Frequently Asked Questions for Omega-3 Index

 

We use a single drop of blood to measure the Omega-3 Index.

  • A single finger prick provides enough blood for us to measure your Omega-3 Index.
  • This eliminates the need to have your blood drawn at a clinic and the hassle of sending hazardous materials (blood) through the mail. You can collect your sample and send it through the mail from the comfort of your own home!

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.

  • Other fatty acid tests do not use the same analysis methods and cannot be interchanged with the Omega-3 Index. So your EPA+DHA, for example, might be 6.7% in Lab A and 5.2% in Lab B. Which one is “right?”
  • The unique method we use at OmegaQuant has more research behind it than any other commercially-available test, and new studies continue to be published.

Dr. Harris, the founder of OmegaQuant Analytics®, has been doing research in omega-3s for 30 years, and has over 80 published research papers in this field.

For more information visit our FAQ on this question on the researcher’s page here.

Omega-3 Index Basic test is $54.95. This includes a collection kit, the envelope and postage to send in your blood spot, and a detailed report of your results. Your results will include your Omega-3 Index.

Omega-3 Index Plus test is $79.95. This includes a collection kit, the envelope and postage to send in your blood spot, and a detailed report of your results. Your results will include your Omega-3 Index, Trans Fat Index and AA:EPA ratio and Omega-6:Omega-3 ratio.

Omega-3 Index Complete test is $99.95. This includes a collection kit, the envelope and postage to send in your blood spot, and a detailed report of your results. Your results will include your Omega-3 Index, Trans Fat Index, full fatty acid profile, AA:EPA ratio and Omega-6:Omega-3 ratio.

You can read the collection instructions here or watch the video below.

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 CHD. 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) indicates the highest risk*. 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 and time.

In North America, the test is performed by OmegaQuant in Sioux Falls, SD; in Europe, the test can be obtained from our sister laboratory, Omegametrix (Munich, Germany); and in Asia, at Omegaquant Asia (Seoul, Korea). As other labs around the world become licensed to offer the Omega-3 Index test they will be listed on our website.

For private pay individuals submitting a dried blood spot for analysis, once the sample is received at OmegaQuant, the results will be available within 3 working days.

No. It is not necessary to fast before collecting your sample; however, it is best to collect the sample before taking fish oil supplements.

Whole blood and RBCs are different starting materials and the EPA+DHA content of each is different, but highly correlated. Based on multiple experiments, we have derived a mathematical equation that converts the DBS EPA+DHA value into the corresponding RBC value (which is the Omega-3 Index). Therefore, the sum of EPA and DHA in the DBS report will usually be slightly different from the Omega-3 Index.

The OmegaQuant full fatty acid report now includes information on percentile ranks for not only the Omega-3 Index, but also for each of the 5 major fatty acid groups and two ratios. The purpose of the percentile ranks it to give the client a perspective of where he or she falls within the normal range of the population. For example, an Omega-3 Index of 5.5% would correspond to a percentile rank of 44%. This means that approximately 44% of the population has a lower Omega-3 Index, and 56% a higher Index.

Since at OmegaQuant we perform both red blood cell-based tests and dried blood spot-based tests (which generate the same values for the Omega-3 Index, but different values for the other fatty acids reported because of the different sample types), the “populations” used to make the percentile determinations are different. Percentiles on the red blood cell test were determined based on about 11,000 individuals who have had this test, and percentiles on the dried blood spot test were determined based on about 27,000 individuals.

Included with each the 5 classes of fatty acids are “reference ranges.” The reference range is provided simply to give an idea of how these values compared to a large number of others taken from a relatively healthy population. In the case of the RBC assay, the reference range was taken from approximately 11,000 individuals whose samples were submitted to the laboratory for analysis. In the case of the dried blood spot assay, the reference range was taken from approximately 27,000 individuals. No information regarding the state of health of any of these individuals is known. In both cases, the reference range encompasses 99% of the individuals in their respective populations. Although “average,” these are not necessarily “optimal” levels, i.e., target levels or levels that one should to attempt to achieve. The only results for which we feel justified in providing actual targets or optimal levels are the Omega-3 Index and Tran Fat Index since these have undergone the most research. As the research in this area matures, we may recommend new “target” values for other fatty acids or ratios when we believe that they have been adequately validated.

As noted above, we provide reference ranges for general information only, not to suggest or guide changes in diet. We do not believe that the research has advanced to the point where we can tell people who have a below (or above) “average” level of any given fatty acid class that they should try to change it. There are several reasons for this. First, since most fatty acid levels in the blood are not influenced by diet but are established by internal genetics and metabolism, even attempting to alter a fatty acid level by dietary change would be largely futile. Secondly, we don’t have the data at present to show that even if one could change fatty acid levels (again, except for the Omega-3 Index and trans fatty acids), it would benefit them to do so. So until further research convincingly demonstrates that raising or lowering a certain fatty acid or class is beneficial or not, we will take the conservative approach of simply giving each client the numbers, and they can track them as they wish.

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.