Release of hepatic TG might take more than 6 weeks to establish itself and could explain the observed increase in serum TG levels after 12 weeks of supplementation. This potential beneficial
effect of krill oil on the liver in addition to a high variation in TG Avasimibe clinical trial measurements could have caused the loss of significance in serum TG reduction at 12 weeks in particular in the 4 g krill oil group. The reliability of plasma cholesterol measurements is much lower than for TG measurements [24]. It was therefore possible to compare individual treatment groups for changes in cholesterollevels at weeks 6 and 12. In our study, no significant effects of krill oil treatment on serum HDL-C and LDL-C concentration could be observed at any time point. The EPA to DHA ratio of 2:1 in krill oil might help to prevent an increase in LDL-C that has been observed with fish oil intake or the intake of n-3 LCPUFA preparations containing predominantly DHA [32] and [33]. Another suggested Doxorubicin cost risk factor for CVD is the omega-3 index that gives the percentage of EPA and DHA in total fatty acids in red blood cells [34]. Red blood cell omega-3 fatty acids are highly correlated with their corresponding atrial fatty acids [35]. In this study, the omega-3 index was significantly increased at both time-points with all krill oil doses given and confirmed regular study product intake. Furthermore, approximately
2/3 of the omega-3 index increase during the study period was already seen after the first 6 weeks. Noteworthy, the omega-3 index went from 3.7 to 6.3% at 4 g daily krill oil intake. Similar changes were associated with decreased risk for sudden cardiac death in
a prospective cohort study by about 80% [36] and by a 90% reduction for risk of primary cardiac arrest in a case–control study [37]. In conclusion, the hypothesis could be confirmed and the combination of n-3 PUFA and PLs in krill oil has shown to be a safe and promising intervention with regards to reducing fasting serum TG levels and increasing omega-3 index, while not increasing LDL-C or total cholesterol. Krill oil in combination with lifestyle changes that include old diet and exercise may therefore significantly reduce one’s risk for CVD morbidity and mortality. However, due to the individual fluctuations of TG concentrations measured, a potential biasing effect of TG release from presumably fatty liver with time or other reasons, a new study with more individual measurements per treatment group and preferentially over a longer study period would help to clarify the shortcomings of this study. The following are the supplementary data related to this article. Supplementary Fig. 1. Figure options Download full-size image Download high-quality image (140 K) Download as PowerPoint slide We are very grateful for comments on the protocol from Intertek Cantox (Canada) and on the manuscript from the Aker BioMarine science board members. Thanks to Laura Stibich for editing the final manuscript.