Fish Oil for Cholesterol: Benefits, Risks & Science Explained

What Is Cholesterol?

Cholesterol is a fatty substance found in the blood^[1]. Because your body has this substance, it can produce hormones that help you digest food and build cells.

While cholesterol is the good thing our body needs to function, an excess can harm health. Cholesterol can attach itself to the walls of your artery, clogging and restricting blood flow. This restriction can cause stroke and heart disease.

Types Of Cholesterol

We have established that excess cholesterol is harmful to the body. However, this does not apply to all. Cholesterol can be divided into three types:

• HDL (High-Density Lipoprotein): This cholesterol is termed good cholesterol. It removes excess cholesterol from your bloodstream, decreasing your body's chances of having a heart-related disease.
• LDL (Low-Density Lipoprotein): High levels of Low-Density Lipoprotein in your body can accumulate to form plaque, which blocks the walls of your arteries.
• Triglycerides: Triglyceride is a type of fat in your blood.

However, when we talk about the health of the heart, we are essentially considering HDL (High-Density Lipoprotein) and LDL (Low-Density Lipoprotein)

What Is Fish Oil?

Fish oil is obtained from the tissues of oily fish. Oily fishes are good sources of omega-3 acids, which are great for the wellness of the brain and heart.

The best sources of fish oil are fatty fishes like sardine, salmon, tuna, Mackerel, Halibut, Anchovies, and Herring. Fish oil can be obtained from oysters, caviar (or roe), cod liver, and krill.

What Are The Main Components Of Fish Oil?

“The main active compounds in fish oil are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which support heart health, brain function, and help control levels of inflammation” says Dr. Shernell Surratt-Gary, D.O.

Eicosapentaenoic Acid (EPA)

This acid is known for its anti-inflammatory qualities. Eicosapentaenoic Acid (EPA) helps enhance blood flow, reduce triglycerides, and combat the possibility of heart disease.

Docosahexaenoic Acid (DHA)

The docosahexaenoic Acid is the main structure in the heart, brain, and retina. The DHA helps your cognitive function, reduces oxidative stress, and supports your heart.

Eileen Wang, MD, says;

The key thing that fish oil, specifically the EPA in fish oil, does for the body is keep it from producing triglycerides. Triglycerides are heavily correlated with cardiovascular issues, so lowering levels is key.

Interestingly, the human body cannot produce these fatty acids. Therefore, it depends on meals and supplements to obtain them.

How Is Fish Oil Different From Other Fats?

Trans fat and unsaturated fat can increase cholesterol levels, leading to heart disease. This case is not so with omega-3 acid. Here are other ways omega3 fatty acid differs from other fats

• Saturated fats in full-fat dairy, red meat, and butter can raise your 'bad' cholesterol, increasing your chances of heart disease.
• Trans fat: This kind of fat can be found in fried and processed foods. Trans fat harms the body and contributes to plaque that blocks the arteries.
• Monounsaturated and polyunsaturated fats: This fat is present in seeds, nuts, and vegetable oil. Unlike previous fats mentioned, Monounsaturated and polyunsaturated fats are healthy and help to stabilize your body's cholesterol levels.
• Omega3 fatty acid present in fish oil: Omega-3 fatty acids are outstanding because they protect the heart. This fatty acid improves the flexibility of the artery and reduces triglycerides and inflammation. However, how the Omega-3 fatty acid directly impacts LDL and HDL is still debated.

Read More: Fish Oil VS Omega 3

How Does Fish Oil Affect Cholesterol Levels (Clinical Evidence)

Fish oil is well known for reducing triglycerides and inflammation, contributing to heart health.

A 2023 preprint on medRxiv explored how fish oil affects cholesterol levels. Using data from the UK Biobank, which includes 441,985 participants, it found that fish oil supplementation reduced genetic risk for high total cholesterol, LDL-C (bad cholesterol), and triglycerides. It also boosted the genetic potential for higher HDL-C (good cholesterol).^[2]

A randomized controlled trial published in Diabetologia found that fish oil significantly reduced plasma triglyceride levels but did not affect LDL or HDL cholesterol levels. Fish oil increased omega-3 fatty acids (20:5 and 22:6) in lipoproteins. The study involved non-insulin-dependent diabetic patients.^[3]

Another study, published in the Journal of Lipid Research, tested the effects of 4 g/day of fish oil on 20 hypertensive patients.^[4] Key results include:

• Fish oil reduced triglycerides by 24% and increased LDL cholesterol by 6%.
• LDL particles became larger, which may be beneficial.
• Fish oil also made LDL more prone to oxidation, which could be harmful for heart health.

This study shows that fish oil can improve cholesterol levels, but it also raises concerns about increased LDL oxidation.

Bottom line: Fish oil supplementation can be a helpful addition to your heart health routine, especially if you have elevated triglycerides. However, its benefits for overall cholesterol management aren't as clear-cut. The effect varies depending on individual health conditions.

Other Strategies For Lowering Cholesterol Level

Many people widely recommend you take Fish oil to reduce your cholesterol level. However, there are other effective strategies to accomplish this goal. These strategies can help you achieve a healthy heart and overall body wellness. To effectively protect your heart, try changes such as:

• Eating well-balanced diets:

A well-balanced meal is essential for heart and body health. Eating more fiber-rich foods, such as beans, oats, fruits, and lentils, equips your body to combat diseases.

Instead of saturated fats, you can choose unsaturated fats from avocados, olive oil, and nuts.

You can also reduce your intake of sugary or processed foods. These foods contain trans fat and carbs, which increase your cholesterol levels.

Consuming plant-based foods like whole grains, fruits, legumes, and vegetables is a great option.

• Regularly engaging in physical exercise helps increase HDL cholesterol and decrease the body's LDL cholesterol.
• Medications like satins are highly effective for reducing cholesterol LDL levels. Satins increase the liver's function to extract LDL from the blood and slow down the rate at which the liver produces cholesterol.
• Healthy habits like avoiding smoking, limiting alcohol consumption, and monitoring your weight can impact your cholesterol levels.

Other Benefits of Taking Fish Oil

Fish oil has many benefits for the human body. Let's explore some of these benefits below.

Health Benefits of Fish Oil

Fish oil improves brain and mental functioning

Omega 3 fatty acids help your mental cognitive function, enabling you to execute daily activities. Studies show that this fatty acid can improve your focus, memory, and overall brain performance^[5]. This is not all— early studies show that Fish oil can help decrease the symptoms of depression and anxiety by aiding neurotransmitter function^[6].

Fish oil safeguards your eyesight

Studies show that Omega3 can protect your vision by helping your body combat age-related macular degeneration (AMD)^[7]. This fish oil can also keep your eyes moisturized and reduce irritation.

Fish oil enables you to combat joint pains and inflammation

The inflammation property in fish oil makes it a perfect option for combatting swelling, stiffness, and pain in the joint.^[8]

Omega3 fatty acid improves your skin

Fish oil improves the appearance of skin by controlling acne and redness through anti-inflammation. This oil can also keep skin hydrated, improving its overall appearance.^[9]

Fatty oil is beneficial for pregnancy and child development

Fatty oils are known for their benefits for pregnant women and their unborn children. The Docosahexaenoic Acid (DHA) in fish oil helps the baby's eyes and brain develop properly.^[10]

Learn more about fish oil benefits in this video by Toni Abelseth, a psychiatric mental health nurse practitioner.

Fish Oil & Omega 3 Dosage

The Office of Dietary Supplements (ODS) recommends 1–2 servings of seafood per week for heart health. For those with heart disease, 1 gram of EPA + DHA daily is suggested, preferably from fish, or under healthcare guidance. The FDA advises a maximum of 5 grams per day of EPA and DHA from supplements.^[11]

To learn more about fish oil dosage, check out the article - “How Much Fish Oil Should You Take?”

Risks Associated with Fish Oil

An article published in Regulatory Toxicology and Pharmacology stated that fish oil may contain harmful contaminants, such as dioxins and PCBs. Despite the risks, the study concludes that consuming fish, particularly those high in omega-3 fatty acids (such as sardines, mackerel, and salmon), can offer significant health benefits. ^[12]

Few downsides include:

Fish oil can cause digestive problems

Many people who take fish oil, especially in large quantities, complain of its negative reaction. Fish oil can cause abdomen upsets, diarrhoea, nausea, or indigestion. If you are starting to take fish oil, it is advisable to take it in small doses alongside food. This way, the discomfort is reduced.

Fish oil causes bad breath.

Let's be frank—the smell of fish oil is not exactly the world's most sweet scenting supplement. After consuming fish oil, it is common to experience bad breath, burps, or a fishy aftertaste.

It is important, however, that you choose good quality fish oil to reduce these problems. Some stores attach a 'fishy burp-free' to their fish oil capsules or pills to reduce this fishy smell. You may choose to try bulb-free fish oil pills for cholesterol.

“Though generally safe, high doses of fish oils may increase your risk of bleeding, especially when combined with blood-thinning medications,” adds Dr. Shernell Gary.

Meet the Experts

• Dr. Shernell Surratt-Gary, D.O., Clinical Advisor at Aura Wellness in the United States
• Eileen Wang, MD, MSCP for Modern Menopause in the Greater Toronto Area, Canada