Omega-3 Index: 10% or greater?

We've previously considered the question:

What is an ideal level of omega-3 fatty acids in the blood?

Recall that omega-3 levels in red blood cells (RBCs), a measure called the "omega-3 index," have been associated with risk for sudden cardiac death:

In a recent analysis, 265 people experiencing sudden death during a heart attack (ventricular fibrillation, successfully resuscitated) showed an omega-3 index of 4.88%, while 185 people not experiencing sudden death during a heart attack showed an omega-3 index of 6.08%.

We have more ambitious goals than just avoiding sudden death, of course! How about the omega-3 index associated with reduced risk for heart attack? A recent analysis of females from the Harvard School of Public Health suggested that RBC omega-3 levels as high as 8.99% were still associated with non-fatal heart attack (myocardial infarction), compared to 9.36% in those without heart attacks, suggesting that even higher levels are necessary to prevent non-fatal events.

Most recently, another study comparing 50 people after heart attack with 50 controls showed that people with heart attack had an omega-3 index of 9.57% vs 11.81% in controls--even higher. (This study was in a Korean population with higher fish consumption. There was also a powerful contribution to risk from trans fat RBC levels.) The investigators concluded: "The area under the receiver operating characteristic curve of fatty acid profiles was larger than that for traditional risk factors, suggesting that fatty acid profiles make a higher contribution to the discrimination of MI cases from controls compared with modified Framingham risk factors."

The data suggest that, while an omega-3 index of 7.3% is associated with reduced risk for sudden cardiac death, a higher level of 10% or greater is associated with less risk for heart attack. Surprisingly, fish consumption and fish oil intake account for only 47% of the variation in omega-3 index.

I believe the emerging data are becoming increasingly clear: If you desire maximal control over heart health, know your omega-3 index and keep it 10% or higher.

Comments (19) -

  • Medical Answering Services

    2/9/2010 1:29:37 PM |

    There are foods, which can easily lower the LDL. You should consume fishes. They are considered to be the greatest source of omega3 fatty acids. They can easily lower LDL levels and increase good cholesterol levels. In order to discard heart diseases, it is always advisable to eat high soluble fibers. You should consume lots of green colored vegetable, fruits and cereals to reduce LDL.

  • Matt Stone

    2/9/2010 1:38:00 PM |

    Thanks Dr. Davis. This is definitely very interesting. Would it be plausible that higher omega 3 levels are protectorant solely because omega 6 intake and cellular AA is so astronimically high?  

    I ask if you've considered this because there is a sect of researchers that believe, when both omega 6 and 3 levels are low, an even more beneficial and anti-inflammatory PUFA is produced in its place called Mead Acid.  

    Just wondering if you've encountered these ideas, and if so, why you've written them off in favor of achieving a high omega 3 level.

  • Ed

    2/9/2010 1:53:29 PM |

    My guess is the other biggest cause of variation in omega-3 index, after omega-3 consumption, is omega-6 consumption. Inversely of course. Dr Bill Lands writes extensively about this on his essential fatty acids education (efaeducation) web site hosted by the NIH.

    Does the omega-3 index likewise have the same striking correlation with stroke incidence?

  • Mike

    2/9/2010 4:28:58 PM |

    Dr Davis,

      Is there any issues with international orders for the O3 Index kit?  For myself, Canada specifically.

    Also, I'd be interested to hear your thoughts on *over* consumption of omega-3s and the potential health hazards, if any, in a future post.

  • MontyApollo

    2/9/2010 6:36:37 PM |

    I'm kinda fuzzy on the interaction between omega-6 and omega-3. Would lowering omega-6 consumption increase the Omega-3 Index as well?

  • Will @ Fitness Achievement

    2/9/2010 6:55:06 PM |

    I've lost over 40 pounds so far with diet and exercise.  I blog at Fitness Achievement

  • Dr Matti Tolonen

    2/10/2010 9:52:14 AM |

    Harris and v. Schacky proposed omega-3 index in 2004 as a novel physiologically relevant, easily modified, independent, and graded risk factor for death from CHD that could have significant clinical utility

    In my view it is impossible to reach a 8-10% omega-3 index just by increasing intake of fish and other seafood. One needs fish oil as dietary supplements.

    The role of LDL cholesterol in atherosclerosis is a major misunderstanding. The mechanism of the disease is mainly chronic low-grade inflammation, and omega-3:s are excellent anti-inflammatory agents. JELIS demonstrated it nicely. The effect goes beyond cholesterol.

    E-EPA (1.800 mg/day), as dietary supplement, prevented angina pectoris, clinical myocardial infarctions and new cases of coronary heart disease in Japanese population, although they eat 5-6 times more fish and Americans.

  • brainpower

    2/10/2010 11:45:33 AM |

    And even more important: keep the Omega-6 low. One you do that, you won't have to worry so much about additional intake of omega-3.

  • Peter

    2/10/2010 5:16:11 PM |

    If fish oil does turn out to be the fountain of youth it will be bad news for the fish.

  • Alfredo E.

    2/10/2010 11:01:53 PM |

    Omega 3 and omega 6 should in a 1/1 ratio. In order to maintain that you need a low carbs diet and supplement with about 3.000 mg of fish oil per day.

    Commercial fish is loaded with omega 6, so is most of the meat you buy at the supermarket.

    So, in the real world you have to cut all grains, grain oils and take some omega 3 supplements.

    If any of the readers is interested in reading about omega 3 in spanish, please go to

    Best wishes,
    Alfredo E.

  • Healthy Oil Planet

    2/12/2010 3:44:26 PM |

    While fish oils are a viable source for omega 3 fatty acids, reports indicate krill oil may be a more suitable supplement for cholesterol lowering strategies.  

    A recent study on neptune krill oil and cholesterol found patients taking 500 mg. per day of Neptune Krill Oil experienced total cholesterol decrease of 19%, LDL cholesterol decreased by 44% and HDL cholesterol increased by 33%.  Study subjects who took 3 grams a day of fish oil supplements experienced Total cholesterol decrease of 6%, LDL cholesterol decrease of 4% and HDL cholesterol increase of 4%.  

    Fish oils do offer cardiovascular benefits, but it may appear Neptune Krill Oil could be a more suitable supplement for patients seeking more aggressive cholesterol lowering treatment.

  • Anonymous

    2/13/2010 2:20:51 PM |

    What a great resource!

  • tareq

    2/14/2010 5:10:28 PM |

    I ate fishes but fried them in sunflower oil but there was no benifit

  • Dr Matti Tolonen

    3/4/2010 5:19:52 PM |

    Here is the latest article written by Prof Clemens von Schacky about Omega-3 Index

    Dr Pentti Raaste and yours truly have just published a small leaflet for prevention and self treatment of cardiovascular diseases

  • TedHutchinson

    7/26/2010 12:25:28 PM |

    30-Days of High Omega-6 Diet--Stiffens Arteries and Increases Belly Fat

    I was shocked to see what happens when someone with a good omega 3 status changes to an omega 6 rich diet for a month.

    Now consider what happens when people have been consuming too much omega 6 in relation to omega 3 from  conception and throughout their entire lives.

  • buy jeans

    11/3/2010 8:44:26 PM |

    The data suggest that, while an omega-3 index of 7.3% is associated with reduced risk for sudden cardiac death, a higher level of 10% or greater is associated with less risk for heart attack. Surprisingly, fish consumption and fish oil intake account for only 47% of the variation in omega-3 index.

  • best omega 3

    2/2/2011 10:00:23 AM |

    That graph really shows how healthy omega 3 is. It is just a very amazing thing. I think taking omega 3 regularly will keep our body healthy.

  • Susan

    5/27/2011 4:39:02 PM |

    I discovered the powers of omega-3 when I was diagnosed with rheumatoid arthritis. of course, that didn't cure me but I'm really better now on omega-3 supplemts. It's not eliminating fats what we need to be healthy (as many would say), it the RIGHT fats. I'm glad the healthy fats topic is getting more and more popular.