Abstract

Because of the inverse relation between dietary fish consumption and coronary heart disease and because of the importance of serum homocysteine as an independent risk factor for atherosclerosis, the effect of fish oil on serum homocysteine was studied in hyperlipemic men. Fifteen men with either type IIa or IIb lipoproteinemia or hypertriglyceridemia were maintained on a controlled, balanced diet and given either fish oil or olive oil supplements, 12 g/d for 3 weeks, followed by a cross-over period of 3 weeks during which the olive oil or fish oil supplements were given in reverse order. Serum homocysteine was determined by liquid chromatography of acid hydrolyzates of whole serum. Fish oil was found to diminish serum homocysteine levels in 14 of 17 subjects (P < 0.01). Serum homocysteine was 48% +/- 33% less than control values in seven of nine patients and 36% +/- 22% less than values in seven of eight subjects who had first received olive oil. There was no effect of olive oil supplements on serum homocysteine, compared with control values, but olive oil produced an increase in serum homocysteine in those who had first received fish oil. Serum triglycerides and very low-density lipoprotein were decreased by fish oil in patients who were first given olive oil, in agreement with previous studies. There was no effect of either fish oil or olive oil on total cholesterol, apolipoprotein B, low-density lipoprotein, or high-density lipoprotein. The protection against coronary heart disease afforded by a diet rich in fish may be attributed to the lowering of serum homocysteine levels by the n-3 polyunsaturated fatty acids of fish oils.

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