Women cardiovascular disease: at risk after age 40 for omega-3 deficiency

More than 70 percent of women between 40 and 59 years of age show a high likelihood of suffering from cardiovascular disease due to insufficient EPA and DHA in the blood. In fact, according to a study conducted on the German female population, almost all middle-aged women have a low Omega 3 Index, that is, a low percentage of EPA and DHA in the cell membranes of red blood cells, a dangerous condition for heart health and beyond.

The research, carried out by researchers at Leibniz University in Hannover, Germany, was published in recent months in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids.

Omega-3s protect heart health

The positive effects of proper omega-3 consumption are numerous, well documented and endorsed by EFSA (European Food Safety Authority), especially with regard to brain health and cardiovascular health. The association between dietary EPA and DHA consumption and cardiovascular prevention was first observed in the middle of the last century, thanks to a study involving the Inuit population in Greenland, showing a reduced incidence of cardiovascular disease in these subjects due to a diet of fatty fish rich in omega-3. The relationship between a fish-rich diet and protection from cardiovascular disease was later confirmed by many epidemiological studies. The mechanisms by which omega-3 exerts cardiovascular protective effects are diverse:

• increase the fluidity of cell membranes
• They improve endothelial function
• Modulate platelet aggregation
• have antiarrhythmic action
• reduce blood triglycerides

Therefore, measuring an individual's omega-3 level, and in particular knowing the fatty acid composition of red blood cells, is important in defining cardiovascular risk. Blood concentrations of DHA and EPA can be measured by the Omega-3 Index, a new method for assessing cardiac risk. The Omega-3 Index represents the sum of omega-3s in red blood cell membranes and is expressed as the percentage of EPA and DHA out of the total fatty acids in the membrane. A low index value is associated with an increased likelihood of sudden cardiac death, that is, death from cardiovascular arrest that occurs unexpectedly even in individuals who have never exhibited cardiac dysfunction. Obviously, a high Omega-3 Index value is associated with a lower risk of sudden cardiac death. Based on numerous epidemiological studies on the link between risk of sudden cardiac death and the amount of omega-3 in red blood cells, scientists have concluded that:

• Indice Omega-3 < del 4%: indica forte probabilità per un individuo di essere colpito da morte cardiaca improvvisa
• Omega-3 index between 4 and 8%: moderate risk
• Omega-3 index > 8%: indicates a low-risk situation

Several studies have shown that omega-3 concentration in women in Western countries is low. The purpose of this new study was precisely to assess omega-3 status in German women and to identify variables that might influence them.

Omega-3 index too low for almost all women involved in the study

The research, conducted on the German female population, showed that the vast majority of middle-aged women do not consume enough omega-3 in their diets, and as many as 97.3% of all women involved had an Omega-3 Index of less than 8%, revealing, as a result, a dangerous situation for the heart. Specifically, 62.8 percent of the women selected in the study, showed an Omega-3 Index between 4 and 6 percent, while a small percentage of them (9 percent) even had an Omega-3 Index below 4 percent; a risky condition for cardiac health, but one that also increases the likelihood of issues such as cognitive decline and depressive symptoms. As Professor Sandra Geller, who directed the study, mentioned, cardiovascular disease is the leading cause of death in Europe and has a higher incidence in women than men, which tends to increase with age. Cardiovascular events occur in 10 percent of women aged 20 to 39, while the frequency rises to 35.5 percent among women aged 40 to 59.

Some details of the study

The German research team analyzed data from 446 women aged 40 to 60 who had previously participated in a much larger national study. For each of the participants, omega-3 levels in the membranes of the red blood cells were measured, as a percentage of EPA and DHA to total fatty acids present. The results showed an average Omega-3 Index score of 5.49. Reference values for the index in this study were broken down as: very low (index below 4%), low (4% - 6%), moderate (6% - 8%) or high (above 8%). The data obtained showed that the Omega-3 Index appeared to be influenced by age and smoking, with slightly higher values in women aged 50 and older and nonsmokers. Those taking hormonal contraceptives had also shown a lower level of EPA, and a lower ratio of EPA to Alpha Linoleic Acid, a precursor fatty acid of EPA and DHA, than women not taking hormonal contraception.

It is necessary for women to increase omega-3 levels

The study showed that more than 97 percent of middle-aged women, had an Omega-3 Index below 8 percent, which is the value considered protective for the heart, this suggests the need to increase omega-3 consumption so as to reduce the risk of cardiovascular disease, depression and cognitive decline. The same authors noted that in Germany the current recommendations for omega-3 consumption for the general population refer only to Alpha Linoleic Acid, despite the fact that it is known that the conversion rate of this to EPA and, especially DHA, is very low. Reference intakes for EPA and DHA issued by various scientific organizations and competent authorities range from 250 to 500 milligrams of EPA and DHA per day, for healthy adults.

Source: Sandra Gellert, et al. "Low long chain omega-3 fatty acid status in middle-aged women" Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA)