Cholesterol and systemic inflammation changes following dietary supplementation

Introduction: Omega-3 fatty acids [n-3] have been used in previous studies to control cholesterol levels and inflammatory markers with equivocal findings. Methods: This study was conducted using a double-blind, permuted-block-randomized and placebo controlled experimental design. End-Stage-Renal Disease (ESRD) patients (N=33) were followed prospectively for 8-months while supplementing their diet with either six grams of n-3 or corn oil (placebo [n-6]). Results: Cox proportional-hazards regression model revealed no significant differences between the groups concerning age, months on dialysis, diabetes, ethnicity, and tobacco history. ANOVA revealed a significant difference in LDL with higher posttest levels in the n-6 group (p=.007) and a significant difference in LDL particle number (p=.035) with lower particle numbers in the n-3 group. Total cholesterol was significantly different (p=.011) with lower levels in the n-3 group at posttest. A significant difference was reported in C-reactive protein (CRP) levels (p=.028) with lower levels in the control group at posttest. HDL (p=.234), VLDL (p=.671), triglycerides (p=.892), LDL size (p=.286), large LDL (p=.799), Lp(a) (p=.849), and large VLDL (p=.957) were not significantly different. Conclusions: Dietary behavior changes (supplementation) improved the cardiovascular risk profile of patients with elevated lipid levels by decreasing LDL, LDL particle number and total cholesterol. The protective effects that have occurred in this study are primarily due to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in n-3, which has been linked to reduced cardiovascular morbidity and mortality. Yet, inflammation was lowered in the control group suggesting n-6 may help to lower systemic inflammation in a chronic disease population but not n-3.