New research has ranked omega-3 status as being on a par with smoking habits (or lack thereof) and cholesterol levels when it comes to predicting cardiovascular disease (CVD) risk.
That’s not a typo.
And if you’re like most Americans, your omega-3 levels are nowhere near where they ought to be.
Here’s what the latest science is telling us—and what you can do about it.
What Is the Omega-3 Index?
When researchers talk about omega-3 status, they’re increasingly referring to something called the Omega-3 Index. This index is a measurement of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as a percentage of total fatty acids found within red blood cell membranes.
Because red blood cells only live for three to four months, the Omega-3 Index reflects longer-term omega-3 intake—much the way an A1c test shows average blood sugar over a period of time (rather than at a particular moment in time). As such, the Omega-3 Index provides a more accurate snapshot of what’s occurring inside your cells relative to omega-3 levels.
An Omega-3 Index of 8% or higher is associated with low CVD risk. Anything below 4% is considered very low, and is a cause for concern.
Here’s the uncomfortable truth:
Most Americans fall somewhere between 4% and 6%. Many fall even lower than that.
The Study That’s Turning Heads
A study published in the Journal of Clinical Lipidology in early 2025 followed 2,550 participants from the Framingham Heart Study’s Offspring Cohort over a ten-year period. These participants did not have a CVD diagnosis at the beginning of the study. Researchers measured Omega-3 Index at baseline, and then they tracked cardiovascular outcomes.
The findings were striking. A low Omega-3 Index was confirmed as being an independent risk factor for CVD—meaning that it predicted risk above and beyond the standard measures already being tracked. In fact, its predictive power was comparable to two of the already most well-recognized CVD risk factors: smoking and high LDL cholesterol.
For most people, that comparison is surprising. We’ve collectively spent decades talking about the dangers associated with elevated LDL cholesterol, and also with smoking. And yet, omega-3 status—something that is entirely addressable through diet and supplementation—has largely been absent from routine conversations about CVD risk.
Why Most People Are Omega-3 Deficient
EPA and DHA come primarily from fatty fish, like salmon, mackerel, sardines, and tuna. To maintain an Omega-3 Index of above 8%, most people would need to eat fatty fish at least two or three times per week…and they would have to do so consistently. Of course, most Americans don’t come close to that.
Plant-based omega-3s (like those found in flaxseed and walnuts) contain a different type of fatty acid called ALA, which the body converts to EPA and DHA. However, conversion of ALA to EPA and DHA occurs very inefficiently. As a result, relying on plant sources to provide adequate amounts of omega-3 fatty acids generally won’t work.
This is why omega-3 supplementation is often necessary—particularly for those who don’t eat much seafood.
What to Look for in an Omega-3 Supplement
Not all omega-3 supplements are created equal. A few things matter:
- Dose—Researchers now recommend least 1,000 mg per day of combined EPA and DHA to raise a person’s Omega-3 Index reading sufficiently. Many people will need more than thats.
- Form—Triglyceride (TG) or re-esterified triglyceride (rTG) forms of omega-3s are absorbed more efficiently than ethyl ester forms.
- Quality—Fish oil can oxidize, which diminishes its benefits. Look for products that are third-party tested for purity and freshness.
Omega-3s and Hormones
For patients focused on healthy aging and hormone optimization, omega-3s are a natural complement to hormone therapy. EPA and DHA reduce systemic inflammation, which promotes better hormonal signaling throughout the body. They also support brain health, mood stability, joint comfort, and heart function—all areas where hormone optimization is already doing important work.
In other words, if you’re invested in your hormone health, making sure your omega-3 status is optimized will augment that investment.
Should You Get Tested?
Omega-3 Index testing is a blood test that can easily be added to routine lab work. Given what the research now shows about its role in CVD risk, it’s a reasonable ask for anyone who is proactive about their long-term health.
If your levels are low, this is very fixable. Studies suggest that consistent supplementation with adequate doses of EPA and DHA can raise a person’s Omega-3 Index to target range within approximately 12 weeks.
Take the Guesswork Out of Your Health
The science around omega-3 fatty acids continues to mature—and what it’s revealing is that we have underestimated their importance. A low Omega-3 Index isn’t just a nutritional footnote. It’s a modifiable CVD risk factor that deserves attention.
At Renew Youth, we help clients to improve their health from every relevant angle—including the ones that often get overlooked. To learn more about Omega-3 Index testing and omega-3 supplementation, call us at (800) 859-7511 or use our easy contact form to schedule your complimentary 30-minute consultation.