Illingworth D R, Schmidt E B
Department of Medicine, Oregon Health Sciences University, Portland 97201-3098.
Ann N Y Acad Sci. 1993 Mar 15;676:60-9. doi: 10.1111/j.1749-6632.1993.tb38725.x.
The body of epidemiologic data indicates that the incidence of cardiovascular disease is lower in populations whose habitual diet is rich in fish. It is unclear however to what extent this apparent protection is due to the intake of n-3 fatty acids in sea food or to the fact that these subjects have generally been consuming lower amounts of saturated fatty acids in their diets. It is clear, however, that when the dietary intake of n-3 fatty acids is increased to 4-8 g/day distinct metabolic effects are observed, including reductions in plasma triglycerides, effects on platelet function and coagulation factors and blood pressure. Larger intakes exert a more profound hypotriglyceridemic effect, and in patients with primary hypercholesterolemia daily intakes exceeding 10-12 g/day are effective in reducing plasma concentrations of LDL cholesterol. However, from a practical point of view, the lipid-modifying effects of supplemental dietary n-3 fatty acids are most clearly observed in patients with hypertriglyceridemia and the major usefulness of dietary n-3 fatty acids is in the treatment of this patient population, particularly patients with severe hypertriglyceridemia or potentially those with Type III hyperlipoproteinemia. Further studies are needed to better define the potential utility of dietary n-3 fatty acids when used in combination with lipid-lowering drugs to reduce lipoprotein concentrations in patients with combined hyperlipoproteinemia or severe hypertriglyceridemia.
