We use a single drop of blood to measure the Omega-3 Index
We are able to pass along the savings from our efficient collection system to you, the consumer, and offer a high-quality test at an economical price.
The Omega-3 Index test can give you an unbiased view of your dietary intake of omega-3s as well as a measure of heart disease risk.
No. There is no way to predict – for any given person – what his/her Omega-3 Index will be just by knowing how much fish they eat or how many capsules they take. Individual differences in metabolism, absorption, and genetics make it impossible to predict with certainty how a given person will respond to supplements.
The only way is to directly measure the Omega-3 Index.
The target Omega-3 Index is 8% and above, a level that current research indicates is associated with the lowest risk* for death from cardiovascular disease. This is also a typical level in Japan, a country with one of the lowest rates of sudden cardiac death in the world. On the other hand, an Index of 4% or less (which is common in the US and UK) indicates the highest risk*. At Food for the Brain we are researching what an optimal omega-3 index is for your brain. At present, there is no reason to suggest that the target should be different for men vs. women, or for different age groups. Whether there is an upper limit of safety for the Index is not clear, but there is likely a value above which there is not likely to be any additional health benefit. Further research will help define this level.
*In this context, “risk” refers only to that associated with differing levels of omega-3 fatty acids. Risks associated with other factors such as cholesterol, blood pressure, diabetes, family history of CHD, smoking, or other cardiac conditions are completely independent of the Omega-3 Index. All risk factors – including the Omega-3 Index—should be addressed as part of any global risk reduction strategy.
Increase your intake of EPA+DHA. The amount you would need to take in order to raise your Omega-3 Index into the target range (>8%) depends in part on your starting level, but it cannot be predicted with certainty as described above. Nevertheless, if your Omega-3 Index is between 4% and 8%, we would recommend that you increase your current EPA+DHA intake by 0.5 -1 gram (500 – 1000 mg) per day. This can be accomplished in two ways: eating more oily fish and/or taking fish oil supplements. On the other hand, if it is less than 4%, our recommendation would be that you raise your intake by 1-3 g (1000 – 3000 mg) per day. Although this can be accomplished by eating more oily fish, fish oil supplements are usually necessary to achieve this level of EPA+DHA intake.
In our experience, to increase the Omega-3 Index by 4%, one would need to increase his/her intake by about 1 g of EPA+DHA per day for roughly 6 months. Alternatively, one could increase by 2 g/d and a 4% increase could be achieved more quickly. In other words, raising the Index is a function of both dose
Docosapentaenoic acid (DPA, C22:5n-3) is a long-chain omega-3 fatty acid that is the intermediary between EPA and DHA in the metabolic pathway. Recent studies have demonstrated a relationship between blood levels of DPA and brain, heart, and metabolic health. This begs the question, why is DPA not included in the Omega-3 Index?
In 2002-2003 when Drs. Harris and Von Schacky were “inventing” the concept of the Omega-3 Index, they focused primarily on two studies available at the time: Siscovick DS et al. JAMA, 1995 and Albert CM et al. NEJM, 2002. Both of these studies showed that red blood cell or whole blood omega-3s strongly predicted risk for sudden cardiac death. Siscovick only reported red blood cell EPA+DHA. Albert showed case-control values for EPA, DHA, and DPA, but only EPA and DHA were associated with future events and DPA was not different between cases and controls. Combine that with the very limited knowledge about DPA in those days, it made the most sense to them to focus on EPA+DHA alone. Fast forward 10 years and we are beginning to see some signs that DPA is also predictive certain events. So, should we add it to the Index?
One question is, “How well correlated is the original with the modified Index?” Below are the data from the Framingham Offspring. The modified Index is extremely highly correlated (r=0.98) with the original Index, so adding DPA adds no more information to the original Index. The modified Index is about 2.7% points higher than the original (since that’s what red blood cell DPA typically is).
The other major question is, “Does a modified Omega-3 Index (with DPA) predict events significantly better than the original Index?” This question is harder to answer, but if the two Indexes are that highly correlated, the chances of one metric being significantly better at predicting outcomes (any outcome) than the other are vanishingly small.
With this background, the question becomes, “Is it worth ‘upsetting the apple cart’ to change the numerical cut points for the Omega-3 Index just because some studies are showing DPA to be a predictor on its own?” The upside of adding DPA is that it’s more “intellectually satisfying” to accommodate all the evolving science in biostatus metrics. The downside is that the new cut points would confuse the nascent literature in this field (i.e. “Is that the OLD Index or the NEW one?”), and it would confuse the growing number of practitioners who are managing patients’ Omega-3 Index values in clinical care. We believe the DPA is important scientifically, but that it is not necessary to add to the Omega-3 Index at this time.
We do not provide a target range for EPA and DHA separately yet, as we do not have strong data that the individual levels are more predictive than the combined Omega-3 Index for the general population. Typically, DHA is 85% of the Omega-3 Index, unless someone is supplementing with a high-dose EPA product.
