Association Between Omega‐3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose–Response Meta‐Analysis of Randomized Controlled Trials

BACKGROUND: Previous results provide supportive but not conclusive evidence for the use of omega‐3 fatty acids to reduce blood lipids and prevent events of atherosclerotic cardiovascular disease, but the strength and shape of dose–response relationships remain elusive. METHODS AND RESULTS: This study included 90 randomized controlled trials, reported an overall sample size of 72 598 participants, and examined the association between omega‐3 fatty acid (docosahexaenoic acid, eicosapentaenoic acid, or both) intake and blood lipid changes. Random‐effects 1‐stage cubic spline regression models were used to study the mean dose–response association between daily omega‐3 fatty acid intake and changes in blood lipids. Nonlinear associations were found in general and in most subgroups, depicted as J‐shaped dose–response curves for low‐/high‐density lipoprotein cholesterol. However, we found evidence of an approximately linear dose–response relationship for triglyceride and non‐high‐density lipoprotein cholesterol among the general population and more evidently in populations with hyperlipidemia and overweight/obesity who were given medium to high doses (>2 g/d). CONCLUSIONS: This dose–response meta‐analysis demonstrates that combined intake of omega‐3 fatty acids near linearly lowers triglyceride and non‐high‐density lipoprotein cholesterol. Triglyceride‐lowering effects might provide supportive evidence for omega‐3 fatty acid intake to prevent cardiovascular events.