Survey of the erythrocyte EPA+DHA levels in the heart attack/stroke belt

Prostaglandins Leukot Essent Fatty Acids. 2019 Sep;148:30-34. doi: 10.1016/j.plefa.2019.07.010. Epub 2019 Jul 13.


Background: The Omega-3 Index (O3I; erythrocyte EPA+DHA as a percent of total fatty acids) is inversely related to risk for cardiovascular disease (CVD). The cardioprotective target O3I is 8%-12%. O3I levels in American regions with high CVD risk are poorly characterized.

Purpose: To determine the O3I in individuals participating in a Seafood Nutrition Partnership (SNP) survey in seven US cities in the CVD "belt."

Methods: Fingerstick blood samples were analyzed for the O3I.

Results: The SNP cohort (n = 2177) had a mean (SD) O3I of 4.42% (1.12%). Only 1.2% were in the desirable range, whereas 42% had an undesirable (<4%) O3I. The mean (SD) O3I in a subset of 772 SNP subjects who were matched for age and sex with the Framingham study was 4.6% (1.2%) compared 5.3% (1.6%) in the Framingham cohort (p < 0.0001).

Conclusions: Individuals in the CVD "belt" had relatively low O3I levels. Since in other settings, a low O3I is associated with increased risk for CVD, this may be one factor contributing to the higher risk for CVD in this region of the US.

Keywords: Abbreviations: CVD, Cardiovascular disease; CHD, Coronary heart disease; Community survey; DHA, Docosahexaenoic acid; Docosahexaenoic acid; EPA, Eicosapentaenoic acid; Eicosapentaenoic acid; FHS, Framingham heart study; Fish; Fish oil; HDLab, Health diagnostic laboratory; O3I, Omega-3 index; Omega-3 index; SNP, Seafood nutrition partnership.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Docosahexaenoic Acids / blood*
  • Eicosapentaenoic Acid / blood*
  • Erythrocytes / chemistry*
  • Female
  • Humans
  • Male
  • Myocardial Infarction / metabolism*
  • Nutrition Surveys
  • Stroke / metabolism*
  • United States


  • Docosahexaenoic Acids
  • Eicosapentaenoic Acid