Association of reported fish intake and supplementation status with the omega-3 index

K. H. Jackson, J. M. Polreis, N. L. Tintle, P. M. Kris-Etherton, W. S. Harris

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Background: An Omega-3 Index (O3I; EPA+DHA as a % of erythrocyte total fatty acids) in the desirable range (8%-12%) has been associated with improved heart and brain health. Objective: To determine the combination of fish intake and supplement use that is associated with an O3I of >8%. Design: Two cross-sectional studies comparing the O3I to EPA+DHA/fish intake. Participants/setting: The first study included 28 individuals and assessed their fish and EPA+DHA intake using both a validated triple-pass 24-hr recall dietary survey and a single fish-intake question. The second study used de-identified data from 3,458 adults (84% from US) who self-tested their O3I and answered questions about their fish intake and supplement use. Statistical analyses performed: Study 1, chi-squared, one-way ANOVA, and Pearson correlations were computed. In Study 2, multi-variable regression models were used to predict O3I levels from reported fish/supplement intakes. Results: The mean ± SD O3I was 4.87 ± 1.32%, and 5.99 ± 2.29% in the first and second studies, respectively. Both studies showed that for every increase in fish intake category the O3I increased by 0.50–0.65% (p < 0.0001). In the second study, about half of the population was taking omega-3 supplements, 32% reported no fish intake and 17% reported eating fish >2 times per week. Taking an EPA+DHA supplement increased the O3I by 2.2% (p < 0.0001). The odds of having an O3I of ≥8% were 44% in the highest intake group (≥3 servings/week and supplementation) and 2% in the lowest intake group (no fish intake or supplementation); and in those consuming 2 fish meals per week but not taking supplements (as per recommendations), 10%. Conclusions: Current AHA recommendations are unlikely to produce a desirable O3I. Consuming at least 3 fish servings per week plus taking an EPA+DHA supplement markedly increases the likelihood of achieving this target level.

Original languageEnglish (US)
Pages (from-to)4-10
Number of pages7
JournalProstaglandins Leukotrienes and Essential Fatty Acids
StatePublished - Mar 2019

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Cell Biology


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