Q : What Are Omega-3 Fatty Acids and Where Are They Found? A : Omega-3 fatty acids are essential fatty acids in the human diet that are primarily found in oily fish like salmon, sardines, albacore tuna, herring, mackerel, etc. They are also available in fish oil capsules. The principle omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). A more rudimentary form of omega-3 is found in soybean oil, canola oil, and especially in flaxseed oil. It is called alpha-linolenic acid (ALA), but unlike EPA and DHA, it has not yet been shown to have significant cardiovascular benefits. In other words, flaxseed oil is definitely not a substitute for fish oil.

Q : What Is the Evidence That Omega-3 Oils Are Cardioprotective? A: Over the last 25 years, compelling evidence has accumulated from epidemiological studies and large clinical trials demonstrating the cardioprotective effects of omega-3 oils. The strongest evidence to date relates to reducing risk for sudden cardiac death (SCD), the primary cause of coronary heart disease (CHD) death in the US today.

Q : What Does the American Heart Association Say About Omega-3? A : Patients with documented CHD should consume about 1 g of EPA+DHA per day, and those without documented CHD should eat a variety of fish, preferably oily, at least twice a week. The latter would provide about 500 mg of EPA+DHA daily.

Q : How Can You Know If You Are Getting Enough Omega-3? A : The HS-Omega-3 Index, the original standardized blood test of omega-3 status, measures the content of DHA+EPA in the phospholipids of red blood cell membranes. It is expressed as a percent of total fatty acids in the membrane that are DHA+EPA. The HS-Omega-3 Index is a proven surrogate for cardiac omega-3 levels and is similar in concept to hemoglobin A1c. Just as the latter is a measure of average glucose levels, the HS-Omega-3 Index provides a long-term assessment of tissue omega-3 levels.

Q : What Is the Target Range For the HS-Omega-3 Index? A : The target HS-Omega-3 Index is 8% and above, a level that current research indicates is associated with the lowest risk* for death from CHD. On the other hand, an Index of 4% or less (which is common in the US) indicates the highest risk*. At present, there are no known sex- or age-specific values.

*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 and not influenced by omega-3 fatty acids. All risk factors – including the HS-Omega-3 Index—should be addressed as part of any global risk reduction strategy.

Q: What Can I Do to Correct My HS-Omega-3 Index? A: If your HS-Omega-3 Index is in the high risk zone (<4%), try to increase your intake of DHA+EPA by about 3,000 mg/day; if it is in the intermediate risk zone, (4% to 6%), try to increase your DHA+EPA intake by about 2,000 mg/day; if it is in the lower risk zone (6% to 8%), try to increase your DHA+EPA intake by about 1,000 mg/day. If you are fortunate enough to have an HS-Omega-3 Index greater than 8%, there is probably no need to increase your daily intake of DHA+EPA. Increasing your daily intake of DHA+EPA can be accomplished by eating more oily fish or by taking fish oil supplements. You should wait 4-6 months after changing your omega-3 intake (DHA+EPA) before re-testing your HS-Omega-3 Index in order to allow your system time to reach a new steady state.

Q: Why Not Just Skip the Test and Eat More Fish or Take Supplements? A: Although strongly correlated with one’s DHA+EPA intake, the exact value for the HS-Omega-3 Index cannot be deduced from just knowing your omega-3 intake. There is considerable person-to-person variability and it is very difficult to know the actual amount of omega-3 consumed in the diet, particularly if relying on fish as the source. This is because omega-3 levels vary by season, by location of the catch, and by preparation method so that the specific amount in a particular serving of fish is unknown. We measure lipid levels even when people are on lipid-lowering drugs; the same logic applies to omega-3 levels.

Q: Why should I choose to test with the HS-Omega-3 Index? A: The HS-Omega-3 Index has been shown to be a better indicator of relative risk for sudden cardiac death than other CHD risk factors. At the highest omega-3 level, this risk is reduced by 90%. Low levels are easily corrected through dietary changes or supplements. The test is inexpensive and is now conveniently available through VitalRemedyMD by calling 1-800-770-4360 or going to www.vitalremedymd.com.