The Omega-3 Index in Athletes Brief Review
Main Article Content
Keywords
Biomarker, performance, sports nutrition, eicosapentaenoic acid, docosahexaenoic acid
Abstract
Introduction: The omega-3 index (O3i), the amount of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as a percentage of total fatty acids within erythrocytes, has emerged as a potentially important biomarker for sport. The purpose of this review is to quantify the O3i in athletes across various sporting contexts.
Methods: Two databases (PubMed, Google Scholar) were searched for cross-sectional studies reporting the O3i in athletes. Simple pooled mean analyses were used to quantify the O3i in all studies and by subgroup (i.e., sex and sport).
Results: Based on 18 studies (25 observations) comprised of 1,452 athletes, the combined O3i was 4.43 ± 0.59% and ranged between 2.98% and 5.19%. According to studies that reported the O3i proportion within their sample, less than 1% of all athletes had an O3i > 8%, whereas 32% of athletes had an O3i < 4%. The O3i mean difference between all subgroups (sex and sport activity) was within ± 1%.
Conclusions: Athlete programs should make a concerted effort to: 1) routinely test the O3i, 2) provide education from nutrition professionals on the potential benefits and sources of n-3 fatty acids and, 3) provide meal options comprised of rich sources of EPA and DHA at least three times per week and consider providing supplementation as needed, if allowed by governing organizations.
References
1. Tomczyk M, Heileson JL, Babiarz M, Calder PC. Athletes Can Benefit from Increased Intake of EPA and DHA-Evaluating the Evidence. Nutrients. 2023;15(23):4925. doi:10.3390/nu15234925
2. Medoro A, Buonsenso A, Centorbi M, et al. Omega-3 Index as a Sport Biomarker: Implications for Cardiovascular Health, Injury Prevention, and Athletic Performance. J Funct Morphol Kinesiol. 2024;9(2). doi:10.3390/jfmk9020091
3. Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39(1):212-220. doi:10.1016/j.ypmed.2004.02.030
4. Dicklin MR, Anthony JC, Winters BL, Maki KC. ω-3 Polyunsaturated Fatty Acid Status Testing in Humans: A Narrative Review of Commercially Available Options. J Nutr. 2024;154(5):1487-1504. doi:10.1016/j.tjnut.2024.03.015
5. Harris WS, Tintle NL, Imamura F, et al. Blood n-3 fatty acid levels and total and cause-specific mortality from 17 prospective studies. Nat Commun. 2021;12(1):2329. doi:10.1038/s41467-021-22370-2
6. Harris WS, Del Gobbo L, Tintle NL. The Omega-3 Index and relative risk for coronary heart disease mortality: Estimation from 10 cohort studies. Atherosclerosis. 2017;262:51-54. doi:10.1016/j.atherosclerosis.2017.05.007
7. Bernasconi AA, Wiest MM, Lavie CJ, Milani RV, Laukkanen JA. Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Mayo Clin Proc. 2021;96(2):304-313. doi:10.1016/j.mayocp.2020.08.034
8. Shi F, Chowdhury R, Sofianopoulou E, et al. Association of circulating fatty acids with cardiovascular disease risk: Analysis of individual-level data in three large prospective cohorts and updated meta-analysis. European Journal of Preventive Cardiology. October 2024:zwae315. doi:10.1093/eurjpc/zwae315
9. Lewis NA, Daniels D, Calder PC, Castell LM, Pedlar CR. Are There Benefits from the Use of Fish Oil Supplements in Athletes? A Systematic Review. Adv Nutr. 2020;11(5):1300-1314. doi:10.1093/advances/nmaa050
10. Thielecke F, Blannin A. Omega-3 Fatty Acids for Sport Performance—Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review. Nutrients. 2020;12(12):3712. doi:10.3390/nu12123712
11. Heileson JL, Funderburk LK. The effect of fish oil supplementation on the promotion and preservation of lean body mass, strength, and recovery from physiological stress in young, healthy adults: a systematic review. Nutr Rev. 2020;78(12):1001-1014. doi:10.1093/nutrit/nuaa034
12. Heileson JL, Macartney MJ, Watson NL, et al. Nutritional Optimization for Brain Health in Contact Sports: A Systematic Review and Meta-Analysis on Long-Chain ω-3 Fatty Acids and Neurofilament Light. Curr Dev Nutr. 2024;8(10). doi:10.1016/j.cdnut.2024.104454
13. Jäger R, Heileson JL, Abou Sawan S, et al. International Society of Sports Nutrition Position Stand: Long-Chain Omega-3 Polyunsaturated Fatty Acids. J Int Soc Sports Nutr. 2025;22(1):2441775. doi:10.1080/15502783.2024.2441775
14. Ritz PP, Rogers MB, Zabinsky JS, et al. Dietary and Biological Assessment of the Omega-3 Status of Collegiate Athletes: A Cross-Sectional Analysis. PLoS One. 2020;15(4):e0228834. doi:10.1371/journal.pone.0228834
15. Anzalone A, Carbuhn A, Jones L, et al. The Omega-3 Index in National Collegiate Athletic Association Division I Collegiate Football Athletes. J Athl Train. 2019;54(1):7-11. doi:10.4085/1062-6050-387-18
16. Bernasconi AA, Wilkin AM, Roke K, Ismail A. Development of a novel database to review and assess the clinical effects of EPA and DHA omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids. 2022;183:102458. doi:10.1016/j.plefa.2022.102458
17. Stark KD, Aristizabal Henao JJ, Metherel AH, Pilote L. Translating plasma and whole blood fatty acid compositional data into the sum of eicosapentaenoic and docosahexaenoic acid in erythrocytes. Prostaglandins Leukot Essent Fatty Acids. 2016;104:1-10. doi:10.1016/j.plefa.2015.11.002
18. McKay AKA, Stellingwerff T, Smith ES, et al. Defining Training and Performance Caliber: A Participant Classification Framework. Int J Sports Physiol Perform. 2022;17(2). doi:10.1123/ijspp.2021-0451
19. Tepsic J, Vucic V, Arsic A, Blazencic-Mladenovic V, Mazic S, Glibetic M. Plasma and erythrocyte phospholipid fatty acid profile in professional basketball and football players. Eur J Appl Physiol. 2009;107(3):359-365. doi:10.1007/s00421-009-1131-5
20. Arsić A, Vučić V, Tepšić J, Mazić S, Djelić M, Glibetić M. Altered plasma and erythrocyte phospholipid fatty acid profile in elite female water polo and football players. Appl Physiol Nutr Metab. 2012;37(1):40-47. doi:10.1139/h11-125
21. Tepsic J, Vucic V, Arsic A, Mazic S, Djelic M, Glibetic M. Unfavourable plasma and erythrocyte phospholipid fatty acid profile in elite amateur boxers. Eur J Sport Sci. 2013;13(4):414-421. doi:10.1080/17461391.2011.630105
22. von Schacky C, Kemper M, Haslbauer R, Halle M. Low Omega-3 Index in 106 German elite winter endurance athletes: a pilot study. Int J Sport Nutr Exerc Metab. 2014;24(5):559-564. doi:10.1123/ijsnem.2014-0041
23. Wilson PB, Madrigal LA. Associations between whole blood and dietary omega-3 polyunsaturated fatty acid levels in collegiate athletes. Int J Sport Nutr Exerc Metab. 2016;26(6):497-505.
24. Wilson PB, Madrigal LA. Associations among Omega-3 Fatty Acid Status, Anxiety, and Mental Toughness in Female Collegiate Athletes. J Am Coll Nutr. 2017;36(8):602-607. doi:10.1080/07315724.2017.1335249
25. Arsić A, Petrović S, Čikiriz N, Ristić-Medić D, Vučić V. Effect of long-term strenuous training on the plasma phospholipid fatty acid composition in handball players. Vojnosanitetski pregled. 2020;77(8):826-831. doi:10.2298/VSP180725159A
26. Armstrong A, Anzalone AJ, Pethick W, et al. An Evaluation of Omega-3 Status and Intake in Canadian Elite Rugby 7s Players. Nutrients. 2021;13(11):3777. doi:10.3390/nu13113777
27. Davis JK, Freese EC, Wolfe AS, Basham SA, Stein KMW. Evaluation of Omega-3 Status in Professional Basketball Players. J Strength Cond Res. 2021;35(7):1794-1799. doi:10.1519/JSC.0000000000004023
28. Kunces LJ, Keenan J, Schmidt CM, Schmidt MA. Molecular Deficits Relevant to Concussion Are Prevalent in Top-Ranked Football Players Entering the National Football League Draft. J Strength Cond Res. 2021;35(11):3139-3144. doi:10.1519/JSC.0000000000004131
29. Essman M, Christifano D, Sullivan DK, Chalise P, Carbuhn A. Assessing Omega-3 Intake in Sport: the Brief Food Frequency Questionnaire and the Omega-3 Index in Collegiate Women Soccer Players. J Athl Train. 2022;57(11-12):1079-1084. doi:10.4085/1062-6050-0549.21
30. Lyudinina AYu. Comparative Analysis of the Fatty Acid Profile in the Diet and Blood of Athletes and Students. Hum Physiol. 2022;48(5):563-568. doi:10.1134/S0362119722040053
31. Heileson JL, Elliott A, Buzzard JA, et al. A Cross-Sectional Analysis of Whole Blood Long-Chain ω-3 Polyunsaturated Fatty Acids and Its Relationship with Dietary Intake, Body Composition, and Measures of Strength and Power in Collegiate Athletes. J Am Nutr Assoc. 2023;42(1):94-100. doi:10.1080/07315724.2021.1995910
32. Hooks MP, Madigan SM, Woodside JV, Nugent AP. Dietary Intake, Biological Status, and Barriers towards Omega-3 Intake in Elite Level (Tier 4), Female Athletes: Pilot Study. Nutrients. 2023;15(13):2821. doi:10.3390/nu15132821
33. Zhang Q, Xu Q, Tian H, Chu Y, Qiu J, Sun M. Serum and diet long-chain omega-3 fatty acid nutritional status in Chinese elite athletes. Lipids. 2023;58(1):33-40. doi:10.1002/lipd.12362
34. Fujibayashi M, Nirengi S, Segawa T, Furuno S, Sakane N. Dietary and Biological Assessment of Omega-3 Status in University Rugby Football Players: A Case-Control Study. Asian J Sports Med. 2024;15(1). doi:10.5812/asjsm-134931
35. Craddock JC, Probst YC, Neale EP, Peoples GE. A Cross-Sectional Comparison of the Whole Blood Fatty Acid Profile and Omega-3 Index of Male Vegan and Omnivorous Endurance Athletes. J Am Coll Nutr. May 2021:1-9. doi:10.1080/07315724.2021.1886196
36. Heileson JL, Harris DR, Tomek S, et al. Long-Chain Omega-3 Fatty Acid Supplementation and Exercise-Induced Muscle Damage: EPA or DHA? Medicine & Science in Sports & Exercise. 2024;56(3):476-485. doi:10.1249/MSS.0000000000003332
37. 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. 2012;225(2):425-431. doi:10.1016/j.atherosclerosis.2012.05.030
38. Ramadoss R, Nichols Q, Volpe S. Dietary Intake Patterns of Omega Fatty Acid Profiles in Athletes. Current Developments in Nutrition. 2021;5:1297. doi:10.1093/cdn/nzab058_010
39. Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health implications of high dietary omega-6 polyunsaturated Fatty acids. J Nutr Metab. 2012;2012:539426. doi:10.1155/2012/539426
40. Calder PC. Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clin Pharmacol. 2013;75(3):645-662. doi:10.1111/j.1365-2125.2012.04374.x
41. Drobnic F, Rueda F, Pons V, Banquells M, Cordobilla B, Domingo JC. Erythrocyte Omega-3 Fatty Acid Content in Elite Athletes in Response to Omega-3 Supplementation: A Dose-Response Pilot Study. J Lipids. 2017;2017:1472719. doi:10.1155/2017/1472719
42. Davinelli S, Corbi G, Righetti S, et al. Relationship Between Distance Run Per Week, Omega-3 Index, and Arachidonic Acid (AA)/Eicosapentaenoic Acid (EPA) Ratio: An Observational Retrospective Study in Non-elite Runners. Front Physiol. 2019;10. doi:10.3389/fphys.2019.00487
43. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002;56(8):365-379. doi:10.1016/s0753-3322(02)00253-6
44. Schuchardt JP, Cerrato M, Ceseri M, et al. Red blood cell fatty acid patterns from 7 countries: Focus on the Omega-3 index. Prostaglandins Leukot Essent Fatty Acids. 2022;179:102418. doi:10.1016/j.plefa.2022.102418
45. Schuchardt JP, Beinhorn P, Hu XF, et al. Omega-3 world map: 2024 update. Prog Lipid Res. 2024;95:101286. doi:10.1016/j.plipres.2024.101286
46. Flock MR, Skulas‐Ray AC, Harris WS, Etherton TD, Fleming JA, Kris‐Etherton PM. Determinants of Erythrocyte Omega‐3 Fatty Acid Content in Response to Fish Oil Supplementation: A Dose–Response Randomized Controlled Trial. J Am Heart Assoc. 2013;2(6). doi:10.1161/JAHA.113.000513
47. Walker RE, Jackson KH, Tintle NL, et al. Predicting the effects of supplemental EPA and DHA on the omega-3 index. Am J Clin Nutr. 2019;110(4):1034-1040. doi:10.1093/ajcn/nqz161
48. Anthony R, Macartney MJ, Peoples GE. Increasing the Omega-3 Index of Endurance Trained Adults: A Pilot Study Comparing Microencapsulated Algae to Fish Powders Provided as Chewable Tablets. Recent Progress in Nutrition. 2025;5(1):1-16. doi:10.21926/rpn.2501004
49. von Schacky C. Omega-3 index and cardiovascular health. Nutrients. 2014;6(2):799-814. doi:10.3390/nu6020799
50. Santos HO, May TL, Bueno AA. Eating more sardines instead of fish oil supplementation: Beyond omega-3 polyunsaturated fatty acids, a matrix of nutrients with cardiovascular benefits. Front Nutr. 2023;10:1107475. doi:10.3389/fnut.2023.1107475
51. Stonehouse W, Pauga MR, Kruger R, Thomson CD, Wong M, Kruger MC. Consumption of salmon v. salmon oil capsules: effects on n-3 PUFA and selenium status. Br J Nutr. 2011;106(8):1231-1239. doi:10.1017/S000711451100153X
52. Home | Dietary Guidelines for Americans. https://www.dietaryguidelines.gov/. Accessed January 15, 2025.
53. Jackson KH, Polreis JM, Tintle NL, Kris-Etherton PM, Harris WS. Association of reported fish intake and supplementation status with the omega-3 index. Prostaglandins Leukot Essent Fatty Acids. 2019;142:4-10.
54. Maughan RJ, Burke LM, Dvorak J, et al. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete. Int J Sport Nutr Exerc Metab. 2018;28(2):104-125. doi:10.1123/ijsnem.2018-0020
55. Anthony R, Jaffrey N, Byron C, Peoples GE, Macartney MJ. Omega-3 Status Evaluation in Australian Female Rugby League Athletes: Ad Libitum Fish Oil Provision Results in a Varied Omega-3 Index. Int J Sport Nutr Exerc Metab. April 2024:1-5. doi:10.1123/ijsnem.2023-0257
2. Medoro A, Buonsenso A, Centorbi M, et al. Omega-3 Index as a Sport Biomarker: Implications for Cardiovascular Health, Injury Prevention, and Athletic Performance. J Funct Morphol Kinesiol. 2024;9(2). doi:10.3390/jfmk9020091
3. Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39(1):212-220. doi:10.1016/j.ypmed.2004.02.030
4. Dicklin MR, Anthony JC, Winters BL, Maki KC. ω-3 Polyunsaturated Fatty Acid Status Testing in Humans: A Narrative Review of Commercially Available Options. J Nutr. 2024;154(5):1487-1504. doi:10.1016/j.tjnut.2024.03.015
5. Harris WS, Tintle NL, Imamura F, et al. Blood n-3 fatty acid levels and total and cause-specific mortality from 17 prospective studies. Nat Commun. 2021;12(1):2329. doi:10.1038/s41467-021-22370-2
6. Harris WS, Del Gobbo L, Tintle NL. The Omega-3 Index and relative risk for coronary heart disease mortality: Estimation from 10 cohort studies. Atherosclerosis. 2017;262:51-54. doi:10.1016/j.atherosclerosis.2017.05.007
7. Bernasconi AA, Wiest MM, Lavie CJ, Milani RV, Laukkanen JA. Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Mayo Clin Proc. 2021;96(2):304-313. doi:10.1016/j.mayocp.2020.08.034
8. Shi F, Chowdhury R, Sofianopoulou E, et al. Association of circulating fatty acids with cardiovascular disease risk: Analysis of individual-level data in three large prospective cohorts and updated meta-analysis. European Journal of Preventive Cardiology. October 2024:zwae315. doi:10.1093/eurjpc/zwae315
9. Lewis NA, Daniels D, Calder PC, Castell LM, Pedlar CR. Are There Benefits from the Use of Fish Oil Supplements in Athletes? A Systematic Review. Adv Nutr. 2020;11(5):1300-1314. doi:10.1093/advances/nmaa050
10. Thielecke F, Blannin A. Omega-3 Fatty Acids for Sport Performance—Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review. Nutrients. 2020;12(12):3712. doi:10.3390/nu12123712
11. Heileson JL, Funderburk LK. The effect of fish oil supplementation on the promotion and preservation of lean body mass, strength, and recovery from physiological stress in young, healthy adults: a systematic review. Nutr Rev. 2020;78(12):1001-1014. doi:10.1093/nutrit/nuaa034
12. Heileson JL, Macartney MJ, Watson NL, et al. Nutritional Optimization for Brain Health in Contact Sports: A Systematic Review and Meta-Analysis on Long-Chain ω-3 Fatty Acids and Neurofilament Light. Curr Dev Nutr. 2024;8(10). doi:10.1016/j.cdnut.2024.104454
13. Jäger R, Heileson JL, Abou Sawan S, et al. International Society of Sports Nutrition Position Stand: Long-Chain Omega-3 Polyunsaturated Fatty Acids. J Int Soc Sports Nutr. 2025;22(1):2441775. doi:10.1080/15502783.2024.2441775
14. Ritz PP, Rogers MB, Zabinsky JS, et al. Dietary and Biological Assessment of the Omega-3 Status of Collegiate Athletes: A Cross-Sectional Analysis. PLoS One. 2020;15(4):e0228834. doi:10.1371/journal.pone.0228834
15. Anzalone A, Carbuhn A, Jones L, et al. The Omega-3 Index in National Collegiate Athletic Association Division I Collegiate Football Athletes. J Athl Train. 2019;54(1):7-11. doi:10.4085/1062-6050-387-18
16. Bernasconi AA, Wilkin AM, Roke K, Ismail A. Development of a novel database to review and assess the clinical effects of EPA and DHA omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids. 2022;183:102458. doi:10.1016/j.plefa.2022.102458
17. Stark KD, Aristizabal Henao JJ, Metherel AH, Pilote L. Translating plasma and whole blood fatty acid compositional data into the sum of eicosapentaenoic and docosahexaenoic acid in erythrocytes. Prostaglandins Leukot Essent Fatty Acids. 2016;104:1-10. doi:10.1016/j.plefa.2015.11.002
18. McKay AKA, Stellingwerff T, Smith ES, et al. Defining Training and Performance Caliber: A Participant Classification Framework. Int J Sports Physiol Perform. 2022;17(2). doi:10.1123/ijspp.2021-0451
19. Tepsic J, Vucic V, Arsic A, Blazencic-Mladenovic V, Mazic S, Glibetic M. Plasma and erythrocyte phospholipid fatty acid profile in professional basketball and football players. Eur J Appl Physiol. 2009;107(3):359-365. doi:10.1007/s00421-009-1131-5
20. Arsić A, Vučić V, Tepšić J, Mazić S, Djelić M, Glibetić M. Altered plasma and erythrocyte phospholipid fatty acid profile in elite female water polo and football players. Appl Physiol Nutr Metab. 2012;37(1):40-47. doi:10.1139/h11-125
21. Tepsic J, Vucic V, Arsic A, Mazic S, Djelic M, Glibetic M. Unfavourable plasma and erythrocyte phospholipid fatty acid profile in elite amateur boxers. Eur J Sport Sci. 2013;13(4):414-421. doi:10.1080/17461391.2011.630105
22. von Schacky C, Kemper M, Haslbauer R, Halle M. Low Omega-3 Index in 106 German elite winter endurance athletes: a pilot study. Int J Sport Nutr Exerc Metab. 2014;24(5):559-564. doi:10.1123/ijsnem.2014-0041
23. Wilson PB, Madrigal LA. Associations between whole blood and dietary omega-3 polyunsaturated fatty acid levels in collegiate athletes. Int J Sport Nutr Exerc Metab. 2016;26(6):497-505.
24. Wilson PB, Madrigal LA. Associations among Omega-3 Fatty Acid Status, Anxiety, and Mental Toughness in Female Collegiate Athletes. J Am Coll Nutr. 2017;36(8):602-607. doi:10.1080/07315724.2017.1335249
25. Arsić A, Petrović S, Čikiriz N, Ristić-Medić D, Vučić V. Effect of long-term strenuous training on the plasma phospholipid fatty acid composition in handball players. Vojnosanitetski pregled. 2020;77(8):826-831. doi:10.2298/VSP180725159A
26. Armstrong A, Anzalone AJ, Pethick W, et al. An Evaluation of Omega-3 Status and Intake in Canadian Elite Rugby 7s Players. Nutrients. 2021;13(11):3777. doi:10.3390/nu13113777
27. Davis JK, Freese EC, Wolfe AS, Basham SA, Stein KMW. Evaluation of Omega-3 Status in Professional Basketball Players. J Strength Cond Res. 2021;35(7):1794-1799. doi:10.1519/JSC.0000000000004023
28. Kunces LJ, Keenan J, Schmidt CM, Schmidt MA. Molecular Deficits Relevant to Concussion Are Prevalent in Top-Ranked Football Players Entering the National Football League Draft. J Strength Cond Res. 2021;35(11):3139-3144. doi:10.1519/JSC.0000000000004131
29. Essman M, Christifano D, Sullivan DK, Chalise P, Carbuhn A. Assessing Omega-3 Intake in Sport: the Brief Food Frequency Questionnaire and the Omega-3 Index in Collegiate Women Soccer Players. J Athl Train. 2022;57(11-12):1079-1084. doi:10.4085/1062-6050-0549.21
30. Lyudinina AYu. Comparative Analysis of the Fatty Acid Profile in the Diet and Blood of Athletes and Students. Hum Physiol. 2022;48(5):563-568. doi:10.1134/S0362119722040053
31. Heileson JL, Elliott A, Buzzard JA, et al. A Cross-Sectional Analysis of Whole Blood Long-Chain ω-3 Polyunsaturated Fatty Acids and Its Relationship with Dietary Intake, Body Composition, and Measures of Strength and Power in Collegiate Athletes. J Am Nutr Assoc. 2023;42(1):94-100. doi:10.1080/07315724.2021.1995910
32. Hooks MP, Madigan SM, Woodside JV, Nugent AP. Dietary Intake, Biological Status, and Barriers towards Omega-3 Intake in Elite Level (Tier 4), Female Athletes: Pilot Study. Nutrients. 2023;15(13):2821. doi:10.3390/nu15132821
33. Zhang Q, Xu Q, Tian H, Chu Y, Qiu J, Sun M. Serum and diet long-chain omega-3 fatty acid nutritional status in Chinese elite athletes. Lipids. 2023;58(1):33-40. doi:10.1002/lipd.12362
34. Fujibayashi M, Nirengi S, Segawa T, Furuno S, Sakane N. Dietary and Biological Assessment of Omega-3 Status in University Rugby Football Players: A Case-Control Study. Asian J Sports Med. 2024;15(1). doi:10.5812/asjsm-134931
35. Craddock JC, Probst YC, Neale EP, Peoples GE. A Cross-Sectional Comparison of the Whole Blood Fatty Acid Profile and Omega-3 Index of Male Vegan and Omnivorous Endurance Athletes. J Am Coll Nutr. May 2021:1-9. doi:10.1080/07315724.2021.1886196
36. Heileson JL, Harris DR, Tomek S, et al. Long-Chain Omega-3 Fatty Acid Supplementation and Exercise-Induced Muscle Damage: EPA or DHA? Medicine & Science in Sports & Exercise. 2024;56(3):476-485. doi:10.1249/MSS.0000000000003332
37. 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. 2012;225(2):425-431. doi:10.1016/j.atherosclerosis.2012.05.030
38. Ramadoss R, Nichols Q, Volpe S. Dietary Intake Patterns of Omega Fatty Acid Profiles in Athletes. Current Developments in Nutrition. 2021;5:1297. doi:10.1093/cdn/nzab058_010
39. Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health implications of high dietary omega-6 polyunsaturated Fatty acids. J Nutr Metab. 2012;2012:539426. doi:10.1155/2012/539426
40. Calder PC. Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clin Pharmacol. 2013;75(3):645-662. doi:10.1111/j.1365-2125.2012.04374.x
41. Drobnic F, Rueda F, Pons V, Banquells M, Cordobilla B, Domingo JC. Erythrocyte Omega-3 Fatty Acid Content in Elite Athletes in Response to Omega-3 Supplementation: A Dose-Response Pilot Study. J Lipids. 2017;2017:1472719. doi:10.1155/2017/1472719
42. Davinelli S, Corbi G, Righetti S, et al. Relationship Between Distance Run Per Week, Omega-3 Index, and Arachidonic Acid (AA)/Eicosapentaenoic Acid (EPA) Ratio: An Observational Retrospective Study in Non-elite Runners. Front Physiol. 2019;10. doi:10.3389/fphys.2019.00487
43. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002;56(8):365-379. doi:10.1016/s0753-3322(02)00253-6
44. Schuchardt JP, Cerrato M, Ceseri M, et al. Red blood cell fatty acid patterns from 7 countries: Focus on the Omega-3 index. Prostaglandins Leukot Essent Fatty Acids. 2022;179:102418. doi:10.1016/j.plefa.2022.102418
45. Schuchardt JP, Beinhorn P, Hu XF, et al. Omega-3 world map: 2024 update. Prog Lipid Res. 2024;95:101286. doi:10.1016/j.plipres.2024.101286
46. Flock MR, Skulas‐Ray AC, Harris WS, Etherton TD, Fleming JA, Kris‐Etherton PM. Determinants of Erythrocyte Omega‐3 Fatty Acid Content in Response to Fish Oil Supplementation: A Dose–Response Randomized Controlled Trial. J Am Heart Assoc. 2013;2(6). doi:10.1161/JAHA.113.000513
47. Walker RE, Jackson KH, Tintle NL, et al. Predicting the effects of supplemental EPA and DHA on the omega-3 index. Am J Clin Nutr. 2019;110(4):1034-1040. doi:10.1093/ajcn/nqz161
48. Anthony R, Macartney MJ, Peoples GE. Increasing the Omega-3 Index of Endurance Trained Adults: A Pilot Study Comparing Microencapsulated Algae to Fish Powders Provided as Chewable Tablets. Recent Progress in Nutrition. 2025;5(1):1-16. doi:10.21926/rpn.2501004
49. von Schacky C. Omega-3 index and cardiovascular health. Nutrients. 2014;6(2):799-814. doi:10.3390/nu6020799
50. Santos HO, May TL, Bueno AA. Eating more sardines instead of fish oil supplementation: Beyond omega-3 polyunsaturated fatty acids, a matrix of nutrients with cardiovascular benefits. Front Nutr. 2023;10:1107475. doi:10.3389/fnut.2023.1107475
51. Stonehouse W, Pauga MR, Kruger R, Thomson CD, Wong M, Kruger MC. Consumption of salmon v. salmon oil capsules: effects on n-3 PUFA and selenium status. Br J Nutr. 2011;106(8):1231-1239. doi:10.1017/S000711451100153X
52. Home | Dietary Guidelines for Americans. https://www.dietaryguidelines.gov/. Accessed January 15, 2025.
53. Jackson KH, Polreis JM, Tintle NL, Kris-Etherton PM, Harris WS. Association of reported fish intake and supplementation status with the omega-3 index. Prostaglandins Leukot Essent Fatty Acids. 2019;142:4-10.
54. Maughan RJ, Burke LM, Dvorak J, et al. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete. Int J Sport Nutr Exerc Metab. 2018;28(2):104-125. doi:10.1123/ijsnem.2018-0020
55. Anthony R, Jaffrey N, Byron C, Peoples GE, Macartney MJ. Omega-3 Status Evaluation in Australian Female Rugby League Athletes: Ad Libitum Fish Oil Provision Results in a Varied Omega-3 Index. Int J Sport Nutr Exerc Metab. April 2024:1-5. doi:10.1123/ijsnem.2023-0257
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Apr 21, 2025
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The Omega-3 Index in Athletes: Brief Review. (2025). Journal of Exercise and Nutrition, 8(1). https://doi.org/10.53520/jen2025.103194
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Copyright, 2025 by the authors. This work is licensed under the Creative Commons Attribution 4.0 International License.
How to Cite
The Omega-3 Index in Athletes: Brief Review. (2025). Journal of Exercise and Nutrition, 8(1). https://doi.org/10.53520/jen2025.103194