Omega-3 index: need at least three servings of fish per week and EPA and DHA supplements to protect the heart
Consuming two servings of fish per week is not enough to reach the desirable level of the Omega-3 Index, a parameter that measures the level of EPA and DHA in red blood cells. In fact, according to recent research, to reach a value of this index between 8 and 12 percent, synonymous with good cardiovascular and general health, it is necessary to combine at least three servings of fish per week with omega-3-rich supplements.
This was reported in the pages of the scientific journal Prostaglandins, Leukotrienes and Essential Fatty Acids by American researchers from OmegaQuant and the University of South Dakota (United States) including Professor Williams Harris, creator of the Omega-3 Index.
The percentage of EPA and DHA in red blood cells as an index of heart health status
TheOmega-3 Index, or Omega-3 Index, indicates the amount of EPA and DHA out of the total fatty acids in the cell membranes of red blood cells, membranes that are easy to analyze and reflect, better than others, the long-term consumption of EPA and DHA, indicating the true level of these substances in the body. The polyunsaturated fatty acid composition of red blood cells is thus an indicator of nutritional status and cardiovascular risk. A high Omega-3 Index, between 8-12%, in fact, has been associated with a lower risk of coronary artery disease and coronary mortality in epidemiological studies, but it would also appear to be associated with maintaining good overall health, especially with regard to vision, joints, and cognitive abilities. This tool was developed in 2004 as a parameter for estimating the risk of sudden cardiac death by William Harris, a professor at the University of the South himself, and Professor Clemens von Schacky, a cardiologist at the University of Munich.
Professor Harris is also the creator of the Omega-3 Index Test, a very minimally invasive test that easily measures EPA and DHA levels in the blood. The Omega-3 Index Test, must be performed in laboratories that follow a rigorous quality management system, to obtain fast, reliable and reproducible results, useful for physicians and patients to estimate the risk of heart disease, and to achieve adequate omega-3 levels, useful in reducing the risk of heart attack and sudden mortality.
At least three servings of fish per week and proper supplementation are needed.e
According to current American Heart Association recommendations, one to two servings of fish per week should be consumed to have an Omega-3 Index of 8 percent. The results of two cross-sectional studies published in Prostaglandins, Leukotrienes and Essential Fatty Acids comparing EPA and DHA levels consumed with fish and the Omega-3 Index found that to achieve an 8% Index, two servings of fish per week is not enough, but it is necessary to consume dietary sources of these unsaturated fatty acids at least three times per week and supplement with the appropriate supplements. These studies look at data from 3,458 people who took the Omega-3 Index test and also answered questions about their food consumption and supplement use. The results indicated that, people who reported not taking omega-3 supplements and not eating fish had an average Index of 4.1 percent. Those who took supplements and consumed three meals of foods rich in EPA and DHA per week achieved a value of 8.1 percent. "These results prompt a review of the optimal amount of omega-3 fatty acids to be consumed in the diet or taken with supplements," said Harry Rice, vice president of regulatory and scientific affairs at the Organization for EPA and DHA (GOED).
According to Dr. Jackson, one of the authors of the study, there is a discrepancy between the amount of EPA and DHA indicated by current recommendations (250-500 milligrams per day) versus the amount needed for most Americans to achieve an Omega-3 Index of 8 percent, which would correspond to more than 800 milligrams of fish per day. To achieve this goal, EPA and DHA supplements can be added to the diet or fish oil sources can be increased to 4-5 servings, per week. Recently, the company OmegaQuant has developed a calculation system to help people estimate their omega-3 needs and adjust their diet and supplementation regimen in order to achieve a good Omega-3 Index. For example, according to that tool, a man with an Omega-3 Index of 4.5 percent would need about 950 milligrams of EPA plus DHA per day to reach the 8 percent value. Considering that three servings of red salmon per week would provide him with about 410 milligrams of EPA and DHA per day, he would need to add dietary supplements for about 500 mg per day of EPA and DHA. Or, consume supplements containing the full dose of 900 milligrams of EPA and DHA each day. Whatever the approach, it should be maintained for at least 4 months in order to reach a new steady state of the Index.
Adequate EPA and DHA intake is not achievable with only two servings of fish per week
Current recommendations for the general population suggest consumption of two servings per week of fish, and do not recommend following supplementation with fish oil products. In light of the observations of this study, this regimen is unlikely to produce an Omega-3 Index of 8%. Consuming at least 3 servings of fish per week plus consuming an EPA and DHA supplement greatly increases the likelihood of achieving this goal. As suggested by the research authors themselves, new dietary recommendations that target blood levels would be needed as an effective strategy to reduce the risk of heart disease.
Source: K.H. Jackson et al. 'Association of reported sh intake and supplementation status with the omega-3 index "Prostaglandins, Leukotrienes and Essential Fatty Acids .March 2019, Volume 142, Pages 4-10.
