Can Omega-3 Doses Lower Children's Triglycerides?

The results of a new study of the triglyceride-lowering effects of omega-3 fatty acid supplements in children and adolescents may offer patients and parents more questions than answers about the health benefits of these supplements, especially in light of other recent study results in other age groups. 

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Researchers at Boston Children's Hospital and Stanford University studied the effect of omega-3 fatty acid supplements on the triglyceride (TG) levels of 25 patients aged 10 to 19 years with high TG.¹ They defined high TG levels as from 150 to 1,000 mg/dL; the average level at the outset of the small study was 227 mg/dL.

Participants in this double-blind study were randomly assigned to 6 months of taking either a daily dose of 3,360 mg of docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA) or placebo. At 3 months, TG levels in those taking the omega-3 supplement had declined by 54 ± 27 mg/dL, while TG levels in the placebo group had declined by 34 ± 26 mg/dL—a difference that was not statistically significant. The two study groups showed no differences in endothelial function, blood pressure, body mass index, C-reactive protein levels, or adverse effects of the supplements.

The authors concluded that while the adolescents tolerated the high-dose omega-3 fatty acid supplements well, beneficial reductions of TG levels did not differ significantly from placebo. The study was published in the May issue of Clinical Pediatrics.

The study comes not long after the publication of two other articles about the effects of supplemental fatty acids in adults.

In a review of published data led by researchers at the University of Cambridge, an international collaborative study analyzed data from 72 studies enrolling 600,000 adult participants to measure fatty acid levels in the participants' diet and bloodstream.² They found no evidence to support the theory that people should avoid saturated fats and increase unsaturated fat consumption in order to lower their risk of heart disease. The article was published online on March 18 in the Annals of Internal Medicine.

Results of the study showed that:

• Levels of saturated fat were not associated with the development of coronary heart disease.

• There was no evidence that levels of omega-3 and omega-6 fatty acids, whether consumed through supplementation or in food, were associated with lower cardiovascular risk. 

They did note, however, that specific fatty acids had different effects on cardiovascular risk from one another.

The evidence does not clearly support cardiovascular guidelines that encourage the consumption of high amounts of polyunsaturated fatty acids and low total saturated fats, the researchers concluded.

And a third recent study analyzing the effect of omega-3 fatty acids on cardiovascular health in middle-aged adults, found that omega-3s from fish oil supplements and from oily fish both modulate platelet lipid profiles efficiently.³ The team of authors from Serbia concluded that EPA and DHA have the same cardioprotective effect, regardless of whether the source is fish oil capsules or fish itself. The article was published online in Nutrition Research January 6.

Eating oily fish (salmon) or taking fish oil capsules at recommended levels increased EPA and DHA in blood cells and platelets in healthy adults who did not previously have a diet high in fish, the study found. The increase in EPA was higher with supplement capsules, and the increase in DHA was higher with salmon. The sum of EPA plus DHA content in platelets increased 38% in the salmon group and 31% in the fish oil capsule group.

"In spite of the quantitative and qualitative differences between n-3 fatty acid profiles in salmon and the fish oil supplement, the overall incorporation of these fatty acids into RBCs and platelets did not differ in our short-term study," the authors wrote.

—Michael Gerchufsky

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References

1. de Ferranti SD, Milliren CE, Denhof ER, et al. Using high-dose omega-3 fatty acid supplements to lower triglyceride levels in 10- to 19-year-olds. Clin Pediatr.2014;53(5):428-438.

2. Chowdhury R, Warnakula S, Kunutsor S, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med. 2014;160(6):398-406.

3. Djuricic ID, Mazic SD, Kotur-Stevuljevic JM, Djordjevic VR, Sobajic SS. Long-chain n-3 polyunsaturated fatty acid dietary recommendations are moderately efficient in optimizing their status in healthy middle-aged subjects with low fish consumption: a cross-over study. Nutr Res. 2014;34(3):210-218.