Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have unique properties that benefit female athletes. No study has examined the association between the dietary inflammatory index (DII) and omega-3 index. Therefore, we investigated the association between the DII and omega-3 index. This cross-sectional study included female university athletes and age- and sex-matched controls. Data were collected from anthropometric assessments, a food frequency questionnaire (FFQ), and blood tests for lipidomics. The energy-adjusted DII was calculated using the FFQ. Seventy-four athletes (mean age=19.7±1.2 y, mean BMI=21.1±2.4) and 38 controls (mean age=20.0±0.9 y, mean BMI=20.3±2.4) were enrolled in the study. The athlete group tended to have a higher percentage of high risk/intermediate in the omega-3 index (75.7% vs. 57.9%
p=0.082) or high-risk category in the trans-fat index (9.5% vs. 0.0%
p=0.093) compared to the control group. The energy-adjusted DII negatively correlated with the omega-3 index, although n-3 PUFA intake did not correlate with the omega-3 index in either group. The present findings indicated that DII might affect omega-3 index independent of n-3 PUFAs intake in female athlete. Health care professionals and coach should consider nutritional interventions based on the omega-3 index rather than relying solely on n-3 PUFAs intake for female athletes.