Quick Context: What the Omega-3 Index Measures
The Omega-3 Index reflects the percentage of EPA and DHA in red blood cell membranes. Decades of research link a low score to higher risk of sudden cardiac death. Levels under 4% are considered undesirable, while 8–12% is viewed as the desirable range for cardiovascular protection.
The Stroke Belt Problem—And a Clue in the Blood
For more than half a century, CDC data have shown that residents of the Southeast—often referred to as the “stroke belt,” including states such as Alabama, Georgia, Mississippi, and the Carolinas—face nearly double the lifetime risk of stroke compared with other regions. Diet patterns typical of this area, characterized by frequent fried foods, processed meats, sugary beverages and higher saturated fat intake, are strongly associated with greater rates of hypertension, obesity and diabetes. Researchers asked a simple question with big implications: do people in these communities also have lower omega-3 status?
Inside the Study: Seven Cities, 2,177 Tests
Free community screenings across Charleston (WV), Jacksonville (FL), Indianapolis (IN), Lexington (KY), Memphis (TN), Oklahoma City (OK), and Toledo (OH) measured the Omega-3 Index in 2,177 adults. Events were hosted at churches, malls, public health departments and clinics, coordinated by the Seafood Nutrition Partnership and local health partners.
What the Numbers Showed
A striking 42% of participants had an Omega-3 Index below 4%, a level associated with markedly higher risk of sudden cardiac death. Only about 1% reached 8% or higher. Compared with national datasets, the share of people in the desirable 8–12% band was 83% lower, while the share in the under-4% band was 20% higher. Although socioeconomic data weren’t collected, many screenings occurred in lower-income areas, so socioeconomic status may also be relevant but remains unquantified in this cohort.
Why These Findings Matter
A low Omega-3 Index has been repeatedly associated with higher cardiovascular risk. This regional snapshot suggests omega-3 insufficiency could be one modifiable factor contributing to the stroke and heart disease burden in the Southeast. Raising EPA+DHA intake—through seafood, supplements, or fortified foods—consistently increases the Omega-3 Index and may support better heart health over time.
Fish on the Plate—and in the Data
Large cohorts continue to support higher fish intake. The NIH-AARP Diet and Health Study, which tracked over 420,000 older adults, linked greater non-fried fish consumption with lower all-cause mortality and specific reductions in deaths from CVD, cancer, respiratory disease, and Alzheimer’s disease. Practical access points now include not only oily fish such as salmon, sardines, mackerel and herring, but also EPA/DHA-fortified staples like certain eggs, milks, juices, spreads and nut butters—useful where seafood intake is low.
Beyond Intake: Measure What Matters
More recent cardiovascular research increasingly includes blood omega-3 measurements alongside intake surveys. In the MESA study, higher baseline plasma phospholipid EPA was associated with a reduced risk of incident heart failure over 13 years in more than 6,500 middle-aged adults. Together with multiple large trials reported in 2018 and the high-dose EPA results from REDUCE-IT, the evidence base now spans intake, blood status and outcomes.
What Communities Can Do Next
Improving omega-3 status is actionable. Education on selecting and preparing oily fish, expanding availability of affordable seafood, and promoting EPA/DHA-fortified foods can help. On an individual level, a simple Omega-3 Index test establishes a baseline; adding several weekly servings of oily fish and/or an EPA+DHA supplement, then retesting after three to four months, confirms progress toward the 8–12% target.
The Takeaway
Residents of the stroke belt show alarmingly low omega-3 status—a potential, modifiable contributor to the region’s elevated cardiovascular risk. Raising intake of EPA and DHA and tracking the Omega-3 Index provide a clear, practical path toward better heart and brain health.
