Athletes have an increased risk for sudden cardiac death in comparison to the general population (Chandra et al, 2014, Harmon et al, 2011). Moreover, major depression and cognitive impairment are more frequent in athletes than in the general population (Hammond et al, 2013, Hart et al, 2013). These connections have been discussed in the chapters cardiology, neurology and psychiatry of this website. Therefore, it had to be assumed that competitive athletes have a low HS-Omega-3 Index. This was indeed what we found in 106 German participants of Olympic Games or their substitutes: Only one of them had a HS-Omega-3 Index in the optimal range (8-11%, von Schacky et al, 2014).
Increasing the HS-Omega-3 Index by supplementing EPA +DHA reduced heart rate at submaximal exercise, through a higher stroke volume and a higher cardiac output; moreover, heart rate recovered faster after exercise (Walser et al, 2008, Peoples et al, 2008, Buckley et al, 2009, Macartney et al. 2014). In patients with coronary artery disease, physical performance and its duration correlated with the HS-Omega-3 Index; heart rate recovered faster after exercise (Moyers et al, 2011, Macartney et al, 2014). Endothelial function was also found to be improved in athletes by omega-3 fatty acids (Zebrowska et al, 2014). Conventional aspects of physical performance, like anaerobic threshold or running performance, are not improved in trained athletes (Raastad et al, 1997, Brilla et al, 1990). Whether maximum oxygen uptake (VO2max) is improved (Zebrowska et al, 2014) or not (Raastad et al, 1997, Brilla et al, 1990) is unclear. Thus, specific cardiovascular aspects in sport are being improved.
Delayed onset muscle soreness (DOMS) is a limiting factor for many athletes. With a high Omega-3 Index, there is less DOMS after exertion (Lembke et al, 2014). Several intervention trials, some of them unpublished, demonstrated that pretreatment with EPA+DHA, i.e. an increase of the Omega-3 Index, minimized muscle damage (assessed as serum CK), and the subsequent inflammatory reaction (measured as pro-inflammatory cytokines) (Lembke et al, 2014, Kim & Lee, 2014, Mickleborough et al, 2015). Pretreating untrained individuals for six weeks with 2 g EPA+DHA/day reduced the inflammatory reaction after great strain (Bloomer et al, 2009, Tartibian et al, 2011). With a higher Omega-3 Index, less DOMS was experienced (Kim & Lee, 2014, Lembke et al, 2014). Muscles affected by DOMS have less strength; this phenomenon is minimized by a high Omega-3 Index (Lembke et al, 2014, unpublished). Moreover, aspects of complex brain function, like reaction time or efficiency, are improved in athletes by increasing the Omega-3 Index (Guzman et al, 2011; c.f. Neurology). Taken together, a high HS-Omega-3 Index in athletes means less DOMS, more strength, some improved cardiac parameters, and improved brain performance. Therefore, we feel that athletes, especially elite athletes, should know their HS-Omega-3 Index, and maintain it in the target range of 8 – 11%.
Taken together, the data we have so far support a HS-Omega-3 Index in the optimal range (8 – 11%) in sports and in competitive sports. The American Army will investigate the effects of omega-3 fatty acids on physical and mental performance (Shei et al, 2014). We plan targeted intervention trials based on the HS-Omega-3 Index in sports and competitive sports.