Medication or supplement?

Researchers invited 73 adults with triglyceride levels between 200 and 500 mg per deciliter (dl) into a study on the effects of medication and omega-3 dietary fat supplements on high triglycerides. (A diagnosis of high triglycerides is defined as blood levels greater than 150 to 200 mg per dl.)

Participants were 30 to 70 years old, had normal cholesterol levels, and had never been treated for high triglycerides. They did not have serious conditions including diabetes, chronic inflammation, heart failure, unstable coronary artery disease, heart attack, stroke, or moderate to severe high blood pressure.

Study participants were randomly selected to take one of the following, twice daily, for 12 weeks:

• 200 mg of bezafibrate, a triglyceride-lowering medication
• 1,000 mg (1 gram) of omega-3 fats
• A placebo (no active ingredients) pill

Researchers collected blood samples to test for blood levels of glucose (before and after eating), triglycerides, and cholesterol. They also tested for three blood markers (fibrinogen, factor VII and PAI-1) that play a role in blood clotting and are associated with risk of accelerated progression of heart disease and its complications.

After 4 and 12 weeks of treatment, the researchers noted:

• Both bezafibrate and omega-3 fat supplements significantly reduced blood levels of triglycerides, fibrinogen, factor VII, and PAI-1 activity.
• Only bezafibrate significantly improved blood levels of cholesterol and glucose.

Putting results into context

Both omega-3 fat supplements and the medication bezafibrate effectively reduced triglyceride levels, but only bezafibrate decreased cholesterol and blood sugar levels. This confirms previous research on triglycerides and points to considerations you should make when deciding how best to manage your triglyceride levels.

Study participants had isolated high triglycerides. They did not have high cholesterol, high blood sugar, or high levels of other heart disease risk factors. This means:

• If you only have high triglycerides, an omega-3 supplement may be a good option.
• If you have other cardiovascular risk factors, such as high cholesterol, you may need medication and lifestyle changes including improved diet and regular exercise.

If your triglycerides are mildly elevated, you may not need a supplement or medication. Other ways to lower triglycerides include:

• Cutting back on concentrated sources of simple carbohydrates in your diet (nix regular soda, cookies, cakes, pastries, baked goods, fruit punch and juice, and all types of candy)
• Eliminating or cutting back on alcohol, because alcohol raises triglyceride levels
• Exercising regularly, which helps the body use extra triglycerides for energy
• Sticking to whole grains that do not contain sugar or corn syrup in the ingredient list when you eat bread, rice, or cereal
• Maintaining a healthy body weight

(Pharmacol Rep 2011;63:763–71)