Frank A. Bucci, Jr., MD, Bucci Laser Vision Institute Wilkes Barre, PA Comparison of RBC Saturation with Omega- 3 Oral Supplements The author of this poster is a scientific advisor for Physician Recommended Nutriceuticals.

Introduction the health benefits of dietary omega- 3 fatty the health benefits of dietary omega- 3 fatty acids are well established, especially for dry acids are well established, especially for dry eye and ARMD eye and ARMD absorption and bioavailabilty of oral absorption and bioavailabilty of oral supplements can vary with the type of omega- 3 supplements can vary with the type of omega- 3 (pure triglyceride - TG vs. ethyl ester - EE) and (pure triglyceride - TG vs. ethyl ester - EE) and formulation (mixing omegas with other formulation (mixing omegas with other ingredients) ingredients)

Introduction Oral Supplements Evaluated PRN DEOB = Physicians Recommended Nutriceuticals - Dry Eye Omega Benefit Nature Made = Nature Made - oral omega- 3 supplement Thera Tears = Advanced Vision Research- Thera Tears Nutrition

Purpose To compare the absorption and bioavailability (RBC saturation) of three omega- 3 oral supplements using the HS-Omega- 3 Index blood test ®. Methods Sixty patients randomized to 3 groups masked

Methods Each group received approximately 2300 mg of omega- 3 orally each day for 3 months Group I - PRN 2240 mg omega- 3 4 caps/day Group II - Nature Made 2400 mg omega- 3 2 caps/day Group III - Thera Tears 2332 mg omega- 3 4 caps/day

Methods Three outcomes at 3 time periods Outcomes 1. Total RBC % saturation 2. EPA % saturation of RBCs 3. DHA % saturation of RBCs Time Periods 1. Baseline 2. One month 3. Three months % saturation was evaluated at each time period using the HS Omega -3 Index blood test

Total RBC Saturation % RBC Saturation Results

EPA Saturation of RBCs % EPA Saturation Results

PRNDEOB was significantly greater than Nature Made for DHA at 1 month (4.42% vs. 3.72% / p = 0.23) PRNDEOB trended toward being significantly greater than Nature Made at 3 months (4.53% vs. 3.99% / p = 0.98) PRNDEOB almost reached significantly greater levels of DHA at 1 month vs. Thera Tears ( p =0.62)

Results HS Omega- 3 Index exceeded 8 % at 1 and 3 months PRN DEOB (29% / 44%) Nature Made (0% / 0%) Thera Tears (0% / 0%) HS-Omega- 3 Index exceeded 7 % at 1 and 3 months PRNDEOB (59% / 75%) Nature Made (6% / 29%) Thera Tears (21% / 42%) (Established research has shown that a RBC saturation greater than 8% is cardioprotective)

Conclusions 1. An objective blood test, the HS Omega- 3 Index revealed significantly greater total omega- 3 fatty acid RBC saturation (bioavailability to target tissues) for PRN-Dry Eye Omega Benefit vs. both Nature Made and TheraTears Nutrition at 1 and 3 months after ingesting equal amounts of omega- 3

Conclusions 2. Since the ingestion of EPA has been linked to less dry eye and less ARMD, it is noteworthy that this study revealed significantly greater EPA saturation of RBCs (bioavailability) for PRN Dry Eye Omega Benefit vs. both Nature Made and Thera Tears Nutrition at 1 month and 3 months following ingestion of equal amounts of omega- 3 for each product