opti-o-3: interpretation and consultation
TRANSCRIPT
A practitioner’s guide to the Opti-O-3 biomarker test
Nina BaileyBSc (hons) MSc PhD ANutr
How the Opti-O-3 works and the 26 fatty acids screened for
Why we need to determine baseline omega-3 levels
How personalised dosing optimises clinical outcomes
How to interpret the results: what the biomarkers mean
Omega-3 index an early cardiovascular risk indicatorOmega-6 to omega-3 ratio an established marker of long-term health and chronic illnessAA to EPA ratio a measure of ’silent’ or chronic inflammation
A personalised plan aims to achieve:an omega-3 index of more than 8% an omega-6 to omega-3 ratio of between 3 and 4an AA to EPA ratio of between 1.5 and 3
It is well established that low omega-3 status is linked to poor health and a number of disease states
Omega-3 fatty acids are known to exert beneficial health effects and can be used for both prevention and treatment of chronic disease
Important questions raised are:
Why do ‘intervention’ studies produce inconsistent findings?
Why do patients respond differently to similar treatments?
Interventions use a ‘one size fits all’ approach irrespective of personal requirements
Many factors influence an individual’s response to omega-3
Body weight Omega-3 baseline levels
We are metabolically unique and using biomarkers to identify personal requirements for omega-3 can optimise clinical outcomes
Kohler et al. 2010
Biomarkers: Omega-3 index Omega-6 to omega-3 ratio AA to EPA ratio
Full fatty acid screen (26 fatty acids): Saturated Trans fats Monounsaturated Polyunsaturated
Omega-6 Omega-3
Saturated• Myristic acid • Palmitic acid • Stearic acid • Arachidic acid• Behenic acid• Lignoceric acid
Monounsaturated• Palmitoleic acid n-7 • Oleic acid n-9• Eicosenoic acid n-9 • Nervonic acid n-9
Trans fats• Trans Palmitoleic• Trans oleic• Trans Linoleic
Omega-6• Linoleic acid (LA) • Gamma-linolenic acid (GLA) • Eicosadienoic acid • Dihomo-gamma linolenic acid (DGLA) • Arachidonic acid (AA) • Docosatetraenoic acid n-6 • Docosapentaenoic acid n-6
Omega-3• Alpha-linolenic acid (ALA)• Eicosapentaenoic acid (EPA) • Docosapentaenoic acid (DPA) • Docosahexaenoic acid (DHA)
Dried blood spot (DBS)Minimally invasiveConvenient (can be performed by the client)Data derived from RBC & plasma
Whole bloodInvasive (requires a phlebotomist)Higher cost than DBSData derived from RBC only
High correlation between RBC omega-3 and DBS omega-3 (R=0.96, p<0.0001)
What’s in the kit?
1 x test information sheet1 x Spot Saver card 2 x finger-prick lancets1 x resealable plastic bag with moisture absorbent gel sachet 1 x sterile alcohol cleansing pad 1 x return envelope 1 x personal information form
Taking the test
Taking the test
Taking the test
Taking the test
Resolvins Protectins
Omega-3DHA
ANTI-INFLAMMATORY
Omega-6 DGLA
Omega-3EPA
PRO-INFLAMMATORY
Omega-6AA
LipoxinsResolvins Protectins
AA to EPA ratio
Omega-3 index
Using fatty acids as biomarkers of health and disease
ANTI-INFLAMMATORY
LEAST PROTECTION GREATEST PROTECTION
Greenland Inuit & Japanese
4% 6% 8% 10%
The omega-3 index as a biomarker of cardiovascular health
Western populations
Greenland Inuit
Japanese Western populations Disease biomarker
Optimal Acceptable Suboptimal Poor
0 1.5 3 7 15 20
The AA to EPA ratio as a potential biomarker of pro-inflammatory to anti-inflammatory balance
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.00.02.04.06.08.0
10.012.014.016.018.020.0
AA to EPA ratio
Om
ega-
3 in
dex
Combining the AA to EPA ratio with the omega-3 index gives us a comprehensive overview of health status
The nutraceutical approach to managing inflammation: shift the balance!
AA, EPA and DHA contents of cell membranes can be altered through consumption of omega-3 (marine products/marine oils)
Changing the fatty acid composition of cell membranes:
Improves cardiovascular health Improves cognitive function Improves immune function Improves inflammatory resolution Reduces disease risk
How much omega-3 do we need?
The Opti-O-3 results and recommendations
Using reference ranges
Laboratories provide reference ranges using in-house data
In-house data is skewed because it fails to provide information gathered from ‘normal’ population
There are no validated reference ranges for individual fatty acids
We do not, therefore, provide reference ranges and our recommendations are based on validated and recognised biomarkers
Using reference ranges
Using reference ranges
The AA to EPA ratio
17%
1.2%
5.9%
Consider baseline omega-3 levels!!
0
2
4
6
8
10
12
14
16
18
20
Subject A
Subject B
Base line 4 months ∆ change OutcomeOmega-3 index 3.50 5.98 2.48 Undesirable to desirable AA to EPA ratio 8.52 3.54 4.98 Suboptimal to acceptable
Case study – subject X
Improvement in both AA to EPA ratio and omega-3 index after 4 months supplementation with 1.5g EPA (Pharmepa RESTORE)
Benefits of the Opti-O-3
Knowledge of baseline levels will guide the practitioner recommendations—unsurprisingly, low baseline values may require a larger dose than a high baseline value!
The omega-3 index and AA to EPA ratio are invaluable for assessing both baseline risk and the change in risk (as function of intake – retesting is advisable ≥6 months )
Dose response studies show us that high doses of omega-3 are generally required to reduce the AA to EPA ratio and achieve omega-3 index ≥8%, especially where the baseline levels are suboptimal ≤4%
Use in conjunction with Pharmepa RESTORE & MAINTAIN
Pre-loading with pure EPA for 6-months is advised to reduce the AA to EPA ratio before the introduction of DHA for long-term support of the omega-3 index
[email protected] 1223 421434