Abstract Objectives. Recent studies in adults have suggested that the plasma level of omega-3 fatty acids may be associated with weight status and abdominal adiposity, limited studies exist in paediatric populations. The present study examined the relationship between the omega-3 index, weight status and insulin resistance in children.

Methods. School-age children between 5-12 years, classified as non-obese or obese on the basis of body mass index (BMI) z-scores, were examined. Fat intake was assessed using a parent reported 135-item semi-quantitative food frequency questionnaire. Erythrocyte fatty acid composition was determined using gas chromatography. The Omega-3 index (O3I) was calculated by adding eicosapentaenoic and docosahexaenoic acid % (weight/weight) values.

Results. Obese children had altered erythrocyte fatty acid composition unrelated to reported dietary intake. A greater proportion of obese (BMI z-score > 2.25) children (33%) had an omega-3 index of < 4.0 (high risk) compared with non-obese children (BMI z-score < 2.25) (17%). Simultaneously, the number of children with a higher omega-3 index (6.0-8.0 lower risk) was lower in the obese (13%) versus non-obese children (25%, respectively). A moderate, but statistically significant correlation was found between O3I and fasting insulin level (r = -0.3, P = 0.03) and with homeostatic model assessment (HOMA) scores (r = -0.3, P = 0.04).

Conclusion. The observed association between the omega-3 index, weight status and insulin resistance in children highlights the importance of omega-3 fatty acids in the prevention of obesity-related chronic diseases in later life. The results presented merits confirmation in a larger sample of obese children.