Q. I’ve listened to your podcast on fish oil and omega-3s and shared it with some people I know who take fish oil. But today my physician told me that my “bad” cholesterol is borderline and that a way to get it down without statins would be to take fish oil twice a day. I’m wondering what you think about that.
A. In the podcast you’re referring to, I was talking mostly about prophylactic or preventive use of fish oil supplements. Here’s the point I was trying to make: Taking fish oil supplements, which are high in omega-3s, is one way to balance out diet that’s too high in omega-6 fats. But another way to improve that balance is to reduce your intake of omega-6. Reducing omega-6 intake (which come mostly from vegetable oils and processed foods) can reduce the need to take fish oil supplements.
Your doctor, on the other hand, is proposing a therapeutic use–that is, taking fish oil to lower your LDL cholesterol. I certainly wouldn’t want to contradict the advice that your personal physician has given you. And it’s terrific that s/he’s recommending a non-pharmaceutical approach–probably because your levels are “borderline” as opposed to “high.”
But what do I think of this advice? Without knowing the particulars of your situation, I can only say that, although high dose fish oil definitely helps lower high triglycerides and raise HDL (or “good”) cholesterol, along with other benefits like increasing insulin sensitivity and reducing coagulation, the evidence that fish oil lowers LDL cholesterol is weaker. Although it’s unlikely that taking fish oil will do you any harm, I’d just add that dietary approaches to reduce LDL cholesterol might also include:
- reducing saturated fat intake
- avoiding trans fats from hydrogenated oil
- eating foods that are high in soluble fiber (such as beans, nuts, fruits, oat bran, veggies, flax)
- eating foods that are rich in phytosterols (nuts, seeds, legumes, olive oil, cabbage family veggies)
The good news is that because the problem is only “borderline,” it’s likely that some dietary tweaks (and fish oil supplements, if you choose) can nudge your cholesterol profile back into the healthy zone.