Wellness Assessments: Test, Don’t Guess

Understanding Omega Levels and the Gut Microbiome

Knowing the numbers with health assessments has never been so important in a clinical setting. With regular well visits, a healthcare practitioner may list blood biomarker results, blood pressure readings, and weight to name a few metrics. The omega-3 index and microbiome gut tests are two measures that are not quite regularly used, though. However, they are available and equally important to add to the lineup as overall markers of health quality.

Heart Health Assessments: Omega-3 Index

An omega-3 index, also known as the “HbA1c of Omega-3 Status,” is the measure of the amount of EPA and DHA in red blood cell membrane phospholipids.₁ Health assessments like this identify risk for heart disease (and other conditions) by assessing omega-3 fatty acid status. This number is then expressed as a percent of total fatty acids.

Why care about the omega-3 index? Primarily, it is a marker of overall health, with higher levels being associated with longer life spans (and lower risk for death from heart disease and for dementia). According to Dr. William Harris, the co-inventor of the Omega-3 Index and President of the Fatty Acid Research Institute, “The Omega-3 Index is a better predictor of risk for death from any cause than serum cholesterol is, and much easier and safer to change.”

Where the omega-3 status percent lies on the scale explains the risk category. Thinking of the ranges as a stoplight:

• Green: a desirable omega-3 index, greater than eight percent
• Yellow: an intermediate index, between four to eight percent
• Red: an undesirable omega-3 index, less than four percent

Unfortunately, most Americans are in the undesirable range due to a diet with an insufficient intake of EPA and DHA from seafood and/or fish oil supplements. The green range is typically seen in Japanese populations, where an abundance of fish and seafood is part of the regular diet.

Overall, those with an eight percent omega-3 index have a 35 percent lower risk for fatal coronary heart disease compared to those with a four percent omega-3 index.₂ Additionally, post-menopausal women with an omega-3 index greater than eight percent have a 31 percent lower risk of death from any cause than those with an omega-3 index of less than four percent.₃

Once someone knows their index, it is important to understand what to do about it. Working with a healthcare practitioner to personalize a patient’s plan is key, as it will more than likely include increased consumption of omega-3 rich foods and/or supplementation. If a result is in the red range, about 1,500 milligrams of EPA and DHA is recommended daily, and if in the yellow range, approximately 750 milligrams of EPA and DHA is recommended daily. Most Americans do not consume that amount regularly, which is where supplementation may be required. However, if in the green range, it is important to keep up healthy omega practices, and it is encouraged to retest at least every six months to ensure staying in the green range.

Gut Health Assessments: Microbiome Diversity

The microbiome can tell so much about health and the human body. With both good and bad microorganisms living inside humans, adjustments can only be made when there is information about what specific species live within the microbiome. Gut testing is available to facilitate exploring the unknown.

While most testing involves invasive finger pricks or blood draws, a gut health test usually requires a stool sample or fecal swab. It may not be the most glamorous of testing, but the wealth of insight received makes up for it.

Many practitioners echo a quote historically attributed to Hippocrates: “All illness starts in the gut.” Current gut health testing supports understanding the complexity of the digestive system, which includes understanding the resident fungi, bacteria, and other microorganisms as well as how to actionably change the digestive system for the better. Not all gut tests are created equally. It is important to look for tests that will not only support understanding of phyla balance, pathogenic species, and beneficial species, but also help identify where diversification is needed and break down the microbiome terminology in an understandable, actionable way.

Many factors affect the gut, so it is important to keep it in check throughout the year. If someone has moved locations, created different social circles, is exposed to toxins regularly, or is even simply stressed out, the gut is affected and changing. Working with a reputable microbiome testing company will help identify foods, supplements, and lifestyles that will positively balance the gut, supporting health all year long.

“Knowing your personalized microbiome profile will allow you to see how your microbiome compares with normal/healthy individuals, and whether your microbiota is in balance. Additionally, knowing your specific microbiome profile will allow you to receive customized actionable diet, lifestyle and supplement recommendations based on the specific makeup of your microbiome,” says Dr. Mahmoud Ghannoum, Director of the Center for Medical Mycology at Case Western Reserve University, one of the top 25 medical research universities in the United States.

References

1. Harris, W. S., & Von Schacky, C. (2004). The Omega-3 Index: a new risk factor for death from coronary heart disease?. Preventive medicine, 39(1), 212–220. https://doi.org/10.1016/j.ypmed.2004.02.030
2. Harris, W.S., Gobbo, Liana Del, & Tintle, Nathan L. (2017). The Omega-3 Index and relative risk for coronary heart disease mortality: Estimation from 10 cohort studies. Atherosclerosis, 262, 51-54. https://doi.org/10.1016/j.atherosclerosis.2017.05.007
3. Harris, W. S., Luo, J., Pottala, J. V., Espeland, M. A., Margolis, K. L., Manson, J. E., Wang, L., Brasky, T. M., & Robinson, J. G. (2017). Red blood cell polyunsaturated fatty acids and mortality in the Women’s Health Initiative Memory Study. Journal of clinical lipidology, 11(1), 250–259.e5. https://doi.org/10.1016/j.jacl.2016.12.013