Omega-3 Index (RBC)

check icon Optimal Result: 8 - 12.65 %.

The omega-3 index is defined as the RBC percentage sum of EPA+DHA, both of which are important antiinflammatory omega-3 fatty acids. This index was first proposed in 2004 as a cardiovascular risk factor by Dr. Willian S. Harris and Dr. Clemons von Schacky as a way of assessing risk for coronary artery disease and related death. Since then, it has been repeatedly verified as an important cardiovascular biomarker, and studied in other diseases including obesity, mood disorder, and insulin resistance.

A reasonable target for the omega-3 index is >8% to decrease disease risk. Drs. Harris and von Schacky stratified risk zones as high risk (8%). These percentages have been continually verified in outcome studies and risk assessment.

Dietary intervention to increase the omega-3 index should include oily fish, flax, walnut, and chia. Fish oil supplementation can also be considered.

References:

- Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Preventive medicine. 2004;39(1):212-220.

- Harris WS. The omega-3 index: from biomarker to risk marker to risk factor. Curr Atheroscler Rep. 2009;11(6):411.

- Harris WS. The omega-3 index: clinical utility for therapeutic intervention. Current cardiology reports. 2010;12(6):503-508.

- Burrows T, Collins C, Garg M. Omega-3 index, obesity and insulin resistance in children. International Journal of pediatric obesity. 2011;6(sup3):e532-539.

- Baghai TC, Varallo-Bedarida G, Born C, et al. Major depressive disorder is associated with cardiovascular risk factors and low Omega-3 Index. The Journal of clinical psychiatry. 2010;72(9):1242-1247.

- Parletta N, Zarnowiecki D, Cho J, et al. People with schizophrenia and depression have a low omega-3 index. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2016;110:42-47.

- Albert BB, Derraik JG, Brennan CM, et al. Higher omega-3 index is associated with increased insulin sensitivity and more favourable metabolic profile in middle-aged overweight men. Scientific reports. 2014;4:6697.

- von Schacky C. Omega-3 index in 2018/19. Proceedings of the Nutrition Society. 2020:1-7.

- Aarsetoey H, Aarsetoey R, Lindner T, Staines H, Harris WS, Nilsen DWT. Low Levels of the Omega-3 Index are Associated with Sudden Cardiac Arrest and Remain Stable in Survivors in the Subacute Phase. Lipids. 2011;46(2):151- 161.

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What does it mean if your Omega-3 Index (RBC) result is too low?

Note: Omega-3 Index RBC :- Omega-3 Index is the sum of EPA % and DHA % as measured in red blood cells, and derived by validated calculations to yield the equivalent sum of EPA % and DHA % in red blood cell membranes. Please note this value is a percentage, with the denominator being the sum of all Fatty Acids measured in the red blood cells and thus the index can vary based on fatty acid composition of the diet.

Low levels of omega-3 index are associated with increased risk for cardiac death.

The Omega-3 Index is a validated biomarker of tissue membrane omega-3 (n-3) polyunsaturated fatty acid (PUFA) status. The ratio is expressed as a percentage where the denominator is the sum off all fatty acids measured in the blood. Thus, a decrease in the ratio can be caused by a low intake of omega-3 fatty acids and incorporation of those fatty acids into cell membranes; or due to a proportionally high intake of other dietary fatty acids (saturated fatty acids, mono-unsaturated fatty acids and omega-6’s poly unsaturated fatty acids)

Supplement options:

- Currently, no official dietary intake recommendations have been established.

- Several official health organizations have proposed a minimum dietary intake level of 500 mg/day of EPA+DHA. Because the efficiency of conversion of ALA to DHA is so low, supplementing DHA is generally recommended to meet therapeutic doses.

- The recommended minimum level of DHA supplementation in adults ia 250 mg per day.

- Pregnant and lactating women are recommended to consume at least 200 mg DHA per day.

- Diabetic individuals may benefit from supplementing DHA (along with EPA) due to its triglyceride-lowering effects. High dose supplementation of omega-3 fatty acids (including DHA) has been shown to reduce the need for non-steroidal anti-inflammatory drugs (NSAIDS).

- Persons suffering from ulcerative colitis have been shown to need fewer corticosteroids when supplementing with high dose omega-3 fatty acids.

- Adverse side effects observed with high dose omega-3 fatty acids from supplement form include gastrointestinal upset and loose stools.

- Omega-3 supplements including EPA and DHA should be used with caution in persons with clotting disorders or on anti-clotting medication.

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