-40% depending upon the initial triglyceride levels and the dose used. Vascepa also has proven benefits in favorable affecting other lipid particles as well as anti-inflammatory properties. Recall that the JELLIS trial used a pure EPA compound and showed a significant benefit in reducing heart events. The results of the REDUCE-IT trial, a study specifically evaluating the heart benefits of Vascepa, are expected to be released later this year.
Fish oil works, is natural, and is relatively inexpensive, making it more attractive than many other lipid lowering therapies. The purest preparations like Vascepa have little or no GI side-effects or the fishy odor that often developed with older fish oil preparations. So, no longer can we say that the story about using omega-3 fatty acids to improve lipids and heart disease smells fishy. Instead, it seems to have come up smelling like a rose!
For more information, get the book Don’t Let Your Heart Attack!, available on Amazon, Barnes & Noble and iTunes.