#### The Omega-3 Index and relative risk for coronary heart disease mortality: Estimation from 10 cohort studies

Atherosclerosis, July 2017 Volume 262, Pages 51–54

DOI: http://dx.doi.org/10.1016/j.atherosclerosis.2017.05.007

William S. Harris', William S. Harris, William S. Harris, Liana Del Gobbo, Nathan L. Tintle

- Increasing Omega-3 reduces heart problems, autism, depression, preterm birth, breast cancer, etc.
- Omega-3 levels are sub-optimal in 99 percent of Americans – Aug 2017
- Overview: Omega-3 many benefits include helping vitamin D
- For every Omega-3 dollar there is a 84 dollar savings in Cardiovascular costs - Foster and Sullivan April 2016
- Omega-3 is vital for health, mail-in test is low cost and accurate has the following
**Cardiac Arrest risk reduced with higher levels of Omega-3**

**Acute Coronary Syndrome risk reduced with higher levels of Omega-3**

**Omega-3 index = % of the total amount of fatty acids present in red blood cell**

- Thus, the higher the index, the lower must be the Omega-6 %
- So, to improve the Omega-3 index, one must both increase Omega-3 intake and decrease intake of other fatty acids, such as Omega-6

#### Omega-3 and Cardiovascular (items in both categories)

- Synthetic EPA drug recommended to FDA for Cardio (Omega-3 is 8 X better) – Nov 2019
- Omega-3 reduces heart problems by ~5 percent – meta-analysis by Heart Association Oct 2019
- Cardiovascular Prevention with Omega-3 (finally using high doses) – Sept 2019
- Few people have enough EPA (an Omega-3) to reduce heart failures – July 2019
- Another Nail in the Coffin for Fish Oil Supplements (nope) – JAMA April 2018
- Omega-3 provides many cardiovascular benefits – April 2018
- Omega-3 helps the heart, AHA class II recommendation, more than 1 gm may be needed – March 2018
- 3 days of Omega-3 before cardiac surgery reduced risk of post-op bleeding by half – RCT March 2018
- Perhaps the Omega-3 optimal level is 10 percent, not 8 – Feb 2018
- Omega-3 Cardiovascular meta-analysis has at least 5 major problems – Jan 2018
- Benefits of Omega-3 beyond heart health - LEF Feb 2018
- Higher Omega-3 index (4 to 8 percent) associated with 30 percent less risk of coronary disease (10 studies) July 2017
- Cardiovascular problems reduced by low dose aspirin and perhaps Omega-3 (also Vit K) – Sept 2017
- Omega-3 reduced time in hospital and atrial fibrillation after cardiac surgery – meta-analysis May 2016
- For every Omega-3 dollar there is a 84 dollar savings in Cardiovascular costs - Foster and Sullivan April 2016
- High dose Omega-3 probably reduces heart problems – American Heart Association – March 2017
- Health problems prevented by eating nuts (perhaps due to Magnesium and or Omega-3) – meta-analysis Dec 2016
- Omega-3 – need more than 1 gram for a short time to reduce Cardiovascular Disease – Nov 2016
- Omega-3 is vital for health, mail-in test is low cost and accurate
- Cardiovascular calcification prevented by Omega-3, Magnesium, Vitamin K, and Vitamin D – April 2015
- Atrial fibrillation sometimes treated by Omega-3 – meta-analysis Sept 2015
- Salmon intervention (vitamin D and Omega-3) improved heart rate variability and reduced anxiety – Nov 2014
- Omega-7 - in addition to Omega-3
- Omega-3 reduces Coronary Heart Disease - infographic June 2014
- Cardiovascular diseases – conflicting data on benefits of Omega-3 and vitamin D – Feb 2014
- Cardiovascular system benefits from both Omega-3 and vitamin D – Dec 2012
- Heart problems such as Afib related to little Magnesium, Omega-3, Vitamin D getting to tissues
- Omega-3 does not help heart patients – meta-analysis Sept 2012

** Download the PDF from VitaminDWiki**

**Highlights**

•Higher in vivo omega-3 levels are linked with lower risk for heart disease.

•Omega-3 status is currently expressed using several different metrics.

•The Omega-3 Index (O3I, RBC EPA + DHA) is a useful marker but cutpoints need validation.

•Transformed data from a prior meta-analysis confirms O3I cutpoints of <4% and >8%.

Background and aims

A recent 19-cohort meta-analysis examined the relationships between biomarkers of omega-3 fatty acids and risk for coronary heart disease (CHD). That study did not, however, report hazard ratios (HRs) specifically as a function of erythrocyte eicosapentaenoic (EPA) plus docosahexaenoic (DHA) levels, a metric called the Omega-3 Index in which EPA + DHA content is expressed as a percent of total fatty acids. The Omega-3 Index has been used in several recent studies and is a validated biomarker of omega-3 fatty acid tissue levels, but additional data are needed to confirm (or refute) the originally-proposed clinical cut-points of <4% (higher risk) and 8%–12% (lower risk).

Methods

The present study was therefore undertaken using published data from this meta-analysis to estimate HRs per 1-SD increase in the Omega-3 Index and median quintile values for this metric across 10 of the cohorts for which the needed data were available.

Results

The overall mean (SD) for the Omega-3 Index in these 10 cohort studies was 6.1% (2.1%), and the HR for a 1-SD increase was 0.85 (95% confidence interval, 0.80–0.91). Median quintile 1 and 5 levels were 4.2% vs. 8.3%, respectively. Based on these values, we estimate that risk for fatal CHD would have been reduced by about 30% moving from an Omega-3 Index of 4%–8%.

Conclusions

These findings support the use of <4% and >8% as reasonable therapeutic targets for the Omega-3 Index