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Association of two cut-off points for the n-3 index with cardiometabolic risk factors in Brazilian and Puerto Rican middle-aged adults

Published online by Cambridge University Press:  22 August 2025

Lais Duarte Batista ,
Katherine L. Tucker ,
Sherman Bigornia ,
Sabrina E. Noel ,
William S. Harris Open the ORCID record for William S. Harris [Opens in a new window] ,
Ribanna A. Marques Braga ,
João Valentini Neto Open the ORCID record for João Valentini Neto [Opens in a new window] ,
Nágila R. Teixeira Damasceno Open the ORCID record for Nágila R. Teixeira Damasceno [Opens in a new window] ,
Marcelo Macedo Rogero Open the ORCID record for Marcelo Macedo Rogero [Opens in a new window]  and
Flavia Mori Sarti
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Lais Duarte Batista
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Katherine L. Tucker
Affiliation:
Department of Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
Sherman Bigornia
Affiliation:
Department of Agriculture Nutrition and Food Systems, University of New Hampshire, Durham, NH, USA
Sabrina E. Noel
Affiliation:
Department of Biomedical & Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
William S. Harris
Affiliation:
Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA The Fatty Acid Research Institute, Sioux Falls, SD, USA
Ribanna A. Marques Braga
Affiliation:
Heart Institute, Medical School, University of São Paulo, São Paulo, Brazil
João Valentini Neto
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Nágila R. Teixeira Damasceno
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil Heart Institute, Medical School, University of São Paulo, São Paulo, Brazil
Marcelo Macedo Rogero
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
Flavia Mori Sarti
Affiliation:
School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, Brazil
Josiemer Mattei
Affiliation:
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Regina M. Fisberg*
Affiliation:
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
*
Corresponding author: Regina M. Fisberg; Email: rfisberg@usp.br
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Abstract

The n-3 index has been proposed as a risk factor for CVD endpoints. However, the association of the O3I defined with different cut-offs and cardiometabolic risk factors has been less studied. This study aimed to investigate the association between two cut-off points of the O3I and cardiometabolic risk factors in Brazilian and Puerto Rican adults. This cross-sectional analysis included 249 Brazilians and 1261 Puerto Ricans, aged 45–75 years. Fatty acids composition was quantified in erythrocyte membranes using GC with a flame ionisation detector. The O3I was categorised as ≤ 4 % (low), > 4–8 % (intermediate) and ≥ 8 % (desirable), and as ≤ 4 % (very low), > 4–6 % (low), > 6–8 % (moderate) and > 8 % (high) in the second cut-off classification. Serum lipids, waist circumference and insulin resistance were measured from standardised protocols. Multivariable-adjusted linear models tested the association between the O3I and cardiometabolic factors. Brazilians had a mean (sd) O3I of 4·65 % (1·19 %) v. 4·43 % (1·14 %) in Puerto Ricans (P = 0·033), with only 1·6 % of Brazilians and 1·2 % of Puerto Ricans presenting a desirable/high O3I. The O3I, as continuous or for > 4 % (v. ≤ 4 %), was inversely associated with TAG, VLDL and TAG/HDL-cholesterol ratio in Puerto Ricans. In Brazilians, an O3I > 6 % (v. ≤ 6 %) was associated with higher total cholesterol, LDL-cholesterol and non-HDL-cholesterol. Both populations presented O3I below the desirable levels, and the magnitude and direction of associations with cardiometabolic factors varied by study and cut-offs, reinforcing the importance of expanding these investigations to more diverse populations.

Keywords

n-3 indexFatty acidsCardiometabolic riskErythrocyte membranesBiomarkers

Information

Type
Research Article
Information
British Journal of Nutrition , First View , pp. 1 - 12
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of the Nutrition Society

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Footnotes

Josiemer Mattei and Regina Mara Fisberg are joint senior authors. These authors have contributed equally to this work.

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