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Omega 3 supplements and cholesterol

Dougie22

Well-Known Member
Messages
319
Location
Scotland
Type of diabetes
Type 2
Treatment type
Other
I have been trying to understand how my diet and exercise regime, which is generally if slowly reducing weight, blood pressure and, crucially IMHO, HbA1c is having a negative effect on my total cholesterol level. It seems to be counteer intuitive as losing weight and eating healthily should, in theory, also reduce cholesterol at least a little, not increase it.

I was reading the Sign 116 (Scottish health service recommendations to doctors) for another reason and came across this little gem:

"In patients with type 2 diabetes, a systematic review of short term supplementation with omega-3 polyunsaturated fatty acid (PUFA) showed a reduction in triglycerides (TG) but a rise in low
density lipoprotein (LDL) cholesterol."

Now, this struck a chord with me because, on the recommendation of the dietician, I have been taking daily 1000mg Omega 3 capsules for six months or so.

When I read the full article though, it suggests that total cholesterol readings won't be increased (this is what happened in my case) so the whole thing may be a red herring.

The full study can be found at:
http://summaries.cochrane.org/CD003...fatty-acids-pufa-for-type-2-diabetes-mellitus

The extract reads in part:

Main results:
Twenty three randomised controlled trials (1075 participants) were included with a mean treatment duration of 8.9 weeks. The mean dose of omega-3 PUFA used in the trials was 3.5 g/d. No trials with vascular events or mortality endpoints were identified. Among those taking omega-3 PUFA triglyceride levels were significantly lowered by 0.45 mmol/L (95% confidence interval (CI) -0.58 to -0.32, P < 0.00001) and VLDL cholesterol lowered by -0.07 mmol/L (95% CI -0.13 to 0.00, P = 0.04). LDL cholesterol levels were raised by 0.11 mmol/L (95% CI 0.00 to 0.22, P = 0.05). No significant change in or total or HDL cholesterol, HbA1c, fasting glucose, fasting insulin or body weight was observed. The increase in VLDL remained significant only in trials of longer duration and in hypertriglyceridemic patients. The elevation in LDL cholesterol was non-significant in subgroup analyses. No adverse effects of the intervention were reported.

Authors' conclusions:
Omega-3 PUFA supplementation in type 2 diabetes lowers triglycerides and VLDL cholesterol, but may raise LDL cholesterol (although results were non-significant in subgroups) and has no statistically significant effect on glycemic control or fasting insulin. Trials with vascular events or mortality defined endpoints are needed.

This record should be cited as:
Hartweg J, Perera R, Montori VM, Dinneen SF, Neil AHAWN, Farmer AJ. Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD003205. DOI: 10.1002/14651858.CD003205.pub2

Anyone out there have any insights on this matter?
 
Amazingly, I just discovered that I had quoted the same info on a forum response on 2nd June, when I was just starting this journey. I'd forgotten it completely!

At that point, I said I'd try it and see if it brought the readings down.

Well it clearly has not, but I'll continue to my next set of tests in December unless further information turns up.

Must remeber to ask about it at DESMOND course on Wednesday.
 
Just to add to my confusion on this topic, a different NHS dietician at my DESMOND course told me that they don't generally recommend Omega 3 supplements (although they do value an Omega 3 contribution from eating oily fish).
 
Do you think, with all their years of tax-payer subsidised university education, any of them actually learn to think for themselves, and not just read from the (rarely updated) instruction manual.

Surely there must be some good NSH dieticians somewhere?
 
The more I see of the medical profession, the motre worried I become that everyone, doctors, nurses, dieticians, etc seems to be bound to comply exactly with the NICE/SIGN guidelines and that thinking for themselves has been abolished.

This is a pretty dangerous situation if you think about it. What happens if the guidelines are wrong or at least not correct for every patient.

When I went to see the senior partner in my practice, I asked him what his opinion on a particular subject was. His reply was that he had to tell me what the guidelines said. In his case, and his case only in that particular practice, there was a least a degree of sarcasm in his reply. The younger doctors appear to be totally brainwashed.
 
Luckily my cholesterol isn't a problem at 4.1 but I was chatting to a pharmacist recently about cod liver oil for my arthritis and he told me that omega 3 is good for lowering cholesterol, he also told me that you will not see any benefits from oil supplement for around 2 years after starting them.
Possibly something to bear in mind.

He is a very knowledgeable guy who has never put me wrong in the past so I am inclined to believe him
 
Dougie,

I've been taking CLO for 20 years and all my lipids are all within range so it hasn't raised my LDL levels. I honestly believe fish oils have many health benefits one of which is protecting the heart. I started taking it after being told I would get arthritis in my foot by the time I was 30 after a serious break, 20 years later still no arthritis there although it may have not occurred even if I didn't take CLO........who knows! :?

Nigel
 
A bit more reading has led me to a couple of people saying that sometimes your cholesterol goes up a bit temporarily as you lose weight so I think I retain an open mind on the Omega 3 supllement.

Will see what happens at next test.
 
Well after all that reading and considering, I've decided to keep taking the supplement until my next full set of bloods at least.

It doesn't look like I'm going to have lost much weight this time :( so if the theory of cholesterol jumping a little when you lose some weight is correct, it should be better this time. Confused? you bet.

Interestingly, there is very little published or internet info available on the variability of cholesterol testing. While it is easy to find out about snap-shot, fasting and HbA1c BG tests, it's very difficult to find out about cholesterol tests.

- Do your readings go up or down in hours, days, weeks or months?
- If not in hours, then why a fasting test?
- If you tested every day for a week, would your readings be the same?
- How variable are they with diet and what part of the diet (not as simple as NHS make out by a long way)

Even reading Kendrick's book doesn't answer this type of stuff yet the doctors are quite happy to prescribe drugs for many years based on the results.

Mmmmmmmmm
 
I would imagine lipid levels do fluctuate from week to week, I know my gp practise advise patients not to alter their eating habits before the fasting test as this would give a false reading and not true to their normal dietary intake.

Diet I believe does play a important part and this is why it is discussed in great detail on coronary wards.

Nigel
 
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