Does Fish Oil Lower Cholesterol?

Fish oil is a nutritious dietary addition with numerous health benefits. It contains healthy fats, such as omega-3 fatty acids, essential in boosting one's health. It helps fight inflammation, reduce blood pressure, improve brain health, and more. Yet, when it comes to lowering cholesterol, there are contradictory results in research. Some argue that it does lower, while others maintain it doesn't.

Many studies,¹ however, agree that fish oil is beneficial in lowering triglycerides.

What is fish oil?

As the name suggests, fish oil is found in fish tissue and is rich in omega-3 fatty acids. Omega-3s are essential nutrients key to maintaining a healthy body. 

Fish oil contains two omega-3 polyunsaturated fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Types of omega-3-rich fish include salmon, sardine, mackerel, herring, tuna, etc.

You can get the essential DHA and EPA nutrients either through dietary sources or by taking omega-3 supplements sold in liquid, pill, or capsule form.

The potential benefits of consuming fish oil include lowering triglycerides in the blood, improving brain health, fighting inflammation, improving heart health, reducing blood pressure, improving bone health, enhancing skin health, and relieving symptoms of rheumatoid arthritis.

Understanding cholesterol

Cholesterol is a fat-like, waxy substance found in the body. It plays a crucial role in body functions such as producing vitamin D, forming bile acids, synthesizing hormones, and forming cell membranes.

However, when too much cholesterol is circulating in the blood, it can stick to the arterial walls and clog them hindering the smooth flow of blood.

Proteins carry cholesterol in the bloodstream. When the two (proteins and fats) combine, they are lipoproteins. There are two types of lipoproteins: high-density lipoprotein (HDL) and low-density lipoprotein (LDL).

HDL is considered good cholesterol since it helps regulate cholesterol levels in the blood by transporting the excess cholesterol molecules to the liver. On the other hand, when the cells have more cholesterol than they need, LDL carries it to the arterial walls, leading to clogging. Clogged arteries restrict blood flow to body organs, increasing the risks of heart conditions such as coronary heart disease and heart attacks.

Common causes of high cholesterol in the blood include consuming a diet high in saturated fats, genetics, excess weight (especially around your waist), chronic illnesses, underactive thyroid, etc.

Does fish oil lower cholesterol?

Replacing saturated fats with fish oil can help manage cholesterol. However, if you already have unhealthy levels of LDL, consuming fish oil will only raise cholesterol levels. In other words, fish oil cannot treat high cholesterol since it does not lower it.

While most studies² maintain fish oil does not lower cholesterol, others³ have found that the coadministration of omega-3 fatty acids (extracted from fish oil) and statin increases the molecule size of LDL. Increasing the molecule size of LDL reduces their chances of sticking to the arterial walls, lowering the risk of heart conditions due to restricted blood flow.

Drawbacks of fish oil

Substituting saturated fats with the polyunsaturated fats found in fish oil can be immensely beneficial in reducing unhealthy fats in your blood. However, overconsumption can harm your health.

Some common drawbacks of consuming too much fish oil include:

• Increased blood sugar – People with diabetes should avoid consuming excessive fish oil as it can increase blood sugar levels.

• Diarrhea – Taking too much fish oil can cause diarrhea.

So, how much fish oil is enough? The recommended daily dosage⁴ should not exceed three grams.

Other ways of lowering cholesterol

If you have high cholesterol, you can lower it with the help of medication, as well as dietary and lifestyle changes.

Medication

There are several medications for treating cholesterol, including the following:

Statins

Statins are one of the most effective medicines recommended for lowering LDL cholesterol. Statins work in two ways. It slows down cholesterol production in the liver and boosts the liver's ability to remove LDL from the blood.

Bile acid sequestrants

Taking bile acid sequestrants helps remove LDL cholesterol from the bloodstream, which is broken down to make bile acids.

Fibrates

Fibrates help increase the removal of LDL molecules and consequently increase HDL.

Nicotinic acid

Nicotinic acid helps create a balance by raising HDL cholesterol levels and lowering LDL.

Injections

People with familial hypercholesterolemia (a condition characterized by high LDL cholesterol levels) are given injections to lower bad cholesterol levels in their blood.

Dietary changes

Once you're on treatment to lower your cholesterol, you may also want to make dietary changes to maintain healthy levels. To begin with, replace foods with saturated fats with those that contain healthy fats. 

Saturated fats food sources include fatty meats, cheese, and dairy. Increase consumption of foods high in soluble fiber, such as oats, beans, bananas, and oranges, and substitute white bread, flour, and rice, with wholemeal/wholegrain. Increasing consumption of fruits and vegetables also boosts cholesterol-lowering compounds.  

Other lifestyle changes

Besides changing your diet, making other lifestyle changes can help keep cholesterol in check. 

Regular physical activity

If you're an adult, you should commit to moderate-intensity activities for at least 150 minutes/week or 30 minutes daily for five days. 

On the other hand, children between three and five years should be active throughout the day, while those aged between six and 17 should get at least 60 minutes of moderate-vigorous-intensity activity each day.

Lose weight

Having excess weight increases the risk of accumulating more LDL cholesterol. If you're overweight, reduce your caloric intake by removing foods with high calories from your diet. For instance, you could choose water instead of sugary beverages when thirsty. 

If you take alcohol, moderate your consumption, and increase your daily physical activity to burn more calories and keep your cholesterol levels in check. 

Moderate alcohol consumption 

Alcohol consumption adds extra calories to your body. It can lead to weight gain and can eventually raise your cholesterol levels. Men should avoid taking more than two drinks⁵ per day to maintain healthy cholesterol levels. At the same time, women should limit their consumption to one drink per day.  

Testing for cholesterol levels

Testing regularly your cholesterol levels is recommended to help keep them in control and minimize the risk of getting heart conditions. Healthy adults should have their cholesterol checked after four to six years. However, your doctor may recommend a shorter testing frequency if you have a heart condition.

The test (lipid profile or lipid panel) shows results for total blood cholesterol levels in milligrams (mg) per deciliter (dL) of blood, triglycerides, HDL, and LDL. Assessing each component's levels helps the doctor determine your risk of getting heart conditions.

The lowdown

Adding fish oil to your diet can provide numerous health benefits. From lowering triglycerides in the blood to fighting inflammation, improving brain and skin health, and relieving symptoms of rheumatoid arthritis, consuming fish oil can impact your health immensely.

But as much as fish oil helps lower triglycerides in the blood, if you already have high cholesterol levels, it does not help lower it. Instead, you may opt for cholesterol medicine such as statins, bile acid sequestrants, and nicotinic acid. 

In addition, you should accompany the treatment with dietary and lifestyle changes such as increasing physical activity, moderating alcohol consumption, and losing weight.  

All in all, fish oil remains a rich source of healthy fats, and its consumption is recommended but in moderation. Otherwise, overconsumption can cause side effects, such as increased blood sugar, diarrhea, and bleeding.