What do my Omega-3 Index results mean?
- The Omega-3 Index report you received shows you the percentage of EPA and DHA in your red blood cell membranes. Your levels are indicative of the amount of omega-3s in your diet and how much your body is using. An Omega-3 Index range between 8-12% is considered the desirable range.
- Here is a helpful video that explains in more detail what your Omega-3 Index results mean.
What dose should I be taking?
- Short answer: We don’t like to talk about the issue of dose without knowing your Omega-3 Index score first. If you received your Omega-3 Index results, you can try and calculate your dose here.
- Here is a blog we wrote about how you can get to the optimal range of the Omega-3 Index.
- Here is a helpful video about how to change your Omega-3 Index. But remember, the only way to truly know if you are getting enough of the right omega-3s is to test your level.
How much omega-3 should I get from my diet?
- We believe, if possible, that you should try and get your omega-3s from fish first. Some good choices are salmon, tuna and herring. Here is an infographic that lists how much EPA and DHA there is in certain fish. If fish is not an option for you, then we suggest taking an omega-3 supplement that contains EPA and DHA. If you choose to take a supplement, make sure you can locate these two omega-3s on the label, so you can add them up to see how much you are getting.
- Here is a helpful video about food and supplement sources of EPA and DHA.
What does my AA/EPA level mean?
- The AA/EPA ratio is your level of arachidonic acid (AA), an omega-6 fatty acid, vs. eicosapentaenoic acid (EPA), an omega-3 fatty acid. These are important fatty acids in metabolism because eicosanoids and prostaglandins can be made from them. These molecules are very potent in the body in causing a lot of changes. Having different levels of these two fatty acids could affect processes that ultimately impact inflammation and overall health. We recommend optimizing the omega-3 side of the equation, which inevitably means increasing your Omega-3 Index and getting into the optimal range.
- Here is a blog we wrote about the AA/EPA ratio.
- Here is a helpful video that describes the AA/EPA ratio.
What does my Omega-6/Omega-3 ratio mean?
- The Omega-6/Omega-3 ratio (also written “n-6/n-3”) report provides analysis for 7 omega-6 fatty acids and 4 omega-3 fatty acids. This analysis is performed from your whole blood as opposed to red blood cell membranes like the Omega-3 Index. The total amount of omega-6s and omega-3s are divided by each other to get a ratio. We recommend a ratio of 3-5:1 (omega-6:omega-3). It will be displayed in the little blue circles and then on the scale in your report.
- Here is a blog post we wrote about the omega-6/omega-3 ratio.
- Here is a helpful video about the omega-6/omega-3 ratio.
Are Omega-3s good and Omega-6s bad?
- We at OmegaQuant are aware that there people generally consider omega-3s to be good and omega-6 to be bad. However, we think this may be too simplistic, even if biologically omega-6s and 3s are pro- and anti-inflammatory, respectively. Still, we have seen research showing that higher levels of linoleic acid, which is an omega-6 fatty acid, are linked to better outcomes in terms of cardiovascular health and diabetes. So rather than focus on lowering your omega-6s, we believe increasing your omega-3s will automatically balance out this ratio and is something that is more actionable for most people.
- Here is a helpful video that explains why you need both omega-3 and omega-6.
How does the Omega-3 Index from OmegaQuant compare to other omega-3 tests (Quest/Lab Corp, etc)?
- The Omega-3 Index is a very unique and complex test and any lab attempting to do it needs have serious expertise in the methodologies that are involved. There are 6 seemingly mundane steps that make all the difference in a final Omega-3 Index score. Any changes in those steps from another lab will impact a result. Because OmegaQuant’s Omega-3 Index has been used in more than 200 studies, its test has been standardized over time, which means you can trust your Omega-3 Index score.
- Here is a blog post we wrote about how the Omega-3 Index from OmegaQuant is different from other labs doing omega-3 testing.
- Here is a helpful video about how the Omega-3 Index test is unique.
What does it mean if my Omega-3 Index is below 8%?
- The Omega-3 Index target range of 8-12% is important, but it doesn’t mean that anything below that is completely unhealthy, especially for those who might be at 6-7%. The research has shown that people in the 8-12% range tend to have better health outcomes in relation to the heart, brain and eyes. Below 4% is associated with the most negative health outcomes. Going from 4% to 8% is a great goal for anyone worried about general wellness. If you are not quite at 8% yet, you’re still making great progress.
- Here is a helpful video that explains your level in more detail.
Can my Omega-3 Index be too high?
- We talk a lot about low Omega-3 Index levels but we don’t talk about very high Omega-3 Index levels. First of all, having an Omega-3 index over 12% is very rare. About 3% of the individuals we’ve tested over the years had levels over 12%. We don’t have evidence that being over 12% is harmful but we also don’t have evidence to suggest that being over 12% offers extra benefits.
- Here is a helpful video that explains what having a high Omega-3 Index level means for your health.
If I am vegan or vegetarian, how can I get to an Omega-3 Index of 8%?
- If fish is not part of your diet for whatever reason you can still get your Omega-3s EPA and DHA from algal supplements. It is much more effective in raising your Omega-3 Index as opposed to other plant sources like flax and chia, which contain a totally different omega-3 called ALA.
- Here is a helpful video for vegans/vegetarians who are looking to raise their Omega-3 Index to the desirable range.
What is palmitic acid and why do we measure it?
- Another fatty acid that we at OmegaQuant find interesting is palmitic acid, which is a saturated fat. It is found in palm oil and is very common in the diet. What’s interesting is that if you eat a lot of palm oil or saturated fat, your levels won’t increase; it’s more likely to be affected by eating too much carbohydrate-rich food. Palmitic acid doesn’t have the same relationship in the body to diet that omega-3s do.
- Here is a helpful video that explains why we find palmitic acid levels interesting and useful.
Is my saturated fatty acid level related to the saturated fats in my diet?
- Saturated fatty acids in your red blood cell membranes are not related to the saturated fat you consume in your diet. Typically, saturated fat in your diet raises blood cholesterol levels. Our tests look at specific patterns of fatty acids and not the specific amount of cholesterol in your bloodstream. So when you receive your Omega-3 Index Complete report and you notice your saturated fatty acid level is high, please keep in mind that this has no relation to your cholesterol level.
- Here is a helpful video that explains why this is important.
What is linoleic acid and why is my blood level of this fatty acid important?
- Linoleic acid is the parent essential omega-6 fatty acid found in oils like sunflower oil and in nuts and seeds. We have seen research showing that higher blood levels of linoleic acid are linked to better outcomes in terms of cardiovascular health and diabetes. Some other research suggests that higher linoleic acid intake or blood levels is bad for health. Whether linoleic acid levels are too high in the diet and/or blood in the general public is an area of scientific controversy.
- Here is a helpful video that explains the relevance of linoleic acid to your health.
Omega 3 Index FAQs
How is the Omega-3 Index different from other fatty acid profile tests?
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 and President of OmegaQuant, has been doing research in omega-3s for nearly 40 years, and has more than 300 published research papers in this field.
What is the cost of the test?
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.
How do I collect a dried blood spot sample for testing?
If patients are taking omega-3 supplements, won’t their Omega-3 Index be above 8%?
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.
How can I know if I am getting enough omega-3?
The only way is to directly measure the Omega-3 Index.
What is the target range for 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.
What can I do to correct my Omega-3 Index?
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.
How quickly will the results be available?
For private pay individuals submitting a dried blood spot for analysis, once the sample is received at OmegaQuant, the results will be available within 3-5 working days.
Why don’t the EPA and DHA values add up to the Omega-3 Index on my dried blood spot (DBS) report?
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.
What is the meaning of the percentile ranks?
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.
What is the purpose of the reference ranges for the Omega-3 Index?
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 75,000 dried blood spots analyzed at OmegaQuant between 2015-2019. 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 Fat Index), 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.
Considering the emerging literature about docosapentaenoic acid (DPA), should it be included in the Omega-3 Index?
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.
Can I return an unused collection kit?
Yes, you can return your unused sample collection kit for a refund if the following conditions are met.
- You have 30 calendar days to return a collection kit from the date you received it.
- To be eligible for a return, your collection kit must be unused and in the same condition that you received it.
- Your collection kit must be in the original packaging.
- You will need to email email@example.com to provide your receipt, proof of purchase and/or barcode prior to returning the collection kit.
- Once we receive your collection kit, we will inspect it and notify you that we have received your returned collection kit. We will immediately notify you on the status of your refund after inspecting the kit.
- If your return is approved, we will initiate a refund to your credit card or original method of payment minus a 20% re-stocking fee.
- You will receive the credit within a certain amount of days, depending on your card issuer’s policies.
- You will be responsible for paying for your own shipping costs for returning your collection kit. Shipping costs are nonrefundable.
Mother’s Milk FAQs
Why are omega-3s important for infants?
DHA, the most abundant omega-3 fatty acid in the brain and retina, is a particularly important factor in the first two years of a child’s development. DHA assists in brain and eye development and function, and supports healthy heart function.
Does it matter if I test my Mother's Milk DHA from fresh or frozen breast milk?
No, either will work.
Do I have to take my breast milk sample at a certain point during the feeding?
No, you may take it at any point during the feeding. Although breast milk has a higher fat content at the end of the feeding, the percentage of DHA remains the same.
When should I start measuring the DHA in my breast milk?
It’s best to measure your breast milk DHA levels about 2-4 weeks after delivering your baby. DHA levels change naturally from the breast milk in the first few days after delivery (called “colostrum”) to the later breast milk (“mature milk”). Measuring your DHA breast milk level within the first month of breast feeding will allow you to make the necessary changes to your diet if you have low DHA levels.
How often should I measure the DHA in my breast milk?
If your DHA levels are optimum with your first testing, and you maintain the same health status, diet, and/or supplements, then once is enough. However, if your levels are low, and you decide to increase your intake of DHA (via fish or fish oil pills), then you can take the test as soon as two weeks after your previous test. (It only takes two weeks to change the levels of DHA in your breast milk!
How much DHA should I have in my diet while I am breast feeding?
Due to differences in metabolisms, and a variety of other health issues, the right amount of DHA can vary between individuals. Current recommendations are that lactating women consume at least 200 mg of DHA per day. The average intake for women in their 20s-30s in the United States is about 55 mg per day.
If my baby was premature, will his/her DHA needs be different?
Premature infants have an even greater need for DHA after they are born, as they missed out on some time for brain DHA accumulation from their mother in utero. Mothers of premature infants can safely increase their Mother’s Milk DHA levels by eating fish and supplementing with up to 800 mg DHA per day.
What is the scientific evidence that DHA is important?
There are literally thousands of studies on the role of and need for DHA during pregnancy and after birth. Like virtually all areas of human nutrition, there is some controversy about DHA as well. Some believe that even the low levels of DHA in the breast milk of American women is good enough for babies. Others contend that higher levels (like those in Japan, where DHA levels are eight times higher than in the United States) give babies an intellectual “head start.”
The following facts about DHA are not controversial:
1) The brain contains large amounts of DHA.
2) DHA has to come from mom in utero, and needs to be in formulas/breast milk after birth.
3) Studies have shown behavioral, IQ, and developmental benefits of higher DHA levels in the infant diet, whereas others have not.
4) Breast milk levels of 1% (compare to the less than 0.2% in American milk) are completely safe for the baby. All baby formula makers now enrich their products with DHA, and often to levels that are higher than commonly found in American breast milk. The reason for this is to match the worldwide average DHA level in human breast milk (about 0.32%).
What is the cost of the test?
The Mother’s Milk DHA Test. 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 DHA level.
How is the Omega-3 Index different from other fatty acid profile tests?
A. It differs in several ways.
First, the sample types we typically use (red blood cells or dried blood spots versus whole plasma or plasma phospholipids). Each of these sample types has a unique fatty acid profile, so you cannot compare the EPA+DHA level in RBCs to the EPA+DHA level in plasma, or in plasma phospholipids – the numbers will be quite different, even from the same lab. So regardless of which lab you choose to work with, you should always order the same type of test if you want to be able to track trends in the same patient over time. We focus on RBC and whole blood (dried blood spot) analyses because from either one we can provide the Omega-3 Index. These metrics provide the best reflection of tissue omega-3 fatty acid status. In addition, there is considerably more day-to-day variation in the plasma tests than in the RBC – (or whole blood) – based tests, and an acute load of omega-3 fatty acids (from fish or capsules) will significantly perturb the plasma-based markers but not the RBCs. Nevertheless, for research purposes, OmegaQuant can and does analyze any sample type based on the client’s needs and sample types available.
B. The uniqueness of the specific method we use
Second, even if you order the RBC-based assay from two different labs, there is no guarantee that you’ll get the same answer. That’s a big problem. The reason is that, unlike serum cholesterol or glucose or calcium, there is no standardized method (i.e., internationally recognized gold standard) to which all labs must peg their assays. There is no standard test material to which all labs are required to conform. So your EPA+DHA, for example, might be 6.7% in Lab A and 5.2% in Lab B. Which one is “right?” We don’t know what “right” is because there is no formal standard. However, obtaining the Omega-3 Index from OmegaQuant guarantees you a metric that has been accepted in over 100 research publications over the last 9 years, making it the most published of all the commercially-available methods. A significant advantage of the Omega-3 Index test is the ability to correlate it to clinical outcomes from major epidemiological and interventions studies (see below for “Research behind the test”)
C. The number of fatty acids reported in the profile
In addition to the Omega-3 Index, we also provide, at no additional charge, a complete fatty acid profile including 4 omega-3 fatty acids, 7 omega-6 fatty acids, 4 monounsaturated fatty acids, 6 saturated fatty acids, 3 groups of trans fatty acids, 5 composites (group sums), and 2 ratios (see below). Other ratios or groups of fatty acids can be calculated from these. But beyond these 26 fatty acids, there are still others (very minor components) that can be detected in both RBCs and in whole blood, and some labs will report these as well. It is our view at OmegaQuant that it is possible to provide too much information, and hence we draw the line at these 26, and in many respects, even this is more than can practically be addressed. We provide them as a courtesy to those clients who want to know. Sometimes “less is more” and we believe that applies here. Having said that, we are happy to modify our standard protocol for investigators interested in more obscure fatty acids that are not routinely measured (e.g., odd chain fatty acids).
D. The ratios included in the profile
As noted above, we provide two fatty acid ratios: the omega-6/omega-3 and AA/EPA. Although we include these values, we believe that the Omega-3 Index is, by far, the single most important (and actionable) component of our report. These ratios are provided as a courtesy and because some practitioners find them useful. We would suggest that for the dried blood spot assay, the omega-6/omega-3 ratio that would correspond to an Omega-3 Index of >8% would be 3.5 or less, and for the AA/EPA ratio, the target should be 9 or less. For the red blood cell assay, the target omega-6/omega-3 ratio should be 2.6 or less, and the AA/EPA ratio should be 15 or less.
E. The use of “reference” or “normal” ranges
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 result for which we feel justified in providing an actual target or optimal level is the Omega-3 Index since it has 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.
F. The provision of dietary recommendations to correct deviations from “normal”
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.
Clearly, we are very comfortable with recommending specific targets for the Omega-3 Index because the research supporting a target of 8% is strong, and we know that you can specifically raise the Index by eating more omega-3. We don’t, however, know exactly how much EPA+DHA any particular person should be told to take to achieve the 8% target. People differ, and so each person’s response to supplemental omega-3s will vary. Just like one cannot predict how much serum cholesterol will go down when a patient is placed on statins, we cannot accurately predict how the Omega-3 Index will respond to an increased intake; it must be individually tested. (See Question 2).
G. The research behind the test
Dr. Harris has been doing research in omega-3s for 30 years, and has over 80 published research papers in this field. In 2004, he, along with his colleague Clemens von Schacky, MD, a cardiologist from Munich, was the first to propose the Omega-3 Index as an independent risk factor for heart disease. More importantly, currently Dr. Harris is the Principal Investigator for and is using the Omega-3 Index test in two major epidemiological studies, both funded by the National Institutes of Health (NIH): the Framingham Heart Study and the Women’s Health Initiative’s Memory Study. In addition, he will be doing the blood analyses in the “VITAL” study which will be testing the effects of omega-3 fatty acid and/or vitamin D on CHD and cancer incidence in 20,000 subjects. Dr. Harris has used the same method in at least 8 additional clinical studies being funded by the NIH.
H. The clinical applicability of the test
Because of the research foundation supporting the Omega-3 Index, its clinical utility will continue to grow and mature as the results of these new studies are published. Health care providers and consumers alike want their results to be comparable to those published in the mainstream medical literature. If high or low risk for disease “X” is defined by a particular Omega-3 Index value as derived from these research studies, then only by using this specific test can you be sure that your level of risk is accurately predicted; a value from another lab may or may not give you a clinically-useful estimate of risk. It is for these reasons that the Cooper Aerobics Center (Dallas, TX) selected OmegaQuant as their sole provider for fatty acid testing.
How do I collect a dried blood spot sample for testing?
Do you follow Good Lab Procedures? Are your assays validated per FDA guidance?
Yes, we follow Good Laboratory Practices. All of our assays are validated. In particular for plasma/serum total and free (i.e., unbound) concentrations of EPA, DHA, DPA and ARA have been validated per the Guidance for Industry: Bioanalytical Method Evaluation (FDA; May, 2001). These assays (and our red blood cell fatty acid assay) have been and are currently being used in new drug development studies with pharmaceutical sponsors.
What kinds of samples do you analyze?
Any biological sample that contains fatty acids. Typically we are asked to analyze human plasma or erythrocytes, but we have experience with whole blood, plasma lipid classes (TG, CE, PL, NEFA), lipoproteins (VLDL, LDL, HDL), lipoprotein lipid classes, tissues (biopsies or from animals), tears, fish, and fish oil capsules.
How much sample do you need?
It depends on the sample type, but our typical assays require < 25 uL of plasma or blood or RBCs, or about 25 mg of tissues. We prefer to receive aliquots of at least 200 uL for liquid samples. If dried spots are preferred, 25 uL of whole blood or of RBCs mixed 50:50 with Erythrosolve™ (which we will provide) is sufficient. These would be spotted and sent on cards that we have pre-treated with our proprietary anti-oxidant OxyStop®.
How should samples be shipped?
Whole blood, packed RBCs, and dried blood spots are remarkably resistant to degradation and can typically be shipped overnight at ambient temperature. If samples are being collected at a research site for later batch shipment, they should be frozen at -80°C and shipped on dry ice. Note: RBC samples should not be kept at -20°C for more than 1 day as the long-chain PUFAs will begin to degrade. Storage at room temperature or 4°C for up to 3 weeks (before analysis) is acceptable.
What analytes and what sample types would be best for my specific research question?
This depends on your research question. For example, if a study is examining the short term (1 day to 2-4 weeks) effects of fish oil supplementation on omega-3 status, then plasma is the preferred analytical sample type; if longer term studies are contemplated (>1 month, optimally >4 months), then RBCs provide a more robust picture of status. Platelets turn over in about 10 days, RBCs in 120. Hence, short term studies can use platelets to track fatty acid compositional changes as well as plasma.
How are results returned?
Can OmegaQuant serve as a quality control laboratory and/or provide QC samples for other laboratories testing blood fatty acids?
Yes, we provide this service.
Does OmegaQuant offer scientific consultation in study design and interpretation of results in addition to laboratory analysis?
Yes. This is one of the advantages of working with OmegaQuant. Dr. Harris has over 30 years of research experience with fatty acids, and has published more than 300 papers in this field. He is happy to serve as a coauthor on scientific publications, or to simply provide advice and perspective on the findings for no additional charge.
Trans Fat FAQs
What are trans fats?
Trans fats are unsaturated fats (i.e., fats with 1 or more double bonds) in which at least 1 of the double bonds is in the trans (instead of the more natural cis) configuration (see diagram below). Trans fats can occur naturally at fairly low levels in some meat and milk products, but most of the trans fats that Americans consume are industrially produced. That is, they are produced from liquid vegetable oils by the process of “hydrogenation”, which results in the creation of solid fats like shortening, margarine, etc.
Examples of cis and trans-configured unsaturated fatty acids. Elaidic acid is the most common trans fatty acid in our food supply. Image from Mozaffarian D, et al. 2006, New England Journal of Medicine (click here for abstract).
Why are trans fats in our foods?
Food industry began to produce margarines (which include trans fats) as a replacement for butter because the latter had been declared a health hazard due to its high saturated fat content. Industry needed an alternative for their frying and baking needs. Adding hydrogen to unsaturated oils created a semi-solid, trans fat product, e.g. Crisco, that was shelf-stable and made flakey baked goods and crispy fried chicken. Unfortunately, trans fats turned out to be worse than butter with regards to heart disease risk (See “Why are trans fats bad for my heart?”). Now there is an effort to replace trans fats with alternatives, such as palm oil and, you guessed it, butter. The pendulum swings.
What foods are high in trans fats?
Processed foods, such stick margarine, baked goods, deep-fried fast foods, crackers and other pre-packaged snack foods, are our primary sources of industrially-produced trans fats. However, many of these types of foods are constantly being reformulated to reduce trans fat levels (See “What is being done to lower the trans fat content in foods?”).
Why are trans fats bad for my heart?
Trans fats increase the risk for heart disease through negative effects on cardiovascular risk factors which leads to an increased risk for heart attacks. Trans fats cause an increase in the “bad” (LDL) cholesterol, a reduction in the “good” (HDL) cholesterol, and worsens the total cholesterol:HDL-cholesterol ratio compared to cis-unsaturated and saturated fats. Inflammatory makers, such as C-reactive protein and interleukin-6, were elevated in obese women with higher vs. lower intakes of trans fats. Endothelial function (blood vessel health) was worsened in clinical trials when subjects consumed trans fats in the place of monounsaturated fats or carbohydrates.
Higher trans fat levels in red blood cells was associated with a 47% increased risk for sudden cardiac death in a case-control study. Some studies also show an increased risk of diabetes in women who consumed more trans fats, but this is not as consistent as the heart disease data. It is estimated that eliminating trans fat from the food supply would avert between 6-19% of heart disease-related deaths per year, totaling up to 228,000 deaths.
This information is sourced from the article, “Trans Fatty Acids and Cardiovascular Disease,” published in The New England Journal of Medicine in 2006 by Dr. Dariush Mozaffarian et al. 2006. Please click here for access to the abstract of the paper.
What is being done to lower the trans fat content of foods in the US?
Trans fats are an excellent product for baking and frying, but they are being removed from the food supply due to the discovery of their effect on heart disease risk. Indeed, the Food and Drug Administration removed the GRAS (Generally Recognized As Safe) status from trans fats in 2013, meaning that food processors must get permission to use trans fats in their foods. Many food processers have been removing and replacing trans fats from their products for years. The following graph shows the progress that has been made in lowering trans fat levels in foods with traditionally high levels. US consumers can expect these levels to drop further once the FDA ruling comes into effect.
Average trans fatty acid (TFA) content from 2007 through 2011 of brand-name US supermarket food products that contained ≥0.5 g/serving trans fatty acids in 2007, by food categories. Data were not collected in 2009. All products listing 0 g trans fatty acids but still containing partially hydrogenated oils in the ingredients list were considered to still contain 0.25 g per serving of trans fatty acids. Image from Otite FO, et al. 2013, Prev Chronic Disease. To access the complete article, please click here.
How can you tell how much trans fat is in a particular food?
The Nutrition Facts Panel on packaged foods lists the amount of trans fats per serving. If a serving of the food has less than 0.5 g of trans fat, then the manufacturer can list it as “0.” Non-packaged foods like bulk grains, cereals, candies; store-packaged meat; fresh fruits and vegetables do not have a Nutrition label and thus any trans fats in those foods will not be listed. The vast majority of trans fats in the US diet are found in packaged foods. The Nutrition Facts Panel example given here is the updated version, proposed by the FDA in 2014. Click here for more information.
What is the rationale for the Trans Fat Index cutpoints (low, intermediate, and high)?
The cut points were derived from a combination of two sets of data. First, based on over 27,000 samples analyzed at OmegaQuant Analytics over the last few years, we have an idea of the distribution of the Trans Fat Index in the US population. Second, we used published data from Sun et al. (Circulation 2007;115:1858-1865) in the Nurses’ Health Study. These researchers measured levels of industrially-produced trans fats in red blood cell membranes and related those levels to risk for cardiovascular events. They found a statistically significant, direct relationship between the Trans Fat Index and heart disease – higher levels were associated with higher risk. Those women in the highest 25% of the population (4th quartile) were 2.8x as likely to have a cardiac event as women in the lowest quartile.
Based on these two data sets, we chose the lowest quartile in the Sun paper (1.0%) as the upper limit of the Desirable level, and we chose the highest quartile (1.65%) as the beginning of the lower limit of the Undesirable category. Individuals between 1% and 1.65% would be considered in the Intermediate zone. In the 27,000 sample data set from OmegaQuant, only about 13% of the population had a Desirable Trans Fat Index; 65% of the population had an Intermediate score; and 22% of the population was in the Undesirable range.
Since we still need more data to really know what the “healthiest” level of trans fats would be, it is more important for the consumer to see a decrease in his/her Trans Fat Index after making healthier dietary choices than for the consumer to be in a specific risk group. In other words, lowering the Trans Fat Index from whatever level it is at the start shows good progress and would be expected to lower heart disease risk.