HS-Omega-3 Index in Sports

Athletes have an increased risk for sudden cardiac death in comparison to the general population (Chandra et al, 2014, Harmon et al, 2011). Moreover, major depression and cognitive impairment are more frequent in athletes than in the general population (Hammond et al, 2013, Hart et al, 2013). These connections have been discussed in the chapters cardiology, neurology and psychiatry of this website. Therefore, it had to be assumed that competitive athletes have a low HS-Omega-3 Index. This was indeed what we found in 106 German participants of Olympic Games or their substitutes: Only one of them had a HS-Omega-3 Index in the optimal range (8-11%, von Schacky et al, 2014).

Increasing the HS-Omega-3 Index by supplementing EPA +DHA reduced heart rate at submaximal exercise, through a higher stroke volume and a higher cardiac output; moreover, heart rate recovered faster after exercise (Walser et al, 2008, Peoples et al, 2008, Buckley et al, 2009, Macartney et al. 2014). In patients with coronary artery disease, physical performance and its duration correlated with the HS-Omega-3 Index; heart rate recovered faster after exercise (Moyers et al, 2011, Macartney et al, 2014). Endothelial function was also found to be improved in athletes by omega-3 fatty acids (Zebrowska et al, 2014). Conventional aspects of physical performance, like anaerobic threshold or running performance, are not improved in trained athletes (Raastad et al, 1997, Brilla et al, 1990). Whether maximum oxygen uptake (VO2max) is improved (Zebrowska et al, 2014) or not (Raastad et al, 1997, Brilla et al, 1990) is unclear. Thus, specific cardiovascular aspects in sport are being improved.

Delayed onset muscle soreness (DOMS) is a limiting factor for many athletes. With a high Omega-3 Index, there is less DOMS after exertion (Lembke et al, 2014). Several intervention trials, some of them unpublished, demonstrated that pretreatment with EPA+DHA, i.e. an increase of the Omega-3 Index, minimized muscle damage (assessed as serum CK), and the subsequent inflammatory reaction (measured as pro-inflammatory cytokines) (Lembke et al, 2014, Kim & Lee, 2014, Mickleborough et al, 2015). Pretreating untrained individuals for six weeks with 2 g EPA+DHA/day reduced the inflammatory reaction after great strain (Bloomer et al, 2009, Tartibian et al, 2011). With a higher Omega-3 Index, less DOMS was experienced (Kim & Lee, 2014, Lembke et al, 2014). Muscles affected by DOMS have less strength; this phenomenon is minimized by a high Omega-3 Index (Lembke et al, 2014, unpublished). Moreover, aspects of complex brain function, like reaction time or efficiency, are improved in athletes by increasing the Omega-3 Index (Guzman et al, 2011; c.f. Neurology). Taken together, a high HS-Omega-3 Index in athletes means less DOMS, more strength, some improved cardiac parameters, and improved brain performance. Therefore, we feel that athletes, especially elite athletes, should know their HS-Omega-3 Index, and maintain it in the target range of 8 – 11%.

Taken together, the data we have so far support a HS-Omega-3 Index in the optimal range (8 – 11%) in sports and in competitive sports. The American Army will investigate the effects of omega-3 fatty acids on physical and mental performance (Shei et al, 2014). We plan targeted intervention trials based on the HS-Omega-3 Index in sports and competitive sports.

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Bloomer RJ, Larson DE, Fisher-Wellman KH, Galpin AJ, Schilling BK. Effect of eicosapentaenoic and docosahexaenoic acid on resting and exercise-induced inflammatory and oxidative stress biomarkers: a randomized, placebo controlled, cross-over study. Lipids Health Dis. 2009;8:36.
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Buckley JD, Burgess S, Murphy KJ, Howe PR. DHA-rich fish oil lowers heart rate during submaximal exercise in elite Australian Rules footballers. J Sci Med Sport. 2009;12:503-7.
Chandra N, Bastiaenen R, Papadakis M, Sharma S. Sudden cardiac death in young athletes: practical challenges and diagnostic dilemmas. J Am Coll Cardiol. 2013;61:1027-40.
Hammond T, Gialloreto C, Kubas H, Hap Davis H 4th. The prevalence of failure-based depression among elite athletes.
Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation. 2011;123:1594-600. Clin J Sport Med. 2013;23:273-7.
Hart J Jr, Kraut MA, Womack KB, Strain J, Didehbani N, Bartz E, Conover H, Mansinghani S, Lu H, Cullum CM. Neuroimaging of cognitive dysfunction and depression in aging retired National Football League players: a cross-sectional study. JAMA Neurol. 2013;70:326-35
Lembke P, Capodice J, Hebert K, Swenson T. Influence of omega-3 (n3) index on performance and wellbeing in young adults after heavy eccentric exercise. J Sports Sci Med. 2014;13:151-6
Macartney MJ, Hingley L, Brown MA, Peoples GE, McLennan PL. Intrinsic heart rate recovery after dynamic exercise is improved with an increased omega-3 index in healthy males. Br J Nutr. 2014;112:1984-92
Moyers B, Farzaneh-Far R, Harris WS, Garg S, Na B, Whooley MA. Relation of Whole Blood n-3 Fatty Acid Levels to Exercise Parameters in Patients With Stable Coronary Artery Disease (from the Heart and Soul Study). Am J Cardiol. 2011;107:1149-54
Mickleborough TD, Sinex JA, Platt D, Chapman RF, Hirt M. The effects PCSO-524®, a patented marine oil lipid and omega-3 PUFA blend derived from the New Zealand green lipped mussel (Perna canaliculus), on indirect markers of muscle damage and inflammation after muscle damaging exercise in untrained men: a randomized, placebo controlled trial. J Int Soc Sports Nutr. 2015;12:10.
Peoples GE, McLennan PL, Howe PR, Groeller H. Fish oil reduces heart rate and oxygen consumption during exercise. J Cardiovasc Pharmacol. 2008;52:540-7.
Raastad T, Høstmark AT, Strømme SB. Omega-3 fatty acid supplementation does not improve maximal aerobic power, anaerobic threshold and running performance in well-trained soccer players. Scand J Med Sci Sports. 1997;7:25-31.
Kim J, Lee J. A review of nutritional intervention on delayed onset muscle soreness. Part I. J Exerc Rehabil. 2014;10:349-56
Tartibian B, Maleki BH, Abbasi A. Omega-3 fatty acids supplementation attenuates inflammatory markers after eccentric exercise in untrained men. Clin J Sport Med. 2011;21:131-7.
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;24:559-64.
Walser B, Stebbins CL. Omega-3 fatty acid supplementation enhances stroke volume and cardiac output during dynamic exercise. Eur J Appl Physiol. 2008;104:455-61.
Zebrowska A, Mizia-Stec K, Mizia M, Gąsior Z, Poprzęcki S. Omega-3 fatty acids supplementation improves endothelial function and maximal oxygen uptake in endurance-trained athletes. Eur J Sport Sci. 2014 Sep 1:1-10. [Epub ahead of print]

De Omega-3 Index meet het gehalte aan de omega-3 vetzuren EPA en DHA, met als doel de gezondheid van uw circulatie op te volgen.

De HS-Omega-3 Index-test is voor u rechtstreeks beschikbaar, in de vorm van een vingerpriktest. De testkit bevat een teststrip waarmee zowel uw Omega-3 Index als de verhouding tussen uw omega-6- en uw omega-3-vetzuren kan worden bepaald.


The HS-Omega-3 Index is provided to you by Omega Metrix Lab and Prof. Dr C. von Schacky.
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