Page 47 - JSOM Summer 2024

foods, which are high in omega-6 FAs and low in O3FAs. Inad- Omega Score
equate O3FA consumption and excess omega-6 consumption The Omega Score is the percentage of total circulating O3FAs,
favor a proinflammatory state, consequently hindering opti- including all types of endogenous O3FAs, such as ALA, in the
mal healing following a brain injury. 31 blood. Higher Omega Scores would be theorized to be pro-
tective, but risk categories have not been defined as they have
Favorable O3FA status and supplementation appear to have been for O3I.
positive effects on a wide range of outcomes in the body
before and during the acute phase of a brain injury. 27,31 On Survey
the other hand, an imbalanced O6:O3 ratio may impair the The survey consisted of 17 questions, including demograph-
body’s response to a brain injury. 27,31 Assessing O3FA status ics (age, height, weight, gender) and information regarding
in military personnel at increased risk for brain injury may diet and O3FA supplement use, history of exposure to blasts,
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help optimize response to a brain injury. The purposes of this participation in sports, and current brain injury symptoms
cross- sectional study were to: (adapted from the United States Special Operations Command
[USSOCOM] Omega Index Assessment survey).
1. Identify participants’ brain injury risk based on their O3FA
status. Procedure
2. Compare O3FA status to fish consumption and O3FA The study was approved by the Human Research Protection
supplementation. Office, Headquarters, USSOCOM after approval by the In-
3. Explore relationships between brain injury history and fish stitutional Review Board (IRB) of the University of Colorado
consumption and O3FA supplementation. Colorado Springs (UCCS). Active-duty military members re-
turned from deployment and were recruited during a briefing
following their return. Lieutenant Colonel Mario Soto, MD;
Methods
Captain Stephen Karagosian, PA-C; and Kelsey Bailey, MS,
Subjects RD, CSSD, CSCS, recruited participants from the 10th Special
In 2021, active-duty military members were recruited by the Forces Group (Airborne) from April through October 2021.
medical team at the base to which they returned following de- Informed consent was obtained from all participants. Partici-
ployment. A total of 351 Soldiers (349 males and 2 females) pants completed a brief survey and underwent a Holman fin-
participated in this study (Table 1). ger-prick blood test. Four drops of blood were collected from
each participant and sent to Lipid Technologies (Austin, MN)
for analysis. Data were de-identified by the Fort Carson re-
TABLE 1 Participants’ Descriptive Characteristics
search team and then sent to the UCCS research members for
Variable n Mean (SD) analysis. Analysis of the de-identified data was approved by
Age, y 351 32.9 (5.2) the IRB of the UCCS (UCCS Protocol 2021-173).
BMI, kg/m 2 350 27.3 (2.7)
No. of deployments 351 2.0 (2.4) Statistical Analysis
Fish servings/wk 349 0.7 (0.9) Data were analyzed using SPSS version 28 (IBM Corp, Ar-
monk, NY). Continuous variables are presented as a means
and standard deviations. Categorical variables are presented
Instrumentation and Measures
as a frequency and percentage of total. Correlations and re-
Holman Finger-Prick Test gressions were conducted to determine relationships between
The Holman finger-prick test is a self-administered blood continuous variables. Chi-square tests were used to analyze
sampling test that captures three measures of omega-3 status: categorical variables. Cramer’s V was used to calculate the ef-
omega-3 index (O3I), O6:O3 ratio, and Omega Score. While fect size of chi-square.
omega-3 status and O3I are not identical, between the two,
O3I is the most widely described measure of omega-3 status in Fish consumption and O3FA supplementation were reported
TBI research and is a validated assessment. 33–35 and analyzed as categories (yes/no), and as continuous vari-
ables (servings per week or dose per day in mg). Fish consump-
O3I tion was also analyzed ordinally (does not eat fish, eats less
The O3I is the combined amount of DHA and EPA bound to red than one serving per week, 1–2 servings per week, 2+ servings
blood cells and it is expressed as a percentage of the total FAs per week). Owing to uncertainties in the reporting of O3FA
bound to red blood cells. This validated measure of omega-3 sta- supplement dosage form, compliance, and brand, researchers’
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tus is not strongly influenced by acute dietary intake. Research ability to draw conclusions from continuous data on supple-
examining O3I in relation to heart disease has established an ments was limited.
O3I of less than 4% as high risk, 4%–8% as moderate risk, and
greater than 8% as low risk. Although these risk categories Lifetime sports history was coded into three categories
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were established in studies examining heart disease outcomes, (non-contact, contact, and collision) based on the frequency
the same categories were used during this study, since O3I risk and magnitude of blows to the head. Non-contact sports in-
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categories for TBI have not been established. cluded running and tennis. Contact sports included basketball,
baseball, softball, soccer, and combat sports without striking
O6:O3 Ratio (i.e., folk-style wrestling). Collision sports included sports such
The O6:O3 ratio is the ratio of circulating concentrations of as football, rugby, lacrosse, and combat sports with striking.
omega-6 FAs to O3FAs in all lengths and degrees of satura-
tion in the blood. Lower O6:O3 ratios are associated with de- A two-step cluster analysis was used to separate the cohort
creased mortality risk. 36 based on the following continuous variables: fish servings,

Factors Influencing Omega-3 Index Status | 45