The Omega-3 Index, a biomarker developed by Drs. Bill Harris and Clemens von Schacky, measures the amount of EPA + DHA as a percentage of total fatty acids in red blood cell membranes.[1] The Omega-3 Index has been proposed as a measurable biomarker of sudden cardiac death risk.[1] and may provide a means of standardizing methodologies that produce equivalent measures in clinical trials, allowing researchers to interpret clinical trial outcomes more accurately.[2]

Since its inception in 2004, the Omega-3 Index has been assessed in numerous populations and correlates closely with health. Some of the most compelling findings include:

  • A higher Omega-3 Index was associated with a 35 percent reduced risk of dying from all causes of premature death.[3]
  • Increases in Omega-3 Index scores correlated with improved microstructural integrity of both white and gray matter in multiple areas of the brain and enhanced executive function.
  • Lower Omega-3 Index scores correlated with higher red blood cell distribution width, an indicator of nutrient deficiency or disease.[4]
  • The Omega-3 Index is a powerful predictor of heart disease, similar to other well-known risk factors.[1]
  • COVID-19 patients with higher Omega-3 Index scores (5.7 percent or higher) were 75 percent less likely to die from the disease than those with the lowest scores.[5]

Measuring omega-3 concentrations in red blood cells provides reliable assessments of long-term intake, is more accurate than measuring omega-3 concentrations in plasma or serum (which fluctuate daily), and is highly reflective of fatty acid composition in most tissues, except the brain.[6] [7] [8] [9] Determination of an Omega-3 Index relies on the use of specific, standardized laboratory procedures that provide consistent, valid results.[10]

Most people living in the United States and other western countries have an Omega-3 Index of approximately 4 percent. Robust evidence suggests, however, that an Omega-3 Index of 8 to 11 percent provides the greatest health benefits.[1] To raise an individual's Omega-3 Index from 4 percent to the recommended range of 8 percent or greater, intake should be between 1,750 and 2,500 milligrams (1.75 and 2.5 grams) per day._[11]

It is noteworthy that gender and age influence Omega-3 Index scores in humans. A meta-analysis of 51 studies found lower levels of arachidonic acid (an omega-6 fatty acid) and DHA as a percentage of plasma lipid in men compared to women,[12] suggesting that gender-specific differences occur in long-chain fatty acid metabolism, possibly modulated by sex hormones. Similarly, young women tend to have higher DHA and lower EPA levels than older women, suggesting that younger women have an enhanced ability to convert EPA to DHA, likely due to DHA's important role in reproduction and development.[13] Furthermore, fatty acid levels tend to shift with age such that the Omega-3 Index is higher and linoleic acid levels are lower in older age.[13] [14]

  1. ^ a b c d Harris, William S; Von Schacky, Clemens (2004). The Omega-3 Index: A New Risk Factor For Death From Coronary Heart Disease? Preventive Medicine 39, 1.
  2. ^ Von Schacky, Clemens (2020). Omega-3 Index In 2018/19 Proceedings Of The Nutrition Society 79, 4.
  3. ^ Harris, William S.; Tintle, Nathan L.; Etherton, Mark R.; Vasan, Ramachandran S. (2018). Erythrocyte Long-Chain Omega-3 Fatty Acid Levels Are Inversely Associated With Mortality And With Incident Cardiovascular Disease: The Framingham Heart Study Journal Of Clinical Lipidology 12, 3.
  4. ^ McBurney, Michael I.; Tintle, Nathan L.; Harris, William S. (2022). Omega-3 Index Is Directly Associated With A Healthy Red Blood Cell Distribution Width Prostaglandins, Leukotrienes And Essential Fatty Acids (PLEFA) 176, .
  5. ^ Asher, Arash; Tintle, Nathan L.; Myers, Michael; Lockshon, Laura; Bacareza, Heribert; Harris, William S. (2021). Blood Omega-3 Fatty Acids And Death From COVID-19: A Pilot Study Prostaglandins, Leukotrienes And Essential Fatty Acids (PLEFA) 166, .
  6. ^ Harris, William S.; Varvel, Stephen A.; Pottala, James V.; Warnick, G. Russell; McConnell, Joseph P. (2013). Comparative Effects Of An Acute Dose Of Fish Oil On Omega-3 Fatty Acid Levels In Red Blood Cells Versus Plasma: Implications For Clinical Utility Journal Of Clinical Lipidology 7, 5.
  7. ^ Harris, William S.; Thomas, Rachael M. (2010). Biological Variability Of Blood Omega-3 Biomarkers Clinical Biochemistry 43, 3.
  8. ^ von Schacky C; Fischer S; Weber PC (1985). Long-term effects of dietary marine omega-3 fatty acids upon plasma and cellular lipids, platelet function, and eicosanoid formation in humans. J Clin Invest 76, 4.
  9. ^ Sugasini, Dhavamani; Yalagala, Poorna C. R.; Subbaiah, Papasani V. (2020). Plasma BDNF Is A More Reliable Biomarker Than Erythrocyte Omega-3 Index For The Omega-3 Fatty Acid Enrichment Of Brain Scientific Reports 10, 1.
  10. ^ von Schacky C (2014). Omega-3 index and cardiovascular health. Nutrients 6, 2.
  11. ^ Walker, Rachel E; Hedengran, Anne; Shearer, Gregory C.; Jackson, Kristina Harris; Tintle, Nathan L; Bernasconi, Aldo, et al. (2019). Predicting The Effects Of Supplemental EPA And DHA On The Omega-3 Index The American Journal Of Clinical Nutrition 110, 4.
  12. ^ Lohner, Szimonetta; Fekete, Katalin; Marosvölgyi, Tamás; Decsi, Tamás (2013). Gender Differences In The Long-Chain Polyunsaturated Fatty Acid Status: Systematic Review Of 51 Publications Annals Of Nutrition And Metabolism 62, 2.
  13. ^ a b Harris, William S.; Pottala, James V.; Varvel, Stephen A.; Borowski, James J.; Ward, Jennie N.; McConnell, Joseph P. (2013). Erythrocyte Omega-3 Fatty Acids Increase And Linoleic Acid Decreases With Age: Observations From 160,000 Patients Prostaglandins, Leukotrienes And Essential Fatty Acids (PLEFA) 88, 4.
  14. ^ Beckett, Jeffrey M; Pittaway, Jane K.; Chuang, L. T.; Glew, R. H.; Ball, M. J.; Ahuja, K D K (2015). Omega-3 Dietary Fatty Acid Status Of Healthy Older Adults In Tasmania, Australia: An Observational Study The Journal Of Nutrition, Health & Aging 19, 5.

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