Sioux Falls, SD—A new paper published in theAmerican Journal of Clinical Nutrition showed that a low Omega-3 Index (O3I) is just as powerful a predictor of early death as smoking.

The finding comes from data from the Framingham study, one of the longest running studies in the world, which has provided insights into cardiovascular disease (CVD) risk factors and led to the development of the Framingham Risk Score, based on eight standard risk factors: age, sex, smoking, hypertension treatment, diabetes status, systolic blood pressure, total cholesterol, and HDL cholesterol.

Several of these factors, notes a press release from OmegaQuant, can be manipulated by diet. One major diet-based biomarker: fatty acids. The fatty acids most clearly associated with reduced risk for CVD and reduced risk for total mortality are the omega-3s EPA and DHA.

A 2018 report that included 2500 participants in the Framingham Offspring Cohort followed for a median of 7.3 years, the baseline red blood cell EPA and DHA content—the O3I—was significantly and inversely associated with risk for death from all causes. Individuals with the highest O3I were 33% less likely to die from CVD during the follow-up years compared with those who had the lowest O3I.

Similar associations have been seen in the Women’s Health Initiative Memory Study, the Heart and Soul Study, and the Ludwigshafen Risk and Cardiovascular Health Study.

Related: Study: Omega-3 Index is a Strong Risk Predictor of Premature Death Carlson Achieves Sustainability Certification for Omega-3 Products Omega-3 Revisited: The Most Important Benefit You’ve Never Heard Of

An optimal O3I is 8% or higher; an intermediate O3I is between 4-8%; and a low O3I is 4% and below. Most Americans, according to the press release, have an O3I below 4%.

"It is interesting to note that in Japan, where the mean Omega-3 Index is greater than 8%, the expected life span is around five years longer than it is in the United States, where the mean Omega-3 Index is about 5%. Hence, in practice, dietary choices that change the Omega-3 Index may prolong life," said Michael McBurney, Ph.D., FCNS-SCN, lead researcher in this study. "In the final combined model, smoking and the Omega-3 Index seem to be the most easily modified risk factors. Being a current smoker (at age 65) is predicted to subtract more than four years of life (compared with not smoking), a life shortening equivalent to having a low vs. a high Omega-3 Index."

"The information carried in the concentrations of four red blood cell fatty acids was as useful as that carried in lipid levels, blood pressure, smoking, and diabetic status with regard to predicting total mortality," said Dr. Bill Harris, Founder of OmegaQuant and Fatty Acid Research Institute (FARI), who was also an author on this study. "This speaks to the power of the Omega-3 Index as a risk factor and should be considered just as important as the other established risk factors, and maybe even more so."