Table 1.
Combination EPA plus DHA supplementation protocols and omega-3 index (O3i).
| References | Supplementation protocol | Participants | Baseline O3i (%) | Final O3i (%) |
|---|---|---|---|---|
| Saifullah et al. (12) | 680 mg EPA + 340 mg/d DHA for 12 wks | N = 15 adults (73% male) mean age 58 ± 12 yrs receiving hemodialysis (USA) | 2.1 ± 1.1 | 6.8 ± 2.6* |
| Bukhari et al. (26) | Fortified food: Estimated 115 (±68) mg EPA + 246 (±129) mg/d DHA for 8 wks | N = 38 military personnel (79% male) mean age 24 ± 10 yrs (USA) | 2.8 ± 0.7 | 3.7 ± 0.7* |
| Alqarni et al. (54) | 840 mg EPA + 560 mg/d DHA for 6 mos | N = 114 individuals (52% male) median age 17 yrs at ultra-high risk of developing psychosis (International) | Median: 3.0 | Median: 4.1* |
| Spahis et al. (14) | 1,200 mg/d EPA + DHA for 6 mos | N = 11 male children aged 8–18 yrs with severe non-alcoholic fatty liver disease (French Canada) | 3.0 ± 0.2 | 6.9 ± 0.4* |
| Sarter et al. (13) | 82 mg EPA + 172 mg/d DHA for 4 mos | N = 46 adult vegans aged >20 yrs with O3i <4% (USA) | 3.1 ± 0.6 | 4.8 ± 0.8* |
| Dretsch et al. (9) | 1,175 mg EPA + 950 mg/d DHA (EE) for 9 wks | N = 44 soldiers (93% male) mean age 31 ± 7 yrs on deployment (USA) | 3.5 ± 7.1 | 6.7 ± 1.7* |
| Berge et al. (8) A | 67 mg EPA + 33 mg/d DHA for 12 wks | N = 53 adults (66% male) mean age 46 ± 13 yrs with high triglycerides (Canada) | 3.7 ± 0.9 | 4.0 ± 0.8* |
| Berge et al. (8) B | 134 mg EPA + 66 mg/d DHA for 12 wks | N = 53 adults (64% male) mean age 41 ± 13 yrs with high triglycerides (Canada) | 3.6 ± 0.8 | 4.2 ± 0.8* |
| Berge et al. (8) C | 268 mg EPA + 132 mg/d DHA for 12 wks | N = 51 adults (73% male) mean age 44 ± 12 yrs with high triglycerides (Canada) | 4.0 ± 0.9 | 5.2 ± 1.0* |
| Berge et al. (8) D | 536 mg EPA + 264 mg/d DHA for 12 wks | N = 58 adults (67% male) mean age 46 ± 12 yrs with high triglycerides (Canada) | 3.7 ± 0.7 | 6.3 ± 1.0* |
| Van der Wurff et al. (16) | 520 mg EPA + 280 mg/d DHA for 1 yr | N = 108 adolescents (57% male) mean age 14 ± 1 yrs with an O3i ≤5% (The Netherlands) | 3.7 ± 0.5 | 4.9 ± 1.4* |
| Zebrowska et al. (19) | 852 mg EPA + 1,602 mg/day DHA for 3 wks | N = 12 non-elite male endurance runners mean age 33 ± 7 yrs (Poland) | 3.9 ± 0.5 | 4.8 ± 0.8* |
| Hooper et al. (20) | 225 mg EPA + 800 mg/d DHA for 1 yr | N = 98 elderly adults (69% female) mean age 80 ± 5 yrs with memory loss (France) | 4.1 ± 0.6 | 8.8*# |
| Köhler et al. (28) | Fortified sausages providing ~250 mg/d EPA + DHA (EE) for 8 wks | N = 22 healthy adults (59% male) mean age 26 ± 8 yrs (Germany) | 4.2 ± 0.5 | 5.7 ± 0.7* |
| Epitropoulos et al. (55) | 1,680 mg EPA + 560 mg/d DHA (re-esterified EE) for 12 wks | N = 54 adults (70% female) mean age 57 ± 17 yrs with dry eye disease (USA) | 4.2 ± 1.0 | 7.2 ± 2.7* |
| Carboni et al. (27) | Fortified mussels providing ~300 mg/d EPA + DHA for 4 wks | N = 12 university staff and students (67% male) mean age 24 ± 1 yrs (UK) | 4.3 ± 0.8 | 5.1 ± 1.0* |
| Heileson et al. (56) | 560 mg EPA + 2,000 mg DHA + 320 mg/d DPA for 13 wks | N = 31 American male football players aged >18 yrs (USA) | 4.3 ± 0.9 | 7.4*# |
| Flock et al. (50) A | 191 mg EPA + 121 mg/d DHA for 5 mos | N = 23 healthy adults (55% male) mean age 26 ± 2 yrs (USA) | 4.3 ± 0.2 | 6.2 ± 0.2* |
| Flock et al. (50) B | 374 mg EPA + 237 mg/d DHA for 5 mos | N = 22 healthy adults (52% female) mean age 27 ± 2 yrs (USA) | 4.3 ± 0.2 | 6.8 ± 0.2* |
| Flock et al. (50) C | 556 mg EPA + 352 mg/d DHA for 5 mos | N = 24 healthy adults (54% male) mean age 26 ± 1 yrs (USA) | 4.3 ± 0.3 | 7.5 ± 0.2* |
| Flock et al. (50) D | 1,103 mg EPA + 698 mg/d DHA for 5 mos | N = 24 healthy adults (54% male) mean age 26 ± 1 yrs (USA) | 4.3 ± 0.2 | 9.5 ± 0.2* |
| Cao et al. (57) A | 1,296 mg EPA + 864 mg/d DHA for 8 wks | N = 9 healthy adults (60% female) mean age 49 ± 8 yrs (USA) | 4.3 (SE 0.4) | 7.8 (SE 0.3)* |
| Stanton et al. (30) | Fortified chicken and eggs providing ~150 mg/d EPA + DHA for 6 mos | N = 33 healthy adults (59% female) mean age 41 ± 11 yrs (Ireland) | 4.3 ± 1.6 | 5.4*# |
| Meital et al. (58) | 300 mg EPA + 1,500 mg/d DHA for 12 wks | N = 15 elderly male patients mean age 74 ± 5 yrs with abdominal aortic aneurysm (Australia) | 4.5 ± 0.2 | 8.0 ± 0.2* |
| Sanguansri et al. (35) A | 618 mg EPA + 395 mg/d DHA for 4 wks (milk protein-sugar) | N = 14 healthy adults (64% female) mean age 58 (SE 3) yrs (Australia) | 4.7 (SE 0.3) | 5.8 (SE 0.3)* |
| Sanguansri et al. (35) B | 629 mg EPA + 397 mg/d DHA for 4 wks (milk protein-sugar-resistant starch) | N = 16 healthy adults (63% female) mean age 56 (SE 2) yrs (Australia) | 5.1 (SE 0.2) | 6.3 (SE 0.2)* |
| Sanguansri et al. (35) C | 647 mg EPA + 402 mg/d DHA for 4 wks (capsules consumed with milk) | N = 17 healthy adults (71% female) mean age 56 (SE 3) yrs (Australia) | 4.5 (SE 0.1) | 5.8 (SE 0.2)* |
| Macartney et al. (59) | 140 mg EPA + 560 mg/d DHA for 8 wks | N = 13 healthy adult males mean age 24 (SE 7) yrs (Australia) | 4.7 (SE 0.2) | 6.3 (SE 0.3)* |
| Hingley et al. (60) | 140 mg EPA + 560 mg/d DHA (TAG) for 8 wks | N = 13 trained male cyclists mean age 24 ± 7 yrs (Australia) | 4.7 ± 0.2 | 6.3 ± 0.3* |
| Harris et al. (47) | 1,000 mg/d EPA + DHA (TAG) for 6 mos | N = 21 adult (64% male) mean age 55 ± 9 yrs recipients of a heart transplant (Canada) | 4.7 ± 1.1 | 9.0 ± 1.7* |
| Harris et al. (61) | 1,000 mg/d n-3 FA (EE; including 850 mg EPA + DHA) for 13 wks | N = 230 adults (77% male) mean age 67 ± 11 yrs with chronic heart failure (Italy) | 4.8 ± 1.7 | 6.7 ± 1.9* |
| Tobin et al. (33) | 1,380 mg EPA and 1,140 mg/d DHA (EE) for 5.5 mos | N = 81 patients (56% female) mean age 55 ± 13 yrs with non-alcoholic fatty liver disease (USA) | 4.8 ± 1.1 | 8.0 ± 2.6* |
| Yuen et al. (62) | 1,000 mg EPA + 700 mg/d DHA for 12 wks | N = 29 epileptic patients (UK); sex and age not provided | 4.8 ± 1.6 | 9.3* |
| Fischer et al. (34)× | Weeks 1–4: 460 mg EPA + 380 mg/d DHA (EE) Weeks 5–8: 980 mg EPA + 760 mg/d DHA (EE) |
N = 20 healthy adults with O3i <6% (Germany) 50% male mean age 32 ± 8 yrs 50% female mean age 38 ± 6 yrs |
4.9 ± 0.2 | 8.4 ± 0.2* |
| Gerstenblith et al. (32) | 840 mg EPA + 2,520 mg/d DHA (TAG) for 6 mos | N = 17 older adults (71% female) mean age 69 yrs with macular degeneration (USA) | 5.0 | 12.6*# |
| West et al. (63) A | 684 mg EPA + 549 mg/d DHA (EE) for 12 wks | N = 19 healthy adults (53% female) mean age 41 ± 14 yrs (UK) | 4.8 ± 0.8 | 6.4 ± 0.9* |
| West et al. (63) B | 381 mg EPA + 888 mg/d DHA (EE) for 12 wks | N = 20 healthy adults (50% female) mean age 39 ± 13 yrs (UK) | 5.2 ± 0.9 | 7.2 ± 1.0* |
| West et al. (63) C | 726 mg EPA + 576 mg/d DHA in a self-micro-emulsifying delivery system for 12 wks | N = 19 healthy adults (53% male) mean age 40 ± 13 yrs (UK) | 5.1 ± 0.9 | 7.9 ± 0.9* |
| West et al. (63) D | 408 mg EPA + 918 mg/d DHA in a self-micro-emulsifying delivery system for 12 wks | N = 20 healthy adults (50% female) mean age 39 ± 13 yrs (UK) | 5.3 ± 1.1 | 9.0 ± 1.2* |
| Grenon et al. (17) | 2,600 mg EPA + 1,800 mg/d DHA for 4 wks | N = 36 older adults (98% male) mean age 68 ± 7 yrs with peripheral artery disease (USA) | 5.2 ± 1.7 | 9.2*# |
| Heydari et al. (64) | 465 mg EPA + 375 mg/d DHA (EE) for 6 mos | N = 180 older adults (82% male) mean age 60 ± 10 yrs with acute myocardial infarction (USA) | 5.5 ± 1.8 | 10*# |
| Ramirez et al. (18) | 2,600 mg EPA + 1,800 mg/d DHA for 12 wks | N = 11 older male adults mean age 69 ± 8 yrs with peripheral artery disease (USA) | 5.5 ± 2.1 | 12.7*# |
| Martucci et al. (29) | Fortified milk providing 350 mg/d EPA + DHA for 12 wks | N = 48 community-dwelling elderly adults (54% male) mean age of 70 ± 5 yrs (Italy) | 5.6 | 7.3* |
| Handeland et al. (31) A | Fish providing 150 mg EPA + 257 mg/d DHA for 12 wks | N = 128 adolescents (56% female) mean age 15 ± 0.3 yrs (Norway) | 5.8 ± 1.2 | 6.4 ± 1.2* |
| Handeland et al. (31) B | 463 mg EPA + 319 mg/d DHA for 12 wks | N = 142 adolescents (54% female) mean age 15 ± 0.3 yrs (Norway) | 5.7 ± 1.3 | 7.3 ± 1.2* |
| Stonehouse et al. (37) | 600 mg EPA + 280 mg/d DHA for 6 mos | N = 106 healthy adults (56% female) mean age 56 ± 7 yrs with knee osteoarthritis (Australia) | 6.0 ± 1.3 | 9.0 ± 1.6* |
| Wasserfurth et al. (65) | 109 mg EPA + 87 mg DHA + 124 mg/d SDA for 12 weeks | N = 33 older adults (69% female) mean age 59 ± 6 yrs (Germany) | 6.1 ± 1.3 | 7.4 ± 1.1* |
| Udani and Ritz (66) | 756 mg EPA + 228 mg/d DHA for 4 mos | N = 157 healthy adults (sex not specified) mean age 44 ± 1 yrs (USA) | 6.1 | 7.3* |
| Alkhedhairi et al. (53) | 772 mg EPA + 384 mg/d DHA for 6 mos | N = 49 inactive older adults (53% female) mean age 71 ± 5 yrs (UK) | 6.5 ± 1.7 | 10.0 ± 2.1* |
| Hedengran et al. (46) A | 767 mg EPA + 1,930 mg/d DHA (acyl glycerol) for 8 wks | N = 36 adults (92% male) mean age 63 ± 8 yrs with high fasting triglycerides (USA) | 6.8 ± 1.9 | 11.1* |
| Hedengran et al. (46) B | 1,702 mg EPA + 1,382 mg/d DHA (EE) for 8 wks | N = 36 adults (65% male) mean age 60 ± 11 yrs with high fasting triglycerides (USA) | 6.5 ± 1.5 | 10.3* |
| Neubronner et al. (36) A | 1,010 mg EPA + 670 mg/d DHA (rTAG) for 6 mos | N = 41 dyslipidemic adults (56% male) mean age 61 ± 10 yrs (Germany) | 7.0 ± 1.9 | 13.3 ± 2.4* |
| Neubronner et al. (36) B | 1,010 mg EPA + 670 mg/d DHA (EE) for 6 mos | N = 45 dyslipidemic adults (56% male) mean age 60 ± 9 yrs (Germany) | 7.4 ± 1.8 | 12.2 ± 2.3* |
| Külzow et al. (67) | 1,320 mg EPA + 880 mg/d DHA for 6.5 mos | N = 22 healthy older adults (55% male) mean age 63 ± 6 yrs (Germany) | 7.8 ± 2.6 | 10.2 ± 2.9* |
| Lee et al. (68) | 1,104 mg EPA + 912 mg/d DHA for 12 wks | N = 8 adults (75% female) mean age 60 ± 7 yrs on hemodialysis (South Korea) | 7.8 ± 3.4 | 13.2 ± 2.2* |
| Witte et al. (24) | 1,320 mg EPA + 880 mg/d DHA for 6.5 mos | N = 33 healthy older adults (53% male) mean age 65 ± 6 yrs (Germany) | 8.0 ± 2.5 | 9.7 ± 2.9* |
| Dams et al. (23) A | 190 mg EPA + 225 mg/d DHA for 4 mos | N = 17 healthy adults (53% male) mean age 43 ± 12 yrs with BMI 20–35 kg/m2 (Austria) | 8.2 ± 2.3 | 11.7 ± 2.5* |
| Dams et al. (23) B | 380 mg EPA + 450 mg/d DHA for 4 mos | N = 18 healthy adults (50% male) mean age 42 ± 13 yrs with BMI 20-35 kg/m2 (Austria) | 8.1 ± 2.6 | 14.4 ± 2.7* |
Research studies compared different doses, forms of n-3 FA, or composition; thus, each intervention protocol has a separate entry. O3i are presented as means ± SD unless otherwise noted.
*
p < 0.05;
#
calculated final O3i;
×
excluded from Figure 2 due to inconsistent dosage. TAG, triglycerides; rTAG, re-esterified triglycerides; EE, ethyl esters; DPA, docosapentaenoic acid; SDA, stearidonic acid.