A new study from Korea suggests that combining high dose omega 3 fats – 4g/day providing 1.86 grams of eicosapentaenoic acid (EPA) and 1.4 grams of docosahexaenoic acid (DHA) – may be more effective in managing patients with mixed dyslipidemia than using an anti-cholesterol (statin) drug alone. Mixed dyslipidemia is defined as elevated blood levels of total cholesterol and triglycerides.

After a run-in period of 6 weeks on a standardized diet, 62 patients were randomized to receive either simvastin alone, or simvastin plus omega 3 fats. Fifty subjects completed the 6-week prospective, randomized, open-label study, with 7 drop outs in the combination therapy group and 5 in the simvastatin-only group.  In the omega-3 plus statin group there was an average decreases in triglyceride levels of 41.0 percent, compared to 13.9 percent in the statin only group. Additionally, there were significant reductions in LDL cholesterol levels in both groups, while HDL levels (“good” cholesterol) were not affected by either intervention.

While those results might look good on the surface, they may not tell the whole story.  The purpose of conducting clinical trials like this one is to inform clinical decision making and correctly identify therapies that are beneficial, non beneficial, or harmful. Optimal therapy would be the treatment or combination of treatments that gave the best results with fewest side effects that was also cost effective.

What we do not know from this study is what would have been the outcome if high dose omega-3 fats had been tested alone. A more scientifically rigorous study would have included a third intervention group: High dose omega-3 fats alone. As it stands, we do not know if the dose of omega-3 fats used in this study – about three times the standard dose commonly recommended for prophylactic use – would have outperformed the statins alone, and be as good, or even better than the combination treatment.

So, without testing each of the components used in this trial separately we cannot conclude that statins combined with fish oil is the optimal treatment for dyslipidemias.

Reference: Kim SH, et al. Prospective randomized comparison between omega-3 fatty acid supplements plus simvastatin versus simvastatin alone in Korean patients with mixed dyslipidemia: lipoprotein profiles and heart rate variability. Eur J Clin Nutr. 2011;65(1):110-6.