Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD

Aleix Sala-Vila, William S. Harris, Montserrat Cofán, Ana M. Pérez-Heras, Xavier Pintó, Rosa M. Lamuela-Raventós, Maria Isabel Covas, Ramon Estruch, Emilio Ros

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA+DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac death despite a high prevalence of cardiovascular risk factors, dietary data were acquired from FFQ and blood cell membrane fatty acid composition was measured by GC. The average consumption of EPA+DHA was 0•9 g/d and the mean omega-3 index was 7•1 %. In multivariate models, EPA+DHA intake was the main predictor of the omega-3 index but explained only 12 % of its variability (P < 0•001). No associations with other dietary fatty acids were observed. Although the single most influential determinant of the omega-3 index measured here was the intake of EPA+DHA, it explained little of the former's variability; hence, the effects of other factors (genetic, dietary and lifestyle) remain to be determined. Nevertheless, the high omega-3 index could at least partially explain the paradox of low rates of fatal CHD in Spain despite a high background prevalence of cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)425-431
Number of pages7
JournalBritish Journal of Nutrition
Issue number3
StatePublished - Aug 14 2011
Externally publishedYes


  • Cardiovascular risk
  • DHA
  • Diet
  • EPA
  • PUFA
  • SFA

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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