Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals

BackgroundRisk factors of cardiovascular disease such as lipid aberrations, hypertension, abdominal adiposity and elevations in systemic inflammation, are prominent aetiologies in hyperlipidemia. Supplementation with n-3 PUFA is associated with a reduction in cardiovascular events through its hypotriglyceridemic, anti-aggregatory and anti-inflammatory properties. Plant sterols have potent hypocholesterolemic properties, although their effect on the inflammatory cascade is uncertain. This study investigated the effect of combined supplementation with n-3 PUFA and plant sterols on cardiovascular risk factors, blood pressure, body composition, markers of systemic inflammation and overall risk, in hyperlipidemic individuals.MethodsThe study was a 3-week randomised, double-blind, placebo-controlled, 2 × 2 factorial design, in four parallel groups. Sixty hyperlipidemic participants were randomised to recieve either sunola oil or 1.4 g/d n-3 PUFA capsules with or without 2 g plant sterols per day.ResultsThe combination of n-3 PUFA and plant sterols reduced several inflammatory markers. High sensitivity C-reactive protein (hs-CRP) was reduced by 39% (P = 0.009), tumor necrosis factor-α (TNF-α) by 10% (P = 0.02), interleukin-6 (IL-6) by 10.7% (P = 0.009), leukotriene B4 (LTB4) by 29.5% (P = 0.01) and adiponectin was increased by 29.5% (P = 0.05). Overall cardiovascular risk was reduced by 22.6% (P = 0.006) in the combination group.ConclusionWe have demonstrated, for the first time that dietary intervention with n-3 PUFA and plant sterols reduces systemic inflammation in hyperlipidemic individuals. Furthermore, our results suggest that reducing inflammation provides a potential mechanism by which the combination of n-3 PUFA and plant sterols are cardioprotective.