Maximum Wellness, Episode 120: The Omega-3 Index Is a Diagnostic Tool to Assess Omega-3 Status


Cardiovascular disease (CVD) is still the leading cause of death worldwide. The good news is that modifying CVD risk factors, such as an unhealthy diet, physical inactivity, not smoking, and limiting alcohol intake, can reduce the risk to complications, an early demise, or unnecessary risk to Covid-19 and its pervasive variants.

A recent study – Using an Erythrocyte Fatty Acid Fingerprint to Predict Risk of All-Cause Mortality: The Framingham Offspring Cohort – appearing in the June 2021 online issue of the American Journal of Clinical Nutrition (AJCN), sought to compare a combination of RBC (red blood count) FA (fatty acid) levels in predicting all-cause mortality.

Those biomarkers included the FA’s measured in blood plasma and RBC membranes, specifically looking at the omega-3’s EPA, and DHA – which are most notably associated with reduced risk to CVD.  Those referenced FA’s are found in fish oil and walnuts, among other dietary sources.

The study also references a 2018 report, which included 2500 participants in the Framingham Offspring Cohort, who were followed for a median of 7.3 years (i.e., between ages 66 and 73 y) – with a baseline RBC EPA + DHA content [the omega-3 index].  A higher omega-3 index was significantly and inversely associated with risk for death from all causes.

Those, “individuals in the highest quintile were 33% less likely to succumb during the follow-up years compared with those in the lowest quintile,” comments the AJCN.

There have been similar associations seen in the Women’s Health Initiative Memory Study, the Heart and Soul Study, and the Ludwigshafen Risk and Cardiovascular Health Study. However, these prior investigations evaluated only one FA metric, as an exposure variable.

The Framingham Offspring Cohort participants (2240 eligible), who had RBC fatty acid measurements and relevant baseline clinical covariates, were without prevalent cardiovascular disease. The participants were evaluated during eleven years of follow-up looking specifically at the association with eight standard risk factors (age, sex, total cholesterol, HDL cholesterol, hypertension treatment, systolic blood pressure, smoking status, and prevalent diabetes) and 28 FA metrics with all-cause mortality.

The bottom line is that a physician can now assess the patient’s FA levels – along with their medical history and other appropriate lab values – to prescribe or recommend the appropriate intake level of supplementary omega-3’s – prescription or over the counter preparations.