A new study has shed additional light on the still somewhat murky method by which omega-3s and niacin interact with cholesterol to improve heart health.

The new research was published in the journal PLOS ONE and was the work of a team that included noted omega-3s researcher William S. Harris.

The subjects for the research were men and women diagnosed with metabolic syndrome. The Mayo Clinic defines this as “a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.”

Mechanisms of action murky for both niacin and omega-3s

Extended-release niacin (ERN) has been recommended by health authorities such as the Cleveland Clinic for its heart health benefits when used alone. The clinic also says it may be used with “other medications to decrease bad cholesterol and fats (such as LDL, triglycerides) and increase good cholesterol (HDL) in your blood.”

It has long been known that omega-3s have heart health benefits. This has been proven through various studies, including large-scale longitudinal research and multi-center drug trials. The mechanism of action for this benefit has not been fully described, however.

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The subjects for the study averaged about 50 years of age, but with a wide range as young as about 37 and as old as the early 60s. The total number of subjects was 56, divided into four groups of 13 to 15 members. One group received a dual placebo, while another group received both ERN and prescription omega-3s (P-OM3). The third and fourth groups received either niacin or omega-3s. Roughly a quarter of the subjects were taking statins and/or blood pressure medications.

For the text materials, the researchers used a dose of 2 grams a day of an ERN supplied by Abbott Labs branded as Niaspan. The omega-3 product was the Lovaza pharmaceutical manufactured by GlaxoSmithKline, which was given to the subjects at a 4 grams-a-day dose.

The study's purpose was to examine how ERN and P-OM3 affected reverse cholesterol transport.

Cholesterol has many positive functions in the body and only becomes a problem when there is too much of the wrong sort accumulating in the wrong areas in the body.  In reverse cholesterol transport, excess cholesterol is transported to the liver for excretion. High-density lipoprotein (HDL, or the ‘good’ cholesterol) is part of this process.

A biochemical pathway known as HDL-apolipoprotein A-I exchange (HAE) is a functional property of HDL associated with its ability to mediate reverse cholesterol transport. The researchers were looking for specific changes in this pathway as the chief endpoint of the study.

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The treatment ran for 16 weeks, and the researchers said the subjects were more than 80% compliant, based on pill count. Blood was drawn before and after the treatment phase.

The results revealed the omega-3s group showed the biggest change over baseline in the HAE measure. The change was pegged at a statistically significant 28% improvement. ERN also showed a positive change, though to a lesser extent, whereas the combination did show a statistically significant difference.

Author: Study goes beyond mere cholesterol levels

The preventative end of heart health is largely focused on lowering overall cholesterol levels and changing the ratio between HDL and LDL (low-density lipoprotein, or ‘bad’ cholesterol).

Harris, when contacted by Natural Products Insider to provide additional context, said a significant aspect of this new study is that it delves deeper than just evaluating overall cholesterol status, which is something of a blunt instrument.

“I would say that the novel finding in the study is that omega-3 fatty acids can improve the function of HDL particles, without necessarily changing their blood levels,” he said. “That’s an important step forward toward understanding some of the mechanisms by which omega-3 fatty acids protect against heart disease.”

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