Association Between Omega-3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose–Response Meta-Analysis of Randomized Controlled Trials

Abstract

BACKGROUND: Previous results provide supportive but not conclusive evidence for the use of omega-3 fatty acids to reduce blood lipids and prevent events of atherosclerotic cardiovascular disease, but the strength and shape of dose–response relationships remain elusive. METHODS AND RESULTS: This study included 90 randomized controlled trials, reported an overall sample size of 72 598 partici-pants, and examined the association between omega-3 fatty acid (docosahexaenoic acid, eicosapentaenoic acid, or both) intake and blood lipid changes. Random-effects 1-stage cubic spline regression models were used to study the mean dose– response association between daily omega-3 fatty acid intake and changes in blood lipids. Nonlinear associations were found in general and in most subgroups, depicted as J-shaped dose–response curves for low-/high-density lipoprotein cholesterol. However, we found evidence of an approximately linear dose–response relationship for triglyceride and non-high-density lipoprotein cholesterol among the general population and more evidently in populations with hyperlipidemia and overweight/ obesity who were given medium to high doses (>2 g/d). CONCLUSIONS: This dose–response meta-analysis demonstrates that combined intake of omega-3 fatty acids near linearly lowers triglyceride and non-high-density lipoprotein cholesterol. Triglyceride-lowering effects might provide supportive evidence for omega-3 fatty acid intake to prevent cardiovascular events.