Researchers develop “omega 3 calculator” to ensure the ideal dose

03 Sep 2019 --- A study published in the American Journal of Clinical Nutrition will make it possible to calculate how much omega 3 EPA and DHA is needed in studies, for subjects to reach a healthy Omega 3 Index. The index measures the level of omega 3 EPA and DHA’s in the blood, and can be used as a risk factor for heart disease, among other conditions. The researchers highlight that dose likely played a role in the relative success or failure of previous studies that have focused on omega 3 as a research variable.

Until now, there has been minimal guidance about what dose of EPA and DHA should be tested in a study, as outlined by the report. The researchers explain that if the dose of EPA and DHA in a study is not high enough to make an impact on blood levels (i.e. the Omega 3 Index), there may be no effect on the observed outcome of omega 3 supplementation, leading to a neutral result.

When it comes to cardiovascular disease (CVD), in particular, the literature supporting the benefits of omega 3 types EPA and DHA has been mixed, note the study’s researchers. Contradicting findings of studies further underline the significance of omega 3 dose.

For instance, a 2018 meta-analysis concludes that current evidence does not support a role for omega 3s in CVD risk reduction.

Conversely, three major randomized trials reported in late 2018 show that omega 3s significantly reduced risk for vascular death, myocardial infarction and major adverse cardiovascular events. The latter study was particularly compelling because it used 4 grams of EPA (as opposed to the usual 0.84 grams of EPA and DHA) in statin-treated patients and found a 25 percent risk reduction in CVD events.

“A low dose could make a study show no effect of EPA and DHA, which makes the literature more indecisive and the medical community more skeptical of omega 3 benefits. Hopefully, ensuring the dose of EPA and DHA is high enough to reach a target Omega 3 Index level will clarify whether or not EPA and DHA are effective,” explains Kristina Harris Jackson, Ph.D., co-lead author on this paper.

The calculator presented in this study does not eliminate the need for Omega 3 Index testing.How to use the calculator
The model equation developed in this paper can be used to estimate the final Omega 3 Index (and 95 percent confidence interval) of a population given the omega 3 EPA and DHA dose and baseline Omega 3 Index. As an example, a population with a baseline Omega 3 Index of 4.9 percent that is given 840 mg EPA and DHA per day (as a 1-gram ethyl ester capsule) would achieve a mean Omega 3 Index of 6.5 percent (95 percent CI: 6.3 percent, 6.7 percent).

Rearranging the equation, one can calculate the approximate EPA/DHA doses (of triglyceride forms) needed to achieve a mean omega 3 index of 8 percent in 13 weeks. This would require about 2,200 mg of EPA and DHA for a baseline Omega 3 Index of 2 percent, approximately 1,500 mg for a baseline Omega 3 Index of 4 percent, and roughly 750 mg of EPA and DHA for a baseline Omega 3 Index of 6 percent.

Using this example, Jackson and her colleagues predicted that the minimum dose of EPA and DHA necessary to be 95 percent certain that the mean baseline Omega 3 Index of 4 percent will increase to 8 percent (in 13 weeks) is 1,750 mg per day of a triglyceride formulation or 2500 mg per day of an ethyl ester formulation. Both of these forms are common in fish oil preparations.

Therefore, in order for 95 percent of subjects (not just 50 percent) to achieve a desirable Omega 3 Index from a baseline of 4 percent, roughly 2,000 mg per day of EPA and DHA (depending on the chemical form) would likely be required.

Do researchers still need the Omega 3 Index?
The calculator presented in this study does not eliminate the need for Omega 3 Index testing. In fact, establishing a baseline Omega 3 Index is essential to use the calculator.

“The recommended doses are simply average responses, but individual responses to EPA and DHA are still very difficult to predict,” says Dr. Jackson. “In a recent consumer cohort, we found individuals spanned the full range of Omega 3 Index despite reporting the same amount of fish intake and supplement use.”

This paper outlines that if people want to reach 8 percent in a relatively short amount of time, such as three to four months, they would need 1-2 grams EPA and DHA per day, depending on their starting Omega 3 Index.

“As noted, the equation developed [in this paper] can aid in predicting population Omega 3 Index changes, but because of the large interindividual variability in the Omega 3 Index response to EPA and DHA supplementation, it will likely be less useful in the clinical setting where direct testing of the Omega 3 Index would be the preferred approach to assessing EPA and DHA status,” the study authors explain.

Edited by Benjamin Ferrer