CoChat
Sign Up
Cited by 56Fatty Acid Research and HealthNutritional Studies and DietAquaculture Nutrition and Growth

Red blood cell fatty acid patterns from 7 countries: focus on the Omega-3 Index

Open access
Schuchardt, Jan Philipp, Cerrato, Marianna, Ceseri, Martina, DeFina, Laura F., Delgado, Graciela E., Gellert, Sandra, Hahn, Andreas, Howard, Barbara V. +14 more·2022·Prostaglandins, Leukotrienes and Essential Fatty Acids
DOI 10.1016/j.plefa.2022.102418PMC PMC10440636
Open this paper in CoChat — free accountOpen PDF

Abstract

Red blood cell (RBC) fatty acid (FA) patterns are becoming recognized as long-term biomarkers of tissue FA composition, but different analytical methods have complicated inter-study and international comparisons. Here we report RBC FA data, with a focus on the Omega-3 Index (EPA + DHA in% of total FAs in RBC), from samples of seven countries (USA, Canada, Italy, Spain, Germany, South Korea, and Japan) including 167,347 individuals (93% of all samples were from the US). FA data were generated by a uniform methodology from a variety of interventional and observational studies and from clinical laboratories. The cohorts differed in size, demographics, health status, and year of collection. Only the Canadian cohort was a formal, representative population-based survey. The mean Omega-3 Index of each country was categorized as desirable (>8%), moderate (>6% to 8%), low (>4% to 6%), or very low (≤4%). Only cohorts from Alaska (treated separately from the US), South Korea and Japan showed a desirable Omega-3 Index. The Spanish cohort had a moderate Omega-3 Index, while cohorts from the US, Canada, Italy, and Germany were all classified as low. This study is limited by the use of cohorts of convenience and small sample sizes in some countries. Countries undertaking national health status studies should utilize a uniform method to measure Omega-3 FA levels.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.plefa.2022.102418

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 47

  1. [1]Casula M, Olmastroni E, Gazzotti M, Galimberti F, Zambon A, Catapano AL, Omega-3 polyunsaturated fatty acids supplementation and cardiovascular outcomes: do formulation, dosage, and baseline cardiovascular risk matter? An updated meta-analysis of randomized controlled trials, Pharmacol. Res 160 (2020) 105060. 10.1016/j.phrs.2020.105060. 32634581 · DOI · Paper page
  2. [3]McNamara RK, Carlson SE, Role of omega-3 fatty acids in brain development and function: potential implications for the pathogenesis and prevention of psychopathology, Prostaglandins Leukot. Essent. Fatty Acids 75 (2006) 329– 349. 10.1016/j.plefa.2006.07.010. 16949263 · DOI
  3. [5]Shulkin M, Pimpin L, Bellinger D, Kranz S, Fawzi W, Duggan C, Mozaffarian D, n-3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis, J. Nutr 148 (2018) 409– 418. 10.1093/jn/nxx031. 29546296 PMC6251555 · DOI
  4. [6]Harris WS, von Schacky C, The Omega-3 Index: a new risk factor for death from coronary heart disease?, Prev. Med 39 (2004) 212– 220. 10.1016/j.ypmed.2004.02.030. 15208005 · DOI · Paper page
  5. [7]von Schacky C, The Omega-3 Index as a risk factor for cardiovascular diseases, Prostaglandins Other Lipid Mediat. 96 (2011) 94– 98. 10.1016/j.prostaglandins.2011.06.008. 21726658 · DOI
  6. [8]Harris WS, The omega-3 index: from biomarker to risk marker to risk factor, Curr. Atheroscler. Rep 11 (2009) 411– 417. 10.1007/s11883-009-0062-2. 19852881 · DOI
  7. [9]von Schacky C, Omega-3 index and cardiovascular health, Nutrients 6 (2014) 799– 814. 10.3390/nu6020799. 24566438 PMC3942733 · DOI
  8. [10]Wagner A, Simon C, Morio B, Dallongeville J, Ruidavets JB, Haas B, Laillet B, Cottel D, Ferrières J, Arveiler D, Omega-3 index levels and associated factors in a middle-aged French population: the MONA LISA-NUT Study, Eur. J. Clin. Nutr 69 (2015) 436– 441. 10.1038/ejcn.2014.219. 25335443 · DOI
  9. [11]de Groot RHM, van Boxtel MPJ, Schiepers OJG, Hornstra G, Jolles J, Age dependence of plasma phospholipid fatty acid levels: potential role of linoleic acid in the age-associated increase in docosahexaenoic acid and eicosapentaenoic acid concentrations, Br. J. Nutr 102 (2009) 1058– 1064. 10.1017/S0007114509359103. 19402937 · DOI
  10. [12]Harris WS, Pottala JV, Lacey SM, Vasan RS, Larson MG, Robins SJ, Clinical correlates and heritability of erythrocyte eicosapentaenoic and docosahexaenoic acid content in the Framingham Heart Study, Atherosclerosis 225 (2012) 425– 431. 10.1016/j.atherosclerosis.2012.05.030. 22727409 PMC3593234 · DOI
  11. [13]Itomura M, Fujioka S, Hamazaki K, Kobayashi K, Nagasawa T, Sawazaki S, Kirihara Y, Hamazaki T, Factors influencing EPA+DHA levels in red blood cells in Japan, In Vivo 22 (2008) 131– 135. 18396795
  12. [14]Sands SA, Reid KJ, Windsor SL, Harris WS, The impact of age, body mass index, and fish intake on the EPA and DHA content of human erythrocytes, Lipids 40 (2005) 343– 347. 10.1007/s11745-006-1392-2. 16028715 · DOI
  13. [15]Block RC, Harris WS, Pottala JV, Determinants of Blood Cell Omega-3 Fatty Acid Content, Open Biomark. J 1 (2008) 1– 6. 10.2174/1875318300801010001. 19953197 PMC2785093 · DOI
  14. [16]Sala-Vila A, Harris WS, Cofán M, Pérez-Heras AM, Pintó X, Lamuela-Raventós RM, Covas M-I, Estruch R, Ros E, Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD, Br. J. Nutr 106 (2011) 425– 431. 10.1017/S0007114511000171. 21450116 · DOI
  15. [17]Kalsbeek A, Veenstra J, Westra J, Disselkoen C, Koch K, McKenzie KA, O'Bott J, Vander Woude J, Fischer K, Shearer GC, Harris WS, Tintle NL, A genome-wide association study of red-blood cell fatty acids and ratios incorporating dietary covariates: Framingham Heart Study Offspring Cohort, PLoS One 13 (2018) e0194882. 10.1371/journal.pone.0194882. 29652918 PMC5898718 · DOI
  16. [18]Wood KE, Mantzioris E, Gibson RA, Ramsden CE, Muhlhausler BS, The effect of modifying dietary LA and ALA intakes on omega-3 long chain polyunsaturated fatty acid (n-3 LCPUFA) status in human adults: a systematic review and commentary, Prostaglandins Leukot. Essent. Fatty Acids 95 (2015) 47– 55. 10.1016/j.plefa.2015.01.001. 25687496 PMC9406118 · DOI
  17. [19]Greupner T, Koch E, Kutzner L, Hahn A, Schebb NH, Schuchardt JP, Single-Dose SDA-Rich Echium Oil Increases Plasma EPA, DPAn3, and DHA Concentrations, Nutrients 11 (2019). 10.3390/nu11102346. PMC6835614 31581725 · DOI
  18. [20]Micha R, Khatibzadeh S, Shi P, Fahimi S, Lim S, Andrews KG, Engell RE, Powles J, Ezzati M, Mozaffarian D, Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys, BMJ 348 (2014) g2272. 10.1136/bmj.g2272. 24736206 PMC3987052 · DOI · Paper page
  19. [21]Rimm EB, Appel LJ, Chiuve SE, Djoussé L, Engler MB, Kris-Etherton PM, Mozaffarian D, Siscovick DS, Lichtenstein AH, Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association, Circulation 138 (2018) e35– e47. 10.1161/CIR.0000000000000574. 29773586 PMC6903778 · DOI · Paper page
  20. [22]U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2020-2025. 9th Edition, Available at Dietary Guidelines.gov, 2020.
  21. [24]de Groot RHM, Meyer BJ, ISSFAL Official Statement Number 6: The importance of measuring blood omega-3 long chain polyunsaturated fatty acid levels in research, Prostaglandins Leukot. Essent. Fatty Acids 157 (2020) 102029. 10.1016/j.plefa.2019.102029. 31740196 · DOI
  22. [25]Schuchardt JP, Hahn A, Bioavailability of long-chain omega-3 fatty acids, Prostaglandins Leukot. Essent. Fatty Acids 89 (2013) 1– 8. 10.1016/j.plefa.2013.03.010. 23676322 · DOI
  23. [26]Nova Science Publishers, Inc. (Ed.), The Omega-3 Fatty Acid Deficiency Syndrome: Standardizing methods for assessing omega-3 fatty acid biostatus, 2013.
  24. [27]Harris WS, Schacky C, Park Y, Standardizing methods for assessing omega-3 fatty acid biostatus, in: Nova Science Publishers, Inc. (Ed.), The Omega-3 Fatty Acid Deficiency Syndrome: Standardizing methods for assessing omega-3 fatty acid biostatus, 2013, pp. 385– 398.
  25. [28]Stark KD, van Elswyk ME, Higgins MR, Weatherford CA, Salem N, Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults, Prog. Lipid Res 63 (2016) 132– 152. 10.1016/j.plipres.2016.05.001. 27216485 · DOI · Paper page
  26. [29]Hodson L, Skeaff CM, Fielding BA, Fatty acid composition of adipose tissue and blood in humans and its use as a biomarker of dietary intake, Prog. Lipid Res 47 (2008) 348– 380. 10.1016/j.plipres.2008.03.003. 18435934 · DOI
  27. [30]Harris WS, Thomas RM, Biological variability of blood omega-3 biomarkers, Clin. Biochem 43 (2010) 338– 340. 10.1016/j.clinbiochem.2009.08.016. 19733159 · DOI
  28. [32]Nobmann ED, Ponce R, Mattil C, Devereux R, Dyke B, Ebbesson SOE, Laston S, MacCluer J, Robbins D, Romenesko T, Ruotolo G, Wenger CR, Howard BV, Dietary intakes vary with age among Eskimo adults of Northwest Alaska in the GOCADAN study, 2000-2003, J. Nutr 135 (2005) 856– 862. 10.1093/jn/135.4.856. 15795447 · DOI
  29. [33]Cave C, Hein N, Smith LM, Anderson-Berry A, Richter CK, Bisselou KS, Appiah AK, Kris-Etherton P, Skulas-Ray AC, Thompson M, Nordgren TM, Hanson C, Thoene M, Omega-3 Long-Chain Polyunsaturated Fatty Acids Intake by Ethnicity, Income, and Education Level in the United States: NHANES 2003-2014, Nutrients 12 (2020). 10.3390/nu12072045. PMC7400855 32660046 · DOI
  30. [34]Welch AA, Lund E, Amiano P, Dorronsoro M, Brustad M, Kumle M, Rodriguez M, Lasheras C, Janzon L, Jansson J, Luben R, Spencer EA, Overvad K, Tjønneland A, Clavel-Chapelon F, Linseisen J, Klipstein-Grobusch K, Benetou V, Zavitsanos X, Tumino R, Galasso R, Bueno-De-Mesquita HB, Ocké MC, Charrondière UR, Slimani N, Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study, Public Health Nutr. 5 (2002) 1273– 1285. 10.1079/PHN2002404. 12639232 · DOI
  31. [37]Demonty I, Langlois K, Greene-Finestone LS, Zoka R, Nguyen L, Proportions of long-chain ω-3 fatty acids in erythrocyte membranes of Canadian adults: Results from the Canadian Health Measures Survey 2012-2015, Am. J. Clin. Nutr 113 (2021) 993– 1008. 10.1093/ajcn/nqaa401. 33675340 · DOI
  32. [38]Harris WS, Pottala JV, Varvel SA, Borowski JJ, Ward JN, McConnell JP, Erythrocyte omega-3 fatty acids increase and linoleic acid decreases with age: observations from 160,000 patients, Prostaglandins Leukot. Essent. Fatty Acids 88 (2013) 257– 263. 10.1016/j.plefa.2012.12.004. 23375840 · DOI
  33. [39]Chen C, Xun P, Kaufman JD, Hayden KM, Espeland MA, Whitsel EA, Serre ML, Vizuete W, Orchard T, Harris WS, Wang X, Chui HC, Chen J-C, He K, Erythrocyte omega-3 index, ambient fine particle exposure, and brain aging, Neurology 95 (2020) e995– e1007. 10.1212/WNL.0000000000010074. 32669395 PMC7668549 · DOI
  34. [40]Lukaschek K, von Schacky C, Kruse J, Ladwig K-H, Cognitive Impairment Is Associated with a Low Omega-3 Index in the Elderly: Results from the KORA-Age Study, Dement. Geriatr. Cogn. Disord 42 (2016) 236– 245. 10.1159/000448805. 27701160 · DOI
  35. [42]Markhus MW, Skotheim S, Graff IE, Frøyland L, Braarud HC, Stormark KM, Malde MK, Low omega-3 index in pregnancy is a possible biological risk factor for postpartum depression, PLoS One 8 (2013) e67617. 10.1371/journal.pone.0067617. 23844041 PMC3701051 · DOI
  36. [43]Amin AA, Menon RA, Reid KJ, Harris WS, Spertus JA, Acute coronary syndrome patients with depression have low blood cell membrane omega-3 fatty acid levels, Psychosom. Med 70 (2008) 856– 862. 10.1097/PSY.0b013e318188a01e. 18842751 PMC3579549 · DOI
  37. [44]Rein D, Claus M, Frosch W, März W, Lorkowski S, Webendoerfer S, Schreiner T, Changes in Erythrocyte Omega-3 Fatty Acids in German Employees upon Dietary Advice by Corporate Health, Nutrients 12 (2020). 10.3390/nu12113267. PMC7693012 33113826 · DOI
  38. [45]Murphy KJ, Meyer BJ, Mori TA, Burke V, Mansour J, Patch CS, Tapsell LC, Noakes M, Clifton PA, Barden A, Puddey IB, Beilin LJ, Howe PRC, Impact of foods enriched with n-3 long-chain polyunsaturated fatty acids on erythrocyte n-3 levels and cardiovascular risk factors, Br. J. Nutr 97 (2007) 749– 757. 10.1017/S000711450747252X. 17349088 · DOI · Paper page
  39. [46]Marine n–3 Fatty Acids and Vitamin D Supplementation and Primary Prevention, N. Engl. J. Med 380 (2019) 1878– 1880. 10.1056/NEJMc1902636. 31067388 · DOI
  40. [51]Mozaffarian D, Jacobson MF, Greenstein JS, Food reformulations to reduce trans fatty acids, N. Engl. J. Med 362 (2010) 2037– 2039. 10.1056/NEJMc1001841. 20505187 · DOI
  41. [52]Sala-Vila A, Jackson KH, Harris WS, Parallel declines in erythrocyte trans fatty acids and US fatal ischemic heart disease rates, Nutr. Res 71 (2019) 111– 114. 10.1016/j.nutres.2019.09.010. 31757633 · DOI
  42. [53]Jackson KH, Harris WS, Assessing the Omega-3 Index in a population: Canada did it right, Am. J. Clin. Nutr 113 (2021) 779– 780. 10.1093/ajcn/nqab021. 33711102 · DOI
  43. [54]Harris WS, Masson S, Barlera S, Milani V, Pileggi S, Franzosi MG, Marchioli R, Tognoni G, Tavazzi L, Latini R, Red blood cell oleic acid levels reflect olive oil intake while omega-3 levels reflect fish intake and the use of omega-3 acid ethyl esters: The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Heart Failure trial, Nutr. Res 36 (2016) 989– 994. 10.1016/j.nutres.2016.06.012. 27632919 · DOI
  44. [55]Gellert S, Schuchardt JP, Hahn A, Low long chain omega-3 fatty acid status in middle-aged women, Prostaglandins Leukot. Essent. Fatty Acids 117 (2017) 54– 59. 10.1016/j.plefa.2017.01.009. 28237088 · DOI
  45. [56]Ebbesson SOE, Voruganti VS, Higgins PB, Fabsitz RR, Ebbesson LO, Laston S, Harris WS, Kennish J, Umans BD, Wang H, Devereux RB, Okin PM, Weissman NJ, MacCluer JW, Umans JG, Howard BV, Fatty acids linked to cardiovascular mortality are associated with risk factors, Int. J. Circumpolar Health 74 (2015) 28055. 10.3402/ijch.v74.28055. 26274054 PMC4536775 · DOI
  46. [57]Bigornia SJ, Lichtenstein AH, Harris WS, Tucker KL, Associations of erythrocyte fatty acid patterns with insulin resistance, Am. J. Clin. Nutr 103 (2016) 902– 909. 10.3945/ajcn.115.123604. 26864364 PMC4763498 · DOI
  47. [58]Pottala JV, Espeland MA, Polreis J, Robinson J, Harris WS, Correcting the effects of −20 °C storage and aliquot size on erythrocyte fatty acid content in the Women's Health Initiative, Lipids 47 (2012) 835– 846. 10.1007/s11745-012-3693-y. 22782370 · DOI

Cited by

Sorted by citations

Authors
Schuchardt, J. P., Cerrato, M., Ceseri, M., DeFina, L. F., Delgado, G. E., Gellert, S., Hahn, A., Howard, B. V., Kadota, A., Kleber, M. E., Latini, R., Maerz, W., Manson, J. E., Mora, S., Park, Y., Sala-Vila, A., von Schacky, C., Sekikawa, A., Tintle, N., Tucker, K. L., Vasan, R. S., & Harris, W. S.
Affiliations
  • Leibniz University Hannover (DE)
  • Mario Negri Institute for Pharmacological Research (IT)
  • Cooper Institute (US)
  • Heidelberg University (DE)
  • MedStar Health Research Institute (US)
  • Shiga University of Medical Science (JP)
  • Medical University of Graz (AT)
  • Brigham and Women's Hospital (US)
  • Fatty Acid Research Institute (US)
  • University of Pittsburgh (US)
  • University of Illinois Chicago (US)
  • University of Massachusetts Lowell (US)
  • Boston University (US)
  • University of South Dakota (US)
Corresponding author
Schuchardt, Jan Philipp
ORCID
Venue
Prostaglandins, Leukotrienes and Essential Fatty Acids
Publisher
Elsevier BV
Published
2022-04
Volume
179
Pages
102418
ISSN
0952-3278 (ISSN-L)
DOI
10.1016/j.plefa.2022.102418
PMC
PMC10440636
OpenAlex
W4221131425
Cited by
56
References
5
Citations by year
2026: 9 · 2025: 14 · 2024: 18 · 2023: 13 · 2022: 2
FWCI
7.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Prostaglandins Leukotrienes and Essential Fatty Acids (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
Funders
  • U.S. Department of Health and Human Services (HHSN268201100002C, HHSN 268201100001C, HHSN268201100004C, HHSN-271-2011-00004C, HSN268201100003C)
  • Office of Dietary Supplements
  • Pfizer
  • AstraZeneca
  • School of Medicine, Boston University (N01-HC25195)
  • Deutsches Krebsforschungszentrum
  • European Commission (201668, 848146, 727565, 305739, HORIZON2020)
  • National Research Foundation
  • Ministry of Education, Culture, Sports, Science and Technology ((A) 13307016, 13307016, HL068200, 16790335, B 16790335)
  • Bundesministerium für Bildung und Forschung (727565, 01EA1411A)
  • Korea Health Industry Development Institute (HI15C3153)
  • National Research Foundation of Korea (NRF-2012, NRF-2015)
  • Rottapharm|Madaus
  • National Institutes of Health (M10RR0047-34, HHSN268201100004C, 16790335, 201668, HHSN271201100004C, A 13307016, 305739, HHSN268201100001C, HHSN268201100002C, n01hc25195-41-0-1, B 16790335, N01-HC 25195, CA-138962, HL105185, HL068200, R01CA138962)
  • Japan Society for the Promotion of Science (13307016, 848146, 16790335, 21890108)
  • National Institute on Aging (HHSN-271-2011-00004C,, P01AG023394, R01AG027087)
  • National Heart, Lung, and Blood Institute (HHSN2682011-00001I, HHSN2682011-00002I, N01‐HC25195, AG023394, HHSN268201100004C, U01HL082490, U01HL082458, R01HL089590, HHSN271201100004C, R01HL068200, HHSN2682011‐00004I, R01HL134811, HHSN26820-1100002C, N01-HC-025195, DK112940, HHSN268201100001C, P50HL105185, HSN268201100003C, K24HL136852, U01HL064244)
  • National Cancer Institute (CA138962, U01CA138962, R01CA138962)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK112940)
  • National Center for Complementary and Alternative Medicine
  • National Center for Research Resources (M01RR000047)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
Keywords
red blood cell fatty acids, omega-3 index, eicosapentaenoic acid, docosahexaenoic acid, tissue fatty acid composition, biomarkers, cross-national comparison
MeSH terms
Canada, Docosahexaenoic Acids, Erythrocytes, Fatty Acids, Humans, Eicosapentaenoic Acid, Fatty Acids, Omega-3

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review