Purpose

To measure the impact of AquaOmega’s High EPA Omega-3 fatty acid supplement on blood levels of omega-3 fatty acids after 30 days of use.

Investigator

Dr. Maille Devlin, ND

Methods

Participants
Naturopathic doctors, naturopathic medical students, registered dieticians who were not taking omega-3 supplementation within 4 weeks of the beginning of the study.

Design
Quantitative observational study which investigated the impact of AquaOmega’s High EPA Omega-3 fatty acid supplement on blood levels of omega-3 fatty acids. Blood levels of omega-3 fatty acids were measured using the OmegaScore™test created by Lipid Analytics. OmegaScoreTM is a blood spot analysis which measures the long chain omega-3 fatty acids (EPA + DHA + DHA) as a percent of the total amount of fatty acids in whole blood. The OmegaScore™ test is different from an Omega-3 Index which measures EPA and DHA at a percent of the fatty acids in red blood cells. An OmegaScore™ can be easily converted to an Omega-3 Index to identify the omega-3 fatty acids specifically in red blood cells.

The blood spot kit sent to patients uses a specialized paper strip technology for collecting blood samples which were mailed in by each participant for laboratory analysis at baseline. Participants were then required to take 1.5 teaspoons of AquaOmega’s High EPA Omega-3 fatty acid supplement (4380 mg omega-3 fatty acids, 3380mg EPA, 670mg DHA, 1000IU vitamin D) daily for 4 weeks. At the end of the 4 weeks, participants sent in a second blood spot sample in order to measure their new OmegaScore™.

Results

There were 48 participants who sent in a baseline OmegaScore™ sample. There were eight participants who did not finish the study. One participant did not send enough blood in a sample, one person reported adverse effects and did not maintain adequate dosing, three individuals were not consistent in supplementing and three more did not send in a second sample.

There were 40 participants with two OmegaScore™ samples for analysis. The average baseline score was 3.9. The score after four weeks of supplementation of AquaOmega’s High EPA Omega-3 fatty acid supplement was 7.0. There was an average increase of score of 44%.

Discussion

Supplementing daily with 1.5 tsp (4380 mg) of omega-3 fatty acids increased the omega-3 fatty acid content in whole blood by an average of 44% within one month. Although more research has to be conducted with larger populations, this information is valuable to clinician’s and patients when determining dosing and outcomes of supplementation.

OmegaScore™
The OmegaScore™ blood spot test is an effective and minimally invasive way to measure blood levels of omega-3 fatty acids in participants. Providing individuals with at-home test kits allows them to easily gauge their omega-3 fatty acid levels and associated risks. Using the OmegaScore™, clinicians can more easily determine appropriate dosing on an individualized level.

Clinical Relevance of the score
Through this study, it was found that individuals can increase the ratio of omega-3 fatty acids in their blood by supplementing with a high dose of omega-3 fatty acid supplement in triglyceride form. A higher omega-3 fatty acid level in the blood (often measured using an Omega-3 Index) is associated with several positive clinical outcomes.

According to Olsen et al. 2018, the risk of preterm pregnancy is inversely correlated with an individual’s Omega-3 Index. In the study, women with less than 1.6% omega-3 fatty acids had 10.27 times (95% confidence interval 6.80–15.79, p 1

In a study assessing the impact of omega-3 fatty acids on the risk of cognitive deterioration with aging, analysis was conducted among 720 participants aged 68-92 years.₂ Omega-3 Index scores were measured. An Omega-3 Index greater than 6.8% was associated with 81% risk reduction of cognitive impairment when compared to those with scores less than 5.7%.₂ In a study assessing the impact of the Omeg-3 Index in adolescents, 266 teens aged 13-15 years had their Omega-3 Index measured at baseline. The average Omega-3 Index was 3.83%.₃ After the Omega-3 Index was determined, a series of cognitive tests were run. Significantly higher information processing speed and less impulsivity was found in those with a higher Omega-3 Index.₃

In a 2018 study by Harris et al, a higher Omega-3 Index was associated with significantly lower cardiac risks for total mortality, for non-cardiovascular and non-cancer mortality, and for total cardiovascular events in 2500 participants.₄ Those in the highest (>6.8%) compared to those in the lowest Omega-3 Index quintiles (<4.2%) had a 34% lower risk for death from any cause and 39% lower risk for incident cardiovascular disease.₄ Omega-3 index in Australians, aged approximately 76 years-old was inversely associated with plasma triglycerides, total cholesterol:high-density lipoprotein (HDL) cholesterol ratio and was positively associated with HDL-cholesterol in all subjects.₅ In a Canadian study, levels of omega-3 fatty acids in the blood between 4% to 8% were related to higher HDL-cholesterol levels in white Canadians.₆ However, this association was not present for South Asians living in Canada. Therefore, the index score may not be as good of a predictive risk factor for the prevalence of cardiovascular disease and diabetes in South Asians. However more studies are needed.₅ In adolescents, testing levels of omega-3 fatty acids can also be useful. In a study of 1301 teens aged 13-15 years, the omega-3 index was assessed along with diet, lifestyle, socioeconomic factors, cardiovascular and metabolic risk factors.₅ The mean score was 4.90 ± 1.04% (range 1.41–8.42%). The study found that the omega-3 index score was positively associated with dietary intakes of EPA and DHA, proteins, omega-3 fats and fish and wholegrain food groups, and negatively associated with the intake of soft drinks and crisps.₅

Adverse effects
One participant noted adverse effects of gastrointestinal nature including nausea and loose stools.

Consistency
The most significant barrier to increasing blood levels of omega-3 fatty acids was consistency. Three participants were unable to stay consistent with the daily intake of omega-3 fatty acids, impacting their ability to raise blood levels. Finding individualized techniques to keep individuals consistent with supplementation is needed in further study as well as clinically.

Conclusion
After supplementing with AquaOmega’s High EPA Omega-3 fatty acid for four weeks, blood levels of omega-3 fatty acid increased on average 44%. The OmegaScore™ blood spot test is an effective and minimally invasive way to measure blood levels of omega-3 fatty acids in participants. Providing individuals with at-home test kits allows them to easily gauge their omega-3 fatty acid levels. A high dose of omega-3 fatty acids in a triglyceride form can quickly raise blood levels of omega-3 fatty acids. Further, more complex, larger scale studies are needed to measure the direct clinical relevance of increasing omega-3 fatty acid levels rather than through association.

Study Sponsored By
AquaOmega and Lipid Analytical Laboratories