The Journal of Nutrition Nutrition and Disease Low Doses of Eicosapentaenoic Acid and Docosahexaenoic Acid From Fish Oil Dose- Dependently Decrease Serum Triglyceride Concentrations in the Presence of Plant Sterols in Hypercholesterolemic Men and Women1–3

Plant sterols (PSs) lower LDL-cholesterol (LDL-C) concentrations, whereas the n–3 (v-3) fish fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) lower triglyceride (TG) concentrations. Incorporating both PSs and EPA+DHA fromfish oil (FO) in a single food format was expected to beneficially affect 2 blood lipid risk factors. The aim of this study was to investigate the dose-response relation between low doses (<2 g/d) of EPA+DHA from FO, incorporated in a low-fat PS-enriched spread, and TG concentrations. In addition, effects on LDL-C were investigated. The study was designed as a randomized, double-blind, placebo-controlled parallel study. After a 4-wk run-in period, subjectswere randomly assigned to consumeeither a control (C) spread (noPSs, no FO) or 1 of 4 intervention spreads containing a fixed amount of PSs (2.5 g/d) and varying amounts of FO (0.0, 0.9, 1.3, and 1.8 g/d of EPA+DHA) for 4 wk. Before and after the intervention, fasting blood samples were drawn for measuring serum lipids and EPA andDHA in erythrocytemembranes. In total, 85 hypercholesterolemicmen and 247womenwith amean age of 57.9 y (range: 25–74 y)were included. Eighteen subjects dropped out during the study. At baseline,mean TGand LDL-C concentrationswere 1.09 and 4.00 mmol/L, respectively. After the intervention, a significant dose-response relation for the TG-lowering effect of EPA +DHA [bln(TG) =20.07mmol/L per gram of EPA+DHA; P < 0.01] was found. Comparedwith the C group, TG concentrations were 9.3–16.2 % lower in the different FO groups (P < 0.05 for all groups). LDL-C concentrations were 11.5–14.7 % lower in the different PSgroups than in theCgroup (P<0.01 for all groups). EPA andDHA in erythrocytemembraneswere dose-dependently higher afte