Flock · Journal of the American Heart Association 2013 · randomized controlled trial · n=115

Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-response randomized controlled trial.

Cited 222 times in the scientific literature.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 24252845 · doi:10.1161/JAHA.113.000513 · record verified 2026-08-26

What was done

A randomized, double-blind, placebo-controlled, parallel-group trial examined 115 healthy men and women assigned to one of five daily EPA+DHA doses (0, 300, 600, 900, or 1800 mg) via fish oil or placebo supplements for approximately 5 months. The erythrocyte membrane content of EPA and DHA (Omega-3 Index, O3I) was measured at baseline and study completion to model predictive determinants of the O3I response.

What was found

O3I increased in a dose-dependent manner (P < 0.0001). Supplement dose alone accounted for 68% of response variability (quadratic model, P < 0.0001), while dose adjusted per unit body weight (g/kg) accounted for 70% (linear model, P < 0.0001). Incorporating baseline O3I, age, sex, and physical activity alongside dose further improved prediction, collectively explaining 78% of the response variability (P < 0.0001).

Why it matters

This study provides quantitative models showing that body weight, baseline omega-3 levels, and demographic factors significantly influence erythrocyte EPA+DHA incorporation, supporting personalized dosing regimens to achieve target Omega-3 Index levels.

Limits

The sample size was relatively small (115 participants divided across five arms, averaging ~23 per group). The study was conducted only in healthy adults, so response kinetics in clinical populations with cardiovascular or metabolic diseases were not evaluated. The abstract does not report baseline dietary intake, absolute baseline/post-treatment index values, adherence measures, or clinical outcomes.

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