Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals

Atherosclerosis. 2009 Jun;204(2):476-82. doi: 10.1016/j.atherosclerosis.2008.09.020. Epub 2008 Sep 27.


Background: Risk factors of cardiovascular disease such as lipid aberrations, hypertension, abdominal adiposity and elevations in systemic inflammation, are prominent aetiologies in hyperlipidemia. Supplementation with n-3 PUFA is associated with a reduction in cardiovascular events through its hypotriglyceridemic, anti-aggregatory and anti-inflammatory properties. Plant sterols have potent hypocholesterolemic properties, although their effect on the inflammatory cascade is uncertain. This study investigated the effect of combined supplementation with n-3 PUFA and plant sterols on cardiovascular risk factors, blood pressure, body composition, markers of systemic inflammation and overall risk, in hyperlipidemic individuals.

Methods: The study was a 3-week randomised, double-blind, placebo-controlled, 2 x 2 factorial design, in four parallel groups. Sixty hyperlipidemic participants were randomised to receive either sunola oil or 1.4 g/d n-3 PUFA capsules with or without 2g plant sterols per day.

Results: The combination of n-3 PUFA and plant sterols reduced several inflammatory markers. High sensitivity C-reactive protein (hs-CRP) was reduced by 39% (P=0.009), tumor necrosis factor-alpha (TNF-alpha) by 10% (P=0.02), interleukin-6 (IL-6) by 10.7% (P=0.009), leukotriene B(4) (LTB(4)) by 29.5% (P=0.01) and adiponectin was increased by 29.5% (P=0.05). Overall cardiovascular risk was reduced by 22.6% (P=0.006) in the combination group.

Conclusion: We have demonstrated, for the first time that dietary intervention with n-3 PUFA and plant sterols reduces systemic inflammation in hyperlipidemic individuals. Furthermore, our results suggest that reducing inflammation provides a potential mechanism by which the combination of n-3 PUFA and plant sterols are cardioprotective.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / blood
  • Anti-Inflammatory Agents / therapeutic use*
  • Blood Pressure
  • Body Composition
  • Capsules
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Dietary Supplements*
  • Double-Blind Method
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / blood
  • Fatty Acids, Omega-3 / therapeutic use*
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications
  • Hyperlipidemias / diet therapy*
  • Hyperlipidemias / physiopathology
  • Hypolipidemic Agents / administration & dosage
  • Hypolipidemic Agents / blood
  • Hypolipidemic Agents / therapeutic use*
  • Inflammation Mediators / blood
  • Lipids / blood
  • Male
  • Middle Aged
  • Phytosterols / administration & dosage
  • Phytosterols / blood
  • Phytosterols / therapeutic use*
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Capsules
  • Fatty Acids, Omega-3
  • Hypolipidemic Agents
  • Inflammation Mediators
  • Lipids
  • Phytosterols