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Journal of Lipid Research, Vol 30, 785-807, Copyright © 1989 by Lipid Research, Inc.

REVIEWS

Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review

WS Harris
Department of Medicine, University of Kansas Medical Center, Kansas City 66103.

Epidemiological studies in Greenland Eskimos led to the hypothesis that marine oils rich in n-3 fatty acids (also referred to as omega (omega)- 3 fatty acids) are hypolipidemic and ultimately antiatherogenic. Metabolically controlled trials in which large amounts of fish oil were fed to normal volunteers and hyperlipidemic patients showed that these fatty acids (FAs) are effective at lowering plasma cholesterol and triglyceride levels. Although more recent trials using smaller, more practical doses of fish oil supplements have confirmed the hypotriglyceridemic effect, they have shown little effect on total cholesterol levels; hypertriglyceridemic patients have even experienced increases in low density lipoprotein cholesterol (LDL-C) levels of 10- 20% while taking n-3 FA supplements. Discrepancies among fish oil studies regarding the effects of n-3 FAs on LDL-C levels may be understood by noting that, in the majority of studies reporting reductions in LDL-C levels, saturated fat intake was lowered when switching from the control diet to the fish oil diet. When fish oil is fed and saturated fat intake is constant, LDL-C levels either do not change or may increase. Levels of high density lipoprotein cholesterol have been found to increase slightly (about 5-10%) with fish oil intake. Plasma apolipoprotein levels change in concert with their associated lipoprotein cholesterol levels. Although the decrease in triglyceride levels appears to result from an inhibition in hepatic triglyceride synthesis, the mechanisms leading to the increases in LDL and HDL have not been determined. Finally, fatty fish or linolenic acid may serve as alternative sources of long-chain n-3 FAs, but further studies will be needed to document their hypolipidemic and/or antiatherogenic effects.
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				M. L. Barbeau, K. F. Klemp, J. R. Guyton, and K. A. Rogers Dietary Fish Oil : Influence on Lesion Regression in the Porcine Model of Atherosclerosis Arterioscler Thromb Vasc Biol, April 1, 1997; 17(4): 688 - 694. [Abstract] [Full Text]

				K. Sugiyama, A. Yamakawa, H. Kawagishi, and S. Saeki Dietary Eritadenine Modifies Plasma Phosphatidylcholine Molecular Species Profile in Rats Fed Different Types of Fat J. Nutr., April 1, 1997; 127(4): 593 - 599. [Abstract] [Full Text]

				R. P. Glahn and D. R. Van Campen Iron Uptake Is Enhanced in Caco-2 Cell Monolayers by Cysteine and Reduced Cysteinyl Glycine J. Nutr., April 1, 1997; 127(4): 642 - 647. [Abstract] [Full Text]

				T. A. Mori, L. J. Beilin, V. Burke, J. Morris, and J. Ritchie Interactions Between Dietary Fat, Fish, and Fish Oils and Their Effects on Platelet Function in Men at Risk of Cardiovascular Disease Arterioscler Thromb Vasc Biol, February 1, 1997; 17(2): 279 - 286. [Abstract] [Full Text]

				N. J. Stone Fish Consumption, Fish Oil, Lipids, and Coronary Heart Disease Circulation, November 1, 1996; 94(9): 2337 - 2340. [Full Text]

				R. M. Krauss, R. J. Deckelbaum, N. Ernst, E. Fisher, B. V. Howard, R. H. Knopp, T. Kotchen, A. H. Lichtenstein, H. C. McGill, T. A. Pearson, et al. Dietary Guidelines for Healthy American Adults: A Statement for Health Professionals From the Nutrition Committee, American Heart Association Circulation, October 1, 1996; 94(7): 1795 - 1800. [Full Text]

				M.-F. Hau, A. H.M. Smelt, A. J.G.H. Bindels, E. J.G. Sijbrands, A. Van der Laarse, W. Onkenhout, W. van Duyvenvoorde, and H. M.G. Princen Effects of Fish Oil on Oxidation Resistance of VLDL in Hypertriglyceridemic Patients Arterioscler Thromb Vasc Biol, September 1, 1996; 16(9): 1197 - 1202. [Abstract] [Full Text]

				I. Toft, K. H. Bonaa, O. C. Ingebretsen, A. Nordoy, and T. Jenssen Effects of n-3 Polyunsaturated Fatty Acids on Glucose Homeostasis and Blood Pressure in Essential Hypertension: A Randomized, Controlled Trial Ann Intern Med, December 15, 1995; 123(12): 911 - 918. [Abstract] [Full Text]

				W. E. Connor Diabetes, Fish Oil, and Vascular Disease Ann Intern Med, December 15, 1995; 123(12): 950 - 952. [Full Text]

				A. Abdel-Gayoum, A. Bashir, and M. El-Fakhri Effects of fish oil and sunflower oil supplementations on gentamicin-induced nephrotoxicity in rat Human and Experimental Toxicology, November 1, 1995; 14(11): 884 - 888. [Abstract] [PDF]

				Council on Scientific Affairs Management of Disorders of Cholesterol, Triglyceride, and Lipoprotein Metabolism: Report 6 of the Council on Scientific Affairs Arch Fam Med, October 1, 1995; 4(10): 869 - 878. [Abstract] [PDF]

				B N C Prichard, C C T Smith, K L E Ling, and D J Betteridge Fish oils and cardiovascular disease BMJ, April 1, 1995; 310(6983): 819 - 820. [Full Text]

				F. Supari, T. Ungerer, D. G. Harrison, and J. K. Williams Fish Oil Treatment Decreases Superoxide Anions in the Myocardium and Coronary Arteries of Atherosclerotic Monkeys Circulation, February 15, 1995; 91(4): 1123 - 1128. [Abstract] [Full Text]

				A. Salachas, C. Papadopoulos, G. Sakadamis, J. Styliadis, V. Voudris, D. Oakley, and R. Saynor Effects of a Low-Dose Fish Oil Concentrate on Angina, Exercise Tolerance Time, Serum Triglycerides, and Platelet Function Angiology, December 1, 1994; 45(12): 1023 - 1031. [Abstract] [PDF]

				E. A. Turvey, G. J. F. Heigenhauser, M. Parolin, and S. J. Peters Elevated n-3 fatty acids in a high-fat diet attenuate the increase in PDH kinase activity but not PDH activity in human skeletal muscle J Appl Physiol, January 1, 2005; 98(1): 350 - 355. [Abstract] [Full Text] [PDF]

				J. Dallongeville, E. Bauge, A. Tailleux, J. M. Peters, F. J. Gonzalez, J.-C. Fruchart, and B. Staels Peroxisome Proliferator-activated Receptor alpha Is Not Rate-limiting for the Lipoprotein-lowering Action of Fish Oil J. Biol. Chem., February 9, 2001; 276(7): 4634 - 4639. [Abstract] [Full Text] [PDF]

				E. A. Fisher, M. Pan, X. Chen, X. Wu, H. Wang, H. Jamil, J. D. Sparks, and K. J. Williams The Triple Threat to Nascent Apolipoprotein B. EVIDENCE FOR MULTIPLE, DISTINCT DEGRADATIVE PATHWAYS J. Biol. Chem., July 20, 2001; 276(30): 27855 - 27863. [Abstract] [Full Text] [PDF]