The Omega-3 Index in Military Personnel: A Systematic Review.

Area of Science:

• Nutritional Science
• Military Health
• Biochemistry

Background:

• Long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), including EPA and DHA, are vital for cardiovascular health, cognitive function, and physical performance.
• Military personnel face unique physiological and psychological stressors, making nutritional interventions like LC n-3 PUFA supplementation potentially beneficial for Warfighter readiness.
• The omega-3 index (O3i) serves as a reliable biomarker for assessing habitual intake of EPA and DHA, reflecting their concentration in red blood cells.

Purpose of the Study:

• To systematically review existing literature and determine the baseline omega-3 index (O3i) status in active duty military personnel.
• To provide evidence-based nutritional recommendations for optimizing LC n-3 PUFA intake within the military population.
• To establish a foundation for future research and policy development aimed at enhancing military health and performance through targeted nutrition.

Main Methods:

• A systematic literature search was conducted across PubMed, Google Scholar, and the Omega-3 Clinical Study Database.
• Eleven studies, comprising 13 observations and 3,615 military personnel, were included after screening 645 articles.
• Data on non-red blood cell (RBC) EPA+DHA levels were converted to O3i using validated equations, with analyses stratified by military service branch.

Main Results:

• The average O3i across all military personnel studied was 3.18%, with a range of 2.47% to 4.62%.
• A significant majority of observations (76.9%) reported an average O3i below the optimal threshold of 4%.
• Specific groups, including U.S. Army, combined Army, and Special Forces, exhibited O3i levels below 4%, while Austrian Army and Air Force personnel showed levels between 4% and 5%.

Conclusions:

• Military personnel, irrespective of service branch, demonstrate suboptimal omega-3 index (O3i) levels.
• Enhancing O3i represents a low-cost, modifiable factor that can complement traditional medical and training approaches to support military readiness.
• Defense organizations should acknowledge the evidence and implement strategies to improve LC n-3 PUFA status among military personnel to bolster health and performance.