Is the Effect of Omega-3 Polyunsaturated Fatty Acids Dependent on Life-Style, Severity of Disease, and Use of Concomitant Medications?

An epidemiological study in the Danish Green-land Inuit suggested a key role of fish oil (omega-3 fatty acids) in the prevention of atherosclerotic diseases 1). Following this landmark study, the health benefits of omega-3 fatty acids as part of a diet rich in fatty acids have been extensively researched, with large-scale epidemiological studies, clinical outcomes trials, and meta-analyses demonstrating statistically significant relative cardiovascular (CV) risk reductions with omega-3 fatty acids 2). Hypertriglyceridemia is shown to be a major CV risk factor 3) , and omega-3 fatty acids are reported to reduce serum triglyceride (TG) in patients with hyper-triglyceridemia while at the same time increasing high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels, in addition to lowering small, dense LDL-C 2). Although a highly purified eicosapentaenoic acid (EPA) preparation was developed and applied to humans in 1983 in Japan ahead of the rest of the world 4) , omega-3 fatty acids have also been commercially available in many other parts of the world as Omacor/Lovaza (containing the same active ingredients as Lotriga ®) (highly concentrated omega-3 fatty acid ethyl esters consisting of EPA ethyl ester (EPA-E) and docosahexaenoic acid ethyl ester (DHA-E)