Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis

Int J Cardiol. 2009 Jul 24;136(1):4-16. doi: 10.1016/j.ijcard.2008.03.092. Epub 2008 Sep 6.


Background: Fish oils have been widely reported as a useful supplement to reduce fasting blood triglyceride levels in individuals with hyperlipidemia. We performed an updated meta-analysis to quantitatively evaluate all the randomized trials of fish oils in hyperlipidemic subjects.

Methods: We conducted a systematic literature search using several electronic databases supplemented by manual searches of published reference lists, review articles and conference abstracts. We included all placebo-controlled randomized trials of parallel design that evaluated any of the main blood lipid outcomes: total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol or triglycerides (TG). Data were pooled using DerSimonian-Laird's random effects model.

Results: The final analysis comprised of 47 studies in otherwise untreated subjects showed that taking fish oils (weighted average daily intake of 3.25 g of EPA and/or DHA) produced a clinically significant reduction of TG (-0.34 mmol/L, 95% CI: -0.41 to -0.27), no change in total cholesterol (-0.01 mmol/L, 95% CI: -0.03 to 0.01) and very slight increases in HDL (0.01 mmol/L, 95% CI: 0.00 to 0.02) and LDL cholesterol (0.06 mmol/L, 95% CI: 0.03 to 0.09). The reduction of TG correlated with both EPA+DHA intake and initial TG level.

Conclusion: Fish oil supplementation produces a clinically significant dose-dependent reduction of fasting blood TG but not total, HDL or LDL cholesterol in hyperlipidemic subjects.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Dietary Fats / administration & dosage
  • Dietary Fats / therapeutic use
  • Dietary Supplements
  • Fish Oils / administration & dosage*
  • Humans
  • Hyperlipidemias / blood*
  • Hyperlipidemias / diet therapy*
  • Randomized Controlled Trials as Topic / methods
  • Triglycerides / blood


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Dietary Fats
  • Fish Oils
  • Triglycerides