Fish Oil Supplements Improve Lipid Risk Factors in Obese Children

Fish oil supplementation can improve the lipid profile in overweight children and teenagers at high risk for heart disease.

"There were dramatic changes in the lipid profile of high-risk children who took fish oil supplements in addition to diet and exercise," said Gary A. Mayman, MD, a pediatric cardiologist at the University of Nevada School of Medicine and codirector of Children’s Heart Center in Las Vegas. "Children who were overweight and had a high triglyceride/high-density lipoprotein (HDL) ratio significantly responded."

The researchers studied 49 overweight children, all with a body mass index higher than the 95th percentile, during a 12-week period. The children, aged 10 to 18 years, were randomized to a control group (n = 19) or to active treatment (n = 30) and matched by sex and age.

All children received a low-glycemic load diet rich in fruit, vegetables, and protein, as well as a supervised exercise program during a three-month period. In addition, the treatment group was given 3 g of a daily fish oil supplement (OmegaRx). Fasting blood samples were drawn at the first visit and at week 12.

At baseline, lipid profiles in both groups were similar. After 12 weeks, the researchers found that triglyceride levels in the control group did not significantly differ from baseline. In contrast, triglyceride levels in children treated with fish oil significantly decreased. However, differences in other lipid measures were not statistically significant.

When researchers looked specifically at 25 children with a triglyceride/HDL ratio >/= 3, there was a significant decrease in triglyceride levels, HDL cholesterol levels, total cholesterol/HDL ratios, cholesterol/LDL ratio, and cholesterol/triglyceride ratios. Of these patients, 13 with a triglyceride/HDL ratio >/= 3 were in the fish oil supplement group.

In addition, triglyceride levels in the treatment group decreased from 212 to 144 mg/dL (P < .01) and HDL cholesterol levels increased from 37 to 41 mg/dL in treated patients (P = .02). There were no significant changes in the control group.

Both total cholesterol/HDL and total cholesterol/LDL ratios significantly decreased from baseline to follow-up in the treatment group (from 5.1 to 4.5, respectively [P = .01]; and 1.8 to 1.6, respectively [P = .04]). In addition, total cholesterol/triglyceride ratios increased from 0.9 to 1.3 (P < .01). None of the control subjects had significant changes in these lipid profiles.

The change in the ratio of triglyceride/HDL cholesterol suggests an increase in size of the particles, lowering the risk of heart disease, Dr. Mayman said. "While the LDL levels didn’t drop, there are indications the size distribution has changed to larger particles that are less atherogenic.

"This is an effort to change the lipid profiles in children who are at risk of heart disease in later life," he added.

If there had been a larger number of subjects in the overall trial, Dr. Mayman said that, he believes there would have been larger changes in the lipid profiles of all overweight children treated in the study.

"This is a very interesting study," said. "It is important in that it records the risks of obesity in young people who have increasing lower levels of good cholesterol and elevated triglycerides."

Nieca Goldberg, MD, AHA spokesperson and chief of Women’s Cardiac Care Unit at Lennox Hill Hospital in New York City stated that, the study is too small to recommend that overweight children take fish oil supplementation. "It was a well designed trial, but there were only 49 children studied," she said. "Larger studies are needed."

AHA 2005 Scientific Sessions: Poster B94, Abstract 210. Presented Nov. 13, 2005.

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