Using High-Dose Omega-3 Fatty Acid Supplements to Lower Triglyceride Levels in 10- to 19-Year-Olds

Randomized placebo-controlled trial in adolescents 10 to 19 years old with moderate to severe hypertriglyceridemia, recruited from pediatric clinics in Boston, United States. The active omega-3 arm included 12 participants, who were predominantly overweight or obese.

Participants in the active arm took four 1-g Lovaza capsules daily by mouth for 6 months, for a total dose of about 4 g/day of omega-3 fatty acids. Each 1-g capsule contained 840 mg omega-3 fatty acids, including 465 mg EPA and 375 mg DHA; the comparator was placebo.

High-dose omega-3 fatty acid supplementation was well tolerated but did not reduce triglycerides significantly more than placebo. In the omega-3 arm, triglycerides fell from 226 ± 24 mg/dL at baseline to 171 ± 18 mg/dL at 3 months and 165 ± 18 mg/dL at 6 months; within-arm changes were -54 ± 27 (P = .02) and -61 ± 31 (P = .03), but between-group differences were not significant (P = .52 and P = .43). LDL increased by 14 ± 6 mg/dL at 3 months (P = .02), while other vascular and anthropometric outcomes were mixed and generally not superior to placebo. The authors concluded that triglyceride lowering did not differ significantly from placebo in this small trial.

The trial was small and short, limiting power to detect differences versus placebo and to assess longer-term safety or efficacy. All participants also received dietary counseling, which may have influenced lipid changes, and several secondary outcomes were mixed or not significantly different from placebo. Generalizability is limited to overweight or obese adolescents with hypertriglyceridemia.