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In Reply: Dr Chen and colleagues note 2 points of contention with our systematic review: the validity of dietary assessments for estimating fatty acid intake and our assessment of the quality of the animal and in vitro literature.

They are correct that the studies included in our meta-analysis did not measure fatty acid composition but rather estimated intake of fatty acids based on dietary information obtained from patients. However, their assertion that the methods used to define fatty acid intake in these studies were not valid is contradicted by other studies. As evidence that dietary questionnaires and records correlate poorly with direct measurements in patients, Chen et al cited 2 studies. The first study¹ reported correlation coefficients between patient-reported intakes and measured content in subcutaneous tissue of 0.49 to 0.50 (P<.001) for polyunsaturated fats and 0.47 (P<.001) for eicosapentaenoic acid. Although not perfect, these correlations cannot . . . [Full Text of this Article]

Catherine H. MacLean, MD, PhD
maclean@rand.org

Sydne J. Newberry, PhD
RAND Health
Santa Monica, Calif

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