Strength Trial Casts Some Doubt On Omega
But a recent study has raised some questions. The STRENGTH trial, published in JAMA, looked at a different formulation of omega-3 fish oil a combination of EPA and DHA to see if it would also reduce cardiovascular risk. This study enrolled over 13,000 patients who were randomized to receive either the EPA/DHA combination pill or the placebo . The trial was terminated early due to an interim analysis revealing no difference between the two treatment groups.
We dont know for certain why the REDUCE-IT trial showed a benefit from omega-3s while the STRENGTH trial did not. One possibility is that the different results are due to the different drugs studied. REDUCE-IT studied a purified formulation of high-dose EPA, which resulted in higher EPA levels. This was similar to the results of another trial, which also found that pure EPA reduced the risk of cardiac events. The STRENGTH trial tested a combination of EPA and DHA. No large study has ever evaluated the effects on cardiovascular outcomes of purified DHA alone, leaving us to wonder whether DHA might counteract the benefits of EPA.
Increase Your Consumption Of Dietary Fiber
Ideally, you should be getting 25 to 35 grams of fiber a day, says Dr. Cho. Fiber binds to cholesterol and eliminates it from your body.
To increase your fiber intake, eat more whole grains, legumes like beans and lentils, vegetables and fruits. You should be getting a good mix of both soluble fibers, which are more beneficial for cholesterol, and insoluble fibers, which are better for your gut health.
Lower cholesterol isnt the only benefit of getting enough fiber. Other benefits include reducing your risk of diseases, preventing constipation and keeping you full longer.
What Foods Should I Eat What Foods Should I Avoid
Maintaining a healthy diet can help lower your cholesterol. Recommended foods include fruits and vegetables whole grain foods fat-free, 1%, or low-fat milk products poultry without skin and lean meats fatty fish such as salmon, trout, albacore tuna, and sardines and unsalted nuts, seeds, and legumes.
A diet high in cholesterol, saturated fats, and trans fats should be avoided. This includes high-sodium foods sweetened or sugary beverages red, fatty, or processed meats full-fat dairy products baked goods with saturated and trans fats solid fats or fried foods and hydrogenated and saturated oils.
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Is The Ldl Increase By Dha Enough To Worry About
Many patients who are prescribed fish oil to reduce triglycerides naturally are already on a statin to lower their total and LDL cholesterol. For them, the fact that fish oil increases LDL isnt considered much of an issue, because a high enough dose of a powerful statin can counteract that increase. But there has been concern for those who are not taking statins, either because of personal preference or issues with side effects. In these individuals, especially if they have high or borderline-high LDL, the LDL-increasing effects of DHA could be as much as 16%, resulting in increased risk of developing cardiovascular disease. This is where taking a fish oil supplement formulated to contain very high amounts of EPA and low amounts of DHA may be especially useful.
The Good And Bad Of It All
There are two types of cholesterolLDL cholesterol is considered bad, and HDL is good.LDL cholesterol contributes to the buildup of fatty plaques in your arteries, which can interfere with blood flow.
Over time this causes high blood pressure and increases your risk of cardiovascular disease. HDL is considered good because it scavenges LDL and removes it from your blood, taking it back to your liver to be processed and then excreted.
Cholesterol can easily build up in your system because it is naturally produced by your body and can be ingested from certain animal products. Diets that are high in cholesterol like red meats, saturated fats, and whole-fat dairy products allow for excess cholesterol in your body.
When this happens, your HDL cholesterol has a difficult time scavenging all the LDL, and it accumulates to dangerous levels.
Triglycerides are fats that store excess energy from your diet. When combined with HDL or LDL, these fats cause the plaque accumulation in your arteries that leads to cardiovascular problems.
Because triglycerides can combine with both types of cholesterol and because HDL cannot scavenge all the LDL from your blood, the best approach to heart health is to reduce all levels. Dietary changes can achieve this, as can adding beneficial fatty acids to the mix.
You can always opt for a high-quality omega-3 supplement, but there are plenty of foods sources available to add to your diet. The best food sources for omega-3 fatty acids include:
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What Causes High Cholesterol
There are numerous reasons why you might have high cholesterol, including your genetics. If you exercise and eat a healthy diet, finding out you have unhealthy cholesterol numbers can feel like a kick in the gut.
Other causes of high cholesterol in the general population include:
- Excess weight and obesity
- Chronic illnesses
- Genetic factors
In addition to improving you diet and exercising more, your doctor may also suggest taking a supplement like omega-3s or another prescribed medication to improve your heart health.
Heres what you should know about fish oil and how it affects cholesterol.
What Problems Result From High Cholesterol
High blood cholesterol is a condition in which you have too much cholesterol in your blood.
Heres the alarming part: By itself, the condition usually has no signs or symptoms as per research studies.
Thus, many people dont know when their cholesterol levels are too high.
And thats a huge problem because people who have high blood cholesterol have a greater chance of getting coronary heart disease.
You have to remember that the higher your LDL, the GREATER your chance of getting heart disease.
On the other hand, the higher your HDL, the LOWER your risk of getting heart disease.
Moreover, Coronary heart disease is a health condition in which plaque builds up inside the coronary arteries. Over time, plaque develops in your coronary arteries and hardens and narrows your arteries.
According to studies, plaque limits the flow of oxygen-rich blood to your heart muscle.
If the flow of oxygen-rich blood to a section of the heart muscle is blocked or reduced, angina or a heart attack may occur.
Angina is a type of chest pain or discomfort because of reduced blood flow to the heart. It may feel like pressure, squeezing, heaviness and tightness in your chest.
The pain can also extend to your arms, shoulders, neck, jaw, or back. Angina pain may even feel like indigestion.
A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked.
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Omega 3 Supplements Could Lower Cholesterol Flags Us Study
22 Dec 2020 — Omega 3 supplements do not raise cholesterol, according to US researchers. The findings dispel suggestions from a number of previous studies that show bad cholesterol could increase upon consumption of fish oil and other omega 3 sources.
Omega 3 fatty acids have a long history of being heart-healthy and are well-known for lowering triglycerides blood levels but typically not cholesterol.
Previous studies, however, have raised concerns over docosahexaenoic acid commonly found in fish oil supplements and the possibility that it might actually raise levels of low-density lipoprotein cholesterol , the bad cholesterol.
DHA could lower cholesterolTo investigate this connection, researchers extracted data from the Cooper Center Longitudinal Study , which has collected medical records from 116,000 individuals over 21 years.
The investigators utilized data from over 9,200 healthy men and women who had had at least two preventive medical examinations at the Cooper Clinic in Dallas, Texas, over ten years.
These examinations routinely included both blood cholesterol testing and the omega 3 index , EPA and DHA levels).
Researchers found that omega 3 supplements could lower cholesterol levels.Regarding participants fish oil intake, the researchers found that these supplements did not raise LDL-C levels.
The study was conducted by the Cooper Institute and the Fatty Acid Research Institute and published in the Journal of Clinical Lipidology.
Fish Oil Research: Mixed Results
Other studies have also looked at fish oil and cardiovascular health. The evidence has been mixed, partly because researchers used different types and quantities of fish oils and different placebos.
- The 2007 JELIS trial also evaluated the use of EPA and statins and found a reduction in non-fatal coronary events. Major coronary events were reduced slightly in those with a history of coronary artery disease. No placebo was used.
- The 2019 VITAL study used supplements including vitamin D3 and omega-3 fatty acids. It showed fish oil didnt lower the risk for major cardiac events.
- The 2019 REDUCE-IT trial evaluated icosapent ethyl , a high-dose pure EPA . The study included people with heart disease or people who were taking a statin medication with raised triglyceride levels. People on the omega-3 supplement had a 25% lower incidence of heart disease and stroke, and a 20% reduction in death from heart disease.
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Fish Oil Supplements: Heart
About 145 million Americans use nutritional supplements each yearthats almost one-half of the population. One of the most common is fish oil. They annually generate $1.2 billion in sales, according to Nutrition Business Journal. Manufacturers claim that these fish oil can lower your risk of cardiovascular diseases, improve immunity, and boost athletic performance. But what does the science say? In this article, the research of the effects of fish oil supplements on key health indicators in your bodyespecially triglycerides, cholesterol, and testosteronewill be critically evaluated.
What Are The Functions Of Cholesterol
Cholesterol is necessary because it is involved in these processes:
- Building and maintaining the outer layer of cell membranes.
- Determining which molecules can cross into the cell and which cannot .
- Support production of sex hormones
- Assist in the production of hormones released by the adrenal glands
- Helps in the production of bile
- It helps in converting sunlight to vitamin D
- Metabolism and absorption of fat-soluble vitamins, including vitamins A, D, E, and K
- Insulating nerve fibers
Some of the important factors that can lead to high cholesterol are:
- Excess weight Being overweight is directly linked to increased cholesterol.
- Heredity Unfortunately, a family history of heart cholesterol problems puts you at a higher risk of having high cholesterol.
- Diet Foods that can increase your cholesterol are those that are high in cholesterol, saturated fat, and trans fat.
- Age The risk of high cholesterol increases as you get older.
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Apolipoprotein E And N
ApoE is a further important apolipoprotein found in HDL particles, and its role in RCT is well establishedapoE enhances cholesterol efflux via ABCA1 in macrophages and delivers HDL cholesterol to the liver through interactions with SR-BI and LDLr. It also facilitates the maturation of large HDL particles through LCAT . Most available studies on the interplay between n-3 PUFAs and apoE relate to Alzheimers disease previous findings suggest apoE4 polymorphisms to be a genetic risk factor for late onset Alzheimers disease , and epidemiological studies have postulated a clinical benefit of dietary supplementation with n-3 PUFAs in patients with dementia . Studies investigating the direct effects of n-3 PUFAs on apoE expression and function are scarce since the most commonly used atherosclerosis model is the apoE knockout mouse .
Yet, in obese rats fed a mixture of n-3 and n-6 PUFAs , an increase in apoE within HDL particles has been observed . However, the study did not investigate the effects of isolated n-3 PUFA supplementation on apoE plasma levels. A recent study in healthy volunteers with an n-3 PUFA enriched diet showed a significant increase in apoE within the LDL fraction and in a subgroup with reduced triglyceride levels, an increase in total plasma apoE concentrations . Interestingly, genetic polymorphisms of apoE seem to impact the metabolism and bioavailability of supplemented EPA and DHA .
What To Do If You Cant Lower Your Cholesterol The Natural Way
If youve spent about six months trying to adopt healthier lifestyle habits but still arent seeing a change in those cholesterol numbers, its time to talk to your doctor. They can provide specialized guidance specific to your health, and they may be able to prescribe you a medication to help, as well.
The great news is that heart disease is preventable and even if you cant do it with diet and exercise, there are some amazing medications out there, Dr. Cho says. Were so lucky to live in an era where we have something that can treat our diseases and help us live longer.
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Do They Have A Direct Relationship With Cholesterol
As there are mixed reviews on how omega-3 and omega-6 fatty acids affect cholesterol, its best to lay out all the knowledge and findings out there. While the American Heart Association and Heart Foundation, claim that consuming polyunsaturated fats help increase HDL levels and lower LDL levels , it may be the case that not all polyunsaturated fats are considered equal. According to the International Food Information Council Foundation, omega-3 fatty acids decrease serum triglyceride and total cholesterol levels, and may increase or have no effect on high-density-lipoprotein cholesterol, while diets high in omega-6 fatty acids are associated with lower blood levels of total cholesterol and LDL-cholesterol, but also with lower blood levels of the protective HDL cholesterol. Overall, this means that our bodies may be out of sync in our omega-3 to omega-6 balance. Omega-3 seems to have a better outlook for healthy HDL levels than omega-6, which focus more on LDL levels.
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Continue Learning About Omega 3 Fatty Acids
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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What To Know About Taking A Highly Concentrated Epa Supplements For Your Lipids
Not everyone at risk for cardiovascular disease needs a fish oil supplement highly concentrated in EPA. As discussed above, both EPA and DHA combined have been shown to significantly benefit heart and vascular health. Plus, there are many additional ways to lower LDL naturally while still taking fish oil high in both EPA and DHA. But if youve been taking fish oil and have noticed a negative effect on your LDL, consider trying a high-EPA fish oil for your cholesterol and cardiovascular health.
Anyone who has spent time perusing the seemingly endless brands of fish oil in their local store already knows EPA and DHA amounts vary tremendously between products. Always look for the specific amounts of EPA and DHA listed in the ingredients section of the label.
If you decide to try a fish oil highly concentrated in EPA to improve your lipids without raising LDL, aim for a total daily dose of at least 1800 mg EPA, based on evidence from clinical studies. Many high quality fish oil companies now selling fish oil capsules with enhanced amounts of EPA.
Mozaffarian D, Wu JH. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol. 2011 Nov 8 58:2047-67.
Delgado-Lista J, Perez-Martinez P, Lopez-Miranda J, Perez-Jimenez F. Long chain omega-3 fatty acids and cardiovascular disease: a systematic review. Br J Nutr. 2012 Jun 107 Suppl 2:S201-13.
When Is Your Cholesterol Too High
How do you know if your cholesterol is too high?
A simple blood test. A lipid panel will tell you your LDL, HDL, and triglyceride levels.
Your blood test lab results will come in the form of a set of numbers known as the reference range. Here is how to interpret your cholesterol reference range:
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The Truth About 4 Popular Heart Health Supplements
Watching your cholesterol levels is a smart idea, especially since one inthree people have high levels of bad cholesterol: low-density lipoprotein. If youre facing an increased risk for high cholesterol and yourestruggling to manage it, you might consider reaching for supplements orother over-the-counter products. But you should think twice before you dothat, saysSeth Martin, M.D., M.H.S., Johns Hopkins cardiologist and co-director of the Advanced LipidDisorders Center.
Some people try supplements instead of prescription medications because they think its a safer way to address health issues, he says. But many of those supplements dont benefit the heart like people think.
What About Supplements
Here at HEART UK we dont recommend supplements of Omega 3s. Its always best to get your nutrients from foods rather than supplements.
Thats because foods contain a whole range of different nutrients which improve your health in different ways. But supplements only contain specific nutrients.
If you choose to top up on Omega 3s by using over-the-counter supplements, follow these golden rules.
- Choose a fish oil or an Omega 3 supplement.
- Dont choose fish liver oils, they contain less Omega 3 than fish oils and too much vitamin A.
- Go for a supplement with lower levels of vitamin A less than 1mg per day .
- If you are pregnant or breastfeeding, avoid supplements that contain vitamin A altogether. Beta carotene .
- Aim to get 500mg of EPA and DHA combined each day, this works out as around the same as a 140g portion of oily fish per week.
- If you take medicines to thin your blood, such as aspirin, warfarin or heparin, speak to your doctor before taking fish oil supplements they can also thin your blood.
- If you are vegan or vegetarian, you can take marine oils made from algae.
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