Cholesterol, High Cholesterol

A 3.5-year study including 11,324 myocardial infarction (MI) survivors with an MI occurring within 3 months) showed that fish oil supplementation at a dose of 1 gram daily, but not vitamin E at a dose of 300 mg daily, significantly reduced the total rate of all-cause mortality, nonfatal MI, and nonfatal stroke (80).

Omega-3 fish oil adverse reactions and interactions:

• A total of 10 studies were reviewed by Villani AM et al to determine potential serious adverse effects of fish oil at a dose of under 1.86 grams per day (98). It was found that there were no serious adverse effects reported in 994 adults over 59 years of age and other non-serious adverse effects were not significantly different from placebo (81).
• Fish oil has been reported to affect platelet aggregation, reduce vitamin K dependent factors which may be associated with an increased anticoagulation (reduce blood clotting) effect. Consumption should be avoided when taking anticoagulants like aspirin, warfarin, or ticlopidine because of the potential increased risk of bleeding (82).
• A case of a 67-year old woman taking warfarin (1.5 mg/day), an increase in her fish oil intake from 1 g/day to 2 g/day was associated with an increase in time for blood to clot as measured by the international normalized ratio (INR) which went from 2.8 to 4.3 within 1month, and decreased to 1.6 after the fish oil dose was reduced (83).
• An intake of 6 grams per day of docosahexaenoic acid (DHA) found no significant difference found in blood coagulation, platelet function, or thrombotic parameters including prothrombin time, activated partial thromboplastin time, antithrombin-III levels, and platelet aggregation (84).
• Fish oil may contain harmful contaminants such as heavy metals including mercury, dioxins, and polychlorinated biphenyls (PCBs). This risk can be reduced by purchasing fish oil that has undergone a purification process specified on the label (approved by the FDA, EPA, or US Pharmacopeia) (85)

Kiwi fruit, HDL, and triglycerides:

Consuming kiwi fruit, rich in vitamins C and E and polyphenols, may be beneficial in cardiovascular disease. A randomized cross-over study found that eating 2-3 kiwi fruit per day for 28 days significantly reduced platelet activation response to collagen and adenosine diphosphate (ADP) by 18% compared to those not eating the fruit. Compared to placebo, kiwi fruit consumption also lowered blood triglycerides levels by 15%. Reduced platelet aggregation and blood triglyceride levels in subjects have been linked with reduced incidence and severity of cardiovascular disease. (86)