21. Cardiovascular disease risk attributed to blood fish oil (omega-3 fatty acid) levels differ significantly in Saudi Men and Women

Cardiovascular disease is a major health problem in the Saudi population. Fish consumption and blood fish oil levels have been linked to CHD risk in European, American, and Japanese populations. A knowledge gap exists regarding blood omega-3 fatty acid levels in the Saudi population. The omega-3 index (% of fatty acids composed of EPA + DHA) <3.5% has been linked to increased CVD risk in European and American investigations. A EPA/AA ratio <0.75 has been linked to increased CVD risk in a Japanese population. The aim of this investigation is to determine population distribution and gender ranges in a Saudi population. Methods: This population study involved 2672 consecutive blood samples (1544 men and 1128 women) from residence of Saudi Arabia that were de-identified and analyzed for eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA), and arachadonic acid (AA) using mass spectroscopy. Data was analyzed for analysis of variance following adjustment for age differences between genders. Results: For the entire population mean ±SD, age = 44.8 ± 14.2 years, omega-3 index = 3.91 ± 1.45%, EPA = 0.27 ± 0.22%, DHA = 3.67 ± 1.37% and AA=0.36 ± 0.13%. Mean and standard deviation age was higher in Females (45.6 ± 15 years) versus Males (44.1 ± 14 years) p = 0.005. Age adjusted differences in Females versus Males were EPA (0.23 ± 0.23% vs. 0.26 ± 0.20%, p = 0.0001), DHA (3.54 ± 1.36 vs. 3.73 ± 1.37, p = 0.0001), Omega-3 index (3.76 + 1.44 vs. 3.99 + 1.47), p = 0.0001, AA (0.36 + 0.13 vs. 0.36 + 0.13, p = NS), and EPA/AA (0.70 ± 0.64 vs. 0.79 ± 0.66, p = 0.0002). 46.4% of females and 39.1% of males had a blood omega-3 index <3.5% (p < 0.0002), and 73.7% of females and 66.3% of males (p < 0.0001) had an EPA/AA <0.75 suggesting increased CVD risk which was evident significantly more in women compared to men. Conclusion: A large proportion of the Saudi population may be at increased CVD risk due to low blood levels of omega-3 fatty acids and low EPA/AA blood level ratio. Females may be at higher risk than males. Future research will investigate the relationship of blood omega-3 blood levels and CHD incidence in the Saudi population