Nutrition Research Division, Bureau of Nutritional Sciences, Health Canada, Ottawa, ON, Canada.
Health Analysis Division, Statistics Canada, Ottawa, ON, Canada.
Am J Clin Nutr. 2021 Apr 6;113(4):993-1008. doi: 10.1093/ajcn/nqaa401.
The Omega-3 Index (OI) is a proposed marker of coronary artery disease (CAD) risk. Another index, the EPA/arachidonic acid (AA) ratio has also been proposed as a possible risk marker for CAD.
Our primary objective was to characterize the Canadian population subgroups that have an undesirable OI (<4%, associated with high CAD risk) and to identify the participants' characteristics most strongly associated with the OI. Our secondary objective was to identify the characteristics most strongly associated with the EPA/AA ratio.
Data from 4025 adult participants of cycles 3 and 4 (2012-2015) of the cross-sectional Canadian Health Measures Survey were pooled. Adjusted mean proportions of erythrocyte membrane ω-3 (n-3) fatty acids, total ω-6 fatty acids, and ratios were analyzed by sociodemographic, health, and lifestyle characteristics using covariate-adjusted models.
The mean OI was 4.5%. Almost 40% of Canadians had an undesirable (<4%) OI. ω-3 supplement use, fish intake, and race were the variables most strongly associated with OI scores. The prevalence of undesirable OI was significantly higher among participants consuming fish less than twice a week (43.8%; 95% CI: 39.0%, 48.6%) than among those consuming more fish (12.7%; 95% CI: 7.8%, 19.9%), among smokers (62.7%; 95% CI: 52.9%, 71.7%) than nonsmokers (33.4%; 95% CI: 29.4%, 37.7%), in whites (42.7%; 95% CI: 38.2%, 47.4%) than in Asians (23.0%; 95% CI: 15.4%, 33.0%), and in adults aged 20-39 y (49.6%; 95% CI: 42.3%, 56.9%) than in those aged 60-79 y (24.4%; 95% CI: 21.0%, 28.1%). ω-3 supplement intake and fish intake were the characteristics most strongly associated with EPA/AA. All P ≤ 0.05.
An important proportion of Canadian adults has an undesirable (<4%) OI, with higher prevalence in some subgroups. Further assessment is required to determine the value and feasibility of an increase in the population's OI to the currently proposed target of ≥8% as a potential public health objective.
ω-3 指数（OI）是一种用于预测冠心病（CAD）风险的标志物。另一种指数，即 EPA/花生四烯酸（AA）比值，也被认为是 CAD 风险的可能标志物。
我们的主要目的是描述加拿大人群亚组中 OI 值较低（<4%，与 CAD 风险高相关）的情况，并确定与 OI 值最相关的参与者特征。我们的次要目的是确定与 EPA/AA 比值最相关的特征。
对来自 4025 名参加 2012-2015 年加拿大健康测量调查（Canadian Health Measures Survey）第 3 轮和第 4 轮横断面研究的成年参与者的数据进行了汇总。采用协变量调整模型，根据社会人口统计学、健康和生活方式特征分析红细胞膜 ω-3（n-3）脂肪酸、总 ω-6 脂肪酸和比值的调整均值比例。
平均 OI 值为 4.5%。几乎 40%的加拿大人的 OI 值较低（<4%）。ω-3 补充剂的使用、鱼类摄入和种族是与 OI 评分最相关的变量。每周食用鱼类少于两次的参与者（43.8%；95%CI：39.0%，48.6%）与每周食用鱼类更多的参与者（12.7%；95%CI：7.8%，19.9%）相比，OI 值较低的比例显著更高，与不吸烟者（33.4%；95%CI：29.4%，37.7%）相比，吸烟者（62.7%；95%CI：52.9%，71.7%）的 OI 值较低，与亚洲人（23.0%；95%CI：15.4%，33.0%）相比，白人（42.7%；95%CI：38.2%，47.4%）的 OI 值较低，与 20-39 岁的成年人（49.6%；95%CI：42.3%，56.9%）相比，60-79 岁的成年人（24.4%；95%CI：21.0%，28.1%）的 OI 值较低。ω-3 补充剂摄入和鱼类摄入是与 EPA/AA 最相关的特征。所有 P 值均<0.05。
相当一部分加拿大成年人的 OI 值较低（<4%），某些亚组的患病率更高。需要进一步评估以确定增加人群 OI 值至目前建议的≥8%作为潜在公共卫生目标的价值和可行性。
