Free Shipping on All Orders $75 Or More!

Your Trusted Brand for Over 35 Years

Life Extension Magazine

<< Back to May 2010

Optimize Your Omega-3 Status

Personalized Blood Test Reveals a Novel Cardiac Risk Factor

May 2010

By Julius Goepp, MD

Critical Ratios

Critical Ratios

Dr. Holub’s own work demonstrated that the omega-6: omega-3 ratio is closely and inversely correlated with total omega-3 levels.18 That is, the lower the omega-6:omega-3 ratio, the higher the total proportion of fatty acids represented by beneficial omega-3s. Holub’s group found that an omega-6:omega-3 ratio of less than 4.5 corresponded with total omega-3s of greater than 7.2%, at which level significant protection against developing heart disease results.18,29 Your Omega Score™ report will include this vital ratio calculated from your own fatty acid composition.

The arachidonic acid (AA) to EPA ratio is another important measurement of risk for atherosclerosis and its consequences.38 AA is an omega-6 fatty acid that is metabolized into dangerous mediators of inflammation, including leukotrienes and prostaglandins, while EPA tips the scale in the direction of anti-inflammatory activity, so EPA helps downregulate these pro-inflammatory agents. A lower AA:EPA ratio is correlated with reduced risk for cardiovascular diseases.39

The average American male has a dangerously high ratio of 16.2, whereas the maximum recommended AA:EPA ratio is 5.18 By contrast, Japanese men, whose diets are rich in omega-3s through fish consumption, generally possess AA:EPA ratios of 1.7,18 reflecting a substantially lower risk of chronic inflammation.33

Supplementation with EPA can have a powerful effect on the important AA:EPA ratio, in one study dropping it from a concerning 23.7 at baseline in people with coronary artery disease to a remarkable 4.9.40 And a falling AA:EPA ratio was strongly correlated in reduction in gene expression of the inflammatory mediator IL-1b in patients with coronary artery disease.41 Finally, supplementation with EPA suppressed triglyceride synthesis in liver cells and reduced liver fat accumulations in lab animals on a high-fat high-sugar diet.42 Together these results compellingly demonstrate the importance of knowing (and responding to) the AA:EPA ratio.

Convenient At-Home Blood Sampling

Your Omega Score™ report will include your own AA:EPA ratio, allowing you to determine and track your risk for systemic inflammation, a primary cardiovascular disease risk marker.

Convenient At-Home Blood Sampling

This novel, convenient technology does not require a trip to a blood-drawing lab. You obtain the blood specimen yourself by finger stick at home, then send the sample in to the lab for testing. Your result, complete with graphic illustrations of your risk categories, will arrive in the mail.

Most first-time users of the Omega Score™ who are not already taking adequate levels of fish oil can expect to find themselves with higher-than-desirable risk levels.18 They may then take steps under the guidance of a healthcare practitioner or registered dietician to address their cardiovascular disease risk and monitor the changes they are making. Those who are already taking fish oil will discover if the amounts they are taking are providing them with the greatest possible risk reductions. Some people will find they either need to adjust their dose or their ratios of oils to obtain greater health benefits.

If your numbers reflect anything other than the lowest risk category, a high-quality fish oil supplement is recommended. Repeat the test in 4 weeks and adjust your supplementation accordingly to reduce your cardiovascular risk to the lowest possible level. Of course, because your metabolism and lifestyle change over time, it is important to repeat the test periodically to detect any undesirable reversals that would increase your cardiovascular disease risk.

How Much Omega-3 Should You Ingest?

It is by now widely recognized that the typical North American diet is replete with omega-6 fats (most commonly in the form of vegetable oil) and sorely lacking in omega-3s.43,44 The Canadian government’s department of public health, typically more forward-thinking than organized medicine in this country, has taken the step of recommending a ratio of omega-6 to omega-3 not greater than 4:1 for optimal cardiovascular health. Yet the typical American diet hovers at a ratio of roughly 8:1.1

EPA and DHA may reverse the potentially deadly effects of this egregious dietary imbalance in as little as three weeks. In fact, individuals ingesting 2,000-4,000 mg for that interval have experienced significant improvements across a range of key cardiovascular risk factors, including platelet aggregation (clotting potential), lower triglycerides, improved endothelial function, and reduced blood viscosity (“thickness”).1,2,45 Research indicates that in some patients on lipid-lowering statin drugs, the addition of omega-3 may reduce levels of LDL and VLDL cholesterol while maintaining a better safety profile than adding additional drugs.1,46 By favorably influencing electrical conduction in heart tissue, EPA and DHA supplements can also reduce cardiovascular disease mortality, especially sudden cardiac death.1,3,47

You may think of a regular heart rate as a sign of good health, but in healthy humans, heart rates should undergo slight variations. For this reason, low variability in heart rate is predictive of increased risk for coronary heart disease, death, and arrhythmias (irregular heart beat).48 In adult heart attack survivors, 4 grams of combined EPA and DHA per day was able to restore heart rate variability to normal levels.49 And endothelial dysfunction, the complex result of years of elevated cholesterol, inflammation, and structural remodeling of tissue, is improved in large arteries by 3-4 grams/day of combined omega-3 supplements.50

These benefits save lives. For example, in people with established coronary artery disease, ingestion of fish oil concentrate containing 55% EPA/DHA (6 grams/day for 3 months, followed by 3 grams/day for 21 months) substantially slowed progression of cardiovascular disease. These individuals also had fewer heart attacks and strokes compared to controls.15

Finally, in one of the largest of its kind, a European prevention study of 2,836 subjects showed that supplementation of less than 1 gram/day of EPA and DHA over 3.5 years in patients who’d already suffered one heart attack reduced the mortality rate from cardiovascular disease by an average of 30%.16


Omega-3 fatty acids combat cardiovascular disease through a host of interrelated mechanisms, including the suppression of pro-inflammatory cytokines, elevation of beneficial HDL, and reduction of triglycerides and VLDL. The ratio of omega-3 to omega-6 fatty acids in blood and cell membranes strongly influences cardiovascular disease risk factors. Until recently there was no good way of knowing your omega-3 status and the risk that it represents. A new at-home test called the Omega Score™ allows for convenient determination of your individual omega-3 status and your risk of developing or dying from cardiovascular disease. This breakthrough technology enables you to establish several critical threats to your health, including risk of sudden cardiac death, risk for developing heart disease, risk of fatal ischemic heart disease, and risk of sudden heart attack. With this revolutionary analytic technology, aging individuals can optimize their omega-3 status and minimize their risk of cardiovascular disease.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.


1. Holub BJ. Clinical nutrition: 4. Omega-3 fatty acids in cardiovascular care. CMAJ. 2002 Mar 5;166(5):608-15.

2. Angerer P, von Schacky C. n-3 polyunsaturated fatty acids and the cardiovascular system. Curr Opin Lipidol. 2000 Feb;11(1):57-63.

3. Schmidt EB, Skou HA, Christensen JH, Dyerberg J. N-3 fatty acids from fish and coronary artery disease: implications for public health. Public Health Nutr. 2000 Mar;3(1):91-8.

4. Park Y, Park S, Yi H, et al. Low level of n-3 polyunsaturated fatty acids in erythrocytes is a risk factor for both acute ischemic and hemorrhagic stroke in Koreans. Nutr Res. 2009 Dec;29(12):825-30.

5. Marik PE, Varon J. Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review. Clin Cardiol. 2009 Jul;32(7):365-72.

6. Vedin I, Cederholm T, Freund Levi Y, et al. Effects of docosahexaenoic acid-rich n-3 fatty acid supplementation on cytokine release from blood mononuclear leukocytes: the OmegAD study. Am J Clin Nutr. 2008 Jun;87(6):1616-22.

7. Carter AM. Inflammation, thrombosis and acute coronary syndromes. Diab Vasc Dis Res. 2005 Oct;2(3):113-21.

8. Pauwels EK, Kostkiewicz M. Fatty acid facts, Part III: Cardiovascular disease, or, a fish diet is not fishy. Drug News Perspect. 2008 Dec;21(10):552-61.

9. Denkins Y, Kempf D, Ferniz M, Nileshwar S, Marchetti D. Role of omega-3 polyunsaturated fatty acids on cyclooxygenase-2 metabolism in brain-metastatic melanoma. J Lipid Res. 2005 Jun;46(6):1278-84.

10. De Lorgeril M, Salen P. Use and misuse of dietary fatty acids for the prevention and treatment of coronary heart disease. Reprod Nutr Dev. 2004 May-Jun;44(3):283-8.

11. Yudkin JS. Inflammation, obesity, and the metabolic syndrome. Horm Metab Res. 2007 Oct;39(10):707-9.

12. Pittet YK, Berger MM, Pluess TT, Voirol P, Revelly JP, Tappy L, Chioléro RL. Blunting the response to endotoxin in healthy subjects: effects of various doses of intravenous fish oil. Intensive Care Med. 2010 Feb;36(2):289-95.

13. Lev EI, Solodky A, Harel N, et al. Treatment of Aspirin-Resistant Patients With Omega-3 Fatty Acids Versus Aspirin Dose Escalation. J Am Coll Cardiol. 2010 Jan 12;55(2):114-21.

14. Franceschini G, Calabresi L, Maderna P, Galli C, Gianfranceschi G, Sirtori CR. Omega-3 fatty acids selectively raise high-density lipoprotein 2 levels in healthy volunteers. Metabolism. 1991 Dec;40(12):1283-6.

15. von Schacky C, Angerer P, Kothny W, Theisen K, Mudra H. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999 Apr 6;130(7):554-62.

16. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet. 1999 Aug 7;354(9177):447-55.

17. León H, Shibata MC, Sivakumaran S, Dorgan M, Chatterley T, Tsuyuki RT.Effect of fish oil on arrhythmias and mortality: systematic review.BMJ. 2008 Dec 23;337:a2931.

18. Holub BJ, Wlodek M, Rowe W, Piekarski J. Correlation of omega-3 levels in serum phospholipid from 2053 human blood samples with key fatty acid ratios. Nutr J. 2009;8:58.

19. Danaei G, Ding EL, Mozaffarian D, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009 Apr 28;6(4):e1000058.

20. Available at: Accessed February 24, 2010.

21. Heinrichs SC. Dietary omega-3 fatty acid supplementation for optimizing neuronal structure and function. Mol Nutr Food Res. 2010 Jan 28.

22. McNamara RK. Membrane omega-3 Fatty Acid deficiency as a preventable risk factor for comorbid coronary heart disease in major depressive disorder. Cardiovasc Psychiatry Neurol. 2009;2009:362795.

23. Das UN. Can essential fatty acids reduce the burden of disease(s)? Lipids Health Dis. 2008;7:9.

24. Lindberg M, Saltvedt I, Sletvold O, Bjerve KS. Long-chain n-3 fatty acids and mortality in elderly patients. Am J Clin Nutr. 2008 Sep;88(3):722-9.

25. Dewailly E, Blanchet C, Gingras S, Lemieux S, Holub BJ. Fish consumption and blood lipids in three ethnic groups of Quebec (Canada). Lipids. 2003 Apr;38(4):359-65.

26. Bradbury KE, Skeaff CM, Green TJ, Gray AR, Crowe FL. The serum fatty acids myristic acid and linoleic acid are better predictors of serum cholesterol concentrations when measured as molecular percentages rather than as absolute concentrations. Am J Clin Nutr. 2010 Feb;91(2):398-405.

27. Hjartaker A, Lund E, Bjerve KS. Serum phospholipid fatty acid composition and habitual intake of marine foods registered by a semi-quantitative food frequency questionnaire. Eur J Clin Nutr. 1997 Nov;51(11):736-42.

28. Kuriki K, Nagaya T, Tokudome Y, et al. Plasma concentrations of (n-3) highly unsaturated fatty acids are good biomarkers of relative dietary fatty acid intakes: a cross-sectional study. J Nutr. 2003 Nov;133(11):3643-50.

29. Simon JA, Hodgkins ML, Browner WS, Neuhaus JM, Bernert JT, Jr., Hulley SB. Serum fatty acids and the risk of coronary heart disease. Am J Epidemiol. 1995 Sep 1;142(5):469-76.

30. Holub DJ, Holub BJ. Omega-3 fatty acids from fish oils and cardiovascular disease. Mol Cell Biochem. 2004 Aug;263(1-2):217-25.

31. Lemaitre RN, King IB, Mozaffarian D, Kuller LH, Tracy RP, Siscovick DS. n-3 Polyunsaturated fatty acids, fatal ischemic heart disease, and nonfatal myocardial infarction in older adults: the Cardiovascular Health Study. Am J Clin Nutr. 2003 Feb;77(2):319-25.

32. Amiano P, Dorronsoro M, de Renobales M, Ruiz de Gordoa JC, Irigoien I. Very-long-chain omega-3 fatty acids as markers for habitual fish intake in a population consuming mainly lean fish:

the EPIC cohort of Gipuzkoa. European Prospective Investigation into Cancer and Nutrition. Eur J Clin Nutr. 2001 Oct;55(10):827-32.

33. Kobayashi M, Sasaki S, Kawabata T, Hasegawa K, Akabane M, Tsugane S. Single measurement of serum phospholipid fatty acid as a biomarker of specific fatty acid intake in middle-aged Japanese men. Eur J Clin Nutr. 2001 Aug;55(8):643-50.

34. Nikkari T, Luukkainen P, Pietinen P, Puska P. Fatty acid composition of serum lipid fractions in relation to gender and quality of dietary fat. Ann Med. 1995 Aug;27(4):491-8.

35. Albert CM, Campos H, Stampfer MJ, et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med. 2002 Apr 11;346(15):1113-8.

36. Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004 Jul;39(1):212-20.

37. von Schacky C, Harris WS. Cardiovascular benefits of omega-3 fatty acids. Cardiovasc Res. 2007 Jan 15;73(2):310-5.

38. Rizzo AM, Montorfano G, Negroni M, et al. A rapid method for determining arachidonic:eicosapentaenoic acid ratios in whole blood lipids: correlation with erythrocyte membrane ratios and validation in a large Italian population of various ages and pathologies. Lipids Health Dis. 2010 Jan 27;9(1):7.

39. Russo GL. Dietary n-6 and n-3 polyunsaturated fatty acids: from biochemistry to clinical implications in cardiovascular prevention. Biochem Pharmacol. 2009 Mar 15;77(6):937-46.

40. Burns T, Maciejewski SR, Hamilton WR, Zheng M, Mooss AN, Hilleman DE. Effect of omega-3 fatty acid supplementation on the arachidonic acid:eicosapentaenoic acid ratio. Pharmacotherapy. 2007 May;27(5):633-8.

41. de Mello VD, Erkkilä AT, Schwab US, et al. The effect of fatty or lean fish intake on inflammatory gene expression in peripheral blood mononuclear cells of patients with coronary heart disease.Eur J Nutr. 2009 Dec;48(8):447-55.

42. Kajikawa S, Harada T, Kawashima A, Imada K, Mizuguchi K. Highly purified eicosapentaenoic acid prevents the progression of hepatic steatosis by repressing monounsaturated fatty acid synthesis in high-fat/high-sucrose diet-fed mice. Prostaglandins Leukot Essent Fatty Acids. 2009 Apr;80(4):229-38.

43. Raper NR, Cronin FJ, Exler J. Omega-3 fatty acid content of the US food supply. J Am Coll Nutr. 1992 Jun;11(3):304-8.

44. Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr. 2000 Jan;71(1 Suppl):179S-88S.

45. Connor WE. Importance of n-3 fatty acids in health and disease. Am J Clin Nutr. 2000 Jan;71(1 Suppl):171S-5S.

46. Nordoy A, Bonaa KH, Sandset PM, Hansen JB, Nilsen H. Effect of omega-3 fatty acids and simvastatin on hemostatic risk factors and postprandial hyperlipemia in patients with combined hyperlipemia. Arterioscler Thromb Vasc Biol. 2000 Jan;20(1):259-65.

47. Leaf A, Kang JX, Xiao YF, Billman GE, Voskuyl RA. The antiarrhythmic and anticonvulsant effects of dietary N-3 fatty acids. J Membr Biol. 1999 Nov 1;172(1):1-11.

48. Dekker JM, Crow RS, Folsom AR, et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. Circulation. 2000 Sep 12;102(11):1239-44.

49. Christensen JH, Gustenhoff P, Korup E, et al. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial. BMJ. 1996 Mar 16;312(7032):677-8.

50. Goodfellow J, Bellamy MF, Ramsey MW, Jones CJ, Lewis MJ. Dietary supplementation with marine omega-3 fatty acids improve systemic large artery endothelial function in subjects with hypercholesterolemia. J Am Coll Cardiol. 2000 Feb;35(2):265-70.

51. Emken EA, Adlof RO, Gulley RM. Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males. Biochim Biophys Acta. 1994 Aug 4;1213(3):277-88.

52. Weaver KL, Ivester P, Chilton JA, Wilson MD, Pandey P, Chilton FH. The content of favorable and unfavorable polyunsaturated fatty acids found in commonly eaten fish. J Am Diet Assoc. 2008 Jul;108(7):1178-85.